Patterns of multimorbidity associated with 30-day readmission: a multinational study.
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ABSTRACT: 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.
SUBMITTER: Aubert CE
PROVIDER: S-EPMC6567629 | biostudies-literature | 2019 Jun
REPOSITORIES: biostudies-literature
Publications
Patterns of multimorbidity associated with 30-day readmission: a multinational study.
Aubert Carole E CE Schnipper Jeffrey L JL Fankhauser Niklaus N Marques-Vidal Pedro P Stirnemann Jérôme J Auerbach Andrew D AD Zimlichman Eyal E Kripalani Sunil S Vasilevskis Eduard E EE Robinson Edmondo E Metlay Joshua J Fletcher Grant S GS Limacher Andreas A Donzé Jacques J
BMC public health 20190613 1
<h4>Background</h4>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.<h4>Methods</h4>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 ...[more]
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