CDC COVID-19 Response Team.
MMWR Morb Mortal Wkly Rep. 2020 Nov 13;69(45):1695-1699. doi: 10.15585/mmwr.mm6945e2.
Coronavirus disease 2019 (COVID-19) is a complex clinical illness with potential complications that might require ongoing clinical care (1-3). Few studies have investigated discharge patterns and hospital readmissions among large groups of patients after an initial COVID-19 hospitalization (4-7). Using electronic health record and administrative data from the Premier Healthcare Database,* CDC assessed patterns of hospital discharge, readmission, and demographic and clinical characteristics associated with hospital readmission after a patient's initial COVID-19 hospitalization (index hospitalization). Among 126,137 unique patients with an index COVID-19 admission during March-July 2020, 15% died during the index hospitalization. Among the 106,543 (85%) surviving patients, 9% (9,504) were readmitted to the same hospital within 2 months of discharge through August 2020. More than a single readmission occurred among 1.6% of patients discharged after the index hospitalization. Readmissions occurred more often among patients discharged to a skilled nursing facility (SNF) (15%) or those needing home health care (12%) than among patients discharged to home or self-care (7%). The odds of hospital readmission increased with age among persons aged ≥65 years, presence of certain chronic conditions, hospitalization within the 3 months preceding the index hospitalization, and if discharge from the index hospitalization was to a SNF or to home with health care assistance. These results support recent analyses that found chronic conditions to be significantly associated with hospital readmission (6,7) and could be explained by the complications of underlying conditions in the presence of COVID-19 (8), COVID-19 sequelae (3), or indirect effects of the COVID-19 pandemic (9). Understanding the frequency of, and risk factors for, readmission can inform clinical practice, discharge disposition decisions, and public health priorities such as health care planning to ensure availability of resources needed for acute and follow-up care of COVID-19 patients. With the recent increases in cases nationwide, hospital planning can account for these increasing numbers along with the potential for at least 9% of patients to be readmitted, requiring additional beds and resources.
新型冠状病毒病 2019（COVID-19）是一种具有潜在并发症的复杂临床疾病，可能需要持续的临床护理。（1-3）。很少有研究调查过大量患者在首次 COVID-19 住院后的出院模式和医院再入院情况。（4-7）。CDC 使用来自 Premier Healthcare Database 的电子健康记录和管理数据，评估了患者首次 COVID-19 住院（索引住院）后出院、再入院以及与再入院相关的人口统计学和临床特征模式。在 2020 年 3 月至 7 月期间有 126,137 例独特的 COVID-19 入院索引患者中，15%在索引住院期间死亡。在 106,543 名（85%）幸存患者中，9%（9,504 人）在 2020 年 8 月前出院后 2 个月内再次入住同一医院。在出院后的患者中，超过 1.6%的患者发生了不止一次再入院。与出院后居家或自我护理（7%）的患者相比，出院至熟练护理机构（SNF）（15%）或需要家庭保健的患者（12%）再入院的可能性更高。年龄在 65 岁及以上的人群、在索引住院前 3 个月内住院、以及从索引住院出院至 SNF 或有医疗保健协助的家庭的人群，其再入院的几率随着年龄的增长而增加。这些结果支持了最近的分析，这些分析发现慢性疾病与医院再入院显著相关（6、7），这可能是由于 COVID-19 存在基础疾病的并发症（8）、COVID-19 后遗症（3）或 COVID-19 大流行的间接影响（9）。了解再入院的频率和危险因素可以为临床实践、出院处置决策以及公共卫生重点提供信息，例如医疗保健规划，以确保 COVID-19 患者的急性和后续护理所需资源的可用性。随着全国病例的最近增加，医院规划可以考虑到这些不断增加的数字，以及至少 9%的患者可能需要再次入院的可能性，这需要额外的床位和资源。
