Comparison of 30-day Planned and Unplanned Readmissions in a Tertiary Teaching Hospital in China

Overview

Journal BMC Health Serv Res

Publisher Biomed Central

Specialty Health Services

Date 2023 Mar 6

PMID 36879245

Authors

Mengjiao Zhang

Siru Liu

Yongdong Bi

Jialin Liu

Affiliations

Soon will be listed here.

Abstract

Purpose: The purpose of this study was to analyze and compare the clinical characteristics of patients with 30-day planned and unplanned readmissions and to identify patients at high risk for unplanned readmissions. This will facilitate a better understanding of these readmissions and improve and optimize resource utilization for this patient population.

Methods: A retrospective cohort descriptive study was conducted at the West China Hospital (WCH), Sichuan University from January 1, 2015, to December 31, 2020. Discharged patients (≥ 18 years old) were divided into unplanned readmission and planned readmission groups according to 30-day readmission status. Demographic and related information was collected for each patient. Logistic regression analysis was used to assess the association between unplanned patient characteristics and the risk of readmission.

Results: We identified 1,118,437 patients from 1,242,496 discharged patients, including 74,494 (6.7%) 30-day planned readmissions and 9,895 (0.9%) unplanned readmissions. The most common diseases of planned readmissions were antineoplastic chemotherapy (62,756/177,749; 35.3%), radiotherapy sessions for malignancy (919/8,229; 11.2%), and systemic lupus erythematosus (607/4,620; 13.1%). The most common diseases of unplanned readmissions were antineoplastic chemotherapy (2038/177,747; 1.1%), age-related cataract (1061/21,255; 5.0%), and unspecified disorder of refraction (544/5,134; 10.6%). There were statistically significant differences between planned and unplanned readmissions in terms of patient sex, marital status, age, length of initial stay, the time between discharge, ICU stay, surgery, and health insurance.

Conclusion: Accurate information on 30-day planned and unplanned readmissions facilitates effective planning of healthcare resource allocation. Identifying risk factors for 30-day unplanned readmissions can help develop interventions to reduce readmission rates.

References

Shah L, Ding J, Spaulding E, Yang W, Lee M, Demo R . Sociodemographic Characteristics Predicting Digital Health Intervention Use After Acute Myocardial Infarction. J Cardiovasc Transl Res. 2021; 14(5):951-961. PMC: 8127845. DOI: 10.1007/s12265-021-10098-9. View

Bianco A, Mole A, Nobile C, Di Giuseppe G, Pileggi C, Angelillo I . Hospital readmission prevalence and analysis of those potentially avoidable in southern Italy. PLoS One. 2012; 7(11):e48263. PMC: 3487865. DOI: 10.1371/journal.pone.0048263. View

Graham K, Auerbach A, Schnipper J, Flanders S, Kim C, Robinson E . Preventability of Early Versus Late Hospital Readmissions in a National Cohort of General Medicine Patients. Ann Intern Med. 2018; 168(11):766-774. PMC: 6247894. DOI: 10.7326/M17-1724. View

Kossovsky M, Perneger T, Sarasin F, Bolla F, Borst F, Gaspoz J . Comparison between planned and unplanned readmissions to a department of internal medicine. J Clin Epidemiol. 1999; 52(2):151-6. DOI: 10.1016/s0895-4356(98)00142-5. View

Ellimoottil C, Khouri R, Dhir A, Hou H, Miller D, Dupree J . An Opportunity to Improve Medicare's Planned Readmissions Measure. J Hosp Med. 2017; 12(10):840-842. DOI: 10.12788/jhm.2833. View

Spiva L, Hand M, VanBrackle L, McVay F . Validation of a Predictive Model to Identify Patients at High Risk for Hospital Readmission. J Healthc Qual. 2015; 38(1):34-41. DOI: 10.1111/jhq.12070. View

Chiu S, Gee M, Muo C, Chu C, Lan S, Chen C . The sociocultural effects on orthopedic surgeries in Taiwan. PLoS One. 2018; 13(3):e0195183. PMC: 5875864. DOI: 10.1371/journal.pone.0195183. View

