Predictors and impact of thirty-day readmission on patient outcomes and health care costs after reduced-toxicity conditioning allogeneic hematopoietic cell transplantation

Sherri Rauenzahn, Quoc Truong, Aaron Cumpston, Londia Goff, Sonia Leadmon, Kim Evans, Jianjun Zhang, Sijin Wen, Michael Craig, Mehdi Hamadani, Abraham S. Kanate

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Thirty-day readmission (30-DR) has become an important quality-of-care measure. Allogeneic hematopoietic cell transplantation (allo-HCT) presents a medical setting with higher readmission rates. We analyzed factors affecting 30-DR and its impact on patient outcomes and on health care costs in 91 patients who underwent reduced-toxicity conditioning (RTC) allo-HCT with fludarabine and busulfan. The patient cohort was divided into 2: the readmission group (R-gp) or the no-readmission group (NR-gp). Overall, 38% (n= 35) required readmission with a median time to readmission of 14 days. In multivariate analysis, only documented infection during the index admission predicted 30-DR, P= .01. With a median follow-up of 18 months (range, 1 to 69) for surviving patients, the 2-year overall survival was 49% and 58% in the R-gp and NR-gp respectively, P= .48. The 1-year nonrelapse mortality in R-gp and NR-gp was 18% and 13% respectively, P= .43. The median post-transplantation hospital charges in the R-gp and NR-gp were $85,115 (range, $32,015 to $242,519) and $45,083 (range, $10,715 to $485,456), P= .0002. In conclusion, only documented infections during the index hospitalization influenced 30-DR after RTC allo-HCT. Although 30-DR did not adversely affect mortality or survival, it was associated with significantly increased 100-day post-transplantation hospital charges, thus supporting its role as a quality-of-care measure in allo-HCT patients.

Original languageEnglish (US)
Pages (from-to)415-420
Number of pages6
JournalBiology of Blood and Marrow Transplantation
Volume20
Issue number3
DOIs
StatePublished - Mar 2014
Externally publishedYes

Keywords

  • Allogeneic hematopoietic cell transplantation
  • Health care cost
  • Reduced-toxicity conditioning
  • Thirty-day readmission

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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