Number of Readmissions and Its Determinants Among Patients With Heart Failure at Referral Hospitals in Amhara Region, Northwest Ethiopia: A Cross-Sectional Study Using Zero-Inflated Negative Binomial Model, 2023

Background: Heart failure is a leading cause of hospital readmissions in the Amhara region, Northwest Ethiopia. Aim: This study aimed to determine the number of readmissions and identify the determinants among patients with heart failure at referral hospitals in the Amhara region, Northwest Ethiopia, in 2023. Methods: A cross-sectional study was conducted with 663 heart failure patients in Amhara region referral hospitals from September 2022 to February 2023. Simple random sampling was used for patient selection, and data were collected through chart reviews and interviewer-administered questionnaires. Zero-inflated negative binomial models were applied for data analysis. Data collection tools were pre-tested for reliability and validity. Results: Among 663 patients, 237 (35.7%) were readmitted at least once. An increased respiratory rate (IRR = 1.015; 95% CI: 1.0004, 1.031; p < 0.044) and longer medication duration (IRR = 1.011; 95% CI: 1.016, 1.051; p < 0.0001) were associated with more readmissions. Patients with poor social support had 59.4% fewer readmissions compared to those with good social support (IRR = -1.595; 95% CI: -0.02, -0.005; p < 0.041). A higher body mass index (IRR = 0.115; 95% CI: 0.035, 0.196; p < 0.004) was linked with a higher likelihood of remaining in the "always-zero" group, while an increased pulse rate reduced the odds (IRR = -0.013; 95% CI: -0.025, -0.008; p < 0.036). The mortality rate among readmitted patients was 11.39%. Conclusion: This study found significant readmission rates among HF patients. Factors such as respiratory rate and medication duration were linked to increased readmissions, while poor social support was associated with fewer readmissions, this likely reflects limited healthcare access in low- and middle-income countries among individuals with lower social support. The high mortality rate underscores the need for targeted interventions to improve patient outcomes.