Patterns of multimorbidity associated with 30-day readmission: a multinational study.

Aubert, Carole E; Schnipper, Jeffrey L; Fankhauser, Niklaus; Marques-Vidal, Pedro; Stirnemann, Jérôme; Auerbach, Andrew D; Zimlichman, Eyal; Kripalani, Sunil; Vasilevskis, Eduard E; Robinson, Edmondo; Metlay, Joshua; Fletcher, Grant S; Limacher, Andreas; Donzé, Jacques (2019). Patterns of multimorbidity associated with 30-day readmission: a multinational study. BMC public health, 19(1), p. 738. BioMed Central 10.1186/s12889-019-7066-9

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BACKGROUND Multimorbidity is associated with higher healthcare utilization; however, data exploring its association with readmission are scarce. We aimed to investigate which most important patterns of multimorbidity are associated with 30-day readmission. METHODS We used a multinational retrospective cohort of 126,828 medical inpatients with multimorbidity defined as ≥2 chronic diseases. The primary and secondary outcomes were 30-day potentially avoidable readmission (PAR) and 30-day all-cause readmission (ACR), respectively. Only chronic diseases were included in the analyses. We presented the OR for readmission according to the number of diseases or body systems involved, and the combinations of diseases categories with the highest OR for readmission. RESULTS Multimorbidity severity, assessed as number of chronic diseases or body systems involved, was strongly associated with PAR, and to a lesser extend with ACR. The strength of association steadily and linearly increased with each additional disease or body system involved. Patients with four body systems involved or nine diseases already had a more than doubled odds for PAR (OR 2.35, 95%CI 2.15-2.57, and OR 2.25, 95%CI 2.05-2.48, respectively). The combinations of diseases categories that were most strongly associated with PAR and ACR were chronic kidney disease with liver disease or chronic ulcer of skin, and hematological malignancy with esophageal disorders or mood disorders, respectively. CONCLUSIONS Readmission was associated with the number of chronic diseases or body systems involved and with specific combinations of diseases categories. The number of body systems involved may be a particularly interesting measure of the risk for readmission in multimorbid patients.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > CTU Bern
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)

UniBE Contributor:

Aubert, Carole Elodie; Fankhauser, Niklaus; Limacher, Andreas and Donzé, Jacques

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1471-2458

Publisher:

BioMed Central

Language:

English

Submitter:

Christine Baumgartner

Date Deposited:

25 Jun 2019 13:42

Last Modified:

30 Jun 2019 02:40

Publisher DOI:

10.1186/s12889-019-7066-9

PubMed ID:

31196053

Uncontrolled Keywords:

Diseases combinations Multimorbidity Potentially avoidable readmission Readmission

BORIS DOI:

10.7892/boris.131409

URI:

https://boris.unibe.ch/id/eprint/131409

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