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Five Factors That Indicate Patients May Be at Risk for Unplanned Readmissions

Patients discharged on Friday or with previous ER visits are more likely to return

Patients with chronic cardiovascular and pulmonary disease are at a greater risk for unplanned hospital readmissions, new research shows.

The study, published in the August issue of the Journal of Evaluation in Clinical Practice, analyzed the Belgian Hospital Discharge Dataset, which included data from 1,130,491 patients discharged in 2008. The investigators identified patients who were readmitted to the same hospital within 30 days of discharge. They classified a readmission as “unplanned” when the hospital coded it as an urgent admission.

The overall unplanned readmission rate was 5.2%, according to the study. Cardiovascular and pulmonary diagnoses were the most common reasons for readmission. The authors found that 10.4% of all readmissions were due to complications.

The strongest predictor of readmission was a high number of previous emergency department (ED) visits. The odds ratio (OR) for readmission was 4.65 for patients with at least four ED visits during the past 6 months. Patients discharged on Friday (OR, 1.05) and patients with a long length of stay (OR, 1.19) also had a higher risk for readmission. Patients with short lengths of stay were not at risk for readmission (OR, 0.99).

The findings indicate that hospitals can reduce readmissions by targeting the patient groups at risk, such as those with cardiovascular or pulmonary diseases, and by preventing complications, the researchers said. In addition, because multiple ED visits and longer patient stays are linked to higher readmission rates, clinicians must work with caregivers and primary care physicians to coordinate a smoother transition from hospital to home, especially for patients discharged on Friday.

Previous research has also called for post-discharge monitoring to ensure that patients follow the hospital’s detailed care plan, such as taking medications correctly and keeping follow-up appointments.

Sources: FierceHealthcare; August 19, 2105; JECP; August 2015; and FierceHealthcare; June 3, 2105.

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