5 factors that indicate patients are at risk for unplanned readmissions

Patients with chronic cardiovascular and pulmonary disease are at a greater risk for unplanned and expensive hospital readmissions, new research shows.

The study, published in the August issue of the Journal of Evaluation in Clinical Practice, analyzed 2008 discharge data from the Belgian Hospital Discharge Dataset, to identify patient and hospital factors that contribute to high readmission rates. Researchers looked at patients who were readmitted to the same hospital within 30 days of discharge. They classified a readmission as "unplanned" when the hospital coded it as an urgent admission.

The overall unplanned readmission rate was 5.2 percent, according to the study. The most common reasons for readmissions were cardiovascular and pulmonary diagnoses and 10.4 percent of all readmissions were due to complications.

However, the strongest predictor of readmission was a high number of previous emergency department visits. Indeed, the odds ratio for patients with at least four ED visits in the past six months was 4.65, according to the study. Other predictors of a higher risk for readmission included discharge on Friday (odds ratio, 1.05) and a long length of stay (odds ratio, 1.19).

The findings indicate that hospitals can reduce readmissions by targeting the patient groups at risk, researchers said, such as patients with cardiovascular or pulmonary diseases, and preventing complications. In addition, because multiple ED visits and longer patient stays are linked to higher readmission rates, clinicians must work with caregivers and primary care physicians to coordinate a smoother transition from hospital to home, especially for patients discharged on Friday. Previous research also calls for post-discharge monitoring to ensure that patients follow the hospital's detailed care plan, such as taking medications correctly and keeping follow-up appointments.

To learn more:
- here's the study abstract