title: Is pain at discharge a risk factor for unplanned hospital readmission?
abstract: BACKGROUND
  Unplanned readmissions are associated with a high cost to health insurances and the incidence of preventable readmissions could be considered as a quality indicator for the initial hospital admission. We aimed to assess the predictive value for unplanned readmission of higher pain scores at discharge of the initial admission as well as of other pain and demographic characteristics. The documentation of significant associations would provide further support for a structured pain management policy.
  
  
  METHODS
  A retrospective analysis of a large single university hospital data-set of 33.122 admissions within a 13-month period allowed for the assessment of the predictive relationship of pain toward unplanned readmission at 7 and at 30 days after discharge through logistic regression, and of other characteristics through linear regression.
  
  
  RESULTS
  Pain scores at discharge of the initial admission were not significantly different (p > 0.05) with or without unplanned readmission and hence have no predictive value on the individual patient level. The prediction of the number of patients for each group, for example the number of patients that will be readmitted (size of the group), shows significance for pain at the moment of discharge (p_initial = 0.000), pain medication (p = 0.0044), and age (p = 0.0017). Pathology (p = 0.6151) and gender (p = 0.7029) have no significant predictive value.
  
  
  CONCLUSIONS
  Pain as dichotomous variable upon discharge cannot be used as single risk predictor for unplanned readmission. However, the pain score at discharge in combination with the use of pain medication and age is a risk factor for the number of short-term unplanned readmissions.
authors.affiliation: a Ghent University Hospital, (Strategic) Policy Cell , Ghent , Belgium.
authors.forename: Mieke
authors.initials: M
authors.lastname: Deschepper
authors.affiliation: b Department of General Internal Medicine , Ghent University Hospital , Ghent , Belgium.|d Faculty of Medicine and Health Sciences, Department of Internal Medicine , Ghent University , Ghent , Belgium.
authors.forename: Peter
authors.initials: P
authors.lastname: Vermeir
authors.affiliation: b Department of General Internal Medicine , Ghent University Hospital , Ghent , Belgium.|d Faculty of Medicine and Health Sciences, Department of Internal Medicine , Ghent University , Ghent , Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: Vogelaers
authors.affiliation: c Ghent University Hospital, Centre Multidisciplinary Pain , Ghent , Belgium.|e Faculty of Medicine and Health Sciences, Department of Anaesthesiology and Perioperative Medicine , Ghent University , Ghent , Belgium.
authors.forename: Jacques
authors.initials: J
authors.lastname: Devulder
authors.affiliation: a Ghent University Hospital, (Strategic) Policy Cell , Ghent , Belgium.|f Faculty of Medicine and Health Sciences, Department of Public Health , Ghent University , Ghent , Belgium.
authors.forename: Kristof
authors.initials: K
authors.lastname: Eeckloo
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain; D010351:Patient Discharge; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012189:Retrospective Studies
keywords: Hospital readmissions; Pain; Patient safety; Quality indicators