OBJECTIVES: To determine the frequency and diagnoses associated with 7- and 30-day acute hospital readmissions of @entity1 discharged to a skilled nursing facility (SNF) from an acute hospital. DESIGN: A quality improvement project focusing on 30-day hospital readmissions, using retrospective data derived from the hospital's electronic data repository. SETTING: A 350-bed nonteaching community hospital in southeast Florida. MEASUREMENTS: Data were collected on all discharges of Medicare fee-for-service @entity1 age 75 and older for a 17-month period in 2007 and 2008. The primary source of data was the hospital's electronic data repository. Seven and 30-day hospital readmission rates were calculated for all discharges to SNFs. Index hospital and readmission diagnoses were determined by hospital coders and categorized by the physician coauthors. RESULTS: Among 10,777 discharges of @entity1 age 75 and older, 3254 (30%) were discharged to an SNF, and of these, 584 (18%) were readmitted to the hospital within 30 days; 191 (33%) of these readmissions occurred within 7 days. The index diagnostic categories with the highest readmission rates were @entity790 (30%) and @entity65 (25%). Specific diagnoses associated with the highest readmission rates included @entity712 ( @entity712 ) (31%), @entity293 (28%), @entity177 (27%), and @entity55 and @entity1030 (23% each). Infections and @entity65 were the primary diagnoses for 63% of the hospital readmissions (36% and 27% respectively). The most frequent readmission primary diagnosis was the same as the index admission primary diagnosis in less than half the cases. CONCLUSION: In this community hospital population, close to 1 in 5 discharges to an SNF resulted in a hospital readmission within 30 days. @entity712 , @entity177 , UTI, @entity55 , and @entity1030 were common index hospital and readmission diagnoses. Care paths and guidelines are available for these conditions that should be helpful to SNFs in initiatives designed to improve transitional care and reduce potentially avoidable hospital readmissions, as well as their associated morbidity and cost.

Frequency and diagnoses associated with 7- and 30-day readmission of skilled nursing facility XXXX to a nonteaching community hospital.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity712 :: ('MESH:D006333', 'Disease') :: ['congestive heart failure', 'CHF'] @entity55 :: ('MESH:D011014', 'Disease') :: ['pneumonia'] @entity1030 :: ('MESH:D029424', 'Disease') :: ['chronic obstructive pulmonary disease', 'COPD'] @entity177 :: ('MESH:D051437', 'Disease') :: ['renal failure'] @entity65 :: ('MESH:D002318', 'Disease') :: ['cardiovascular disorders'] @entity293 :: ('MESH:D014552', 'Disease') :: ['urinary tract infection'] @entity790 :: ('MESH:D014564', 'Disease') :: ['genitourinary disorders']
@entity1 :: (9606,Species) :: ['patients']
