A Retrospective Analysis of Factor Influencing Readmissions and Emergency Visits Post-discharge in Elderly Patients

Aim and Background Hospital readmissions and post-discharge emergency department (ED) visits constitute significant adverse outcomes with substantial implications for healthcare expenditures. This study sought to determine the prevalence and predictors of readmissions and ED visits at 1- and 12-month intervals following hospital discharge among older adults. Methods A retrospective cohort study was conducted among patients aged ≥ 60 years discharged from a hospital in Surabaya, Indonesia. Readmissions and emergency department (ED) visits at 30 days and 12 months were assessed. Multivariable logistic regression was used to identify associated factors, reported as odds rations with 95% confidence intervals. Results A total of 1533 patients met the study criteria. Readmission rates were 18.4% at 1 month and 29% at 12 months, while ED visits were 12.35% and 22.6%, respectively. One-month readmissions were associated with longer hospital stay (OR = 1.801) and comorbidities including CHF (OR = 2.227), cerebrovascular disease (OR = 1.681), and renal disease (OR = 2.565). Twelve-month readmissions were strongly predicted by excessive discharge polypharmacy (defined as ≥ 10 discharge medications) (OR = 5.751) and rheumatoid arthritis (OR = 11.907). Mild liver disease, ulcer disease, and cancer predicted 1-month ED visits, while discharge polypharmacy predicted 12-month ED visits. Conclusion Several predictors of readmission and ED visits likely reflect underlying illness severity and can help identify high-risk patients. Longer length of stay appears to be marker of severity rather than a modifiable factor. Although polypharmacy may be modifiable, it can also represent appropriate treatment for complex conditions. Therefore, distinguishing modifiable risks from necessary therapy is essential when developing strategies to reduce rehospitalization.