Unplanned Readmission within 28 Days of Hospital Discharge in a Longitudinal Population-Based Cohort of Older Australian Women.

Dinberu S Shebeshi,Xenia Dolja-Gore,Julie Byles

doi:10.3390/ijerph17093136

Dinberu S Shebeshi, Xenia Dolja-Gore + Show 1 more

Open Access

https://doi.org/10.3390/ijerph17093136

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Abstract

This study aimed to estimate the incidence of 28-day unplanned readmission among older women, and associated factors. Data were used from the 1921–1926 birth cohort of the Australian Longitudinal Study on Women’s Health. Linkage of self-reported survey data with the Admitted Patient Data Collection allowed the identification of hospital admissions for each woman and the corresponding baseline characteristics. The Cox proportional-hazards model was used to identify factors associated with time to unplanned readmission, using SAS software V 9.4. (SAS Institute, Cary, NC, USA). Of 2056 women with index unplanned admission, 363 (17.5%) were readmitted within 28 days of discharge, and of these 229 (11.14%) had unplanned readmission. Among women with unplanned readmission, 24% were for the same condition as for the index hospitalisation. Cardiovascular diseases were the main diagnoses for the index admission and readmission. Unplanned readmission risk was higher if not partnered (hazard ratio (HR) = 1.43, 95% confidence interval (CI): 1.05–1.95), of non-English speaking background (HR = 1.62%, 95% CI: 1.07–2.47), more than three days length of stay on index admission (HR = 1.41%, 95% CI: 1.04–1.90) and one or two of the assessed chronic diseases (HR = 1.68, 95% CI: 1.19–2.36). At least one in ten women had unplanned readmission at some time between ages 75–95 years. Women who are not partnered, not of English-speaking background, with longer hospital stay and those with multi-morbidity, may need further efforts during their stay and on discharge to mitigate unplanned readmission.

Highlights

In Australia, older people account for a high proportion of hospital users
Unplanned readmission risk was higher if not partnered (hazard ratio (HR) = 1.43, 95% confidence interval (CI): 1.05–1.95), of non-English speaking background (HR = 1.62%, 95% CI: 1.07–2.47), more than three days length of stay on index admission (HR = 1.41%, 95% CI: 1.04–1.90) and one or two of the assessed chronic diseases (HR = 1.68, 95% CI: 1.19–2.36)
The the women had an average age of 82.1 years with a standard deviation of 3.96 years (Table 1)

Summary

Introduction

In Australia, older people account for a high proportion of hospital users. In 2016–2017, 42% of separations and 48% of patient days were for people aged 65 and over [1]. Older patients are most likely to have rapid return or readmission within a few days of hospital discharge [2]. Unplanned readmissions may be associated with hospitalisation-acquired complications, higher use of hospital and community healthcare resources, and faster functional decline [3]. Unplanned readmission is an additional health burden and costly for older populations, and a challenge for healthy ageing. A significant proportion of readmission would be avoidable and potentially preventable, through identifying patients at greatest risk of readmission, and providing focussed attention on their needs during their admission and on discharge [4]

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