Journal of Investigative Medicine | 2019
THE IMPACT OF OBESITY ON 30‐DAY HOSPITAL READMISSION RISK FACTORS AMONG ASTHMATIC ADULTS: 439
Abstract
Purpose of study This study investigated the impact obesity has on 30 day hospital readmission for asthmatic adults. Limited research existed on the association between obesity and asthma readmission. We evaluated readmission risk factors to further explore the link between asthma and obesity. Methods used Data was obtained from the 2012–2014 National Readmission Database and analyzed via Surveyfreq and Surveylogistics analysis in the SAS Software. Patients included were >18 years, had a primary diagnosis of asthma, discharged alive, and had a non-elective readmission. Obese asthmatic patients were compared to non-obese asthmatic patients in regards to risk of readmission. Factors included: emergency department (ED) utilization, length of stay (LOS), risk of mortality and severity of illness (minor, moderate, major, or extreme), income quartile, and insurance. Summary of results Of 29,350,055 asthma-related hospitalizations the overall readmission rate was 12.4%. Increased likelihood of readmission within 30 days of discharge was associated with: obesity, being female, having Medicare, and having moderate risk of mortality. Obese asthmatic patients had a significantly higher risk of mortality (6.1% vs 5.1%), higher severity of illness (7.4% vs 6.2%), longer LOS (median 4 vs 3 days), and higher ED utilization (82.6% vs 78.4%). Median total charges for obese patients were $29 353 compared to $23 848 for non-obese patients (p-value<0.0001). Moreover, obese patients with asthma were also more likely to be female (61.6% vs 56.3%), reside in the lowest income quartile (32.2% vs 29.7%), and have private insurance (25% vs 23.1%). Conclusions Findings suggest social factors such as income status are associated with higher readmission rates for obese asthmatic patients. Analysis showed having private insurance did not reduce readmission in obese asthmatic patients. Identification of criteria associated with higher readmission in this subset is important as obese asthmatic patients had a higher risk of mortality, illness severity, and ED utilization, which has implications for readmission and disease management costs.