Early Hospital Readmission in Patients With Tuberculosis: Social and Cultural Risk Factors

Abstract

Background: Few studies have focused on risk factors for early readmission in patients with tuberculosis. Objective: Determine what are the risk factors for the early readmission of patients with tuberculosis at General Tijuana Hospital, Mexico. Material and methods: All patients aged ≥ 18 years who were admitted with the confirmed diagnosis of pulmonary tuberculosis were prospectively included. Information was obtained on demographic, socioeconomic variables, previous hospitalizations, clinical data, and laboratory and radiographic studies. Results: One hundred and thirty-four patients with tuberculosis were included, and 24 of them (17.9%) corresponded to early hospital readmissions. The interval between initial admission and readmission was 1.45 ± 0.183 months. The readmission group had used illicit drugs for more years (11.3 ± 13.9 years) than the new cases group (8.01 ± 8.25 years; p = 0.03). Forty percent of the patients who were readmitted did not go to their referral health unit after their initial hospital discharge. The reasons argued by the patients included, among others, not having received information regarding their illness during hospitalization, the abuse of illegal substances and the perception of hostility by health personnel. Discussion: One out of every five patients admitted for tuberculosis will be readmitted after only six weeks of initial discharge. Sociocultural factors (addictions, comorbidities, poverty) and of the health system (limited hours of medical care, accessibility) contribute to this phenomenon. Conclusions: Loss of follow-up after hospital discharge is common in most settings and contributes to an increase in morbidity and mortality, and transmission of infection in the community.