Various Independent Predictors Increase Readmissions for Acute Pancreatitis

In a recent study presented at Digestive Disease Week 2018, researchers found a wide variation in 30-day readmission rates among hospitals for acute pancreatitis. Findings demonstrated independent predictors of readmissions including male gender, higher Charlson Comorbidity Index, and insurance status. 

According to prior studies, 1 in 5 patients with acute pancreatitis are readmitted within 30 days. However, beginning in 2012 as part of the Affordable Care Act, the Medicare Hospital Readmission Reduction Program (HRRP) penalizes excess readmissions and it is expected that hospitals may soon have a financial incentive to reduce costly and unnecessary hospital readmissions. 

To better understand the variation in readmissions following hospitalization for acute pancreatitis and to also identify associations between patient characteristics and readmissions, a research team led by Allison Liao Yang, MD, Harvard Medical School, and colleagues, examined data from the Nationwide Readmissions Database—the largest all-payer dataset of hospital readmissions in the United States. 

The researchers reviewed information on patients who were admitted between January 1, 2014 and November 30, 2014 with a primary diagnosis of acute pancreatitis, and omitted patients in December in order to ensure at least 30 days after discharge for a hospitalization for acute pancreatitis. 

Of the 112,373 patients with an admission for acute pancreatitis identified during the study, 17,877 (15.9%) were readmitted within 30 days of discharge. The researchers found that the variation in 30-day readmission rates among hospitals ranged from 0% to 100%. According to the results of a multivariable logistic regression analysis, independent predictors of readmissions included male gender (P < .0001), Charlson Comorbidity Index (P < .0001), and insurance status (Medicare vs private insurance (P < .0001).

“As the HRRP expands to gastrointestinal diagnoses such as acute pancreatitis, hospitals and physicians will need to develop strategies to reduce readmissions by addressing modifiable risk factors, implementing pathways for individuals at risk for readmissions on the basis of comorbidities, and coordinating transitions of care,” Dr Yang and colleagues concluded.

—Julie Gould