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Readmission within three months after inpatient geriatric care-Incidence, diagnosis and associated factors in a
Carl Willers1,2, Anne-Marie Boström3,4,5, Lennart Carlsson6
1Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
Insights
One-fourth of geriatric patients were readmitted within three months, with heart failure, COPD, and pneumonia as common diagnoses. Key risk factors included age, sex, and multiple diagnoses, highlighting the need for proactive monitoring of frail individuals.
Area of Science:
- Geriatric Medicine
- Healthcare Quality Improvement
- Patient Readmission Studies
Background:
- Hospital readmissions incur significant financial costs and impact patient safety and health.
- Understanding readmission drivers is essential for improving care quality.
- Geriatric inpatient care is a critical area for studying readmission patterns.
Purpose of the Study:
- To assess the frequency and main diagnoses of inpatient readmissions within three months post-discharge from geriatric care.
- To analyze associations between readmissions and patient characteristics (demographics, socioeconomic status, morbidity, physical function, risk screening, care processes).
Main Methods:
- Study included all individuals admitted to three Stockholm region geriatric departments in 2016.
- Readmissions were analyzed at three intervals: within 10 days, 11-30 days, and 31-90 days post-discharge.
- Main diagnoses at readmission were systematically assessed.
Main Results:
- One-fourth of discharged geriatric patients experienced readmission within the first three months.
- Common readmission diagnoses included heart failure, chronic obstructive pulmonary disease, and pneumonia.
- Significant risk factors identified were age, sex, number of diagnoses at discharge, polypharmacy, and discharge destination.
Conclusions:
- Clinical risk factors related to physical performance and frailty are associated with readmission risk.
- Socioeconomic factors did not significantly predict readmissions.
- Reducing readmission rates requires proactive monitoring of frail, chronically ill patients and an integrated stakeholder approach.
Introduction:
Readmissions are very costly, in monetary terms but also for the individual patient's safety and health. Only by understanding the reasons and drivers of readmissions, it is possible to ensure quality of care and improve the situation. The aim of this study was to assess inpatient readmissions during the first three months after discharge from geriatric inpatient care regarding main diagnosis and frequency of readmission. Furthermore, the aim was to analyze association between readmission and patient characteristics including demography and socioeconomics, morbidity, physical function, risk screening and care process respectively.
Methods:
The study includes all individuals admitted for inpatient care at three geriatric departments operated by the Stockholm region during 2016. Readmission after discharge was studied within three different time intervals; readmission within 10 days after discharge, within 11-30 days and within 31-90 days, respectively. Main diagnosis at readmission was assessed.
Results:
One fourth of the individuals discharged from inpatient geriatric care was readmitted during the first three months after discharge. The most common main diagnoses for readmission were heart failure, chronic obstructive pulmonary disease and pneumonia. Statistically significant risk factors for readmission included age, sex, number of diagnoses at discharge, and to some extent polypharmacy and destination of discharge.
Conclusions:
Several clinical risk factors relating to physical performance and vulnerability were associated with risk of readmission. Socioeconomic information did not add to the predictability. To enable reductions in readmission rates, proactive monitoring of frail individuals afflicted with chronic conditions is necessary, and an integrated perspective including all stakeholders involved is crucial.
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