HOSPITAL READMISSIONS IN THE MEDICARE POPULATION
HOSPITAL READMISSIONS IN THE MEDICARE POPULATION
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DOI：
10.1056/nejm198411223112105
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发表时间：
1984-01-01
影响因子：
158.5
通讯作者：
STEINBERG, EP
中科院分区：
文献类型：
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作者：
ANDERSON, GF;STEINBERG, EP
为了检验反复入院的医疗保险支出比例，我们评估了1974年至1977年间随机选择的270,266名医疗保险受益人出院后再次入院的频率。22%的医疗保险住院患者在出院后60天内再次入院。1974年至1977年期间，医疗保险每年在这类再入院上花费超过25亿美元（占医疗保险住院病人支出的24%）。1984年类似的支出可能接近80亿美元。即使是再入院率的小幅下降也可以为医疗保险计划节省大量资金。然而，最近颁布的前瞻性付款立法创造了可能增加再入院率的经济激励。专业审查机构或其他机构试图制定医院再入院概况时，需要控制与再入院可能性相关的患者和医院特征。对这些特征的进一步研究可以帮助确定高风险患者群体，增加门诊支持可能证明具有成本效益。
In order to examine the proportion of Medicare expenditures attributable to repeated admissions to the hospital, we assessed the frequency with which 270,266 randomly selected Medicare beneficiaries were readmitted after hospital discharge between 1974 and 1977. Twenty-two per cent of Medicare hospitalizations were followed by a readmission within 60 days of discharge. Medicare spent over $2.5 billion per year (24 per cent of Medicare inpatient expenditures) on such readmissions between 1974 and 1977. Analogous expenditures in 1984 could approach $8 billion. Even a small decrease in the readmission rate could result in substantial savings for the Medicare program. The recently enacted prospective-payment legislation, however, creates economic incentives that could increase readmission rates. Attempts by professional review organizations or others to develop hospital readmission profiles will need to control for patient and hospital characteristics that are correlated with the likelihood of readmission. Further study of such characteristics could help identify high-risk patient groups for whom increased outpatient supports might prove cost effective.