Risk Factors Associated With Unplanned Hospital Readmissions in Adults With Cancer

Purpose/Objectives: To identify risk factors associated with 30-day unplanned hospital readmissions in adults with cancer. Design: Case-control study. Setting: A teaching hospital in an urban center in the Mid-Atlantic region of the United States. Sample: 302 adults with solid tumors: 87 readmitted within 30 days (cases) and 215 not readmitted (controls). Methods: The Conceptual Model of Re-Hospitalization was used as a theoretic framework. Univariate logistic regression and multivariate logistic regression were conducted to identify risk factors for hospital readmission. Main Research Variables: Risk factors included patient, clinical, hospitalization, and discharge-planning characteristics. Findings: From November 2011 to November 2012, 29% of patients were readmitted within 30 days after discharge, and a higher percentage of those readmissions occurred within the first week of discharge. Several predictors for hospital readmission were identified in the univariate logistic analysis, but the most relevant in the final multivariate logistic model were moderate to high risk for falls and advanced stage disease (metastatic). Conclusions: Hospital readmission is an indicator of quality care. Learning about risk factors allows opportunities to prevent hospital readmission by identifying those at high risk and implementing optimal discharge-planning systems and early referrals to palliative care. Implications for Nursing: Oncology nurses are best positioned to develop strategic plans aimed at improving discharge planning and transitions of care that will decrease unplanned hospital readmissions.