Abstract Details

Title Incidence and Predictors of 30 days readmission associated with Parkinson’s disease: 5-year National estimate (2010-2014)

Topic Movement Disorders

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 10-029

Objective To evaluate national estimate of incidence and predictors of increased readmission associated with Parkinson’s disease (PD) and looks for associated hospital characteristics and resource utilization.

Background PD is a neurodegenerative disorder accounting for approximately 60,000 new diagnoses each year in the US. Epidemiological studies to better understand the risk factors and its outcomes are limited.

Design/Methods Nationwide Readmissions Database (NRD) from 2010-14 was utilized to identify hospitalization with PD using ICD-9CM code 332.0-332.1 in primary diagnostic field. Admissions within 30 days of discharge were considered as early readmission and multivariable logistic regression model was used for predictors of 30-day readmission.

Results We identified 56,743 patients with hospitalization for PD, of which 7,912 (13.9%) patients were readmitted within 30 days (mean age 71.4 ± 11 years, 64.3 % male). Higher comorbidity index ≥3 (11.6% vs 9.7%), higher incidence of heart failure (8.1% vs 6.7%), epilepsy (3.6% vs 2.9%), procedures such as deep brain stimulation (DBS) (30.1% vs 22.3%) and higher median cost of hospitalization (10,000$ vs 8324$) was seen in readmitted patients during index hospitalization. Higher comorbidity index(OR:1.08, 95% CI:1.04-1.11, p<0.001), heart failure (OR: 1.25, 95% CI:1.07-1.46, p=0.006), epilepsy (OR:1.43, 95% CI:1.16-1.76, p=0.001), DBS (OR:1.46, 95% CI:1.23-1.73, p<0.001),elective admission(OR:1.29, 95% CI:1.10-1.50, p=0.001) and longer LOS during index hospitalization (OR:1.006, 95% CI:1.002-1.010, p=0.002) were predictors of increased 30-day readmission. Private insurance (OR:0.81, 95% CI:0.72-0.92, p=0.001), self-payment (OR:0.56, 95% CI:0.42-0.74, p<0.001) and admission to teaching hospital (OR:0.87, 95% CI:0.79-0.97, p=0.008) were predictors of decreased readmission.

Conclusions One of eight patients with Parkinson’s readmitted within 30 days post discharge, with co-morbidities such as heart failure, epilepsy, and procedures such as DBS being significant predictors of readmission. Therefore, proactively addressing these co-morbidities during hospitalizations may help in reducing readmissions.

Authors/Disclosures
Tejinder Singh, MD (Reading Hospital- Towerhealth- Division of Neurology) PRESENTER	Dr. Singh has nothing to disclose.
	No disclosure on file
Chirag N. Savani, MD (Tampa General Hospital)	No disclosure on file
Sheyar Amin, MD (University of South Florida)	Dr. Amin has nothing to disclose.
Charles D. Schutt, MD (USF Neurology)	Dr. Schutt has nothing to disclose.
Rossitza Chichkova, MD	Dr. Chichkova has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Argenx. Dr. Chichkova has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Grifols. Dr. Chichkova has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for UCB.
Yazan M. Suradi, MD	No disclosure on file

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