Readmission within three months after inpatient geriatric care—Incidence, diagnosis and associated factors in a Swedish cohort

Abstract

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.

The Impact of Potentially Inappropriate Medications and Polypharmacy on 3-Month Hospital Readmission among Older Patients: A Retrospective Cohort Study from Malaysia

“…Polypharmacy is known to be associated with various negative outcomes including declined physical, cognitive, and emotional capabilities as well as hospitalization [ 5 , 27 ]. Several studies have correlated polypharmacy with hospital readmission among older patients [ 3 , 6 , 7 ]. However, this was not the case in our study, in which neither polypharmacy nor hyperpolypharmacy was significantly related to hospital readmission.…”

“…A high hospital readmission rate among older population might be due to many factors. One of them is the individual’s multiple diseases progression as well as deterioration of their health status that make them more prone to seek treatment [ 3 ]. Other than that, demographic factors were also found to significantly contribute to readmission.…”

“…Other than that, demographic factors were also found to significantly contribute to readmission. For example, male gender was associated with higher readmission risks and frequency compared to female gender in older adults [ 3 ]. Additionally, a study from the United States found that patients who were discharged without getting medical consultation or unprepared for discharge also tend to be re-admitted to the hospital [ 4 ].…”

“…Polypharmacy in older adults is well known to be associated with negative outcomes including increased ADRs and DRH [ 5 ]. Several studies have also reported polypharmacy in older adults being a risk factor for hospital readmissions [ 3 , 6 , 7 ]. On top of that, polypharmacy increases the risk of prescribing potentially inappropriate medications (PIMs) [ 8 , 9 ].…”

Patterns Of Multimorbidity Of Patients In Geriatric Care – A Register-Based Cohort Study In Sweden

“…A Swedish study of a cohort of older people showed how the trajectories of the patients in various clusters changed over a 12-year period 18 . This study is part of a larger project with the aim to analyse reasons and drivers for readmission after discharge from geriatric care 23,24 . Due to the prevalence of multimorbidity in elderly populations, the phenomenon of multimorbidity needs to be explored and analysed more rigorously, contributing to a profound ground for analyses of reasons for readmission.…”