Ensuring adequate length of stay and resolving medical problems before discharge may prevent early hospital readmissions in older medical patients.
Identified predictors should not yet alter discharge practices; leaves open whether optimizing length of stay and resolving issues reduces readmissions in older patients.
OBJECTIVE: To study the risk factors for hospital readmission among older medical patients in Hong Kong. DESIGN: Cohort study. SUBJECTS: 1,204 consecutive hospital medical patients aged 70 years and over in Hong Kong. PROCEDURES: Subjects were interviewed by a research nurse on discharge, and were followed up for six months. OUTCOME: Unplanned hospital readmissions were identified and classified as avoidable or unavoidable. The risk factors for early (within 28 days), recurrent (three or more) and avoidable readmissions were studied by multiple logistic regression. RESULTS: Four hundred and fifty-five patients (37.7%) had at least one readmission in six months; 18%, 6.4%, and 2.9% of subjects had early, recurrent and avoidable readmissions respectively. Recent hospital stay predicted all types of readmissions. Early readmission was predicted by length of stay, Barthel index (assessment of physical and mental function) and unresolved medical problems. Recurrence readmission was predicted by poor family support, residence in a home for the elderly and unresolved medical problems. CONCLUSIONS: Hospital readmission may be prevented by ensuring adequate length of stay, so that medical problems are resolved before discharge.
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Kwok et al. (1999) studied this question.
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