Zamir D, Zamir M, Reitblat T, Zeev W, Polishchuk I . Readmissions to hospital within 30 days of discharge from the internal medicine wards in southern Israel. Eur J Intern Med. 2005; 17(1):20-3. DOI: 10.1016/j.ejim.2005.10.004. View

Mor A, Ulrichsen S, Svensson E, Berencsi K, Thomsen R . Does marriage protect against hospitalization with pneumonia? A population-based case-control study. Clin Epidemiol. 2013; 5:397-405. PMC: 3797619. DOI: 10.2147/CLEP.S50505. View

10.

Krys J, Lyszczarz B, Wyszkowska Z, Kedziora-Kornatowska K . Prevalence, Reasons, and Predisposing Factors Associated with 30-day Hospital Readmissions in Poland. Int J Environ Res Public Health. 2019; 16(13). PMC: 6651338. DOI: 10.3390/ijerph16132339. View

11.

Sharma Y, Miller M, Kaambwa B, Shahi R, Hakendorf P, Horwood C . Factors influencing early and late readmissions in Australian hospitalised patients and investigating role of admission nutrition status as a predictor of hospital readmissions: a cohort study. BMJ Open. 2018; 8(6):e022246. PMC: 6020977. DOI: 10.1136/bmjopen-2018-022246. View

12.

Meurs E, Siegert C, Uitvlugt E, Morabet N, Stoffels R, Scholvinck D . Clinical characteristics and risk factors of preventable hospital readmissions within 30 days. Sci Rep. 2021; 11(1):20172. PMC: 8505517. DOI: 10.1038/s41598-021-99250-8. View

13.

Roshanghalb A, Mazzali C, Lettieri E, Paganoni A, Bottle A . Stability over time of the "hospital effect" on 30-day unplanned readmissions: Evidence from administrative data. Health Policy. 2021; 125(10):1393-1397. DOI: 10.1016/j.healthpol.2021.07.009. View

14.

Ryu B, Yoo S, Kim S, Choi J . Thirty-day hospital readmission prediction model based on common data model with weather and air quality data. Sci Rep. 2021; 11(1):23313. PMC: 8639801. DOI: 10.1038/s41598-021-02395-9. View

15.

Heaton P, Desai V, Kelton C, Rajpathak S . Sulfonylurea use and the risk of hospital readmission in patients with type 2 diabetes. BMC Endocr Disord. 2016; 16:4. PMC: 4719386. DOI: 10.1186/s12902-016-0084-z. View

16.

Wadhera R, Yeh R, Joynt Maddox K . The Hospital Readmissions Reduction Program - Time for a Reboot. N Engl J Med. 2019; 380(24):2289-2291. PMC: 6589834. DOI: 10.1056/NEJMp1901225. View

17.

Kumar V, Chaudhary N, Achebe M . Epidemiology and Predictors of all-cause 30-Day readmission in patients with sickle cell crisis. Sci Rep. 2020; 10(1):2082. PMC: 7005718. DOI: 10.1038/s41598-020-58934-3. View

18.

Hasan O, Meltzer D, Shaykevich S, Bell C, Kaboli P, Auerbach A . Hospital readmission in general medicine patients: a prediction model. J Gen Intern Med. 2009; 25(3):211-9. PMC: 2839332. DOI: 10.1007/s11606-009-1196-1. View

19.

Hoang-Kim A, Parpia C, Freitas C, Austin P, Ross H, Wijeysundera H . Readmission rates following heart failure: a scoping review of sex and gender based considerations. BMC Cardiovasc Disord. 2020; 20(1):223. PMC: 7222562. DOI: 10.1186/s12872-020-01422-3. View

20.

Roger C, Debuyzer E, Dehl M, Bulaid Y, Lamrani A, Havet E . Factors associated with hospital stay length, discharge destination, and 30-day readmission rate after primary hip or knee arthroplasty: Retrospective Cohort Study. Orthop Traumatol Surg Res. 2019; 105(5):949-955. DOI: 10.1016/j.otsr.2019.04.012. View