Kevin J Bennett1,2, Janice C Probst1,3. 1. South Carolina Rural Health Research Center, University of South Carolina, Columbia, South Carolina. 2. Department of Family and Preventive Medicine, School of Medicine, University of South Carolina, Columbia, South Carolina. 3. Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.
Abstract
PURPOSE: Dual-eligible beneficiaries represented 19% of Medicare and 14% of Medicaid enrollment in 2009. Of Medicare discharges among dually eligible beneficiaries, 21.5% resulted in a 30-day rehospitalization. Little has been published regarding dual-eligible beneficiaries' readmission rates and factors affecting readmission. METHODS: We conducted a cross-sectional analysis of Medicare claims, restricted to 297,084 beneficiaries with a hospitalization from February 1, 2009, through November 30, 2009. FINDINGS: Dual eligibles had higher hospitalization and 30-day readmission rates than Medicare-only beneficiaries. Multivariable regression indicated dual eligibility, younger age, and specific chronic conditions increased the likelihood of a 30-day readmission. Rural dually eligible beneficiaries had lower readmission rates than other beneficiaries, and they had a protective effect of physician follow-up care. CONCLUSIONS: Having a 30-day physician follow-up had differential effects in urban versus rural locations, yet rural residents had a higher rate of follow-up care. The impact of adequate follow-up care, and how rural populations are successful, would be beneficial to understand. Substantial savings could accrue if interventions reduced readmissions among dual-eligible beneficiaries.
PURPOSE: Dual-eligible beneficiaries represented 19% of Medicare and 14% of Medicaid enrollment in 2009. Of Medicare discharges among dually eligible beneficiaries, 21.5% resulted in a 30-day rehospitalization. Little has been published regarding dual-eligible beneficiaries' readmission rates and factors affecting readmission. METHODS: We conducted a cross-sectional analysis of Medicare claims, restricted to 297,084 beneficiaries with a hospitalization from February 1, 2009, through November 30, 2009. FINDINGS: Dual eligibles had higher hospitalization and 30-day readmission rates than Medicare-only beneficiaries. Multivariable regression indicated dual eligibility, younger age, and specific chronic conditions increased the likelihood of a 30-day readmission. Rural dually eligible beneficiaries had lower readmission rates than other beneficiaries, and they had a protective effect of physician follow-up care. CONCLUSIONS: Having a 30-day physician follow-up had differential effects in urban versus rural locations, yet rural residents had a higher rate of follow-up care. The impact of adequate follow-up care, and how rural populations are successful, would be beneficial to understand. Substantial savings could accrue if interventions reduced readmissions among dual-eligible beneficiaries.
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