Trajectories of risk after hospitalization for XXXX , @entity583 , or @entity55 : retrospective cohort study.

@entity1 @entity712 @entity55 @entity583 @entity204
OBJECTIVE: To characterize the absolute risks for older @entity1 of readmission to hospital and @entity204 in the year after hospitalization for @entity712 , @entity583 , or @entity55 . DESIGN: Retrospective cohort study. SETTING: 4767 hospitals caring for Medicare fee for service beneficiaries in the United States, 2008-10. @entity1 : More than 3 million Medicare fee for service beneficiaries, aged 65 years or more, surviving hospitalization for @entity712 , @entity583 , or @entity55 . MAIN OUTCOME MEASURES: Daily absolute risks of first readmission to hospital and @entity204 for one year after discharge. To illustrate risk trajectories, we identified the time required for risks of readmission to hospital and @entity204 to decline 50% from maximum values after discharge; the time required for risks to approach plateau periods of minimal day to day change, defined as 95% reductions in daily changes in risk from maximum daily declines after discharge; and the extent to which risks are higher among @entity1 recently discharged from hospital compared with the general elderly population. RESULTS: Within one year of hospital discharge, readmission to hospital and @entity204 , respectively, occurred following 67.4% and 35.8% of hospitalizations for @entity712 , 49.9% and 25.1% for @entity583 , and 55.6% and 31.1% for @entity55 . Risk of first readmission had declined 50% by day 38 after hospitalization for @entity712 , day 13 after hospitalization for @entity583 , and day 25 after hospitalization for @entity55 ; risk of @entity204 declined 50% by day 11, 6, and 10, respectively. Daily change in risk of first readmission to hospital declined 95% by day 45, 38, and 45; daily change in risk of @entity204 declined 95% by day 21, 19, and 21. After hospitalization for @entity712 , @entity583 , or @entity55 , the magnitude of the relative risk for hospital admission over the first 90 days was 8, 6, and 6 times greater than that of the general older population; the relative risk of @entity204 was 11, 8, and 10 times greater. CONCLUSIONS: Risk declines slowly for older @entity1 after hospitalization for @entity712 , @entity583 , or @entity55 and is increased for months. Specific risk trajectories vary by discharge diagnosis and outcome. @entity1 should remain vigilant for deterioration in health for an extended time after discharge. Health providers can use knowledge of absolute risks and their changes over time to better align interventions designed to reduce adverse outcomes after discharge with the highest risk periods for @entity1 .
