Readmission after hospitalization for stroke in Taiwan: results from a national sample

Data on hospital readmission after stroke, which reflects burden of disease, are limited. Our aim was to evaluate readmission and readmission diagnosis within one year after stroke.

We studied administrative claims data of a randomly sampled cohort (n=200,000) of National Health Insurance beneficiaries in Taiwan. Patients aged > or = 18 years and admitted with stroke (International Classification of Diseases, 9th revision, Clinical Modification codes 430 to 438) as principal (first-listed) discharge diagnosis in 2000 were selected for analysis. Each patient's data from January 2000 to December 2001 were obtained. Data analysis was undertaken using descriptive statistics and logistic regression.

Among 515 patients identified, 50.1% were ischemic, 20.4% hemorrhagic, 18.3% ill-defined, 10.3% TIA and 1.0% the remainder. Neurologists were admitting physicians for 45.2% of patients. Patients died in hospital (n=11) and those who were presumed dead during study period (n=29) or without sufficient follow-up data (n=7) were excluded. Within one year following discharge from the index admission, approximately half of the patients (232 of 468) were readmitted. The most frequently reported readmission diagnosis was stroke (26.3%), followed by infection (15.1%). Multivariable regression analysis showed that factors significantly associated with increased risk of readmission included age, length of stay of the index admission, medical specialty of admission other than neurology/neurosurgery, and level of hospital, after adjustment for sex, Charlson comorbidity index score, and primary discharge diagnosis (ischemic/hemorrhagic stroke versus others).

Stroke patients who were admitted to disciplines other than neurology/neurosurgery seemed to have higher risk of readmission.