Factors Associated With 30-Day Readmission Rate Among Stroke Patients From 2009-2012 At Two Tertiary Level Hospitals In Metro Portland Area (P3.090)

OBJECTIVE: To determine factors associated with 30-day readmission of stroke patients BACKGROUND: Centers for Medicare and Medicaid Services is planning to implement 30- day readmission rate as a quality measure for hospital performance in 2014. It can provide a more comprehensive view of quality that extends beyond what is captured by any one process of care measure. METHODS: All stroke patients admitted at 2 tertiary care hospitals from 2009 to 2012 were included. Expired or discharged to hospice patients were excluded. Variables included in the analyses were 30-day readmission rate, patients’ demographic and clinical characteristics and reasons for readmission. Chi square and t-tests (alpha=.05) were used to determine significant differences between those were and were not readmitted at 30 days. RESULTS: Between 2009 and 2012, 4,963 stroke patients were admitted to the two facilities of which 4,296 (50.8% female) were included in this analysis. Of those included, 69.2% had ischemic stroke, 19% had transient ischemia (TIA) and 11.7% had a hemorrhagic stroke on first admission. The readmission rate was 5.60 % (n=241). Most readmissions were due to neurovascular related reasons (n=106, 43.6%). Other reasons for readmission were infections (14%) and cardiovascular events (13.6%). Factors significantly associated with readmission were discharged home (65.1% vs. 57.3%, p<.001), older age (72.8 vs. 70.3, p=.015), shorter length of stay (3.8, vs. 4.9,p=.006), history of diabetes (35.7% vs. 27.4%, p=.007) and of TIA (17.4% vs. 12.3%, p=.025). Among neurovascular related readmissions, discharged home (76.6% vs. 57.3%, p<.001), shorter length of stay (3.0vs. 4.9, p=.001), history of PVD (13.1% vs. 5.8%, p=.004) and diabetes (38.3% vs. 27.4%, p=.017) were significantly associated with readmissions. CONCLUSIONS: Elderly patients with stroke with shorter length of stay who are discharged home are at the highest risk for getting readmitted within 30 days. These subgroups could be targeted for interventions in preventing 30 day readmission. These findings should be validated in larger studies. Disclosure: Dr. Kansara has nothing to disclose. Dr. Stuchiner has nothing to disclose. Dr. Baraban has nothing to disclose. Dr. Bhatt has nothing to disclose.