title: A ten-year retrospective study of unplanned hospital readmissions to a regional Australian hospital.
abstract: OBJECTIVE
  To examine the trend in unplanned readmissions (URs) to Dubbo Base Hospital (DBH) over the period 1996-2005 and assess possible correlations with basic demographic data.
  
  
  RESULTS
  URs increased over the study period, both as a total number and as a proportion of total admissions (from 4.7 to 5.4%), while average length of stay decreased from 5.3 to 4.4 days and available hospital beds decreased from 156 to 116. The proportion of URs for people aged 75 years has more than doubled over the same period. There were clear temporal variations in URs (greatest number occurring on Fridays and in late winter/early spring) and variations with age and gender (greatest number in young males; peaks for males in 0-10 and 71-80-year deciles and for females in 0-10, 21-30 and 71-80 year deciles). Fifty percent of URs occurred within 7 days of discharge. There was a statistically significant but small correlation between length of prior admission and time to readmission (Spearman correlation coefficient, 0.068; P < 0.01) although the time to readmission did not change over the study period. Chronic obstructive pulmonary disease (3.8%), complications of procedures (3.6%), heart failure and pneumonia (each 2.2%), angina (2.1%) and acute bronchiolitis (1.8%) were the top causes of URs.
  
  
  CONCLUSIONS
  URs are becoming more frequent in DBH; analysis of associations and trends over time are the first step in determining targeted measures to address the problem.
authors.affiliation: School of Rural Health, PO Box 1043, Dubbo, NSW 2830, Australia. rmclean@med.usyd.edu.au
authors.forename: Rick
authors.initials: R
authors.lastname: McLean
authors.forename: Kumara
authors.initials: K
authors.lastname: Mendis
authors.forename: Joe
authors.initials: J
authors.lastname: Canalese
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001509:Bed Occupancy / Q000706:statistics & numerical data / Q000639:trends; D002391:Catchment Area, Health / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006779:Hospitals, Public / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data / Q000639:trends; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D010359:Patient Readmission / Q000706:statistics & numerical data / Q000639:trends*; D010507:Periodicity; D012189:Retrospective Studies; D017678:Sex Distribution; D013997:Time Factors; D014600:Utilization Review