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Readmissions among patients with COVID-19
Eleftheria Atalla1, Markos Kalligeros1, Giorgina Giampaolo1
1Infectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Insights
COVID-19 hospital readmissions occurred in 6.8% of patients, often due to comorbidities. Readmitted patients had more complex health issues, impacting healthcare resources and requiring careful discharge planning.
Area of Science:
- Infectious Diseases
- Public Health
- Healthcare Management
Background:
- Hospital readmissions negatively impact patient outcomes and healthcare resource utilization.
- The COVID-19 pandemic exacerbates healthcare system strain, increasing the importance of studying readmission patterns.
Purpose of the Study:
- To analyze readmission rates, reasons, and patient characteristics for COVID-19 patients.
- To compare outcomes between readmitted and non-readmitted COVID-19 patients.
- To inform discharge timing and safe care transitions.
Main Methods:
- Retrospective review of 339 COVID-19 hospitalizations in Rhode Island, US (March 1 - April 19, 2020).
- Analysis of 279 patients discharged alive, focusing on 19 readmitted cases.
- Comparison of clinical characteristics and outcomes between readmitted and non-readmitted groups.
Main Results:
- A 6.8% readmission rate (19/279) was observed within a median of 5 days.
- Readmitted patients had significantly higher rates of hypertension, diabetes, chronic pulmonary disease, liver disease, cancer, and substance abuse.
- Early readmissions (within 12 days) were linked to respiratory distress and thrombotic episodes; later readmissions involved psychiatric exacerbations and falls.
Conclusions:
- Hospitalized COVID-19 patients with higher comorbidity burdens were more likely to be readmitted.
- Readmission causes varied by timing: COVID-19 related early on, and other conditions later.
- Characterizing readmissions is crucial for optimizing discharge and ensuring safe patient transitions.
Background:
Hospital readmissions are associated with poor patient outcomes and increased health resource utilisation. The need to study readmission patterns is even bigger during a pandemic because the burden is further stretching the healthcare system.
Methods:
We reviewed the initial hospitalisation and subsequent readmission for 19 patients with confirmed COVID-19 in the largest statewide hospital network in Rhode Island, US, from March 1st through April 19th, 2020. We also compared the characteristics and clinical outcomes between readmitted and non-readmitted patients.
Results:
Of the 339 hospitalised patients with COVID-19, 279 discharged alive. Among them, 19/279 were readmitted (6.8%) after a median of 5 days. There was a significantly higher rate of hypertension, diabetes, chronic pulmonary disease, liver disease, cancer and substance abuse among the readmitted compared with non-readmitted patients. The most common reasons of readmissions happening within 12 days from discharge included respiratory distress and thrombotic episodes, while those happening at a later time included psychiatric illness exacerbations and falls. The length of stay during readmission was longer than during index admission and more demanding on healthcare resources.
Conclusion:
Among hospitalised patients with COVID-19, those readmitted had a higher burden of comorbidities than the non-readmitted. Within the first 12 days from discharge, readmission reasons were more likely to be associated with COVID-19, while those happening later were related to other reasons. Readmissions characterisation may help in defining optimal timing for patient discharge and ensuring safe care transition.
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