title: Prevalence and temporal pattern of hospital readmissions for patients with type I and type II diabetes.
abstract: OBJECTIVE
  Repeated hospitalisation for patients is common and costly, yet partly preventable. However, we know little about readmissions for patients with diabetes in China. The current study aims to assess the frequency and temporal pattern of and risk factors for all-cause readmission among hospitalised patients with diabetes in Tianjin, China.
  
  
  METHODS
  This retrospective, cohort analysis used the Tianjin Basic Medical Insurance Register System data of 2011. The patterns of and the reasons for all-cause readmissions for patients with diabetes were described. The differences of readmission-free survival (RFS) between newly and previously diagnosed patients were compared. Time-dependent Cox models were established to identify the risk factors for readmission at different time intervals after discharge.
  
  
  RESULTS
  Readmission rates were approximately 30%, with the most common diagnoses of cerebral infarction (for type I) or diabetes (for type II) for patients with diabetes. The majority of patients were readmitted to the hospital after more than 90 days, followed by 8-30 days (all p=0.002). Approximately 37.2% and 42.8% of readmitted patients with type I and type II diabetes were diagnosed previously, and the RFS rates for previously diagnosed patients were significantly lower than for newly diagnosed patients at any time interval after discharge. Prior history of diabetes (all p<0.05), length of stay (all p<0.01) and reimbursement ratio (90% vs >92%, all p<0.0002) were consistently associated with the RFS for patients readmitted to the hospital at <7, 8-30, 31-60 and 61-90 days.
  
  
  CONCLUSIONS
  Hospital readmissions among patients with diabetes were affected by the diagnosis status. Patient characteristics and the quality of healthcare might regulate short-interval and long-interval hospital readmission, respectively, after discharge.
authors.affiliation: College of Public Health, Tianjin Medical University, Tianjin, China.
authors.forename: Xiaoqian
authors.initials: X
authors.lastname: Liu
authors.affiliation: College of Public Health, Tianjin Medical University, Tianjin, China.
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Division of General Internal Medicine, Tianjin Hospital, Tianjin, China.
authors.forename: Yuanjun
authors.initials: Y
authors.lastname: Lv
authors.affiliation: College of Public Health, Tianjin Medical University, Tianjin, China.
authors.forename: Changping
authors.initials: C
authors.lastname: Li
authors.affiliation: College of Public Health, Tianjin Medical University, Tianjin, China.
authors.forename: Zhuang
authors.initials: Z
authors.lastname: Cui
authors.affiliation: College of Public Health, Tianjin Medical University, Tianjin, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Ma
mesh_terms: D000368:Aged; D020520:Brain Infarction / Q000175:diagnosis; D002681:China / Q000453:epidemiology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000401:mortality; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000401:mortality; D003925:Diabetic Angiopathies / Q000175:diagnosis; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D015995:Prevalence; D016016:Proportional Hazards Models; D011787:Quality of Health Care; D012189:Retrospective Studies; D013997:Time Factors
keywords: hospital readmission