Readmissions to medical wards: Analysis of demographic and socio-medical factors

被引:22
作者
Bisharat, Naiel [1 ,2 ]
Handler, Chovav [1 ]
Schwartz, Naama [3 ]
机构
[1] Emek Med Ctr, Dept Med D, IL-18101 Afula, Israel
[2] Technion Israel Inst Technol, Bruce Rappaport Fac Med, IL-31096 Haifa, Israel
[3] Emek Med Ctr, Clin Res Unit, IL-18101 Afula, Israel
关键词
Case-control studies; Hospital readmissions; Length of stay; Multivariate analysis; Risk factors; HOSPITAL READMISSION; ELDERLY-PATIENTS; RISK-FACTORS;
D O I
10.1016/j.ejim.2012.03.004
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Unplanned readmissions affect occupancy rates in medical wards and these have been constantly increasing in Israel. We examined the frequency and risk factors affecting the likelihood of 30-day emergency medical readmissions. Methods: We compared the clinical, epidemiological, and socioeconomic characteristics of readmitted patients during 2009 to a control group matched by age, sex, and primary medical diagnosis. Results: Rate of unplanned readmissions within 30 days was 12.2%. The mean time to readmission was 12.8 days. The mean length of hospital stay at index admission was 4.4 and 3.8 days for the study and control groups, respectively, and 4.99 days in the second admission (study group only). By simple univariate logistic regression, living in a nursing home, chronic kidney disease, ischemic heart disease, previous cerebrovascular accident, number of chronic medications, length of hospital stay at index admission, and hospitalization in the previous year prior to index admission were significantly associated with risk of readmission. In multivariate logistic regression model, only living in a nursing home (OR = 2.94, 95% CI = 1.15-7.48), presence of chronic kidney disease (OR = 1.62, 95% CI = 1.06-2.46), length of index admission >= 3 days (OR = 1.53, 95% CI = 1.07-2.2), and hospitalization in the previous year (OR = 3.33, 95% CI = 2.34-4.74) were found to be significantly associated with likelihood of readmission. Conclusion: Risk factors affecting 30-days readmission at our medical centre are similar to previous observations, and yet, some are perhaps unique to our region. (C) 2012 European Federation of Internal Medicine. Published by Elsevier B. V. All rights reserved.
引用
收藏
页码:457 / 460
页数:4
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