title: Risk factors for unplanned hospital re-admissions: a secondary data analysis of hospital discharge summaries.
abstract: OBJECTIVE
  To identify patient groups at risk for unplanned hospital re-admissions and risk factors for re-admission.
  
  
  METHODS
  We analysed the Belgian Hospital Discharge Dataset including data from 1 130 491 patients discharged in 2008. Patient and hospital factors contributing to re-admission rate were analysed using a multivariable model for logistic regression.
  
  
  RESULTS
  The overall unplanned re-admission rate was 5.2%. Cardiovascular and pulmonary diagnoses were the most common reasons for re-admission. We found that 10.4% of all re-admissions were due to complications. A high number of previous emergency department (ED) visits proved to be a predictor for re-admission [odds ratio (OR) for patients with at least four ED visits in the past 6 months 4.65; 95% confidence interval (CI) 4.25-5.08]. Patients discharged on Friday (OR 1.05; 95% CI 1.01-1.08) and patients with a long length of stay (OR 1.19; 95% CI 1.15-1.23) also had a higher risk for re-admission. Patients with short lengths of stay were not at risk for re-admission (OR 0.99; 95% CI 0.95-1.02).
  
  
  CONCLUSIONS
  Actions to reduce re-admissions can be targeted to patient groups at risk, and should be aimed at the caring for chronic cardiovascular or pulmonary diseases, preventing complications and multiple ED visits, and ensuring continuity of care after discharge, especially for patients discharged on Friday.
authors.affiliation: Department of Public Health and Primary Care, KU Leuven-University of Leuven, Leuven, Belgium.|Medical Department, az Sint-Blasius, Dendermonde, Belgium.
authors.forename: Anja
authors.initials: A
authors.lastname: Braet
authors.affiliation: Flemish Hospital Network, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
authors.forename: Caroline
authors.initials: C
authors.lastname: Weltens
authors.affiliation: Public Health, KU Leuven-University of Leuven, Leuven, Belgium.
authors.forename: Walter
authors.initials: W
authors.lastname: Sermeus
authors.affiliation: Public Health, KU Leuven-University of Leuven, Leuven, Belgium.
authors.forename: Arthur
authors.initials: A
authors.lastname: Vleugels
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium; D059019:Clinical Coding; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003953:Diagnosis-Related Groups; D005260:Female; D006302:Health Services Research; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D010359:Patient Readmission; D012307:Risk Factors; D012720:Severity of Illness Index
keywords: care transition; continuity of care; discharge; hospital re-admission; logistic regression; quality of care