30-day Readmission Rates Among Live Discharges on Chronic Dialysis.

Compared to all Medicare beneficiaries, the 30-day readmission rate in dialysis patients is highly elevated. During all of 2011, the rate was 34.7 percent, higher than corresponding rates in all years dating to 1996, other than the preceding year.

Across quarters and months, rates vary unpredictably, although within a relatively narrow absolute range. In recent years, they tend to be highest among discharges in the first and third quarters of each year. This pattern may be due to differences in admission rates for specific discharge diagnoses, which often follow seasonal patterns.

Like hospital admission rates, readmission rates vary across Census Divisions. Between 2005 and 2011, the highest rates occurred in the East North Central and Middle Atlantic Divisions; in 2011, rates in both exceeded 36 percent. Rates are generally lowest in areas west of the Mississippi River. In 2011, rates were near 33 percent in the West North Central, West South Central, Mountain, and Pacific Divisions.

Between 2004 and 2007, the rate was lowest in Mountain states, but it increased by roughly 2 percentage points between 2007 and 2010. The reasons for this rapid increase are uncertain and demand further attention.

30-day readmission rates among live discharges on chronic dialysis, by year, quarter, and month.

30-day readmission rates among live discharges on chronic dialysis, overall & by U.S. Census Division.

30-DAY READMISSION RATES (%) AMONG LIVE DISCHARGES ON CHRONIC DIALYSIS, OVERALL & BY U.S. CENSUS DIVISION

APC, Annual Percent Change. Maps show 2011 rates.

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