Rich/Poor Divide Linked to Hospital Readmissions in Study02/15/13
FRIDAY, Feb. 15 (HealthDay News) -- The divide between rich and
poor in the state where you live may affect your risk of being
readmitted to the hospital, according to a new report.
For the study, researchers looked at "income inequality," which
they described as "the degree to which income is unevenly
distributed within a society," and its impact on Medicare
readmissions and deaths within 30 days of hospital discharge.
The researchers found that in states with the greatest income
inequality, there were nearly 40,000 extra hospital readmissions
over a three-year period in the United States. But they also found,
in the report published online Feb. 15 in the
BMJ, income inequality was not associated with an increased
risk of death.
The study authors noted that the findings held true even after
they adjusted for individual levels of income and education.
In conducting the study, researchers led by Dr. Peter
Lindenauer, an associate professor of medicine at the Center for
Quality of Care Research at Baystate Medical Center in Springfield,
Mass., examined information on Medicare patients who had been
admitted to the hospital due to a heart attack, heart failure or
For the study, the researchers' mortality (deaths) analyses
included 2.7 million admissions to 4,500 hospitals, and their
readmission analyses included 3.2 million admissions to 4,500
The investigators also analyzed data from the U.S. Census Bureau
in order to compare the states with the three highest quarters of
income inequality with the states in the lowest quarter.
Income inequality was not associated with an increased risk of
death within 30 days for patients who had been admitted for a heart
attack, heart failure or pneumonia, the study found. However, the
findings revealed that patients exposed to greater levels of income
inequality were at increased risk for readmission within 30 days of
being discharged from the hospital. This was true for all three
For patients who had a heart attack or heart failure, the risk
for readmission increased 1.5 percent. Those with pneumonia had a
1.4 percent higher risk. The researchers estimated this would
amount to over 7,000 more readmissions for heart attack, nearly
18,000 more readmissions for heart failure and about 14,000 extra
readmissions for pneumonia over three years.
It remains unclear why the investigators found no link between
income inequality and the risk of death. They suggested in their
report that over a 30-day period, "readmission is more sensitive to
social conditions than is mortality, and that an effect on
mortality might have been observed had we extended the period of
observation to one year."
While the study found an association between distribution of
wealth within a society and hospital readmissions, it did not prove
a cause-and-effect relationship.
More research is needed to explain the findings, the authors
pointed out in a journal news release.
The U.S. Department of Health and Human Services has more about
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