Predictors of Readmission in Internal Medicine Departments in Cairo University Hospitals
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- Category: Vol. 85, June 2017
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Predictors of Readmission in Internal Medicine Departments in Cairo University Hospitals, MERVAT R. EL-RAFIE, AZZA A. EL-NOUMAN, RANDA F. SALAM, YASMINE S. GALAL and EMAN H. EL-SEBAIE
Abstract
Introduction: Patients with liver, renal and Cardiovascular Diseases (CVDs) frequently return to hospital within days of discharge, yet contributing factors have not been fully explored. Hospital readmission places stress on the patient, family, and healthcare system, and requires closer examination to determine potential avoidance and targets for intervention.
Aim: This study was conducted to determine the risk factors contributing to readmission of patients with liver, renal and (CVDs) in Internal Medicine (IM) Departments in Cairo University Hospitals (CUHs) within 30 days of their discharge.
Subjects and Methods: A cross sectional analytical study design was done following an educational program provided to nurses of IM Departments to improve the discharge practices. A convenient sample of 344 patients with liver, renal and (CVDs) were selected and were divided into two groups (readmitted and non-readmitted) based on their admission background in the last month before the study. Data was collected by a structured questionnaire form and referring to patients' medical files.
Results: Bivariate relationship was displayed in cross tabulations and comparison of proportions was performed using the chi-square and Fisher's exact tests where appropriate. Independent samples t-test: Was used to compare the means of two independent groups. The results of the current study showed that old age was a strong risk factor predisposing to frequent hospitalization (p<0.001). Also, a significant differ-ence was detected as regards the educational level, occupa-tional, marital and family status (p<0.001). The whole read-mitted patients were illiterates compared to only 56.4% of the non-readmitted ones. In addition, lack of physical activity, exposure to stress, lack of referral and presence of comorbid-ities were significantly higher among readmitted patients with a p-value <0.05. Logistic regression analysis model revealed that only age, exposure to stress, presence of co-morbidities, lack of referral and not seeking medical care after hospital discharge were significant predictors for readmission (p-value <0.001 and r2: 0.912).
Conclusion: Some individual characteristics that are difficult to change, dramatically increases the risk for hospital readmissions in patients with liver, renal and CVDs.