Abstract
BackgroundPulmonary diseases are a common and costly cause of 30-day readmissions. Few studies have focused on the difference in risk for rehospitalization between men and women in older patients. In this study we analyzed the association between sex and the risk of readmission in a cohort of patients admitted to the hospital for chronic obstructive pulmonary disease (COPD) exacerbation and other major pulmonary diseases.MethodsThis was a retrospective cohort study based on administrative data collected in the Veneto Region in 2016. We included 14,869 hospital admissions among residents aged ≥65 years for diagnosis related groups (DRGs) of the most common disorders of the respiratory system: bronchitis and asthma, pneumonia, pulmonary edema, respiratory failure, and COPD. Multilevel logistic regressions were performed to test the association between 30-day hospital readmission and sex, adjusting for confounding factors.ResultsFor bronchitis and asthma, male patients had significantly higher odds of 30-day readmission than female patients (adjusted odds ratio (aOR), 2.07; 95% confidence interval (CI), 1.11–3.87). The odds of readmission for men were also significantly higher for pneumonia (aOR, 1.40; 95% CI, 1.13–1.72), for pulmonary edema and respiratory failure (aOR, 1.28; 95% CI, 1.05–1.55), and for COPD (aOR, 1.34; 95% CI, 1.00–1.81).ConclusionsThis study found that male sex is a major risk factors for readmission in patients aged more than 65 years with a primary pulmonary diagnosis. More studies are needed to understand the underlying determinants of this phenomena and to provide targets for future interventions.
Highlights
Pulmonary diseases are a common and costly cause of 30-day readmissions
Male patients showed twofold higher odds of being readmitted than female patients
Significant associations with sex emerged for pneumonia, for pulmonary edema and respiratory failure and for chronic obstructive pulmonary disease (COPD)
Summary
Pulmonary diseases are a common and costly cause of 30-day readmissions. Few studies have focused on the difference in risk for rehospitalization between men and women in older patients. In this study we analyzed the association between sex and the risk of readmission in a cohort of patients admitted to the hospital for chronic obstructive pulmonary disease (COPD) exacerbation and other major pulmonary diseases. Countries with developed healthcare systems are working to reduce unnecessary hospital readmissions to reach the triple aim of reducing costs, improving patient satisfaction, and improving health. Readmissions impact both health and satisfaction of patients, as multiple hospitalizations of subjects with chronic comorbidities are associated with emotional distress, loss of function, nosocomial infections, and increased mortality [1]. While several studies have analyzed the risk factors for rehospitalization in patients with pulmonary disease, few have focused on the difference in risk between men and women. The ultimate goal is to use this information to help tailor a discharge program to prevent readmission and waste in resource use
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