September 18, 2018
More than three-quarters of older adults who returned to the hospital after discharge from an inpatient rehab unit were readmitted for different reasons than their original hospital admission, according to a study in BMC Geriatrics.
“Our results confirm and extend previous work that readmissions of older people after hospital admission are due to a wide range of causes, and are often not due to a recurrence of the index problem,” researchers wrote. “Work is needed to develop intervention packages that address readmission risks common to a range of diseases and syndromes of ageing, with a focus both on optimizing physiology, but also supporting patients and carers.”
The study looked at hospital readmission reasons and predictors for 3984 patients discharged from a single inpatient rehab facility over a 13-year period. By focusing on rehab facility discharges, researchers aimed avoid readmissions related to hasty, incomplete discharge planning.
Overall, 5.6% of patients were readmitted to the hospital within 30 days of discharge from inpatient rehab, and 23.2% were readmitted within 180 days of discharge, according to the study.
Among the patients with earlier hospital readmission, 26.6% were readmitted with the same condition as their original admission. The most common diagnoses linked with readmission were chest infection, falls/immobility, and stroke.
Of those readmitted within 180 days of discharge, just 21.1% were hospitalized with the same condition as their index admission. Falls/immobility, cancer, and chest infections were the most common diagnoses associated with these later readmissions.
Analysis revealed older age, male sex, length of stay, and heart failure as predictors of 30- and 180-day hospital readmissions. Additionally, discharge to the patient’s own home predicted 30-day readmission, and diagnoses of cancer, previous myocardial infarction, or chronic obstructive pulmonary disease predicted 180-day readmission.
“Our results reinforce the need to take a multisystem, holistic approach to reducing readmissions,” researchers wrote. “Whilst some success has been noted with disease-specific interventions, e.g. for patients with heart failure, it is unlikely that interventions targeting a single disease (e.g. heart failure) will be successful in reducing readmissions due to other disease diagnoses after an index admission.”
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