Is Obesity a Risk Factor for Readmission after Acute Myocardial Infarction?

INTRODUCTION AND OBJECTIVES:

Hospital readmissions are a major concern in terms of both cost and quality of care. The purpose of this study was to determine which patients were more likely to experience hospital readmissions after acute myocardial infarction in order to help develop more targeted programs and policies.

PATIENTS AND MATERIALS AND METHODS:

The 2014 Nationwide Readmissions Database was used to calculate the national readmission rate by patient characteristics. All U.S. patients who presented to the hospital with acute myocardial infarction in 2014 and incurred a readmission were included in this analysis. The main outcome of interest was the rate of readmission by obesity. Obesity was measured using the comorbidity indicator found in the dataset. National secondary data of a sample of U.S. hospital discharges was used to measure hospital readmission rates. Bivariate analysis and logistic regression were used to determine if a significant relationship existed between readmissions and the patient characteristics. For this purpose odds ratio (OR) and 95% confidence interval has been calculated.

RESULTS:

There were 11.66% hospital readmissions in the database. Non-obese adults were 21% less likely to be readmitted than obese adults. Non-obese patients were 21.2% less likely to be readmitted than obese patients (OR 0.788, CI 0.751-0.827, p-value <.0001). Obese patients with no insurance had significantly higher readmissions compared to obese Medicare patients.

CONCLUSIONS:

The Hospital Readmissions Reduction Program has been effective at reducing hospital readmissions. However, greater focus needs to be placed on reducing hospital readmissions for patients with chronic conditions, especially obesity.