Hospital readmission among older adults with congestive heart failure

Abstract

Introduction. To examine the factors associated with unplanned readmission among older adults with congestive heart failure (CHF) within 28 days of discharge from an index admission, within a large Australian health service. Methods. Using a comparative cohort design, a multivariate logistic regression model was used to compare readmitted patients with non-readmitted patients and identify risk factors associated with readmission. Results. Significant risk factors identified were male gender, numerous diagnoses, length of stay 3 days or longer and patients being admitted from acute, subacute or aged-care facilities. Conclusions. The high risk of patients being readmitted from acute, subacute and aged-care services requires further review as these readmissions may be avoidable. It may also be useful to develop a readmission risk screening tool so that patients at risk of readmission can be identified. What is known about this topic? Older adults with CHF are likely to experience multiple readmissions to hospital. There have been several studies conducted on hospital readmissions; however, generalising the findings is problematic due to the use of variable definitions of what constitutes a readmission. What does this paper add? This paper addresses the absence of Australian research comparing groups of older patients with CHF who are readmitted to hospital with those who are not readmitted. It also adopts one of the more frequently used definitions of readmission to aid in future comparability of research. What are the implications for practice? Further work is necessary to improve discharge planning and effectively manage chronic illnesses such as CHF in patients’ homes. It may be useful to develop a readmission risk screening tool for staff of inpatient medical wards so that these at-risk patients can be identified before discharge.