A casemix: congestive heart failure readmission rate and its associated factors in a tertiary teaching hospital in Kuala Lumpur

• Main Authors: Wong, CM, Abdullah Aliff AW, Mohd Shahrol AW, Diana Safraa Selimin, Lavanyah S, Hamat Hamdi Che Hassan, Amrizal MN, Aljunid SM, Aniza Ismail
• Format: Article
• Language: English
• Published: Pusat Perubatan Universiti Kebangsaan Malaysia 2020
• Online Access: http://journalarticle.ukm.my/15116/1/13_ms0370_pdf_13736.pdf; http://journalarticle.ukm.my/15116/; http://www.medicineandhealthukm.com/toc/15/1
• Institution: Universiti Kebangsaan Malaysia

Cardiovascular mortality is within the top five causes of death from non-communicable disease based on World Health Organization profile. Around 20% of heart failure patients are readmitted within 30 days worldwide. Readmission within 30 days for congestive heart failure often related to non-compliant to fluid restriction, natural progression of the disease or pre-mature discharge. The study aims to evaluate the 30 days readmission rate of congestive heart failure in Universiti Kebangsaan Malaysia Medical Centre (UKMMC) from the year 2016-2017 using casemix data and to determine the associated factors related to it. Based on the data coding, cost of readmission incurred was calculated. The 30-days readmission rate of heart failure to UKMMC in the year 2016-2017 was 53.5% & 43.5%, higher than the developed countries standard but similar to that of local teaching hospitals. After adjustment, age and level of severity are the only significant associated factors for the 30-days readmission rate. Shorter average length of stay (ALOS) & lower extra-tariff were achieved for readmission of heart failure. Total of RM80,329.73 was saved in the year 2017 from prompt treatment and comprehensive care plan of treating 19.3% level 3 severity patients at level 1 ALOS and tariff-cost. The 30-days readmission rate for heart failure in UKMMC was comparable to local teaching hospitals. The reduction of 30-days readmission rate in 2017 saved much cost, shows good clinical governance and advanced treatment strategy. Casemix can be used to guide budget allocation for the cardiology department of UKMMC.