Association of non-adherence and subsequent all-cause readmissions
| Measure | 90-day adjusted* HR (95% CI) | 365-day adjusted* HR (95% CI) |
| Acute myocardial infarction | ||
| Aspirin at arrival | 1.19 (0.29 to 4.86) | 1.07 (0.34 to 3.37) |
| β blocker at arrival | 0.65 (0.16 to 2.69) | 0.35 (0.09 to 1.43) |
| PCI <90 min | 2.36 (1.14 to 4.85) | 2.42 (1.40 to 4.20) |
| Aspirin (D/C) | 2.12 (0.68 to 6.66) | 1.84 (0.69 to 4.95) |
| β blocker (D/C) | 0.61 (0.15 to 2.45) | 0.88 (0.37 to 2.14) |
| ACEI/ARB for LVSD | 1.20 (0.76 to 1.89) | 1.19 (0.82 to 1.72) |
| Smoking counselling | 2.02 (1.13 to 3.62) | 1.59 (0.93 to 2.70) |
| Arrival group measures | 1.17 (0.71 to 1.92) | 1.05 (0.70 to 1.57) |
| Discharge group measures | 1.59 (1.16 to 2.18) | 1.49 (1.14 to 1.93) |
| Failure on any measure | 1.47 (1.12 to 1.93) | 1.32 (1.06 to 1.66) |
| 0–49% adherence (vs all) | 1.97 (1.35 to 2.88) | 2.09 (1.53 to 2.86) |
| 50–99% adherence (vs all) | 1.18 (0.82 to 1.71) | 0.97 (0.71 to 1.32) |
| Heart failure | ||
| ACEI/ARB for LVSD | 1.53 (1.09 to 2.16) | 1.35 (1.01 to 1.79) |
| LV assessment | 0.86 (0.44 to 1.66) | 1.02 (0.63 to 1.66) |
| Discharge instruction* | 1.20 (1.006 to 1.42) | 1.20 (1.05 to 1.37) |
| Smoking counselling | 0.93 (0.55 to 1.56) | 1.09 (0.73 to 1.63) |
| Patient information: none vs all | 1.17 (0.98 to 1.38) | 1.20 (1.05 to 1.36) |
| Failure on any measure | 1.07 (0.92 to 1.25) | 1.13 (1.00 to 1.27) |
| 0–49% vs 100% compliance | 1.01 (0.85 to 1.20) | 1.07 (0.94 to 1.22) |
| 50–99% vs 100% compliance | 1.25 (0.98 to 1.59) | 1.30 (1.07 to 1.57) |
| Pneumonia | ||
| Antibiotic <4 h | 1.22 (0.94 to 1.58) | 1.16 (0.96 to 1.41) |
| Blood culture timing | 1.00 (0.73 to 1.37) | 1.05 (0.83 to 1.32) |
| O2 assessment | NA | NA |
| Antibiotic selection | 1.29 (0.85 to 1.96) | 1.58 (1.19 to 2.10) |
| Influenza vaccine assessment | 1.14 (0.86 to 1.52) | 1.11 (0.89 to 1.38) |
| Pneumonia vaccine assessment | 1.19 (0.96 to 1.49) | 1.07 (0.90 to 1.27) |
| Smoking counselling | 1.59 (1.08 to 2.34) | 1.38 (1.02 to 1.87) |
| Arrival group measure | 1.08 (0.88 to 1.33) | 1.11 (0.95 to 1.30) |
| Health maintenance measures | 1.10 (0.90 to 1.35) | 1.07 (0.92 to 1.25) |
| Failure on any measure | 1.16 (0.97 to 1.38) | 1.14 (0.99 to 1.30) |
| 0–49% adherence (vs all) | 1.40 (1.11 to 1.77) | 1.39 (1.16 to 1.67) |
| 50–99% adherence (vs all) | 1.02 (0.84 to 1.24) | 1.02 (0.88 to 1.19) |
Confounders included patient's age, gender, race, socioeconomic status, comorbidities at admission, DNR order on admission for arrival measures, DNR order anytime during hospitalisation for other measures, and transfer to Massachusetts General Hospital for non-arrival measures.
↵* Discharge instruction model was restricted to patients who were discharged home.
ACEI/ARB, angiotensin-converting enzyme inhibitor/angiotensin receptor blockade; D/C, discharge; DNR, do not resuscitate; LV, left ventricle; LVSD, left ventricular systolic dysfunction; NA, not available.