Predictors for Unplanned Readmissions within 18 Days after Hospital Discharge: a Retrospective Cohort Study

Area of Science:

• Internal Medicine
• Health Services Research

Background:

• Swiss hospitals adopted a diagnosis-related groups (DRG) reimbursement system in 2012.
• Readmissions within 18 days and same major diagnostic category (MDC) are often reimbursed less.
• Identifying predictors for early readmissions can help manage patient distress and healthcare costs.

Purpose of the Study:

• To identify predictors of early unplanned readmissions within the same MDC.
• To pinpoint high-risk index hospitalizations for targeted intervention.
• To potentially prevent unnecessary readmissions and improve patient outcomes.

Main Methods:

• Retrospective data collection from the Clinic of Internal Medicine at University Hospital of Basel, Switzerland.
• Analysis of patients hospitalized for over 24 hours during the pre-DRG period (Oct 2009 - Sep 2010).
• Logistic regression used to identify predictors of unplanned readmissions within 18 days under the same MDC.

Main Results:

• 3.1% of 7479 patients experienced at least one readmission.
• Male sex and a high number of prescribed drugs at discharge were significant patient-related predictors.
• Respiratory, cardiovascular, and gastrointestinal systems were identified as high-risk MDCs for readmission.

Conclusions:

• Early readmissions within the same MDC are infrequent and not significantly influenced by patient age or length of index hospital stay.
• Multimorbid patients and those hospitalized for cardiovascular, respiratory, or gastrointestinal conditions are at higher risk.
• Targeted prevention strategies focusing on these patient groups and conditions are recommended to reduce early readmissions.