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Income Inequality Ups Risk for 30-Day Hospital Readmission

Increased risk of readmission within 30 days of stay for acute MI, heart failure, pneumonia

FRIDAY, Feb. 15 (HealthDay News) -- For Medicare beneficiaries, income inequality correlates with 30-day readmission following hospitalization for myocardial infarction, heart failure, or pneumonia, according a study published online Feb. 14 in BMJ.

Peter K. Lindenauer, M.D., from Baystate Medical Center in Springfield, Mass., and colleagues conducted a retrospective cohort study of Medicare beneficiaries, aged 65 years or older, hospitalized in 2006 to 2008 for acute myocardial infarction, heart failure, or pneumonia, to examine the correlation between income inequality and the risk of mortality and readmission within 30 days of hospitalization.

During the study period the researchers found that income inequality varied across U.S. states, from an average Gini coefficient of 0.41 in Utah to 0.50 in New York. There was no significant association between income inequality and 30-day mortality for patients with myocardial infarction, heart failure, or pneumonia. Income inequality correlated significantly with rehospitalization for myocardial infarction, heart failure, and pneumonia (risk ratios, 1.09, 1.07, and 1.09, respectively); these findings were not significantly attenuated by adjustment for individual income and educational achievement. The estimated excess of readmissions for those in the states with the three highest quarters of income inequality versus the states with the lowest quarter was 7,153 readmissions for acute myocardial infarction, 17,991 for heart failure, and 14,127 for pneumonia.

"In this study of U.S. Medicare beneficiaries hospitalized with acute myocardial infarction, heart failure, and pneumonia, exposure to higher levels of income inequality was associated with increased risk of readmission within 30 days of discharge," the authors write. "The effect was similar in magnitude to the risk associated with major comorbidity."

One author disclosed financial ties to Medtronic and UnitedHealth.

Full Text (http://www.bmj.com/content/346/bmj.f521 )