Identifying risk factors and patterns for unplanned readmission to a general medical service.

摘要: Objective To identify factors and patterns associated with 7- 28-day readmission for general medicine patients at a tertiary public hospital. Methods A retrospective observational study was conducted using an administrative database service in hospital between 1 January 2007 31 December 2011. Demographic clinical factors, as well patterns, were evaluated the association readmission. Results The cohort included 13 802 rate 10.9%. In multivariate analysis, longer stay of index admission (adjusted relative risk (ARR) 1.34), Charlson ≥3 (ARR 1.28), discharge against medical advice 1.87), active malignancy 1.83), cardiac failure 1.48) incomplete summaries 1.61) independently increased Patients diseases respiratory system, neurological or genitourinary disease, injury unclassifiable conditions likely to be readmitted within 7 days. circulatory disease same system diagnosis. Conclusion Readmission 28 days is relatively common patterns. Identification these will enable interventions reduce potentially preventable readmissions. What known about topic? rates following hospitalization are increasing, especially among older those multiple underlying comorbidities. This presents challenging costly problem. does this paper add? Factors early include higher comorbidity score, length during who advice. respiratory, trauma diagnosis most large proportion readmissions had principal diagnoses different diagnostic category that hospitalization. implications practitioners? breadth review required before discharging any patient. Intervention should directed not just made admission. Timing implementation important more urgent some than others.