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Factors associated with unplanned readmissions within 1 day of acute care discharge: a retrospective cohort study

Considine, Julie, Berry, Debra, Newnham, Evan, Jiang, Matthew, Fox, Karen, Plunkett, David, Mecner, Melissa, Darzins, Peteris and O'Reilly, Mary 2018, Factors associated with unplanned readmissions within 1 day of acute care discharge: a retrospective cohort study, BMC health services research, vol. 18, no. 1, doi: 10.1186/s12913-018-3527-6.

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Title Factors associated with unplanned readmissions within 1 day of acute care discharge: a retrospective cohort study
Author(s) Considine, JulieORCID iD for Considine, Julie orcid.org/0000-0003-3801-2456
Berry, DebraORCID iD for Berry, Debra orcid.org/0000-0002-8780-054X
Newnham, Evan
Jiang, Matthew
Fox, Karen
Plunkett, David
Mecner, Melissa
Darzins, Peteris
O'Reilly, Mary
Journal name BMC health services research
Volume number 18
Issue number 1
Article ID 713
Total pages 11
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2018-09-14
ISSN 1472-6963
Keyword(s) Discharge planning
Health services
Hospital readmission
Hospitalization
Patient readmission
Patient safety
Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
ICD-10 ADMINISTRATIVE DATA
HOSPITAL-READMISSION
RISK-FACTORS
CHEST-PAIN
QUALITY
COMORBIDITIES
Summary BACKGROUND: Unplanned hospital readmissions are a quality and safety indicator. In Australian, 8% to 11.1% of unplanned readmissions occur ≤1 day of acute care discharge. The aim of this study was to explore the reasons for unplanned hospital readmissions ≤1 day of acute care discharge, and determine what proportion of such unplanned hospital readmissions were potentially preventable.

METHODS: A retrospective exploratory cohort design was used to conduct this two phase study. In Phase 1, organisational data from 170 readmissions ≤1 day and 1358 readmissions between 2 and 28 days were compared using the Cochran-Mantel-Haenszel test. Binary logistic regression was used to examine factors associated with unplanned readmission ≤1 day. In Phase 2, a medical record audit of 162 Phase 1 readmissions ≤1 day was conducted and descriptive statistics used to summarise the study data. Index discharges occurred between 1 August and 31 December 2015.

RESULTS: In Phase 1, unplanned readmissions ≤1 day were more likely in paediatric patients (< 0.001); index discharges on weekends (p = 0.006), from short stay unit (SSU) (p < 0.001) or against health professional advice (p = 0.010); or when the readmission was for a Diagnosis Related Group (p < 0.001). The significant predictors of unplanned readmission ≤1 day were index discharge against advice or from SSU, and 1-5 hospital admissions in the 6 months preceding index admission. In Phase 2, 88.3% readmissions were unpreventable and 11.7% were preventable. The median patient age was 57 years and comorbidities were uncommon (3.1%). Most patients (94.4%) lived at home and with others (78.9%). Friday was the most common day of index discharge (17.3%) and Saturday was the most common day of unplanned readmission (19.1%). The majority (94.4%) of readmissions were via the emergency department: 58.5% were for a like diagnosis and pain was the most common reason for readmission.

CONCLUSIONS: Advanced age, significant comorbidities and social isolation did not feature in patients with an unplanned readmission ≤1 day. One quarter of patients were discharged on a Friday or weekend, one quarter of readmissions occurred on a weekend, and pain was the most common reason for readmission raising issues about access to services and weekend discharge planning.
Language eng
DOI 10.1186/s12913-018-3527-6
Field of Research 1117 Public Health And Health Services
0807 Library And Information Studies
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2018, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30113780

Document type: Journal Article
Collections: School of Nursing and Midwifery
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.