Allaudeen et al identified factors associated with hospital readmission for patients discharged from a general medical service. These factors can help to identify a patient who may require more aggressive management and follow-up. The authors are from the Veterans Affairs Healthcare System in Palo Alto and the University of California San Francisco.
Patient selection: adult general medical service
Endpoint: 30-day readmission rate
Rate of endpoint: 17%
Predictors of readmission following hospital discharge:
(1) Black race
(2) therapy with narcotics during inpatient stay
(3) therapy with corticosteroids during inpatient stay
(4) cancer
(5) renal failure
(6) congestive heart failure
(7) weight loss
(8) deficiency anemia
All of the odds ratios were less than 2. This means that multiple risk factors need to be present to identify a patient at risk.
Conditions associated with a lower rate of readmission to the general medicine service:
(1) not Medicare or Medicaid
(2) disposition other than to home or a skilled nursing facility (? transfer to another hospital)
(3) anticholinergic therapy during hospital stay
(4) neurologic disorder (a readmission might be to a separate neurology service)
Limitations:
• Patients readmitted to a different hospital or service would have been missed in the study.
• The severity of heart and other organ failures would impact hospital readmission rates.
