RESUMO
Objective: Measurements of the readmission rate and the number of preventable readmissions in a level II South African Hospital; and the identification of factors predictive of readmission. Methods: The admission register for the medical wards at Cecilia Makiwane Hospital (CMH) was used to identify readmitted patients; whose folders were reviewed. A comparison group of patients who were not readmitted was randomly generated from the same register. Results : The readmission rate for the seven months ending October 2006 was 8.5 (262/3083). Patients who were more likely to be readmitted had chronic respiratory disease (OR 4.2;95 CI 1.2 - 14.6); HIV infection (OR 5.0; CI 2.1 - 12.0); were older than 50 years (OR 5.2; CI 2.5 - 10.9); Had a first admission of more than 8 days (OR 3.2; CI 1.5 - 6.6) or a booked medical outpatients follow-up (OR 5.1; CI 2.6 - 10.3). Age distribution of readmissions wasbimodal with HIV positive individuals (27.4noverall) accounting for 50 of all admissions younger than 50 years; but only 9.1 of those 50 years or older. In individuals older than 50 years; 42.1of admissions were due to chronic cardio-respiratory illnesses. Half of readmissions were judged to be potentially preventable; mailnlu through improved education. Conclusion : One in twelve general medical patients was readmitted; with chronic diseases accompanied by inadequate patient education accounting for the largest group of readmision in older patients. Readmission of HIV/AIDS patients has generated a second peak in younger individuals; and the impact of the antiretroviral roll-outon this warrants further scrutiny