Predicting non-elective hospital readmissions: a multi-site study. Department of Veterans Affairs Cooperative Study Group on Primary Care and Readmissions.
OBJECTIVE
To determine clinical and patient-centered factors predicting non-elective hospital readmissions.


METHODS
Secondary analysis from a randomized clinical trial.


METHODS
Nine VA medical centers.


METHODS
Patients discharged from the medical service with diabetes mellitus, congestive heart failure, and/or chronic obstructive pulmonary disease (COPD).


METHODS
Non-elective readmission within 90 days.


RESULTS
Of 1378 patients discharged, 23.3% were readmitted. After controlling for hospital and intervention status, risk of readmission was increased if the patient had more hospitalizations and emergency room visits in the prior 6 months, higher blood urea nitrogen, lower mental health function, a diagnosis of COPD, and increased satisfaction with access to emergency care assessed on the index hospitalization.


CONCLUSIONS
Both clinical and patient-centered factors identifiable at discharge are related to non-elective readmission. These factors identify high-risk patients and provide guidance for future interventions. The relationship of patient satisfaction measures to readmission deserves further study.
Smith
D M
DM
Richard L. Roudebush Veterans Affairs Medical Center (11H), 1481 W. Tenth St., Indianapolis, IN 46202, USA. david@hsrd.va.iupui.edu
Giobbie-Hurder
A
A
Weinberger
M
M
Oddone
E Z
EZ
Henderson
W G
WG
Asch
D A
DA
Ashton
C M
CM
Feussner
J R
JR
Ginier
P
P
Huey
J M
JM
Hynes
D M
DM
Loo
L
L
Mengel
C E
CE
D003920:Diabetes Mellitus; D006297:Health Services Accessibility; D006333:Heart Failure; D006801:Humans; D008173:Lung Diseases, Obstructive; D015999:Multivariate Analysis; D010359:Patient Readmission / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D011788:Quality of Life; D012307:Risk Factors; D014481:United States