Key result
ICU stay linked to ~15-fold higher risk of 30-day unplanned readmission.
Why the study?
Analyzing and comparing clinical characteristics of 30-day planned versus unplanned readmissions was needed to identify high-risk patients and optimize healthcare resource utilization.
Cohort (n=1,118,437)
No
Identifying specific risk factors for 30-day unplanned readmissions, such as longer initial length of stay, ICU admission, and surgery, can help hospitals develop targeted interventions to reduce avoidable readmissions and optimize resource allocation.
ICU admission linked to higher 30-day unplanned readmission; leaves open whether targeted interventions reduce risk in similar cohorts.
PURPOSE: The purpose of this study was to analyze and compare the clinical characteristics of patients with 30-day planned and unplanned readmissions and to identify patients at high risk for unplanned readmissions. This will facilitate a better understanding of these readmissions and improve and optimize resource utilization for this patient population. METHODS: A retrospective cohort descriptive study was conducted at the West China Hospital (WCH), Sichuan University from January 1, 2015, to December 31, 2020. Discharged patients (≥ 18 years old) were divided into unplanned readmission and planned readmission groups according to 30-day readmission status. Demographic and related information was collected for each patient. Logistic regression analysis was used to assess the association between unplanned patient characteristics and the risk of readmission. RESULTS: We identified 1,118,437 patients from 1,242,496 discharged patients, including 74,494 (6.7%) 30-day planned readmissions and 9,895 (0.9%) unplanned readmissions. The most common diseases of planned readmissions were antineoplastic chemotherapy (62,756/177,749; 35.3%), radiotherapy sessions for malignancy (919/8,229; 11.2%), and systemic lupus erythematosus (607/4,620; 13.1%). The most common diseases of unplanned readmissions were antineoplastic chemotherapy (2038/177,747; 1.1%), age-related cataract (1061/21,255; 5.0%), and unspecified disorder of refraction (544/5,134; 10.6%). There were statistically significant differences between planned and unplanned readmissions in terms of patient sex, marital status, age, length of initial stay, the time between discharge, ICU stay, surgery, and health insurance. CONCLUSION: Accurate information on 30-day planned and unplanned readmissions facilitates effective planning of healthcare resource allocation. Identifying risk factors for 30-day unplanned readmissions can help develop interventions to reduce readmission rates.
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Zhang et al. (2023) conducted a cohort in Hospital readmission (n=1,118,437). ICU stay vs. No ICU stay was evaluated on 30-day unplanned readmission (OR 14.64, 95% CI 11.49-18.67, p=<0.001). ICU stay significantly increased the risk of 30-day unplanned readmission (OR 14.64) among discharged adult patients in a Chinese tertiary hospital.
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