OTTAWA, June 14, 2012 /CNW/ - Soon after their discharge from hospital,
more than 180,000 Canadians were readmitted to acute care in 2010,
reveals a study from the Canadian Institute for Health Information (CIHI). In those jurisdictions where detailed emergency department (ED)
data was available—Alberta, Ontario and Yukon—nearly 1 in 10 acute care
patients returned to the ED within seven days of hospital discharge.
The study, All-Cause Readmission to Acute Care and Return to the Emergency
Department, included more than 2.1 million hospitalizations across the country. It
looked at surgical, medical, pediatric and obstetric patients to better
understand who returned to acute care after discharge and for what
"Better understanding of the factors influencing readmission rates is an
important step for improving the quality of care for Canadians," says
Jeremy Veillard, Vice President of Research and Analysis at CIHI.
"Although readmissions cannot always be avoided, research suggests that
in many cases they may be prevented."
Reasons for readmission varied by patient group
Medical and pediatric patients tended to be readmitted for the same or
Medical patients were most likely to be readmitted for chronic
obstructive pulmonary disease and heart failure—more than two in five
of these readmitted patients returned to hospital for the same
The highest volume of readmission among pediatric patients was for
respiratory infection and pneumonia, while pediatric patients who were
originally hospitalized for chemotherapy or radiotherapy had the
highest readmission rates.
Surgical and obstetric patients tended to be readmitted for unplanned
follow-up care needs:
Nearly 1 in 10 (9.3%) readmitted surgical patients—more than 4,000
patients—returned to hospital for infections following a procedure.
Close to one in four patients readmitted following a Caesarean section
returned because of an obstetric or surgical wound infection.
"Returning to the emergency department shortly after discharge, or being
unexpectedly readmitted, can be very stressful for patients and
families," explains Dr. Irfan Dhalla, staff physician and scientist at
St. Michael's Hospital in Toronto. "Understanding who is returning to
hospital and why can help identify strategies to reduce readmissions
and improve care for patients."
Length of initial stay in hospital predicted readmission
The study found that both very long and very short patient lengths of
stay (that is, those that deviated from the expected length of stay)
were predictors of readmission.
Additional predictors of readmission included neighbourhood income and
place of residence: patients from lower-income neighbourhoods and those
from rural areas had a higher risk of readmission.
Other factors associated with higher readmission rates for medical and
surgical patients included the patient's age and the number of other
existing conditions that he or she had. Gender also played a role—male
patients were slightly more likely than female patients to return to
the ED within seven days of their initial discharge.
When: June 14, 2012
The report and the following figures and table are available from CIHI's
website, at www.cihi.ca.
Distribution of Triage Levels for Patients Returning to the ED Within
Seven Days, Compared With All ED Patients (Figure 8 in the report)
Rate of Inpatient Readmissions by Urban/Rural Residence, Overall and by
Patient Group (Figure 3 in the report)
Rate of Inpatient Readmissions, by Income Quintile and by Patient Group
(Percentage) (Table 6 in the report)
SOURCE CANADIAN INSTITUTE FOR HEALTH INFORMATION
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