DRGs and hospital readmissions

Effect of DRGs on three-month readmission rate of geriatric patients with congestive heart failure

We reviewed the three-month hospital readmission rates of 410 patients ages 70 years or older discharged alive with a first time diagnosis of congestive heart failure during the period January 1983-June 1986. The mean age was 79.8 years, 59.5 per cent were women. Mean length of initial hospital stay decreased from 10.8 days in 1983 to 7.8 days in 1986. One hundred-nineteen patients (29 per cent) were rehospitalized at least once within three months of initial discharge. The readmission rates by year were: 1983, 40.0 per cent; 1984, 27.5 per cent; 1985, 21.4 per cent; 1986, 23.2 per cent. During this same interval, the percentage of patients referred for home health care services increased from 3.3 per cent in 1983 to 13.0 per cent in 1984, 5.8 per cent in 1985, and 12.5 per cent in 1986. Thus, decreased length of hospital stay was associated with a parallel decline in early readmission rate and increased utilization of home health care services. Although this study has important methodologic limitations, the data suggest that shorter hospital stays under the DRG system are not necessarily associated with an increased rate of early rehospitalization.