Readmission and Mortality

The composite outcome of 30-day emergency department readmission and 30-day mortality did not differ meaningfully between GEM co-management and usual care. The US Medicare Hospital Readmissions Reduction Programme reduced readmission rates but only partially achieved its intended effect. Unlike some multistrategy emergency department interventions, this study did not find a reduction in 30-day readmissions. The primary outcome was the first unplanned all-cause hospital readmission within 30 days after discharge from the index admission. The secondary outcomes included a composite of 30-day emergency department readmission and 30-day mortality, as well as 90-day mortality and hospital length of stay. The overall 30-day unplanned readmission rate in the study cohort was 6.7%. Readmissions were identified by matching patient identifiers and comparing admission and discharge timestamps across encounters. Planned readmissions were excluded from the outcome definition. Patients who were later readmitted had a significantly longer mean index length of stay (12.16 days) than those who were not readmitted (8.48 days). Patients aged 75 or older had a readmission rate of 9.7% compared with 4…