%0 Journal Article
%T Patients at Risk for 30©\Day Readmission
%A Jacques Donz¨¦
%A MD
%A MSc
%A Jeffrey L. Schnipper
%A MD
%A MPH
%A Robert E. Burke
%A MD
%J Journal of Hospital Medicine
%D 2013
%R 10.1002/jhm.2044
%X BACKGROUNDLittle is known about the contribution of psychiatric illness to medical 30©\day readmission risk.OBJECTIVETo determine the independent contribution of psychiatric illness and substance abuse to all©\cause and potentially avoidable 30©\day readmissions in medical patients.DESIGNRetrospective cohort study.SETTINGPatients discharged from the medicine services at a large teaching hospital from July 1, 2009 to June 30, 2010.MEASUREMENTSThe main outcome of interest was 30©\day all©\cause and potentially avoidable readmissions; the latter determined by a validated algorithm (SQLape) in both bivariate and multivariate analysis. Readmissions were captured at 3 hospitals where the majority of these patients are readmitted.RESULTSOf 6987 discharged patients, 1260 were readmitted within 30 days (18.0%); 388 readmissions were potentially avoidable (5.6%). In multivariate analysis, 2 or more prescribed outpatient psychiatric medications (odds ratio [OR]: 1.1, 95% confidence interval [CI]: 1.01©\1.20) or any prescription of anxiolytics (OR: 1.16, 95% CI: 1.00¨C1.35) were associated with increased all©\cause readmissions, whereas discharge diagnoses of anxiety (OR: 0.82, 95% CI: 0.68©\0.99) or substance abuse (OR: 0.80, 96% CI: 0.65©\0.99) were associated with fewer all©\cause readmissions. These findings were not replicated as predictors of potentially avoidable readmissions; rather, patients with discharge diagnoses of depression (OR: 1.49, 95% CI: 1.09©\2.04) and schizophrenia (OR: 2.63, 95% CI: 1.13©\6.13) were at highest risk.CONCLUSIONSOur data suggest that patients treated during a hospitalization for depression and for schizophrenia are at higher risk for potentially avoidable 30©\day readmissions, whereas those prescribed more psychiatric medications as outpatients are at increased risk for all©\cause readmissions. These populations may represent fruitful targets for interventions to reduce readmission risk. Journal of Hospital Medicine 2013;8:450¨C455. £¿ 2013 Society of Hospital Medicin
%U https://www.journalofhospitalmedicine.com/jhospmed/article/127032/patients-risk-30-day-readmission