Thirty-day Readmission Rate Higher for CVD Patients Who Believe it will Happen

Patients with cardiovascular disease (CVD) who on hospital discharge believe they have a high risk for readmission are, in fact, at higher risk for 30-day readmission than those who perceive the risk to be low.

The findings are based on data published earlier this month in Circulation: Cardiovascular Quality and Outcomes, by researchers at Duke University Medical Center in Durham, NC.

Lead author Hanzhang Xu, PhD, RN and colleagues recruited 730 patients who received treatment for CVD from January 2015 to August 2017. Before hospital discharge, patients completed a standardized survey that documented their perceived risk of returning to the hospital along with sociodemographic, psychosocial, behavioral, and clinical data.

Nearly 1 in 3 patients perceived a high risk of readmission and those patients had significantly more 30-day readmissions (22.8%) vs those who thought their risk of readmission was low (15.8%; p=0.016).

Among those who perceived their readmission risk to be high, those more likely to be readmitted:

-- Were non-white

-- Had poor self-rated health

-- Had difficulty accessing care

-- Had been hospitalized in the past year

Among patients who believed readmission risk was low, those still more likely to be admitted included those who were widowed or reported difficulty accessing care.

The authors suggest their findings are strong evidence for the clinical utility of assessing this perception to help identify those at greater risk of being readmitted.

“Our study also identifies important nonclinical factors that are associated with 30-day readmission in patients with different perceptions of their risk," they wrote. "These findings have important implications for targeting patients with CVD at high risk of 30-day readmission and for developing interventions that are responsive to patient-reported needs and perceptions.”