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Seasonality and Readmission after Heart Failure, Myocardial Infarction, and Pneumonia
Author(s) -
Butala Neel M.,
Secemsky Eric A.,
Wasfy Jason H.,
Kennedy Kevin F.,
Yeh Robert W.
Publication year - 2018
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.12747
Subject(s) - medicine , myocardial infarction , pneumonia , heart failure , poisson regression , incidence (geometry) , relative risk , seasonality , emergency medicine , population , confidence interval , environmental health , statistics , physics , mathematics , optics
Objective To investigate whether hospital readmission after admission for heart failure ( HF ), myocardial infarction ( MI ), and pneumonia varies by season. Data Sources All patients in 2005–2009 Healthcare Cost and Utilization Project State Inpatient Databases for New York and California hospitalized for HF , MI , or pneumonia. Study Design The relationship between discharge season and unplanned readmission within 30 days was evaluated using multivariate modified Poisson regression. Principal Findings Cohorts included 869,512 patients with HF , 448,945 patients with MI , and 813,593 patients with pneumonia. While admissions varied widely by season, readmission rates only ranged from 25.0 percent (spring) to 25.6 percent (winter) for HF ( p > .05), 18.9 percent (summer) to 20.0 percent (winter) for MI ( p < .001), and 19.4 percent (spring) to 20.3 percent (summer) for pneumonia ( p < .001). In adjusted models, in New York, there was lower readmission in spring and fall ( RR : 0.98, 95% CI : 0.96–0.99 for both) after admission for HF and higher readmission in spring ( RR : 1.04, 95% CI : 1.01–1.07) after MI . In California, there was lower readmission in spring and winter ( RR : 0.95, 95% CI : 0.93–0.96 and RR : 0.96, 95% CI : 0.94–0.98, respectively) after pneumonia. Conclusions Given marked seasonality in incidence and mortality of HF , MI , and pneumonia, the modest seasonality in readmissions suggests that readmissions may be more related to non–seasonally dependent factors than to the seasonal nature of these diseases.