Multiple risk factors for unplanned readmissions within 1 month of hospital discharge in acute care hospitals in Japan.

ABSTRACT

AIM: The aim of this study is to analyse the risk factors for unplanned readmissions within 1 month after hospital discharge to develop a seamless support system from discharge to home care. BACKGROUND: With shorter hospital stay lengths, understanding the characteristics of patients with multiple risk factors is important to prevent rehospitalization. DESIGN: This is a single-centre retrospective descriptive study. METHODS: Logistic regression and decision tree analyses were performed using eight items from the records of 3117 patients discharged from a university hospital between April-September 2017 as risk factors. RESULTS: Unplanned readmission risk was significantly associated with emergency hospitalization (odds ratio [OR] 3.12, 95% confidence interval [CI] 2.04-4.77), malignancy (OR 2.16, 95% CI 1.44-3.24), non-surgical admission (OR 1.76, 95% CI 1.07-2.88), hospital stay of ≥ 15 days (OR 1.66, 95% CI 1.14-2.43) and decline in activities of daily living owing to hospitalization (OR 1.68, 95% CI 1.06-2.64). The highest risk combinations for rehospitalization were as follows emergency hospitalization and malignancy; emergency admission, non-malignancy and a hospital stay of ≥15 days; and scheduled hospitalization, no surgery and a hospital stay of ≥15 days. CONCLUSIONS: Patients with multiple risks for unplanned readmission should be accurately screened and provided with optimal home care.