AI Article Synopsis
- The study investigates factors that contribute to 30-day hospital readmissions among older patients, with an emphasis on optimizing healthcare and interventions to reduce these rates.
- Researchers analyzed DRG codes from hospitalized patients and noted a readmission rate of 11.9%, with common causes being heart failure, pneumonia, and sepsis; longer hospital stays were linked to higher readmission rates.
- Findings indicate that greater disability and comorbidity, along with sepsis, are significant risk factors for readmissions, highlighting the need for improved treatment during hospital stays to prevent such occurrences.
Article Abstract
Purpose: Early readmission rate has been regarded as an indicator of in-hospital and post-discharge quality of care. Evaluating the contributing factors is crucial to optimize the healthcare and target the intervention. In this study we evaluated the potential for preventing 30-day hospital readmission in a cohort of older patients and identified possible risk factors for readmission.
Patients And Methods: Diagnosis-Related Group (DRG) codes of patients consecutively hospitalized for acute disease in the Geriatrics Unit of the University Hospital of Pisa within a 1-year window were recorded. All the patients had received a comprehensive geriatric assessment. Crossing and elaboration of the DRG codes was performed by the Potentially Preventable Readmission Grouping software (3M Corporation). DRG codes were classified as stand-alone admissions (SA), index admissions (IA) and potentially preventable readmissions (PPR) within a time window of 30 days after discharge.
Results: In total, 1263 SA and 171 IA were identified, with an overall PPR rate of 11.9%. Hospitalizations were significantly longer in IA and PPR than SA (p<0.05). The more frequent readmission causes were acute heart failure, pulmonary edema, sepsis, pneumonia and stroke. In acute heart failure a nonlinear U-shaped readmission trend (with nadir at 5 days of hospitalization) was observed while, in all the other DRG codes, the PPR rate increased with increasing length of hospitalization. Comprehensive geriatric assessment showed a significantly lower degree of disability and comorbidity in SA than IA patients. At stepwise regression analysis, a high degree of disability and comorbidity as well as the diagnosis of sepsis emerged as independent risk factors for PPR.
Conclusion: Addressing PPR is crucial, especially in older patients. The adequacy of treatment during hospitalization (especially in cases of sepsis) as well as the setting of a comprehensive discharge plan, accounting for comorbidity and disability of the patients, are essential to reduce PPR.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6842315 | PMC |
| http://dx.doi.org/10.2147/CIA.S208572 | DOI Listing |
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