Patient Reports of Night Noise in Hospitals Are Associated With Unplanned Readmissions Among Older Adults.

OBJECTIVE

Sleep disturbance is a key contributor to posthospital syndrome; a transient period of vulnerability following discharge from hospital. We sought to examine the relationship between patient-reported hospital quietness at night, via a validated survey, and unplanned hospital readmissions among hospitalized seniors (ages 65 and older) in Alberta, Canada.

DESIGN

Retrospective, cross-sectional analysis of survey responses, linked with administrative inpatient records.

SETTING

Using the Canadian Patient Experiences Survey-Inpatient Care and Discharge Abstract Database, patients aged 65 and older, and living with one or more chronic conditions were identified.

PARTICIPANTS

Of all, 25 674 respondents discharged from hospital between April 2014 and December 2017.

MAIN OUTCOME MEASURE

All-cause, unplanned readmission within 30 or 90 days (yes vs no).

RESULTS

Approximately half (50.5%) of the respondents reported that the area around their room was always quiet at night. Eight (8.1%) percent of respondents (2066) were readmitted within 30 days (2241 total readmissions), while 15.6% (4000) were readmitted within 90 days (5070 total readmissions). When controlling for a variety of demographic and clinical factors, patients not reporting "always" to the survey question regarding hospital quietness at night had slightly greater odds of readmission within 30 (adjusted odds ratio [aOR] = 1.32, 95% confidence interval [CI]: 1.20-1.45) and 90 days (aOR = 1.14, 95% CI: 1.06-1.23).

CONCLUSION

Our results demonstrate a clear association between patient-reported hospital quietness at night and subsequent readmission within the first 30 and 90 days following discharge. Efforts to minimize hospital noise, particularly at night, may help promote a restful environment, while reducing readmissions among older patients living with chronic conditions.