Hospital Readmissions: Many Caused by Co-Morbid Diseases, Infections

Dr. Jacques Donzé MD PhD Research Associate Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital Harvard Medical School, Boston, MA 02115, USADivision of General Internal Medicine, Bern University Hospital, 3010 Bern, SwitzerlandMedicalResearch.com Interview with:
Dr. Jacques Donzé MD PhD
Research Associate
Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital
Harvard Medical School, Boston, MA 02115,

MedicalResearch.com: What are the main findings of the study?

Dr. Donzé: In a large retrospective cohort study, we identified the primary diagnoses of 30-day potentially avoidable readmissions in medical patients according to the most common comorbidities. Interestingly, almost all of the top five diagnoses of potentially avoidable readmissions for each comorbidity were possible direct or indirect complications of that comorbidity. Patients with cancer, heart failure, and chronic kidney disease had a significantly higher risk of potentially avoidable readmission than those without those comorbidities. Also, when readmitted, patients with chronic kidney disease had a 20% higher risk of having the readmission be potentially avoidable.

MedicalResearch.com: Were any of the findings unexpected?

Dr. Donzé: As much of the existing literature on readmissions focuses on heart failure, it is worth noting that potentially avoidable readmissions were most often due to infections in this study.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Donzé: Transitions of care should not only focus on the acute condition responsible for the hospitalization, but also on patients’ underlying chronic comorbidities that may increase the risk of new, acute complications.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Donzé: Transition care interventions that include consideration of the patients’ underlying chronic comorbidities should be proven to the reduce readmission risk. Also, further work is needed to explore the nature of infections causing potentially avoidable readmission and to identify possible ways in which they could be avoided in the future.

Citation:

Causes and patterns of readmissions in patients with common comorbidities: retrospective cohort study

Donzé J ,Lipsitz S ,Bates DW ,Schnipper JL. Causes and patterns of readmissions in patients with common comorbidities: retrospective cohort study. BMJ 2013;347:f7171