Acute readmissions among care home residents aged 65+ years: a register-based study

Care home residents are characterised by multimorbidity, cognitive impairment, and physical disabilities, resulting in a high risk of acute admissions and readmissions. The risk factors for acute readmissions may differ from those affecting older adults in the community. This study aims to identify risk factors associated with acute readmissions among care home residents within 30 days of discharge from an acute hospital admission.

We included all care home residents aged 65 + years living in Southern Jutland in Denmark from 2014 to 2019 who were discharged from their first acute hospital admission (lasting 12 + h) in the study period. Data on baseline characteristics, index admissions, 30-day readmissions, and mortality were obtained from the highly valid Danish national health registries. Cox regression was employed to identify factors associated with acute readmissions.

The care home residents had a mean age of 83.9-86.2 at index admission, and 57.0-62.3% were women. Of 2108 initial admissions, 328 (15.6%) resulted in an acute readmission, and 302 (14.3%) died within 30 days of follow-up. Notably, nearly half of the readmissions occurred within 1 week of discharge. Being a new care home resident (care home residency < 3 months) was associated with acute readmission (HR 1.40), as was a medical history of cancer (HR 1.31), diabetes (HR 1.45), atrial fibrillation (HR 1.54), and COPD/asthma (HR 1.36). Conversely, dementia was associated with a significantly lower risk of acute readmission (HR 0.71).

Our findings can help identify care home residents at elevated risk of readmission shortly after discharge.