Chronic Medical Condition's Role in Hospital Readmissions Revealed

Hospital readmissions can be a costly problem for both patients and for the health care system. Now, though, scientists have taken a closer look at readmission and have found that the most frequent reasons for readmission were often related to patients' underlying chronic medical conditions. The findings could help researchers focus on reducing readmission rates in the future.

In order to learn a bit more about hospital readmissions, the researchers evaluated the primary diagnoses and patterns of 30-day readmissions and potentially avoidable readmissions according to seven most common comorbidities in medical patients. In all, they analyzed data from 10,731 discharges. Of these, 22 percent were followed by a 30-day readmission.

"We know that the reason for readmission is often different from the reason that the patient was initially hospitalized," said Jacques Donze, one of the researchers, in a news release. "Our research shows that the five most frequent reasons for readmission were often related to patients' existing chronic medical conditions, underscoring the need for post-discharge care to focus attention not just on the primary diagnosis of the previous hospitalization but also on these comorbidities."

In fact, the researchers found that the three most common reasons for readmission were infection, cancer and heart failure. Heart failure and infection in particular were the two most frequent main readmission diagnosis for the seven chronic medical conditions studied; they accounted for 21 to 34 percent of all potentially avoidable readmissions. Most interestingly, the scientists found that all of the top five diagnoses of potentially avoidable readmissions for each comorbidity were possible direct or indirect complications of that comorbidity.

"Transitions of care should not only focus on the acute condition responsible for the hospitalization, but also on patients' underlying chronic conditions that may increase the risk of new, acute complications," said Donze in a news release. "Our research suggests that interventions could include close follow-up and monitoring of patients' comorbidities in the post-discharge period, when we know that patients are particularly vulnerable."

The findings are published in the journal BMJ.