Hospital readmissions in Internal Medicine Specialty: Frequency, associated factors and outcomes

  • Samar Fatima, Dr. Aga Khan University Hospital
  • Sara Shamim, Dr. Aga Khan University Hospital
  • Simra Riffat, Dr. Aga Khan University Hospital
  • Muhammad Tariq, Dr. Aga Khan University Hospital
Keywords: Hospital readmission, Index admission, Discharge

Abstract

Objectives: Hospital readmission has become a focus of national attention as a potential indicator of healthcare quality and has a significant financial impact on healthcare system. Limited data is available regarding readmissions to Internal Medicine specialty from our sub-continent. It is, therefore, essential to determine the frequency and factors leading to readmissions, in order to avoid preventable readmissions and improve quality of healthcare provision.

Methods: This retrospective study reviewed adult discharges from Internal Medicine specialty between October 2018 and February 2019 at Aga Khan University Hospital. Out of 1,835 discharges, 491 were randomly selected after excluding expiries. The frequency, factors and outcomes of readmission were noted. The studied outcomes included length of stay and in-hospital mortality.

Results: Out of 491 patients, 15.3% were readmitted within 30-days of their discharge. Most of the readmitted patients were females (56%) and elderly with a mean age 67.1±14.9 years. Majority of the patient who got readmitted had multi-morbidities (68%) and were of functional Class-II (39%).The mean length of stay for index and readmission was between 4-7days. Eighty-percent readmissions were discharged as planned, 13% on request and seven-percent left against medical advice in their index admission. The most common causes of readmission were persistence of symptoms (43%) and nosocomial infection (29%). Avoidable causes included hospital-associated pneumonia, urinary tract infections and septic shock. Mortality in readmitted patients was 12%.

Conclusions: The causes of readmission is multi-factorial, including advanced age, multi-morbidities, persistence of symptoms and nosocomial infections. Early follow-ups should be advised to prevent avoidable readmissions.

doi: https://doi.org/10.12669/pjms.37.7.3575

How to cite this:
Fatima S, Shamim S, Raffat S, Tariq M. Hospital readmissions in Internal Medicine Specialty: Frequency, associated factors and outcomes. Pak J Med Sci. 2021;37(7):2008-2013. doi: https://doi.org/10.12669/pjms.37.7.3575

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Published
2021-10-06
How to Cite
Fatima, S., Shamim, S., Riffat, S., & Tariq, M. (2021). Hospital readmissions in Internal Medicine Specialty: Frequency, associated factors and outcomes. Pakistan Journal of Medical Sciences, 37(7). https://doi.org/10.12669/pjms.37.7.3575
Section
Original Articles