Skip to main content
NCBI home page
Health Services Research logoLink to Health Services Research
. 1992 Apr;27(1):81–101.

Identification of factors associated with hospital readmission and development of a predictive model.

J M Corrigan 1, J B Martin 1
PMCID: PMC1069865  PMID: 1563955

Abstract

Multiple hospital admissions, especially those related to the chronically ill, represent a particular challenge to both the acute and long-term care sectors to identify effective methods of resource management. This study analyzes the multiple admission patterns associated with a cohort of 4,219 adult medical-surgical patients discharged alive from a community teaching hospital in Michigan. The sample was divided into two groups: 3,818 patients who survived and 392 who expired during the one-year follow-up period. For the surviving subsample, the characteristics found to be directly associated with the likelihood of readmission included increased age, advanced stage of disease, greater index-episode length of stay, discharge by an internist rather than a surgeon, Medicare as expected source of payment, decreased physician age, discharge to a community setting, and increased number of prior hospital episodes. For the subsample who died, only one explanatory variable was significantly associated with an increased likelihood of readmission-discharge to a community setting (with or without home care) rather than a nursing home. The article includes illustrates of the importance of decisions regarding posthospital, long-term care services on the likelihood of rehospitalization.

Full text

PDF
81

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Acheson E. D., Barr A. Multiple spells of in-patient treatment in a calendar year. Br J Prev Soc Med. 1965 Oct;19(4):182–191. doi: 10.1136/jech.19.4.182. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Anderson G. F., Steinberg E. P. Hospital readmissions in the Medicare population. N Engl J Med. 1984 Nov 22;311(21):1349–1353. doi: 10.1056/NEJM198411223112105. [DOI] [PubMed] [Google Scholar]
  3. Bowlyow J. E. Acute and long-term care linkages: a literature review. Med Care Rev. 1990 Spring;47(1):75–103. doi: 10.1177/107755879004700105. [DOI] [PubMed] [Google Scholar]
  4. Fethke C. C., Smith I. M., Johnson N. "Risk" factors affecting readmission of the elderly into the health care system. Med Care. 1986 May;24(5):429–437. doi: 10.1097/00005650-198605000-00006. [DOI] [PubMed] [Google Scholar]
  5. Graham H., Livesley B. Can readmissions to a geriatric medical unit be prevented? Lancet. 1983 Feb 19;1(8321):404–406. doi: 10.1016/s0140-6736(83)91513-1. [DOI] [PubMed] [Google Scholar]
  6. Holloway J. J., Medendorp S. V., Bromberg J. Risk factors for early readmission among veterans. Health Serv Res. 1990 Apr;25(1 Pt 2):213–237. [PMC free article] [PubMed] [Google Scholar]
  7. Holloway J. J., Thomas J. W., Shapiro L. Clinical and sociodemographic risk factors for readmission of Medicare beneficiaries. Health Care Financ Rev. 1988 Fall;10(1):27–36. [PMC free article] [PubMed] [Google Scholar]
  8. Knickman J. R., McCall N. A prepaid managed approach to long-term care. Health Aff (Millwood) 1986 Spring;5(1):90–104. doi: 10.1377/hlthaff.5.1.90. [DOI] [PubMed] [Google Scholar]
  9. McCall N., Wai H. S. An analysis of the use of Medicare services by the continuously enrolled aged. Med Care. 1983 Jun;21(6):567–585. doi: 10.1097/00005650-198306000-00001. [DOI] [PubMed] [Google Scholar]
  10. Riley G., Lubitz J. Outcomes of surgery in the Medicare aged population: rehospitalization after surgery. Health Care Financ Rev. 1986 Fall;8(1):23–34. [PMC free article] [PubMed] [Google Scholar]
  11. Roos L. L., Jr, Cageorge S. M., Roos N. P., Danzinger R. Centralization, certification, and monitoring. Readmissions and complications after surgery. Med Care. 1986 Nov;24(11):1044–1066. doi: 10.1097/00005650-198611000-00008. [DOI] [PubMed] [Google Scholar]
  12. Roos N. P., Flowerdew G., Wajda A., Tate R. B. Variations in physicians' hospitalization practices: a population-based study in Manitoba, Canada. Am J Public Health. 1986 Jan;76(1):45–51. doi: 10.2105/ajph.76.1.45. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Roos N. P., Shapiro E. The Manitoba longitudinal study on aging: preliminary findings on health care utilization by the elderly. Med Care. 1981 Jun;19(6):644–657. doi: 10.1097/00005650-198106000-00007. [DOI] [PubMed] [Google Scholar]
  14. Shapiro E., Tate R. B., Roos N. P. Do nursing homes reduce hospital use? Med Care. 1987 Jan;25(1):1–8. doi: 10.1097/00005650-198701000-00001. [DOI] [PubMed] [Google Scholar]
  15. Victor C. R., Vetter N. J. The early readmission of the elderly to hospital. Age Ageing. 1985 Jan;14(1):37–42. doi: 10.1093/ageing/14.1.37. [DOI] [PubMed] [Google Scholar]
  16. Zook C. J., Savickis S. F., Moore F. D. Repeated hospitalization for the same disease: a multiplier of national health costs. Milbank Mem Fund Q Health Soc. 1980 Summer;58(3):454–471. [PubMed] [Google Scholar]

Articles from Health Services Research are provided here courtesy of Health Research & Educational Trust

RESOURCES