Readmissions - An evaluation of reasons for unplanned readmissions of older people: A United Kingdom and international studies literature review

The measuring of emergency readmission rates to hospital following discharge is one of fifteen health outcomes the United Kingdom government monitors on an annual basis. There is a wide variation between readmission rates, and it is especially important to older people that there is a reduction in unacceptable variations. A closer understanding of reasons for readmission is therefore necessary to inform future developments, identify patients who may be at high risk of readmission and target resources more appropriately. A review of literature from the United Kingdom and international studies may help in determining the reasons for the unplanned readmission of older people. This could then allow for a re-allocation of resources in the most cost-effective and cost-efficient manner. The literature review was conducted via keywords and combination of keyword searches from 1990-2003 using various electronic databases. There were several themes that emerged from the literature, and these have been described within the paper. Following the review of the literature it emerged that many international studies into the causes of readmission of older people have an inconsistent approach in defining certain terms. However, in the United Kingdom, there appears a more consistent approach. Most studies agree that the majority of readmissions occur as a result of a relapse or complication of an initial illness. However, some American studies associate the readmission of older people with a specific disease, and the antecedent care process. The findings in the literature have identified several gaps that enable recommendations for future research to be made.