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.
Hospital | 30-Day Hyperkalemia Readmission Rate from All Inpatient Discharges | 30-Day Hyperkalemia Readmission Rate from Diabetes DRGs | Odds Ratio of Readmission with Hyperkalemia when a Patient has Diabetes |
---|---|---|---|
Montefiore | 2.24% | 3.59% | 1.67 |
Mount Sinai | 1.66% | 7.69% | 5.05 |
Strong Memorial | 1.86% | 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.