Analysis of Risk Factors on Readmission Cases of COVID-19 in the Republic of Korea: Using Nationwide Health Claims Data.

Woo-Hwi Jeon,So-Youn Park,Jeong Yeon Seon,In-Hwan Oh

doi:10.3390/ijerph17165844

Abstract

In South Korea, 4.5% patients of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were readmitted to hospitals after discharge. However, there is insufficient research on risk factors for readmission and management of patients after discharge is poor. In this study, 7590 confirmed coronavirus disease (COVID-19) patients were defined as a target for analysis using nationwide medical claims data. The demographic characteristics, underlying diseases, and the use of medical resources were used to examine the association with readmission through the chi-square test and then logistic regression analysis was performed to analyze factors affecting readmission. Of the 7590 subjects analyzed, 328 patients were readmitted. The readmission rates of men, older age and patients with medical benefits showed a high risk of readmission. The Charlson Comorbidity Index score was also related to COVID-19 readmission. Concerning requiring medical attention, there was a higher risk of readmission for the patients with chest radiographs, computed tomography scans taken and lopinavir/ritonavir at the time of their first admission. Considering the risk factors presented in this study, classifying patients with a high risk of readmission and managing patients before and after discharge based on priority can make patient management and medical resource utilization more efficient. This study also indicates the importance of lifestyle management after discharge.

Highlights

The novel coronavirus disease (COVID-19), which originated in China in December 2019, had recorded 6,535,354 confirmed cases and 387,155 deaths globally as of 15 May, 2020 [1]
In order to examine the characteristics of the patients that can be correlated with COVID-19 readmission, chi-square test on readmission was conducted, and the results are as follows (Table 1): Gender, age, insurance eligibility, and the location of the medical institution, which were considered as demographic characteristics, were all associated with the readmission of COVID-19 patients
The results of logistic regression analysis on the COVID-19 readmission patients are as follows (Table 2): In terms of demographic characteristics, being male (Odds Ratio (OR): 1.340, 95% Confidence Interval (CI): 1.055, 1.706), being 65 years of age or older (OR: 2.235, 95% CI: 1.111–4.497), having medical benefits (OR: 2.757, 95% CI: 2.040–3.725), and living in Gyeongsangbuk-do (OR: 2.876, 95% CI: 2.144–3.857) were associated with a higher risk of readmission due to COVID-19

Summary

Introduction

The novel coronavirus disease (COVID-19), which originated in China in December 2019, had recorded 6,535,354 confirmed cases and 387,155 deaths globally as of 15 May, 2020 [1]. South Korea saw a decline in the number of confirmed cases from the peak of 595 new cases on March 1, but the number has been increasing recently, especially around the capital region [2]. Since COVID-19 currently has no vaccine or treatment and the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes the disease, shows different patterns from the previously known coronaviruses, researchers are trying to understand the detailed characteristics of the virus and the disease through epidemiological investigations and case studies of patients. With the number of cases of readmission increasing abroad, studies analyzing the clinical characteristics and risk factors of those patients have been carried out.

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