Heart attack (CIRCHDTO) patients in the U.S. get out of the hospital sooner than those in other countries and more often are readmitted within a month, researchers said, suggesting they may need better care after being sent home.
The research, which analyzed data from 15 other countries, found a 68 percent higher risk of readmission among U.S. heart attack patients. Americans left the hospital in three days, on average, the shortest time of any country, according to a report today in the Journal of the American Medical Association.
Length-of-stay numbers in the U.S. have “declined dramatically” in the last 25 years, the study said. Now some data suggest the length “has declined too far, resulting in suboptimal outcomes,” the authors wrote. Medical systems elsewhere may also better coordinate care after patients are discharged, the authors said.
“There’s something for us to learn from the other countries,” said Manesh Patel, an assistant professor of medicine at Duke University in Durham, North Carolina and the study's senior author. “We’ve done a good job of getting them to the hospital, we’ve really raised awareness, but we haven’t done as good a job once they’re home.”
The study analyzed data from a trial of 5,571 patients who had suffered massive heart attacks. Thirty-day readmission rates for the U.S. were 14.5 percent compared with 9.9 percent in other countries.
750,000 Heart Attacks
During a heart attack, part of the heart muscle dies or is damaged after being cut off from blood flow. They can be caused by blood clots or plaque build-up on the walls of arteries. In the U.S., each year 785,000 people have a first heart attack, and 470,000 who’ve already had one have another, according to the U.S. Centers for Disease Control and Prevention in Atlanta.
U.S. policy makers have made readmission rates a measure of the quality of health care, including a provision in the 2010 health care overhaul that uses Medicare to penalize hospitals for having too many people re-hospitalized.
“Significant attention has been focused on reducing acute myocardial infection readmission rates in the United States as a means of reducing health-care costs, according to the assumption that readmission is, at least in part, preventable,” the authors wrote. “Our analysis shows that readmission may be preventable because rates are nearly one-third lower in other countries suggesting the U.S. health care system has features that can be modified to decrease readmission rates.”
More study is needed to better understand the relationship between length of stay and readmission rates, the researchers said.
The study’s limitations include that it was a retrospective analysis of data from a clinical trial, they said. The original trial evaluated pexelizumab, an experimental cardiology compound that is now being studied by Cheshire, Connecticut-based Alexion Pharmaceuticals Inc. (ALXN)
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