476 Burn Injury Characteristics and Factors Influencing Unplanned Hospital Readmissions

Abstract

In October of 2012, Section 3025 of the Affordable Care Act (ACA) added section 1886(q) to the Social Security Act mandating reductions in payments to hospitals with comparatively high numbers of readmissions. The Hospital Readmissions Reduction Program (HRRP) was initiated in an effort to reduce hospital readmissions occurring within 30 days of discharge. The mandate impacts not only the financial resources of the treating medical centers and physicians, but patient welfare as well. The National Burn Repository (NBR) compiles data representing burn cases from more than half of the burn centers in the United States. Utilizing data from the 2016 NBR report, this study had the intent to explore associations between characteristics of burn cases and hospital readmissions. The current study was a secondary analysis of the data from the 2016 Burn Repository report using descriptive and bivariate analyses to explore initial relationships among variables of interest, and using binary logistic regression to test relationships between demographic characteristics of burn cases, U.S. geographic regions (east, south, north west), length of stay, pay, etiology, complications and the dependent variable of hospital readmissions. Results showed the hospital readmissions field was underrepresented based on alternate verifiable sources. In Table 128 of the 2016 NBR report, data indicated 179 unscheduled readmissions which represented .28 percent of the complications composite (N=64,436). In a search of the NBR data bank, the field “admstat_cat” reported four “Readmissions, Unplanned” and 9,605 cases listed as “Unknown” (N=176,640). Unforseen hospital readmissions are associated with poor patient outcomes and high financial costs. Under the Hospital Readmission Reduction Program, hospitals and medical providers will be penalized for unplanned hospital readmissions that occur within 30 days of discharge for a growing number of conditions and surgical procedures. The NBR does not currently report data that could provide the type of information necessary to evaluate current patient discharges that result in hospital readmissions. It would be heuristically helpful, to collect and report data for patients who are readmitted to either the burn center or to a community hospital near the patient’s home. Rising health care costs are drawing increasing attention to short-term patient outcomes. The HRRP provides incentive to monitor quality improvement parameters and be more aware of the number of patients who are experiencing complications that lead to unplanned hospital readmissions in the first 30 days following discharge.