Hospital Readmissions – Independent Predictors of 30-day Readmissions derived from a 10 year Database

Hospital Readmissions – Independent Predictors of 30-day Readmissions derived from a 10 year Database

Unplanned medical 30 day readmissions place a burden on the provision of acute hospital services and are increasingly used as quality indicators to assess quality of care in hospitals. Multivariable logistic regression of a 10 year database showed that four factors were most strongly associated with early readmission: Charlson comorbidity index >=1, respiratory disease as a principal diagnosis, liver disease and alcohol-related illness as an additional diagnosis, and the number of previous readmissions. Disease and patient-related factors beyond control of the hospital are the factors most strongly associated with 30 day readmission to hospital, suggesting that this may not be an appropriate quality indicator.

[download-attachments container="div" style="list" display_icon="1" display_count="1" display__size="0"]

References

  1. Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee-for- service program. N Engl J Med. 2009;360(14): 1418-1428.
  2. van Walraven C, Dhalla IA, Bell C, et al. Derivation and validation of an index to predict early death or unplanned readmission after discharge from hospital to the community. CMAJ. 2010;182(6):551-7.
  3. Hospital Episode Statistics Erthwdod-FyHSCIC, 2013.
  4. Report of the National Acute Medicine Program, 2010. https://www.hse.ie/eng/services/publications/hospitals/AMP.pdf
  5. Brock J, Mitchell J, Irby K, et al. Association between quality improvement for care transitions in communities and rehospitalizations among Medicare beneficiaries. JAMA. 2013;309(4):381-91.
  6. Kansagara D, Englander H, Salanitro A, et al. Risk Prediction Models for Hospital Readmission: A Systematic Review. Washington DC 2011 Oct.
  7. Cooksley T, Nanayakkara PW, Nickel CH, et al. Readmissions of medical patients: an external validation of two existing prediction scores. QJM. 2016;109(4):245-8.
  8. Rooney T, Moloney ED, Bennett K, et al. Impact of an acute medical admission unit on hospital mortality: a 5-year prospective study. QJM. 2008;101(6):457-65.
  9. O’Loughlin R, Allwright S, Barry J, et al. Using HIPE data as a research and planning tool: limitations and opportunities. Ir J Med Sci. 2005;174(2):40-5; discussion 52-7.
  10. http://systems.hscic.gov.uk/data/clinicalcoding/codingstandards/icd10/icd104itheedition.
  11. Slee VN. The International Classification of Diseases: ninth revision (ICD-9). Ann Intern Med. 1978;88(3):424-6.
  12. The International Classification of Diseases, 9th Revision, Clinical Modification” (ICD-9-CM), Sixth Edition, Online ICD9/ICD9CM codes icd9.chrisendres.com/.
  13. D’Hoore W, Bouckaert A, Tilquin C. Practical considerations on the use of the Charlson comorbidity index with administrative data bases. J Clin Epidemiol. 1996;49(12):1429-33.
  14. STATA Statistics/Data Analysis, ‘ Copyright 1985-2011 Statacorp Lp’.
  15. Billings J, Blunt I, Steventon A, et al. Development of a predictive model to identify inpatients at risk of re-admission within 30 days of discharge (PARR-30). BMJ Open. 2012;2(4).
  16. Edmans J, Bradshaw L, Gladman JR, et al. The Identification of Seniors at Risk (ISAR) score to predict clinical outcomes and health service costs in older people discharged from UK acute medical units. Age Ageing. 2013;42(6):747-53.
  17. Cotter PE, Bhalla VK, Wallis SJ, et al. Predicting readmissions: poor performance of the LACE index in an older UK population. Age Ageing. 2012;41(6):784-9.
  18. Halfon P, Eggli Y, Pretre-Rohrbach I, et al. Validation of the potentially avoidable hospital readmission rate as a routine indicator of the quality of hospital care. Medical care. 2006;44(11):972-81.
  19. Bianco A, Mole A, Nobile CG, et al. Hospital readmission prevalence and analysis of those potentially avoidable in southern Italy. PloS one. 2012;7(11):e48263.
  20. Cooksley T, Merten H, Kellett J, et al. PRISMA Analysis of 30 Day Readmissions to a Tertiary Cancer Hospital. Acute medicine. 2015;14(2):53-6.
  21. McCarthy D, Johnson MB, Audet AM. Recasting readmissions by placing the hospital role in community context. JAMA. 2013;309(4):351-2.
  22. Moloney ED, Bennett K, Silke B. Patient and disease profile of emergency medical readmissions to an Irish teaching hospital. Postgrad Med J. 2004;80(946):470-4.
  23. Dharmarajan K, Hsieh AF, Lin Z, et al. Diagnoses and timing of 30-day readmissions after hospitalization for heart failure, acute myocardial infarction, or pneumonia. JAMA. 2013;309(4):355-63.
  24. van Galen LS, Nanayakkara PW. [Hospital readmissions: A reliable quality indicator?]. Ned Tijdschr Geneeskd. 2016;160:A9885.

Request Permissions

To request copyright permission to republish or share portions of our works, please visit Copyright Clearance Center’s (CCC) Marketplace website by clicking the button below:

Get Permission

Hospital Readmissions – Independent Predictors of 30-day Readmissions derived from a 10 year Database

20th April 2017
PMID: 28424798
Authors Affiliations
Rachel Kidney BA (Psych), MB, MRCPI Division of Internal Medicine, St James’s Hospital, Dublin, Ireland
Eithne Sexton BA (Psych), PhD Trinity College Dublin, Ireland
Louise Van Galen VU University Medical Centre, Section acute medicine, Department of Internal Medicine, Amsterdam, The Netherlands
Bernard Silke MED Directorate, St James’s Hospital, Dublin 8, Ireland.
Prabath Nanayakkara MD, PhD, FRCP. VU University Medical Centre, Section acute medicine, Department of Internal Medicine, Amsterdam, The Netherlands
John Kellett Department of Emergency Medicine, Hospital of South West Jutland, Esbjerg, Denmark

Hospital Readmissions – Independent Predictors of 30-day Readmissions derived from a 10 year Database

Cite this article as:

Kidney R, Sexton E, Galen LV, Silke B, Nanayakkara P, Kellett J. Hospital Readmissions - Independent Predictors of 30-day Readmissions derived from a 10 year Database. Acute Med. 2017;16(1):4-9. PMID: 28424798.

Hospital Readmissions – Independent Predictors of 30-day Readmissions derived from a 10 year Database

Share this article

Click the icon of the social media platform on which you would like to share this article.


Shopping Basket
Scroll to Top