Prevalence and Predictors of Readmission in the Department of Medicine in a Tertiary Hospital in Manila, Philippines

Abstract

Abstract Background: Identifying factors that increase the risk for hospital readmission can help in determining potential targets for quality improvement efforts. This study described the factors that lead to hospital readmission within 30 days of hospital discharge of patients under the General Medicine service of a tertiary government hospital in Manila, Philippines. Methods: We performed a retrospective observational study which included service patients 19 years old and above readmitted within 30 days following discharge. A total of 324 hospital readmissions within 30 days of discharge from January 1 to December 31, 2019 were reviewed. We estimated the prevalence of 30-day readmission and identified factors associated with preventable readmissions using multivariable logistic regression. Results: Of the 4,010 hospitalizations under General Medicine service in 2019, 602 (18%) were readmissions within 30 days of discharge, majority of which were related to the index admission (90%) and unplanned (68%). Predictors of preventable readmission were emergency readmission (OR 3.37, 95% CI 1.72 to 6.60, p=<0.001), having five to ten medications at discharge (OR 1.78, 95% CI 1.10 to 2.87, p=0.018), and presence of nosocomial infection (OR 1.86, 95% CI 1.09 to 3.17, p=0.024). The most frequent reason for readmission among preventable ones is health-care related infection (42.9%). Conclusions: We identified factors which increased the likelihood of preventable readmissions such as type of readmission, number of medications per day, and presence of nosocomial infections. We propose that these issues be addressed to improve healthcare delivery and reduce readmission-related expenditures. Further studies should be pursued to identify impactful evidence-based practices.