Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:


Hospital readmission studies: Influencing factors identified

Race and insurance status increase likelihood of first readmission; poor nutrition and depression make further rehospitalizations more likely

In two studies published today in the Journal of Hospital Medicine, the risk factors for readmission to the hospital are examined based upon general medicine inpatients and those with at least two admissions in a six-month period.

Alongside clinical factors such as having cancer, chronic diseases such as heart failure or lung disease, or being on high-risk medications, the studies identified other factors which increase the likelihood of a patient being readmitted which could help hospitalists focus in on these groups.

In the first study, Nazima Allaudeen, MD, and colleagues at the University of California San Francisco (UCSF), looked at the factors behind unplanned hospital readmission within 30 days – which occurs in nearly one in five Medicare patients in the US. The study involved patients admitted to UCSF hospitals between June 2006 and May 2008; 6,805 unique patients for a total of 10,359 admissions. 17% of admissions were readmitted within thirty days, with almost half of these (49.7%) occurring within 10 days.

Of the sociodemographic factors, African-American race and Medicaid as payer status were associated with readmission, with a 43% and 15% increased risk of readmission respectively after adjustment for other variables. Of the clinical factors, high-risk medications and six comorbidities (congestive heart failure, renal disease, cancer (with and without metastasis), weight loss, and iron deficiency anemia) were associated with readmission.

The study also examined operational factors, such as weekend discharge or admission source, but none were significantly associated with readmission.

"The US spends over $15 billion in Medicare on readmissions to hospital within 30 days and readmissions are also distressing to patients and their caregivers," said Allaudeen, now based at the VA Palo Alto Health Care System, California. "Many healthcare systems are now making efforts to improve the transition from hospital to home or nursing facility to try to reduce preventable readmissions but they need to know which patients to focus on to have the biggest impact. Studies like ours should give practitioners direction to non-clinical factors to identify."

Recognizing the limitations in the choice of data variables available in studies using administrative data, the second smaller study used detailed clinical assessments to examine a range of readmissions risk factors in a recognized high risk patient group, those with two or more recent admissions. Dr Alison Mudge FRACP and colleagues at the Royal Brisbane and Women's Hospital, Australia, undertook detailed assessment of 142 patients aged over 50 admitted between February 2006 and February 2007 who had two or more hospitalizations in the preceding six months, studying factors such as depression, nutritional status, and functional status as well as demographic and disease variables.

After six months, 55 participants (38.7%) had had a total of 102 unplanned admissions to the hospital. As the researchers expected, the strongest predictor of readmission was the presence of a chronic disease diagnosis, but alongside this, they found that BMI had a non-linear relationship with readmission, with a higher risk in those underweight and obese; 72% and 50% of each category respectively were readmitted compared to 27% of those with normal weight and 37% of those classed as overweight. Depressive symptoms were also associated with a higher risk of readmission (47% readmitted). Age, sex, number of previous admissions, and discharge support were not significantly influential.

"Patients with multiple recent readmissions may have a unique risk factor profile, and may be a group which may particularly benefit from complex interventions, but no previous study has specifically examined risk factors in this high risk group," said Mudge. "We sought to look specifically at health factors which we know are under-recognized in hospitals and primary care, and this showed that poor nutrition and depression are associated with higher health care use in this vulnerable subgroup.

"We hope this study might increase awareness of poor nutrition and depression as importance concurrent factors in medical illness, and encourage research into improving nutritional and depression management in medically ill patients."

Jennifer Beal | EurekAlert!
Further information:

More articles from Studies and Analyses:

nachricht Diagnoses: When Are Several Opinions Better Than One?
19.07.2016 | Max-Planck-Institut für Bildungsforschung

nachricht High in calories and low in nutrients when adolescents share pictures of food online
07.04.2016 | University of Gothenburg

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Etching Microstructures with Lasers

Ultrafast lasers have introduced new possibilities in engraving ultrafine structures, and scientists are now also investigating how to use them to etch microstructures into thin glass. There are possible applications in analytics (lab on a chip) and especially in electronics and the consumer sector, where great interest has been shown.

This new method was born of a surprising phenomenon: irradiating glass in a particular way with an ultrafast laser has the effect of making the glass up to a...

Im Focus: Light-driven atomic rotations excite magnetic waves

Terahertz excitation of selected crystal vibrations leads to an effective magnetic field that drives coherent spin motion

Controlling functional properties by light is one of the grand goals in modern condensed matter physics and materials science. A new study now demonstrates how...

Im Focus: New 3-D wiring technique brings scalable quantum computers closer to reality

Researchers from the Institute for Quantum Computing (IQC) at the University of Waterloo led the development of a new extensible wiring technique capable of controlling superconducting quantum bits, representing a significant step towards to the realization of a scalable quantum computer.

"The quantum socket is a wiring method that uses three-dimensional wires based on spring-loaded pins to address individual qubits," said Jeremy Béjanin, a PhD...

Im Focus: Scientists develop a semiconductor nanocomposite material that moves in response to light

In a paper in Scientific Reports, a research team at Worcester Polytechnic Institute describes a novel light-activated phenomenon that could become the basis for applications as diverse as microscopic robotic grippers and more efficient solar cells.

A research team at Worcester Polytechnic Institute (WPI) has developed a revolutionary, light-activated semiconductor nanocomposite material that can be used...

Im Focus: Diamonds aren't forever: Sandia, Harvard team create first quantum computer bridge

By forcefully embedding two silicon atoms in a diamond matrix, Sandia researchers have demonstrated for the first time on a single chip all the components needed to create a quantum bridge to link quantum computers together.

"People have already built small quantum computers," says Sandia researcher Ryan Camacho. "Maybe the first useful one won't be a single giant quantum computer...

All Focus news of the innovation-report >>>



Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

Agricultural Trade Developments and Potentials in Central Asia and the South Caucasus

14.10.2016 | Event News

World Health Summit – Day Three: A Call to Action

12.10.2016 | Event News

Latest News

How nanoscience will improve our health and lives in the coming years

27.10.2016 | Materials Sciences

OU-led team discovers rare, newborn tri-star system using ALMA

27.10.2016 | Physics and Astronomy

'Neighbor maps' reveal the genome's 3-D shape

27.10.2016 | Life Sciences

More VideoLinks >>>