Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
Region Stockholm, FOU nu, Research and Development Center for the Elderly, Stockholm, Sweden.
PLoS One. 2021 Mar 22;16(3):e0248972. doi: 10.1371/journal.pone.0248972. eCollection 2021.
Readmissions are very costly, in monetary terms but also for the individual patient's safety and health. Only by understanding the reasons and drivers of readmissions, it is possible to ensure quality of care and improve the situation. The aim of this study was to assess inpatient readmissions during the first three months after discharge from geriatric inpatient care regarding main diagnosis and frequency of readmission. Furthermore, the aim was to analyze association between readmission and patient characteristics including demography and socioeconomics, morbidity, physical function, risk screening and care process respectively.
The study includes all individuals admitted for inpatient care at three geriatric departments operated by the Stockholm region during 2016. Readmission after discharge was studied within three different time intervals; readmission within 10 days after discharge, within 11-30 days and within 31-90 days, respectively. Main diagnosis at readmission was assessed.
One fourth of the individuals discharged from inpatient geriatric care was readmitted during the first three months after discharge. The most common main diagnoses for readmission were heart failure, chronic obstructive pulmonary disease and pneumonia. Statistically significant risk factors for readmission included age, sex, number of diagnoses at discharge, and to some extent polypharmacy and destination of discharge.
Several clinical risk factors relating to physical performance and vulnerability were associated with risk of readmission. Socioeconomic information did not add to the predictability. To enable reductions in readmission rates, proactive monitoring of frail individuals afflicted with chronic conditions is necessary, and an integrated perspective including all stakeholders involved is crucial.
再入院的费用非常高，不仅涉及经济方面，还涉及患者个人的安全和健康。只有了解再入院的原因和驱动因素，才能确保医疗质量并改善这种情况。本研究旨在评估老年住院患者出院后三个月内的再入院情况，包括主要诊断和再入院频率。此外，还分析了再入院与患者特征（包括人口统计学和社会经济学、发病率、身体功能、风险筛查和护理过程）之间的关系。
该研究纳入了 2016 年在斯德哥尔摩地区三个老年病房住院的所有患者。在三个不同的时间间隔内研究了出院后的再入院情况，分别为出院后 10 天内、11-30 天内和 31-90 天内。评估了再入院时的主要诊断。
四分之一出院的老年住院患者在出院后的三个月内再次入院。再入院的主要诊断包括心力衰竭、慢性阻塞性肺疾病和肺炎。再入院的统计学显著风险因素包括年龄、性别、出院时的诊断数量，在一定程度上还包括多药治疗和出院去向。
与身体机能和脆弱性相关的几个临床风险因素与再入院风险相关。社会经济信息并没有增加可预测性。为了降低再入院率，需要对患有慢性病的虚弱个体进行积极的监测，并且需要包括所有相关利益相关者的综合视角。
