5 Risk Factors For Unplanned Readmissions Identified
By Christine Kern, contributing writer
Hospitals should target patients with chronic cardiovascular or pulmonary diseases.
A study published by the Journal of Evaluation in Clinical Practice has identified five factors that indicate high risk for unplanned hospital readmissions. The study, Risk Factors For Unplanned Hospital Re-admissions: A Secondary Data Analysis of Hospital Discharge Summaries, found an overall unplanned readmission rate of 5.2 percent in its analysis of the Be lgian Hospital Discharge Dataset of patients discharged in 2008. The study authors conclude hospitals need to target patients with five specific factors to forestall unplanned readmissions.
These factors included patients with chronic cardiovascular or pulmonary diseases, which were the most common reasons the study found for readmission. Other high risk factors included multiple Emergency Department visits over the past six months; a Friday discharge date; and prolonged length of hospital stay. The odds ratio for patients with at least four ED visits in the past six months was 4.65, according to the study, which also found patients with short hospital stays were not at risk for re-admission.
The research demonstrated clinicians must work with caregivers and primary care physicians to coordinate a smoother transition from hospital to home, especially for patients discharged on Friday to reduce unplanned readmissions. The study was focused on urgent unplanned readmissions of patients within 30 days of discharge, who were readmitted to the same hospital as treatment.
In 2004, the study noted, nearly twenty percent of U.S. Medicare patients were readmitted within the study’s benchmark of 30 days of discharge, totaling $17.4 billion in healthcare costs.
A 2013 study, Identifying Patients at Increased Risk for Unplanned Readmission, also found the Rothman Index can be quite useful in assessing the risks of unplanned readmissions in hospital patients. The Rothman Index is a composite measure updated regularly from EMR data based on changes in vital signs, nursing assessments, Braden scores, cardiac rhythms, and lab test results.
According to this study, the risk of readmission for patients in the highest risk category (with RI lower than 70) was more than 20 percent, while the risk of readmission for patients in the lowest risk categories was approximately 10 percent, thus indicating that clinicians can use the RI to help target the potential for patients who are at risk of unplanned readmission.