Risk factors for hospital readmission among Swedish older adults

Abstract

IntroductionHospital readmissions of older persons are common and often associated with complex health problems. The objectives were to analyze risk factors for readmission within 30 days from hospital discharge.MethodsA prospective study with a multifactorial approach based on the population-based longitudinal Swedish Adoption/Twin Study of Aging (SATSA) was conducted. During 9 years of follow-up, information on hospitalizations, readmissions and associated diagnoses were obtained from national registers. Logistic regression models controlling for age and sex were conducted to analyze risk factors for readmissions.ResultsOf the 772 participants, [mean age 69.7 (± 11.1), 84 (63%)] were hospitalized and among these 208 (43%) had one or several readmissions within 30 days during the follow-up period. Most of the readmissions (57%) occurred within the first week; mean days from hospital discharge to readmission was 7.9 (± 6.2). The most common causes of admission and readmission were cardiovascular diseases and tumors. Only 8% of the readmissions were regarded as avoidable admissions. In a multivariate logistic regression, falling within the last 12 months (OR 0.57, p = 0.039) and being a male (OR 1.84, p = 0.006) increased the risk of readmission.ConclusionsMost older persons that are readmitted return to hospital within the first week after discharge. Experiencing a fall was a particular risk factor of readmission. Preventive actions should preferably take place already at the hospital to reduce the numbers of readmission. Still, it should be remembered that most readmissions were considered to be necessary.

Readmission within three months after inpatient geriatric care—Incidence, diagnosis and associated factors in a Swedish cohort

“…Norton score, risk to develop pressure ulcer, and MNA score, risk for malnutrition during index admission and a possible indicator of frailty, came out as significant for some of the time intervals studied; Norton was positively associated with readmission during days 11-30 and with risk of several admissions, and risk of malnutrition was positively associated with readmission during days 31-90. Fall risk (Downton, present in 86% of the study population) was not associated with risk of readmission, which contradicts previous research [8,22], although a meta-analysis has pointed to the ambivalence of using fall risk tools for prediction as correct useability is highly dependent on study design [44]. In a sensitivity analysis, the three risk screening factors were modeled as continuous variables instead of being dichotomized as in the original analysis, with similar results regarding the statistical association with outcomes.…”

Medication-related hospital admissions and readmissions in older patients: an overview of literature

“…Other risk factors which are associated with a higher readmission rate are low adherence, experiencing a fall in the last 12 months, weight loss and medical error due to discontinuity of care from inpatient to outpatient setting [42][43][44][45]. Table 1 shows the different published risk factors.…”

Exploring views and experiences of how infections are detected and managed in practice by nurses, care workers and manager’s in nursing homes in England and Sweden: a survey protocol

“…Evidence suggests that DSTs provide an opportunity to support a consistent approach to early detection of infection, enabling prompt action and treatment, thus avoiding emergency hospital admissions. 9 14 Improving early detection of infection could minimise distress experienced by nursing home residents and their relatives when they are moved to an unfamiliar environment, avoiding associated complications, increased mortality and extended length of stay, 8 17 and help mitigate the spread of COVID-19 during the current pandemic. 18…”

“…Open access mortality and extended length of stay. [4][5][6][7][8][9] Unplanned hospital admissions account for more than one-third of all annual hospital admissions, and cost the National Health Service (NHS) in the UK over £11 billion each year. 6 Unplanned hospital admissions cost the NHS >£11 billion, the US healthcare economy >$1.1 trillion a year 10 and the Swedish healthcare system >SEK 36 trillion a year for people aged >65 years.…”