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Characteristics of Hospitalized COVID-19 Patients Discharged and Experiencing Same-Hospital Readmission - United
Amy M Lavery1, Leigh Ellyn Preston1, Jean Y Ko1
1CDC COVID-19 Response Team.
Insights
Nine percent of COVID-19 patients were readmitted within two months of hospital discharge. Readmissions were more common in older patients, those with chronic conditions, and those discharged to skilled nursing facilities or home health care.
Area of Science:
- Public Health
- Epidemiology
- Health Services Research
Background:
- Coronavirus disease 2019 (COVID-19) presents complex clinical challenges requiring ongoing care.
- Limited research exists on discharge patterns and hospital readmissions for large COVID-19 patient cohorts.
- Understanding readmission risks is crucial for effective patient management and healthcare resource allocation.
Purpose of the Study:
- To assess discharge patterns and hospital readmissions among COVID-19 patients.
- To identify demographic and clinical factors associated with hospital readmission after initial COVID-19 hospitalization.
- To inform clinical practice, discharge planning, and public health strategies for COVID-19 patient care.
Main Methods:
- Utilized electronic health record and administrative data from the Premier Healthcare Database.
- Analyzed data from 126,137 unique patients hospitalized with COVID-19 between March and July 2020.
- Assessed readmission rates and associated patient characteristics within two months of discharge.
Main Results:
- 15% of patients died during their initial COVID-19 hospitalization.
- Among survivors, 9% were readmitted within two months.
- Readmissions were higher for patients discharged to skilled nursing facilities (15%) or home health care (12%) compared to home self-care (7%).
- Increased odds of readmission were linked to age (≥65), chronic conditions, prior hospitalization, and discharge disposition.
Conclusions:
- A significant proportion of COVID-19 survivors experience hospital readmission.
- Identifying high-risk patients (elderly, those with comorbidities) is essential for targeted interventions.
- Findings underscore the need for robust discharge planning and post-hospital care coordination to manage COVID-19 sequelae and prevent readmissions.
Abstract:
Coronavirus disease 2019 (COVID-19) is a complex clinical illness with potential complications that might require ongoing clinical care (1-3). Few studies have investigated discharge patterns and hospital readmissions among large groups of patients after an initial COVID-19 hospitalization (4-7). Using electronic health record and administrative data from the Premier Healthcare Database,* CDC assessed patterns of hospital discharge, readmission, and demographic and clinical characteristics associated with hospital readmission after a patient's initial COVID-19 hospitalization (index hospitalization). Among 126,137 unique patients with an index COVID-19 admission during March-July 2020, 15% died during the index hospitalization. Among the 106,543 (85%) surviving patients, 9% (9,504) were readmitted to the same hospital within 2 months of discharge through August 2020. More than a single readmission occurred among 1.6% of patients discharged after the index hospitalization. Readmissions occurred more often among patients discharged to a skilled nursing facility (SNF) (15%) or those needing home health care (12%) than among patients discharged to home or self-care (7%). The odds of hospital readmission increased with age among persons aged ≥65 years, presence of certain chronic conditions, hospitalization within the 3 months preceding the index hospitalization, and if discharge from the index hospitalization was to a SNF or to home with health care assistance. These results support recent analyses that found chronic conditions to be significantly associated with hospital readmission (6,7) and could be explained by the complications of underlying conditions in the presence of COVID-19 (8), COVID-19 sequelae (3), or indirect effects of the COVID-19 pandemic (9). Understanding the frequency of, and risk factors for, readmission can inform clinical practice, discharge disposition decisions, and public health priorities such as health care planning to ensure availability of resources needed for acute and follow-up care of COVID-19 patients. With the recent increases in cases nationwide, hospital planning can account for these increasing numbers along with the potential for at least 9% of patients to be readmitted, requiring additional beds and resources.
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