Data from Three New York Hospitals Show Hyperkalemia-Related Readmission Rates are Higher for Diabetic Patients


In Hyperkalemia


By: James Pitt  May. 01, 2018

A Dexur analysis of CMS Medicare claims data at three New York hospitals shows that patients diabetes are 1.6 to 5 times more likely to be readmitted with hyperkalemia than the average inpatient. The analysis looked at data between Jan 2013 to Dec 2016 for Montefiore Medical Center, Mt. Sinai & Strong Memorial for patients hospitalized with diabetes hospitalized for diabetes (DRGs 637, 638, and 639) and compared the readmissions across all inpatients. The higher odds of readmissions for these three hospitals were consistent with state & national trends.

Mount Sinai Medical Center presents a striking case. At Mount Sinai, 0.52% of total Medicare-eligible inpatient discharges were patients with diabetes. This is a smaller proportion of total discharges than at Montefiore Medical Center (1.68%) and at Strong Memorial Hospital (1.19%). These figures exclude discharges where the patient was transferred, discharged against medical device, or expired.

Hospital30-Day Hyperkalemia Readmission Rate from All Inpatient Discharges30-Day Hyperkalemia Readmission Rate from Diabetes DRGsOdds Ratio of Readmission with Hyperkalemia when a Patient has Diabetes
Montefiore2.24%3.59%1.67
Mount Sinai1.66%7.69%5.05
Strong Memorial1.86%4.6%2.62

Odds are a useful tool for summarizing likelihood, widely used in medicine. The odds ratio is the odds that an outcome will occur given a particular condition, compared to the odds that that outcome will occur in the absence of that condition. Here, we examine the odds that a hyperkalemia readmission will occur, given diabetes vs in the absence of diabetes. The odds ratio was 5.05 at Mount Sinai, 2.62 at Strong Memorial, and 1.67 at Montefiore.

REGISTERED USERS & SUBSCRIBERS GET ACCESS TO:

  1. January 2013 - December 2016 total discharges, discharges after exclusion, and hyperkalemia 30-day readmissions counts and rates, by diabetes status, for Montefiore Medical Center (Bronx NY), Mount Sinai Medical Center (New York NY), and Strong Memorial Hospital (Rochester NY).
  2. State and national comparisons, including 30 to 60 day hyperkalemia readmissions.
  3. DRG-level discharge volumes for the above hospitals.
  4. Odds ratio calculations, including odds of being readmitted for hyperkalemia if diabetic and odds of being readmitted for hyperkalemia if not diabetic, for the above hospitals.

ABOUT THE AUTHOR

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James Pitt

James Pitt is a science writer with experience in medical devices and textbook publishing. His hobbies include reading, flintknapping, and squinting at RStudio. He received a bachelor's in Human Evolutionary Biology from Harvard.