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30-Day All-Cause All-Payer Adult Readmission Rate For the State of Nevada

Baseline Time Period: June 1, 2009 – May 31, 2010

Overall Readmission Rate
Group	Readmissions	Index Admissions	Readmission Rate
State of Nevada	21113	203258	10.4%

Readmission Rate by Payer
Payer	Readmissions	Index Admissions	Readmission Rate
Medicare	10171	68873	15%
NV Medicaid	4327	33181	13%
Self-Pay: No insurance coverage	3714	43702	8%
Commercial Insurance: Insurance coverage through a carrier that does not have a contract with the hospital allowing for payment at other than billed charges	3132	26806	12%
Negotiated Discounts: Insurance coverage through a carrier that has a contract with the hospital allowing for payment at other than billed charges and the product/benefit is a PPO	2849	30616	9%
HMO: Insurance coverage through a carrier that has a contract with the Hospital allowing for payment at other than billed charges and the product/benefit is an HMO	4762	57552	8%
Medicare HMO	2372	19157	12%
NV Medicaid HMO	361	6828	5%

Readmission Rate by Length of Stay
Length of Stay (LOS)	Readmissions	Index Admissions	Readmission Rate
Group 1 (LOS < 2 days)	3463	47545	7%
Group 2 (2 days ≤ LOS < 4 days)	6586	83407	8%
Group 3 (4 days ≤ LOS < 6 days)	4045	32181	13%
Group 4 (6 days ≤ LOS < 8 days)	2374	15373	15%
Group 5 (LOS 8+ days)	4645	24752	19%

Readmission Rate by Discharge Destination
Discharged to	Readmissions	Index Admissions	Readmission Rate
Home or Self-Care	13498	153889	9%
Skilled Nursing Facility	1915	11160	17%
Intermediate Care Facility	30	158	19%
Hospice - Home	50	993	5%
Hospice - Medical Care Facility	38	1588	2%
Home - Under care of Organized Home Health Organization	2915	18997	15%
Inpatient Rehab	1291	8020	16%
Long-Term Care Hospital	677	3904	17%
Other/Unknown	699	4549	15%

Data Source: Inpatient hospital admissions submitted to the Center for Health Information Analysis (CHIA) at UNLV. Payer designations and labels are as defined by CHIA.

Data Inclusions:

All-Payer
Acute Care and Critical Access Hospitals

Data Exclusions:

Children (<18 years)
Rehab Admits (Billing MS-DRGs 945, 946) Transfers are coded as a single visit

Readmission Rate Calculation:

Readmission Rate =

Number of Readmissions = 21,113 = 10.4% Number of Index Admissions 203,258

Definitions:

All hospital admissions are coded as one of the following:

Index Admission
Readmission
Not a Readmission

Index Admission:

The first admission for each patient in the baseline time period
The next admission occurring greater than 30 days after the discharge date of the previous Index Admission
The following cannot be Index Admissions:

An admission in which the patient dies
An admission in which the patient leaves Against Medical Advice (AMA)

Readmission:

The first admission within 30 days of an Index Admission

Not a Readmission:

An admission that is neither an Index Admission nor a Readmission
An admission that occurs after a Readmission, but before another Index Admission