Evaluating Urban and Rural Readmissions Patient Diagnoses

Regions of Virginia may differ, but data show there is no real difference in hospital readmission diagnoses among Virginians residing in different parts of the state. Most often, patients return because of chronic diseases for which there are no cures. As patients age, chronic diseases worsen and weaken complementary body systems such as the renal (kidney) or immune system in spite of medical care. As was noted in a previous Research Corner item, patients with three or more chronic conditions are highly likely to be readmitted to a hospital. Septicemia is the most common reason for urban and rural patients returning to the hospital (as shown below).  Other diagnoses listed in the table below are for those chronic diseases which lead to impaired hearts, lungs, and kidneys. The opportunity for septicemia increases in bodies with impaired hearts, lungs, or kidneys.  The pattern of diagnoses is the same for readmissions to rural and urban hospitals. The current Hospital Readmission Reduction Program (HRRP) assumes readmissions occur due to deficits in hospital care. However, given the similarities in readmissions across locales, and the influence of chronic diseases, it could be that some readmissions are a marker for body systems failing beyond the ability of health care to intervene. More specific definitions of unnecessary readmissions could explore this possibility. The current global definition of 30 days post discharge is likely measuring several phenomena, of which hospital quality of care is but one. The charts below show the most frequent readmission diagnoses. (9/18/2015)


9-18 2

Sample size: 37,093 readmissions (8,219 rural and 28,874 urban)
Discharge Period: March 31, 2014 through February 28, 2015