Multiple risk factors for unplanned readmissions within 1 month of hospital discharge in acute care hospitals in Japan

Abstract

Aim

The aim of this study is to analyse the risk factors for unplanned readmissions within 1 month after hospital discharge to develop a seamless support system from discharge to home care.

Background

With shorter hospital stay lengths, understanding the characteristics of patients with multiple risk factors is important to prevent rehospitalization.

Design

This is a single-centre retrospective descriptive study.

Methods

Logistic regression and decision tree analyses were performed using eight items from the records of 3117 patients discharged from a university hospital between April–September 2017 as risk factors.

Results

Unplanned readmission risk was significantly associated with emergency hospitalization (odds ratio [OR]: 3.12, 95% confidence interval [CI]: 2.04–4.77), malignancy (OR: 2.16, 95% CI: 1.44–3.24), non-surgical admission (OR: 1.76, 95% CI: 1.07–2.88), hospital stay of ≥ 15 days (OR: 1.66, 95% CI: 1.14–2.43) and decline in activities of daily living owing to hospitalization (OR: 1.68, 95% CI: 1.06–2.64). The highest risk combinations for rehospitalization were as follows: emergency hospitalization and malignancy; emergency admission, non-malignancy and a hospital stay of ≥15 days; and scheduled hospitalization, no surgery and a hospital stay of ≥15 days.

Conclusions

Patients with multiple risks for unplanned readmission should be accurately screened and provided with optimal home care.