Background: Hospital readmission places a high burden on both health care systems and patients. Most readmissions are thought to be related to the quality of the health care system.Objectives: The aim of this study was to examine the causes and rates of early readmission in emergency department in a Tehran hospital.Patients and Methods: A cross-sectional investigation was performed to study readmission of inpatients at a large academic hospital in Tehran, Iran. Patients admitted to hospital from July 1, 2014 to December 30, 2014 via the emergency department were enrolled.Descriptive statistics were used to summarize the distribution demographics in the sample. Data was analyzed by chi2 test using SPSS 20 software.Results: The main cause of readmission was complications related to surgical procedures (31.0%). Discharge from hospital based on patient request at the patient’s own risk was a risk factor for emergency readmission in 8.5%, a very small number were readmitted after complete treatment (0.6%). The only direct complication of treatment was infection (17%).Conclusions: Postoperative complications increase the probability of patients returning to hospital. Physicians, nurses, etc., should focus on these specific patient populations to minimize the risk of postoperative complications. Future studies should assess the relative connections of various types of patient information (e.g., social and psychosocial factors) to readmission risk prediction by comparing the performance of models with and without this information in a specific population.

AbstractBackground: During the Coronavirus Disease 2019 (COVID-19) pandemic, the demand for hospital beds has exceeded substantially. Thus, we aimed to conduct this study to identify factors associated with the risk of readmission in order to introduce the best discharge plan for patients with high risk of hospital readmission. Methods: This is a multicenter, case-control study including 1357 patients hospitalized with COVID-19 infection. Age-sex-matched case and control groups were paired at 1:2 ratios, and COVID-19 readmission rate was assessed. Moreover, the logistic regression analysis was applied to determine the factors associated with readmission.  Results: Of the 1357 patients, 99 (7.29%) subjects were readmitted. The most common cause of readmission was respiratory distress. The median (interquartile) of the interval between hospital discharge and the second admission was 5 (2-16) days. Upon adjusting with the main risk factors, having at least one underlying disease and being treated with the corticosteroid were significantly associated with a higher rate of readmission (OR: 2.76, 95%CI: 1.30- 5.87) and (OR: 8.24, 95%CI: 3.72-18.22), respectively. Conclusion: Identification of risk factors of COVID 19 readmission will improve resource utilization and patient care.

Background: In recent years, the rate of avoidable readmission as an indicator of the quality of hospital care is introduced. Readmission has some effects on the cost and quality of hospital care and it imposes additional burden for patients and their families. Also, reduction the costs is a priority for hospitals administrators and patients. The aim of this study was to identify the reasons of readmission for conducting the appropriate interventions.Methods: In this descriptive study, 250 documents of children who were readmitted in 2013 were assessed. A checklist used for data collection. We used descriptive statistics to summarize the readmission rates and the causes.Findings: Out of the 250 children who readmitted, 41.6% were female and 58.4% were male. The mean age was 2.8 years and the mean length of hospital stay was 4.37 days. The average cost of treatment for every patient was 1, 361, 814 Rails and the average number of readmission was 3.2 times. The most common reasons of readmission included 30.4% unrelated to the first hospitalization, recurrence of the disease (21.2%), follow up (16.8%), discharge without the physician's order (16.4%), treatment failure (4.3%), complications of surgery (4.1%), infection (3.9%), wrong diagnosis (1.8%) and other causes (1.1%).Conclusion: The result of this study shows that readmission increase patients' length of stay as well as additional costs for patients and hospitals, and many causes of readmission are preventable. So, the rate of patient readmission can be minimized by implementing clinical governance guidelines and training of health care workers and patients.

Background and Purpose: Hospital readmission after kidney transplantation is a real challenge for both patients and healthcare systems. Assessment of the risk factors of readmission after kidney transplantation is vital and can reduce morbidity and cost in transplant recipients and donors. The aim of the current study was to determine the risk factors of hospital readmission in patients undergoing kidney transplantation in Montaserieh Hospital of Mashhad, northeast of Iran. Materials and Methods: This retrospective study included 523 first kidney transplant patients between January 2013 and March 2019 from the Montaserieh Hospital Information System (HIS) of Mashhad, Iran. Every-time readmission was the study primary outcome. Donors and recipient's demographic data, recipient's comorbidities, reasons for end-stage renal disease (ESRD), panel reactive antibody (PRA) status, dialysis parameters, cold ischemic time, and delayed graft function (DGF) were the potential risk factors. Statistical analysis was done using Chi-square and Student's t-test. Results: Data from 523 patients were assessed for potential eligibility. Based on the exclusion criteria, data from 479 patients were included in the final analysis. 174 (36. 3%) patients were never readmitted, and 305 (63. 7%) were readmitted at least once post-discharge. 39 (12. 8%) were readmitted within the first-month post-discharge. Older age, sex, higher prevalence of comorbidities, diabetes and hypertension, duration of primary disease before transplantation, hemodialysis and duration of pre-transplant dialysis, mean pretransplant platelet count, intraoperative complications, increased cold ischemic time, and delayed graft function were associated with a higher prevalence of readmission (p<0. 05). Conclusion Our results showed that different independent variables and patients' comorbidities were important risk factors for readmission after kidney transplantation. Early prediction of these risk factors could result in prevention from readmission in patients undergoing kidney transplantation.

Background: This study aimed to investigate the prevalence of hospital readmission for chronic obstructive pulmonary disease (COPD) at 30, 90 and 365 days, and to determine demographic and socioeconomic risk factors for 30-day and 90-day readmission and time to COPD-related readmission within 365 days in Tasmania. Methods: Patients ≥, 40 years admitted for COPD between 2011 and 2015 were identified using administrative data from all major public hospitals in Tasmania, Australia. Factors associated with readmission and time to readmission were identified using logistic and Cox regression, respectively. Results: The rates of COPD-related readmission were 6. 7% within 30 days, 12. 2% within 90 days and 23. 7% within 365 days. Being male (odds ratio [OR]: 1. 49, CI: 1. 06–, 2. 09), Indigenous (OR: 2. 47, CI: 1. 31–, 4. 66) and living in the lower socioeconomic North-West region of Tasmania (OR: 1. 80, CI: 1. 20–, 2. 69) were risk factors for 30-day readmission. Increased COPD-related (OR: 1. 48, CI: 1. 22–, 1. 80,OR: 1. 52, CI: 1. 29–, 1. 78) and non-COPD-related (OR: 1. 12, CI: 1. 03–,1. 23,OR: 1. 11, CI: 1. 03–, 1. 21) emergency department (ED) visits in the preceding six months were risk factors for both 30-day and 90-day readmissions. Being Indigenous (hazard ratio [HR]: 1. 61, CI: 1. 10–, 2. 37) and previous COPD-related ED visits (HR: 1. 30, CI: 1. 21–, 1. 39) decreased, while a higher Charlson Comorbidity Index (CCI) (OR: 0. 91, CI: 0. 83–,0. 99) increased the time to readmission within 365 days. Conclusion: Being male, Indigenous, living in the North-West region and previous ED visits were associated with increased risk of COPD readmission in Tasmania. Interventions to improve access to primary healthcare for these groups may reduce COPD-related readmissions.