More Than One-Third of California Inpatients Readmitted Within a Year

More than one-third of hospitalized Californians were readmitted to the hospital within a year, and Medicare and Medicaid patients had higher readmission rates than private-pay patients, according to a report by the California Office of Statewide Health Planning and Development.

The report, covering a period spanning 2005-2006, also found that two-fifths of the readmissions occurred within 90 days and patients with chronic conditions were most likely to be readmitted.

In general, the report said some readmissions are related to quality of hospital care, discharge planning and coordination of patient care after discharge, but others are a normal part of care, such as return visits for physical therapy, or are due to new health problems or simply a worsening of the disease process.

Here are some details of the study:

The first readmission after discharge from the initial hospital visit occurred:

• within seven days for 13 percent of the patients
• within the second week for 9 percent
• within the third and fourth weeks for 11 percent.

One-year readmissions by payment source were:

• 46 percent Medicare
• 38 percent Medi-Cal (Medicaid)
• 25 percent private-payment
• 24 percent self-payment

The 20 most frequent diagnoses for one-year readmissions, in order of frequency, were:
1. Heart failure
2. Emphysema
3. Kidney failure
4. Psychoses
5. Infection of kidney or urinary tract
6. Pneumonia
7. Lung inflammation
8. Illness of stomach or esophagus
9. Bleeding in stomach with complications
10. Diabetes
11. Heart Attack
12. Rehabilitation
13. Septicemia
14. Heart artery x-ray
15. Alcohol or drug dependency
16. Stroke
17. Hip, knee and ankle replacements
18. Chest pain
19. Hysterectomy and related surgery
20. Appendectomy without complications

Read the Office of Statewide Health Planning and Development's report on readmissions (pdf).