Thirty-Day Readmission Rates Among Dual-Eligible Beneficiaries

Dual-eligible beneficiaries represented 19% of Medicare and 14% of Medicaid enrollment in 2009. Of Medicare discharges among dually eligible beneficiaries, 21.5% resulted in a 30-day rehospitalization. Little has been published regarding dual-eligible beneficiaries' readmission rates and factors affecting readmission.

We conducted a cross-sectional analysis of Medicare claims, restricted to 297,084 beneficiaries with a hospitalization from February 1, 2009, through November 30, 2009.

Dual eligibles had higher hospitalization and 30-day readmission rates than Medicare-only beneficiaries. Multivariable regression indicated dual eligibility, younger age, and specific chronic conditions increased the likelihood of a 30-day readmission. Rural dually eligible beneficiaries had lower readmission rates than other beneficiaries, and they had a protective effect of physician follow-up care.

Having a 30-day physician follow-up had differential effects in urban versus rural locations, yet rural residents had a higher rate of follow-up care. The impact of adequate follow-up care, and how rural populations are successful, would be beneficial to understand. Substantial savings could accrue if interventions reduced readmissions among dual-eligible beneficiaries.