Healthcare News & Insights

Readmissions: Complex factors that cause them

New research says what many hospitals have likely suspected all along: A variety of factors influence whether a patient will be readmitted shortly after discharge, and they aren’t always related to the original reason for the patient’s first hospital stay. 

In a study published in the Journal of the American Medical Association Surgery (JAMA Surgery)78606060, researchers from the University of Washington Medical Center and Harborview Medical Center, both in Seattle, examined admissions data for surgical patients at a safety-net hospital over a one-year period.

According to an article in Reuters, the patients were in the hospital to receive general procedures, such as gallbladder removal or hernia repair. Of the patients who were unexpectedly readmitted within 30 days, only around 18% developed a preventable complication directly attributed to their surgeries.

The rest of the readmissions were caused by issues that were entirely unrelated to the procedures they received. Close to 17% of readmissions happened due to soft tissue infections on different areas of the body caused by patients’ abuse of injectable drugs.

An additional 15% were caused by socioeconomic issues such as being homeless or having trouble getting to follow-up appointments or receiving post-discharge phone calls. Thirteen percent of readmissions were due to infections patients had that weren’t detected during their initial admission, and 1% were admitted because of deterioration of existing medical conditions.

Riskiest categories

When examining the risk factors that contributed to patients being readmitted, they were also directly unrelated to the procedures patients received. Patients in the following categories were more likely to have an unexpected readmission to the hospital within 30 days:

  • women
  • diabetics
  • those admitted with sepsis
  • those who stayed in the intensive care unit
  • those who were discharged to respite care, and
  • those who received Medicare/Medicaid instead of private insurance.

Hospitals’ role

To some extent, post-surgical complications directly related to a patient’s procedure can be directly influenced by the care the person receives in the hospital. Pre-existing conditions or illnesses can also be addressed. But it’s tough for hospitals to get a handle on factors they truly can’t control, such as a patient’s gender or health insurance carrier.

However, what facilities can do is create targeted initiatives for patients that consider their health as a whole, including working with community partners to increase patients’ access to drug counseling or primary care physicians.

It’s important to identify the patients who are at the highest risk for readmission in your facility, regardless of the reasons why this is the case, and come up with ways to improve their health in areas where hospitals can actually make a difference.

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