Research Article

Reducing 30-Day Rehospitalization Rates Using a Transition of Care Clinic Model in a Single Medical Center

Table 1

Patient characteristics.

Not readmitted 
Readmitted 

Age in years (SD)61.19 (17.72)66.25 (16.53)
Female gender (%)175 (52%)23 (58%)
Length of stay (SD)4.04 (3.99)5.58 (5.37)
Hospital admissions in last year (SD)0.891 (1.48)1.83 (2.23)
DRG weight (SD)1.35 (0.85)1.49 (0.85)
Charlson comorbidity index (SD)5.23 (3.05)6.98 (2.90)
Attended TOC clinic (%)50 (15%)2 (5%)
Principal diagnosis (ICD-9 code)
 Septicemia NOS (038.9)36 (11%)5 (12%)
 Cerebral artery occlusion NOS with infarction (434.91)16 (5%)1 (2%)
 Pneumonia, organism NOS (486)14 (4%)2 (5%)
 Obstructive chronic bronchitis with acute exacerbation (491.21)10 (3%)2 (5%)
 Acute and chronic respiratory failure (518.84)9 (3%)1 (2.5%)
 Acute kidney failure NOS (584.9)8 (2%)1 (2.5%)
 Subendocardial infarct, initial (410.71)8 (2%)0 (0%)
 DM type 1 with ketoacidosis, uncontrolled (250.13)3 (1%)5 (12%)
 Urinary tract infection, NOS (599.0)7 (2%)0 (0%)
E. coli septicemia (038.42)6 (2%)1 (2.5%)