Navigation Links
Hospital readmission studies: Influencing factors identified
Date:10/12/2010

In two studies published today in the Journal of Hospital Medicine, the risk factors for readmission to the hospital are examined based upon general medicine inpatients and those with at least two admissions in a six-month period. Alongside clinical factors such as having cancer, chronic diseases such as heart failure or lung disease, or being on high-risk medications, the studies identified other factors which increase the likelihood of a patient being readmitted which could help hospitalists focus in on these groups.

In the first study, Nazima Allaudeen, MD, and colleagues at the University of California San Francisco (UCSF), looked at the factors behind unplanned hospital readmission within 30 days which occurs in nearly one in five Medicare patients in the US. The study involved patients admitted to UCSF hospitals between June 2006 and May 2008; 6,805 unique patients for a total of 10,359 admissions. 17% of admissions were readmitted within thirty days, with almost half of these (49.7%) occurring within 10 days.

Of the sociodemographic factors, African-American race and Medicaid as payer status were associated with readmission, with a 43% and 15% increased risk of readmission respectively after adjustment for other variables. Of the clinical factors, high-risk medications and six comorbidities (congestive heart failure, renal disease, cancer (with and without metastasis), weight loss, and iron deficiency anemia) were associated with readmission.

The study also examined operational factors, such as weekend discharge or admission source, but none were significantly associated with readmission.

"The US spends over $15 billion in Medicare on readmissions to hospital within 30 days and readmissions are also distressing to patients and their caregivers," said Allaudeen, now based at the VA Palo Alto Health Care System, California. "Many healthcare systems are now making efforts to improve the transition from hospital to home or nursing facility to try to reduce preventable readmissions but they need to know which patients to focus on to have the biggest impact. Studies like ours should give practitioners direction to non-clinical factors to identify."

Recognizing the limitations in the choice of data variables available in studies using administrative data, the second smaller study used detailed clinical assessments to examine a range of readmissions risk factors in a recognized high risk patient group, those with two or more recent admissions. Dr Alison Mudge FRACP and colleagues at the Royal Brisbane and Women's Hospital, Australia, undertook detailed assessment of 142 patients aged over 50 admitted between February 2006 and February 2007 who had two or more hospitalizations in the preceding six months, studying factors such as depression, nutritional status, and functional status as well as demographic and disease variables.

After six months, 55 participants (38.7%) had had a total of 102 unplanned admissions to the hospital. As the researchers expected, the strongest predictor of readmission was the presence of a chronic disease diagnosis, but alongside this, they found that BMI had a non-linear relationship with readmission, with a higher risk in those underweight and obese; 72% and 50% of each category respectively were readmitted compared to 27% of those with normal weight and 37% of those classed as overweight. Depressive symptoms were also associated with a higher risk of readmission (47% readmitted). Age, sex, number of previous admissions, and discharge support were not significantly influential.

"Patients with multiple recent readmissions may have a unique risk factor profile, and may be a group which may particularly benefit from complex interventions, but no previous study has specifically examined risk factors in this high risk group," said Mudge. "We sought to look specifically at health factors which we know are under-recognized in hospitals and primary care, and this showed that poor nutrition and depression are associated with higher health care use in this vulnerable subgroup.

"We hope this study might increase awareness of poor nutrition and depression as importance concurrent factors in medical illness, and encourage research into improving nutritional and depression management in medically ill patients."


'/>"/>

Contact: Jennifer Beal
healthnews@wiley.com
44-124-377-0633
Wiley-Blackwell
Source:Eurekalert

Related medicine news :

1. IMNG relaunches Internal Medicine News Digital Network and Hospitalist News Digital Network
2. University Hospitals Case Medical Centers neuroscience intensive care unit earns Beacon Award
3. Pediatric field hospital in Haiti provides lessons in disaster planning and response
4. Researcher at Childrens Hospital LA discovers way to overcome radiation resistance in leukemia
5. New Tool Helps Predict Stroke Patients Risk of Death in Hospital: Study
6. University Hospitals Case Medical Center implements AutoLITT system for treatment of brain tumors
7. Rhode Island Hospital physician receives national award for research
8. St. John Hospital enrolls first patient in US in trial of peripheral artery disease device
9. Henry Ford Hospital study: hVISA linked to high mortality
10. Lack of trust in hospitals a major deterrent for blood donation among African-Americans
11. Many hospital emergency department visits could be treated elsewhere, study finds
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/25/2016)... San Diego, CA (PRWEB) , ... May 25, 2016 , ... There was a time ... more women are going with the flow and turning to menstrual cups, like Lunette ... a party, Lunette is introducing their new anthem in this catchy video ! ...
(Date:5/25/2016)... Indiana (PRWEB) , ... May 25, 2016 , ... ... Network Service Provider, announces that Lake City Bank has selected IFN as a ... manage carrier access, resulting in increased efficiencies and reduced costs. , ...
(Date:5/25/2016)... MA (PRWEB) , ... May 25, 2016 , ... ... Research Institute (WCRI) compare outcomes of injured workers across 15 states. The ... to work, earnings recovery, access to medical care, and satisfaction with medical care. ...
(Date:5/25/2016)... ... May 25, 2016 , ... CloudLIMS, joins an elite number of ... Tech Solution Providers list of 2016 by CIOReview. , In a deliberate session with ... Tech Solution Providers 2016 has been concluded with. The positioning is based on evaluation ...
(Date:5/25/2016)... ... May 25, 2016 , ... The World Molecular ... through Molecular Imaging.” The focus of ADDMI-IG will be geared towards how using ... pipeline issues. Through ADDMI-IG WMIS will provide a platform for productive discussions about ...
Breaking Medicine News(10 mins):
(Date:5/24/2016)... Marziani has joined VMS BioMarketing as senior vice president of sales, announced Andrea ... Marziani will lead the company,s business development and sales team, exploring new opportunities for ... - http://photos.prnewswire.com/prnh/20160523/371089 ... ... ...
(Date:5/24/2016)... 24, 2016 Open Access Journal ... Neurophysiology  Elsevier , a world-leading provider ... today announced the launch of Clinical Neurophysiology ... that focuses on clinical practice issues in clinical neurophysiology. ... series, normal values and didactic reviews. It is an ...
(Date:5/23/2016)... May 23, 2016 Global Paclitaxel ... pages, profiles 12 companies and the Paclitaxel analysis in ... on the industry and its players. This ... in nature, details the current state of the industry ... definitions, classifications, applications and industry chain structure. The Paclitaxel ...
Breaking Medicine Technology: