Internal medicine journal | 2021
All-Cause Unplanned Readmissions in the United States. Insights from the Nationwide Readmission Database.
Abstract
BACKGROUND\nThere are few studies looking into adult, all-cause and age-group-specific unplanned readmissions. The predictors of such unplanned readmissions for all inpatient encounters remain obscure.\n\n\nAIMS\nThe aim of this study was to describe the incidence and factors associated with unplanned readmissions in all inpatient encounters in the United States.\n\n\nMETHODS\nU.S. Nationwide Readmission Database (NRD) is a representative sample of hospitalizations in the US (from about 28 states) accounting for about 60% of the US population. All inpatient encounters during Jan-Nov 2017 in the NRD were evaluated for the rates, predictors, and costs of unplanned 30\u2009days readmissions for age groups 18-44\u2009years; 45-64\u2009years; 65-75\u2009years and 75 and above. Elective readmissions and those patients who died on their index hospitalizations were excluded. Weighted analysis was performed to obtain nationally representative data.\n\n\nRESULTS\nWe identified 28,942,224 inpatients encounters with a total of 3051189 (10.5%) unplanned readmissions within 30\u2009days. Age group 18-44\u2009years, 45-64\u2009years, 65 to 74\u2009years and age over 75\u2009years had 7.0%, 12.0%, 11.7%, and 12.3% readmissions respectively. Female gender, private insurance and elective admissions were negative predictors for readmissions. For age group 18-44\u2009years schizophrenia and diabetes mellitus complications, while in all older age groups septicemia and heart failure were the most frequent primary diagnosis for readmissions.\n\n\nCONCLUSIONS\nThirty-day unplanned readmissions are common in patients over age 45\u2009years leading to significant morbidity. Effective strategies for reducing unplanned readmission may help to improve quality of care, outcomes, and higher value care. This article is protected by copyright. All rights reserved.