What's Behind Door Number Two When It Comes to Causes of Readmissions?

Grace C. Huang, MD

In a retrospective cohort study, the most common causes of avoidable readmissions were complications of preexisting comorbidities.

Current efforts to prevent hospital readmissions focus on optimizing care for diagnoses related to initial hospitalizations. Few data are available on the extent to which readmissions are related to comorbid illnesses. To explore this issue, investigators in Boston retrospectively examined diagnoses associated with 10,731 consecutive hospital discharges and 2398 related 30-day readmissions.

The most common readmission diagnoses were cancer (17%), infection (11%), and heart failure (5%). Using a highly reliable algorithm to identify potentially avoidable readmissions, researchers identified infections (specifically, pneumonia, septicemia, and urinary tract infections) as the most common potentially avoidable causes (12%). Among the subset of patients with comorbidities, heart failure was the most common cause of avoidable readmission, and, in most of these patients, heart failure was a known comorbidity at initial hospitalization. Infection was the most common readmission diagnosis for patients with diabetes, chronic obstructive pulmonary disease, and ischemic heart disease.

Citation(s):

Donzé J et al. Causes and patterns of readmissions in patients with common comorbidities: Retrospective cohort study. BMJ 2013 Dec 16; 347:f7171.