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Patient and disease profile of emergency medical readmissions to an Irish teaching hospital.
Postgrad Med J. 2004 Aug; 80(946):470-4.PM

Abstract

OBJECTIVE

To determine whether there was a relationship between coded diseases at the time of hospital discharge, a pattern of ordering investigations, and hospital readmission in a major teaching hospital.

DESIGN

Systematic review of data relating to emergency medical patients admitted to St James' Hospital Dublin between 1 January and 31 December 2002.

DATA SOURCES AND METHODS

Data on discharges from hospital recorded in the Hospital In-Patient Enquiry (HIPE) system. The value of HIPE data in describing the relationship between the pattern of resource utilisation, diagnostic related groups, and hospital readmission has not previously been examined.

RESULTS

Of 5038 episodes recorded among 4050 patients admitted, the number of readmissions was up to 15. Age and male gender were factors associated with readmission, and readmitted patients remained in hospital for longer. No particular test request predicted readmission, but computed tomography of the brain was associated with a reduced readmission rate. Discharge diagnostic related group coding at first discharge predicted readmission-codes related to heart failure, respiratory system, alcohol, malignancy, and anaemia.

CONCLUSIONS

It was found that clinical coding using the HIPE database strongly predicted hospital readmission. It may be argued that early hospital readmission reflects unsatisfactory patient care, alternatively that many readmissions are not preventable, representing either new events in elderly patients with chronic illnesses and frequent co-morbidity or related to social factors. The utility of specific interventions, in patients at high risk for hospital readmission, could be explored.

Authors+Show Affiliations

Division of Internal Medicine, St James' Hospital, Trinity College Dublin, Trinity Centre at St James' Hospital, Ireland.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15299157

Citation

Moloney, E D., et al. "Patient and Disease Profile of Emergency Medical Readmissions to an Irish Teaching Hospital." Postgraduate Medical Journal, vol. 80, no. 946, 2004, pp. 470-4.
Moloney ED, Bennett K, Silke B. Patient and disease profile of emergency medical readmissions to an Irish teaching hospital. Postgrad Med J. 2004;80(946):470-4.
Moloney, E. D., Bennett, K., & Silke, B. (2004). Patient and disease profile of emergency medical readmissions to an Irish teaching hospital. Postgraduate Medical Journal, 80(946), 470-4.
Moloney ED, Bennett K, Silke B. Patient and Disease Profile of Emergency Medical Readmissions to an Irish Teaching Hospital. Postgrad Med J. 2004;80(946):470-4. PubMed PMID: 15299157.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Patient and disease profile of emergency medical readmissions to an Irish teaching hospital. AU - Moloney,E D, AU - Bennett,K, AU - Silke,B, PY - 2004/8/10/pubmed PY - 2004/10/16/medline PY - 2004/8/10/entrez SP - 470 EP - 4 JF - Postgraduate medical journal JO - Postgrad Med J VL - 80 IS - 946 N2 - OBJECTIVE: To determine whether there was a relationship between coded diseases at the time of hospital discharge, a pattern of ordering investigations, and hospital readmission in a major teaching hospital. DESIGN: Systematic review of data relating to emergency medical patients admitted to St James' Hospital Dublin between 1 January and 31 December 2002. DATA SOURCES AND METHODS: Data on discharges from hospital recorded in the Hospital In-Patient Enquiry (HIPE) system. The value of HIPE data in describing the relationship between the pattern of resource utilisation, diagnostic related groups, and hospital readmission has not previously been examined. RESULTS: Of 5038 episodes recorded among 4050 patients admitted, the number of readmissions was up to 15. Age and male gender were factors associated with readmission, and readmitted patients remained in hospital for longer. No particular test request predicted readmission, but computed tomography of the brain was associated with a reduced readmission rate. Discharge diagnostic related group coding at first discharge predicted readmission-codes related to heart failure, respiratory system, alcohol, malignancy, and anaemia. CONCLUSIONS: It was found that clinical coding using the HIPE database strongly predicted hospital readmission. It may be argued that early hospital readmission reflects unsatisfactory patient care, alternatively that many readmissions are not preventable, representing either new events in elderly patients with chronic illnesses and frequent co-morbidity or related to social factors. The utility of specific interventions, in patients at high risk for hospital readmission, could be explored. SN - 0032-5473 UR - https://www.unboundmedicine.com/medline/citation/15299157/Patient_and_disease_profile_of_emergency_medical_readmissions_to_an_Irish_teaching_hospital_ L2 - https://pmj.bmj.com/lookup/pmidlookup?view=long&pmid=15299157 DB - PRIME DP - Unbound Medicine ER -