Effects of hospitalization on readmission rate


Background: There is increasing concern that the patient experience in the hospital may be associated with post-hospital adverse outcomes, including new or recurrent illnesses after discharge or unplanned return to the hospital or readmission.

Dr. Emily Wang

Study design: Prospective cohort that included 207 patients.

Setting: Two academic hospitals in Toronto.

Synopsis: These patients had been admitted to the internal medicine ward for more than 48 hours and were interviewed at discharge using a standardized questionnaire to assess four domains of the trauma of hospitalization defined as the cumulative effects of patient-reported sleep disturbance, mobility, nutrition, and mood. Among these patients, 64.3% experienced disturbance in more than one domain, and patients who experienced disturbance in three to four domains had a 15.8% greater absolute risk of 30-day readmission or ED visit.

Because this is an observational study, causal inferences were not possible; however, hospitalists should keep in mind the possible association of the patient experience and the link to clinical outcomes.

Bottom line: Trauma of hospitalization is common and may be associated with an increased 30-day risk of readmission or ED visit.

Citation: Rawal J et al. Association of the trauma of hospitalization with 30-day readmission or emergency department visit. JAMA Intern Med. 2019;179(1):38-45.

Dr. Wang is an associate professor of medicine in the division of general and hospital medicine at UT Health San Antonio and a hospitalist at South Texas Veterans Health Care System.

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