1-year Rehospitalization Rates Research Articles

Increasing treatment adherence among outpatients with depression and cocaine dependence: results of a pilot study.

This pilot study examined the effect of a modified motivational therapy intervention on outpatient treatment adherence and completion for patients with comorbid depressive disorder and cocaine dependence. Depressed cocaine patients, stabilized with antidepressant medications on an inpatient psychiatric unit, were consecutively assigned on discharge to motivational therapy (N = 11) or treatment-as-usual (N = 12) during the first month of outpatient care. Patients were compared on treatment adherence and completion and on 1-year rehospitalization rates. Motivational therapy patients attended significantly more treatment sessions during month 1, completed 30 and 90 days of outpatient care at higher rates, and experienced fewer psychiatric rehospitalizations and days in the hospital during the first year from entry into outpatient treatment. An outpatient program combining individual and group motivational therapy sessions holds promise for improving treatment adherence and completion among depressed patients with cocaine dependence.

Rehospitalizations after coronary revascularization among medicare beneficiaries

The rehospitalization experience of Medicare beneficiaries undergoing coronary artery bypass surgery or percutaneous transluminal coronary angioplasty in 1986 and 1987 was studied by following 53,715 patients who underwent coronary artery bypass and 28,817 patients who underwent angioplasty for 1 year using Medicare hospital claims data. The 1-year rehospitalization rate after bypass and angioplasty was 629 and 863 per 1,000, respectively, compared to a rate of 607 for the Medicare patient population in general. About 45% of rehospitalizations after bypass and two thirds after angioplasty were in categories determined by an expert panel to be possibly related to the original procedure. After angioplasty, there were 61 discharges per 1,000 for bypass surgery and 140 per 1,000 for a repeat angioplasty. Rehospitalization rates for coronary artery bypass surgery after angioplasty were significantly lower for female and black patients who underwent angioplasty. The volume of rehospitalization after revascularizations makes it an important outcome measure. Medicare administrative records provide a unique source of information on rehospitalizations and make possible the monitoring of broad trends in the frequency and outcomes of coronary revascularization. The lower rates of bypass surgery after angioplasty for black and female patients are in line with other studies and bear further investigation.