Hospital readmission and its corelates in a selected armed forces hospital.

ABSTRACT

This descriptive study used admission level data of 1040 patients to find out the readmission rate and its possible contributing factors within 30 days of discharge in a selected Armed Forces Hospital (Combined Military Hospital, Dhaka). The patients were grouped according to their admission status like group-I (readmission within 30 days of previous discharge), group-II (readmission after 30 days of previous discharge) and group-III (newly admitted patients). The readmission rate at the study period was 9.5% in group-I and 10.2% in group-II. The overall readmission rate was 19.7%. Disease pattern revealed that patients with surgical ailments (25.3%) comprised the greatest number of readmissions followed by cardiovascular diseases (19.2%) and neoplasm (10.1%). Bivariate analyses between two groups (group-I and group-II) were carried-out on different conditions of readmitted patients. No significant relationship was found between different conditions of the readmitted patients with previous stay in the hospital except adequacy of treatment. It was found that the proportion of readmission was higher in group-I among the patients who perceived that their treatment was not adequate during previous stay. This study was aimed for assessment of quality of care in order to find out the relationship between quality of care and readmission status. No statistically significant difference was found among the three groups of patients in overall quality of care (p>0.05). It is widely believed that hospital readmission has a relationship with the substandard care in previous stay. But findings of this study were not consistent with the findings of other study. Therefore, it can be concluded that readmission in an armed forces hospital is probably related with the different characteristics of the study population, disposal procedure of disease condition and the attitude of the physicians towards admission process. Further investigation and strategies, combined with reduction of avoidable admission and better screening are required to prevent this adverse outcome.