Table 1.
Demographic and clinical information of admission-readmission pairs among Medicare beneficiaries with Alzheimer disease in 2018.
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Total (n=28,946) | Same-hospital readmission (n=24,952) | Fragmented readmission | P value | ||||||||||
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Same HIEa (n=601) | Different HIEs (n=2105) | No HIE (n=1288) |
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| Age (years), mean (SD) | 80.9 (8.6) | 81.1 (8.6) | 80.3 (8.7) | 80.1 (8.6) | 79.8 (8.4) | <.001 | ||||||||
| Sex, n (%) | .10 | |||||||||||||
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Female | 16,163 (55.8) | 14,004 (56.1) | 329 (54.7) | 1142 (54.2) | 688 (53.4) |
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Male | 12,783 (44.2) | 10,948 (43.9) | 272 (45.3) | 963 (45.7) | 600 (46.6) |
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| Race, n (%) | <.001 | |||||||||||||
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White | 24,097 (83.2) | 20,976 (84.1) | 467 (77.7) | 1644 (78.1) | 1010 (78.4) |
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Black | 3341 (11.5) | 2692 (10.8) | 111 (18.5) | 335 (15.9) | 203 (15.8) |
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Other | 1508 (5.2) | 1284 (5.1) | 23 (3.8) | 126 (6) | 75 (5.8) |
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| Urban/rural status, n (%) | <.001 | |||||||||||||
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Metropolitan | 25,110 (87.1) | 21,641 (87) | 526 (87.8) | 1878 (89.5) | 1065 (82.9) |
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Micropolitan | 2748 (9.5) | 2424 (9.7) | 43 (7.2) | 131 (6.2) | 150 (11.7) |
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Rural | 985 (3.4) | 797 (3.2) | 30 (5) | 89 (4.2) | 69 (5.4) |
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| Frailty score, mean (SD) | 0.20 (0.05) | 0.20 (0.05) | 0.20 (0.05) | 0.21 (0.05) | 0.20 (0.05) | .45 | ||||||||
| Chronic condition count, mean (SD) | 20.7 (6.2) | 20.7 (6.2) | 20.4 (6.0) | 20.5 (6.3) | 20.7 (6.2) | .24 | ||||||||
| Reason for admission, n (%) | <.001 | |||||||||||||
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MIb | 2451 (8.5) | 2047 (8.2) | 57 (9.5) | 209 (9.9) | 138 (10.7) |
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CHFc | 12,103 (41.8) | 10,496 (42.1) | 266 (44.3) | 834 (39.6) | 507 (39.4) |
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COPDd | 3916 (13.5) | 3405 (13.6) | 76 (12.6) | 266 (12.6) | 169 (13.1) |
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Pneumonia | 4716 (16.3) | 4097 (16.4) | 91 (15.1) | 336 (16) | 192 (14.9) |
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Dehydration | 1311 (4.5) | 1101 (4.4) | 33 (5.5) | 112 (5.3) | 65 (5) |
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Syncope | 459 (1.6) | 364 (1.5) | 13 (2.2) | 54 (2.6) | 28 (2.2) |
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UTIe | 3954 (13.7) | 3411 (13.7) | 65 (10.8) | 290 (13.8) | 188 (14.6) |
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Behavioral issues | 36 (0.1) | 31 (0.1) | 0 (0) | 4 (0.2) | 1 (0.01) |
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| Reason for readmission, n (%) | <.001 | |||||||||||||
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MI | 651 (2.2) | 516 (2.1) | 29 (4.8) | 63 (3) | 43 (3.3) |
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CHF | 6362 (22) | 5584 (22.4) | 125 (20.8) | 405 (19.2) | 248 (19.2) |
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COPD | 1743 (6) | 1551 (6.2) | 27 (4.5) | 97 (4.6) | 68 (5.3) |
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Pneumonia | 1376 (4.7) | 1238 (5) | 18 (3) | 74 (3.5) | 46 (3.6) |
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Dehydration | 434 (1.5) | 379 (1.5) | 6 (1) | 34 (1.6) | 15 (1.2) |
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Syncope | 132 (0.5) | 111 (0.4) | 4 (0.7) | 9 (0.4) | 8 (0.6) |
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UTI | 936 (3.2) | 838 (3.4) | 8 (1.3) | 55 (2.6) | 35 (2.7) |
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Behavioral issues | 7 (0.02) | 6 (0.02) | 0 (0) | 0 (0) | 1 (0.01) |
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Other | 17305 (59.8) | 14,729 (59) | 384 (63.9) | 1368 (65) | 824 (64) |
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| ICUf stay admission | 8651 (29.9) | 7483 (30) | 153 (25.5) | 603 (28.6) | 412 (32) | .02 | ||||||||
| ICU stay readmission | 9727 (33.6) | 8269 (33.1) | 202 (33.6) | 772 (36.7) | 484 (37.6) | <.001 | ||||||||
| Readmission hospital number of beds, n (%) | <.001 | |||||||||||||
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<500 beds | 21,789 (75.5) | 18,909 (76.1) | 401 (66.8) | 1505 (71.7) | 974 (76.1) |
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≥500 beds | 7051 (24.5) | 5953 (23.9) | 199 (33.2) | 593 (28.3) | 306 (23.9) |
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| Readmission hospital ownership, n (%) | <.001 | |||||||||||||
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Government | 2911 (10.1) | 2483 (10) | 63 (10.5) | 204 (9.7) | 161 (12.6) |
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Religious | 3444 (11.9) | 2997 (12.1) | 67 (11.2) | 260 (12.4) | 120 (9.4) |
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Nonprofit | 18,746 (65) | 16,288 (65.5) | 439 (73.2) | 1271 (60.6) | 748 (58.5) |
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For-profit | 3724 (12.9) | 3080 (12.4) | 31 (5.2) | 363 (17.3) | 250 (19.5) |
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| Readmission hospital type, n (%) | <.001 | |||||||||||||
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General medical/surgical | 28,612 (99.3) | 24,799 (99.8) | 582 (97.2) | 2026 (96.8) | 1205 (94.4) |
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Other | 194 (0.7) | 38 (0.1) | 17 (2.8) | 67 (3.2) | 72 (5.6) |
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| Readmission hospital was a teaching hospital | 20,937 (72.6) | 17,959 (72.2) | 469 (78.2) | 1640 (78.2) | 869 (67.9) | <.001 | ||||||||
| Died during readmission | 1704 (5.9) | 1459 (5.8) | 29 (4.8) | 130 (6.2) | 86 (6.7) | .38 | ||||||||
| 30-Day postdischarge mortalityg | 5667 (19.6) | 4856 (19.5) | 118 (19.6) | 428 (20.3) | 265 (20.6) | .62 | ||||||||
aHIE: health information exchange.
bMI: myocardial infarction.
cCHF: congestive heart failure.
dCOPD: chronic obstructive pulmonary disease.
eUTI: urinary tract infection.
fICU: intensive care unit.
gAmong beneficiaries who did not die during their readmission.