Readmission of High-Risk Discharged Patients at a Tertiary Hospital in Korea

Abstract

This study aims to investigate the readmission rates of major disease groups as stated by the Centers for Medicare and Medicaid Services and to identify risk factors related to readmission in Korea. We studied 2,973 patients discharged from a 2,200-bed tertiary referral hospital in South Korea, from April 1, 2016, to March 31, 2017. Using electronic medical records, we calculated the 30-day readmission rates of seven diseases: acute myocardial infarction, chronic obstructive pulmonary disease (COPD), heart failure (HF), pneumonia, stroke, coronary artery bypass graft (CABG), and total hip arthroplasty/total knee arthroplasty. We used Cox proportional hazards regression analysis to identify risk factors affecting readmission in this retrospective, observational study. For 2,973 consecutively discharged patients, the 30-day unplanned readmission rate was 10.3%. The readmission rate of HF (19.0%) was the highest, followed by pneumonia (13.7%), CABG (12.0%), and COPD (10.5%). Factors associated with readmission were polypharmacy (hazard ratio [HR]: 2.06; 95% confidence interval [CI]: 1.60-2.64), hospitalization history in the previous 6 months (HR: 1.81; 95% CI: 1.41-2.32), and comorbidity (HR: 1.16; 95% CI: 1.11-1.23). Therefore, the discharge intervention program for high-risk discharge patients with polypharmacy, admission history, and comorbidity should include medication reconciliation.