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30-day potentially preventable hospital readmissions in older patients: Clinical phenotype and healthcare related risk factors

Clinical Interventions in Aging Nov 11, 2019

Calsolaro V, Antognoli R, Pasqualetti G, et al. - Researchers analyzed a cohort of older patients to assess the potential for preventing 30-day hospital readmission as well as to determine likely risk factors for readmission, given that in-hospital and post-discharge quality of care is indicated by early readmission rate and it is important to assess the contributing factors in order to optimize the healthcare and target the intervention. For patients consecutively admitted to the Geriatrics Unit for acute disease within a 1-year window, diagnosis-Related Group (DRG) codes were recorded and grouped as stand-alone admissions (SA), index admissions (IA) and potentially preventable readmissions (PPR) within a time window of 30 days post-discharge. They observed a nonlinear U-shaped readmission trend (with nadir at 5 days of hospitalization) in acute heart failure. An increase in the PPR rate with increasing length of hospitalization was reported in all the other DRG codes. SA vs IA patients exhibited a significantly lower degree of disability and comorbidity on comprehensive geriatric assessment. Experts concluded the importance of addressing PPR, particularly in older patients. In order to decrease PPR, it is important to ensure the sufficiency of treatment during hospitalization (particularly in cases of sepsis) and the setting of a comprehensive discharge plan, accounting for comorbidity and disability of the patients.
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