The relationship between discharge destination and rehospitalization in Chinese patients with heart failure: a cohort study

Background The high readmission rate among heart failure (HF) patients is a significant concern, but limited research has explored the relationship between discharge destination and readmission rates in Chinese HF patients. Objective To examine the association between discharge destination and readmission in HF patients. Methods This retrospective cohort study analyzed data from 2,008 HF patients admitted to the Fourth People's Hospital of Zigong City, China, between December 2016 and June 2019. Patients were divided into two groups based on their discharge destination: home and healthcare facility. The primary outcome was readmission within 6 months, with secondary outcomes at 3 months and 28 days. Cox proportional hazards regression and Kaplan–Meier curves were used to assess the relationship, with additional subgroup and interaction analyses for robustness. Results A total of 836 patients with HF were enrolled in this study. Among them, 638 patients were discharged to home, while 198 patients were discharged to healthcare facilities. The multivariable Cox proportional hazards regression model revealed that discharge to healthcare facilities were independently associated with a higher readmission risk compared with discharge to home, adjusted HR 1.26, 95% CI 1.06–1.50, P = 0.009 for readmission within 6 months. Similar trends were observed for readmission within 3 months (HR: 1.26, 95% CI: 1.02–1.55, P = 0.034) and 28 days (HR: 1.53, 95% CI: 1.04–2.26, P = 0.032). Kaplan–Meier analysis (log-rank test P = 0.011) supported the above findings, and the association remained robust in subgroup and sensitivity analyses. Conclusion This study demonstrated that discharge to a healthcare facility was independently associated with an increased readmission risk among HF patients. Discharge destination should be considered as a potential indicator of readmission risk in clinical practice.