Recurrent readmissions in medical patients: A prospective study

Mudge, AM, Kasper, K, Clair, A, Redfern, H, Bell, JJ, Barras, MA, Dip, G and Pachana, NA (2011) Recurrent readmissions in medical patients: A prospective study. Journal of Hospital Medicine, 6 2: 61-67. doi:10.1002/jhm.811


Author Mudge, AM
Kasper, K
Clair, A
Redfern, H
Bell, JJ
Barras, MA
Dip, G
Pachana, NA
Title Recurrent readmissions in medical patients: A prospective study
Journal name Journal of Hospital Medicine   Check publisher's open access policy
ISSN 1553-5592
1553-5606
Publication date 2011-02
Year available 2010
Sub-type Article (original research)
DOI 10.1002/jhm.811
Volume 6
Issue 2
Start page 61
End page 67
Total pages 7
Place of publication Hoboken, NJ, United States of America
Publisher John Wiley & Sons
Collection year 2011
Language eng
Formatted abstract
Background:
Hospital readmissions are common and costly. A recent previous hospitalization preceding the index admission is a marker of increased risk of future readmission.

Objectives
:
To identify factors associated with an increased risk of recurrent readmission in medical patients with 2 or more hospitalizations in the past 6 months.

Design:
Prospective cohort study.

Setting:
Australian teaching hospital acute medical wards, February 2006-February 2007.

Participants:
142 inpatients aged ≥50 years with a previous hospitalization ≤6 months preceding the index admission. Patients from residential care, with terminal illness, or with serious cognitive or language difficulties were excluded.

Variables of interest:
Demographics, previous hospitalizations, diagnosis, comorbidities and nutritional status were recorded in hospital. Participants were assessed at home within 2 weeks of hospital discharge using validated questionnaires for cognition, literacy, activities of daily living (ADL)/instrumental activities of daily living (IADL) function, depression, anxiety, alcohol use, medication adherence, social support, and financial status.

Main outcome measure
:
Unplanned readmission to the study hospital within 6 months.

Results:
A total of 55 participants (38.7%) had a further unplanned hospital admission within 6 months. In multivariate analysis, chronic disease (adjusted odds ratio [OR] 3.4; 95% confidence interval [CI], 1.3-9.3, P = 0.002), depressive symptoms (adjusted OR, 3.0; 95% CI, 1.3-6.8, P = 0.01), and underweight (adjusted OR, 12.7; 95% CI, 2.3-70.7, P = 0.004) were significant predictors of readmission after adjusting for age, length of stay and functional status.

Conclusions:
In this high-risk patient group, multiple chronic conditions are common and predict increased risk of readmission. Post-hospital interventions should consider targeting nutritional and mood status in this population. Journal of Hospital Medicine 2010. © 2010 Society of Hospital Medicine.
Copyright © 2010 Society of Hospital Medicine
Keyword Chronic disease
Depression
Nutritional status
Patient readmission
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article first published online: 12 Oct 2010

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Medicine Publications
School of Psychology Publications
 
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Created: Sat, 26 Feb 2011, 08:42:45 EST by Prof Nancy A Pachana on behalf of School of Psychology