A Casemix: Congestive Heart Failure Readmission Rate and its Associated Factors in a Tertiary Teaching Hospital in Kuala Lumpur
Readmission Rate for Congestive Heart Failure
Vol. 15 No. 1 : 2020 (141-155)
Abstract
Cardiovascular mortality is within the top five causes of death from non-communicable disease based on World Health Organization profile. Around 20% of heart failure patients are readmitted within 30 days worldwide. Readmission within 30 days for congestive heart failure often related to non-compliant to fluid restriction, natural progression of the disease or pre-mature discharge. The study aims to evaluate the 30 days readmission rate of congestive heart failure in Universiti Kebangsaan Malaysia Medical Centre (UKMMC) from the year 2016-2017 using casemix data and to determine the associated factors related to it. Based on the data coding, cost of readmission incurred was calculated. The 30-days readmission rate of heart failure to UKMMC in the year 2016-2017 was 53.5% & 43.5%, higher than the developed countries standard but similar to that of local teaching hospitals. After adjustment, age and level of severity are the only significant associated factors for the 30-days readmission rate. Shorter average length of stay (ALOS) & lower extra-tariff were achieved for readmission of heart failure. Total of RM80,329.73 was saved in the year 2017 from prompt treatment and comprehensive care plan of treating 19.3% level 3 severity patients at level 1 ALOS and tariff-cost. The 30-days readmission rate for heart failure in UKMMC was comparable to local teaching hospitals. The reduction of 30-days readmission rate in 2017 saved much cost, shows good clinical governance and advanced treatment strategy. Casemix can be used to guide budget allocation for the cardiology department of UKMMC.
Keywords :
Casemix,
congestive heart failure,
health economic,
length of stay,
patient readmission,
Correspondance Address
Assoc. Prof. Dr. Aniza Ismail. Department of Community Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia. Tel: +6019-321 7343 Email: draniza@gmail.com
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