tetano
Editor, Senior Moderator
MMWR Morb Mortal Wkly Rep
. 2020 Nov 13;69(45):1695-1699.
doi: 10.15585/mmwr.mm6945e2.
Characteristics of Hospitalized COVID-19 Patients Discharged and Experiencing Same-Hospital Readmission - United States, March-August 2020
Amy M Lavery[SUP] 1 [/SUP], Leigh Ellyn Preston[SUP] 1 [/SUP], Jean Y Ko[SUP] 1 [/SUP], Jennifer R Chevinsky[SUP] 1 [/SUP], Carla L DeSisto[SUP] 1 [/SUP], Audrey F Pennington[SUP] 1 [/SUP], Lyudmyla Kompaniyets[SUP] 1 [/SUP], S Deblina Datta[SUP] 1 [/SUP], Eleanor S Click[SUP] 1 [/SUP], Thomas Golden[SUP] 1 [/SUP], Alyson B Goodman[SUP] 1 [/SUP], William R Mac Kenzie[SUP] 1 [/SUP], Tegan K Boehmer[SUP] 1 [/SUP], Adi V Gundlapalli[SUP] 1 [/SUP]
Affiliations
Abstract
Coronavirus disease 2019 (COVID-19) is a complex clinical illness with potential complications that might require ongoing clinical care (1-3). Few studies have investigated discharge patterns and hospital readmissions among large groups of patients after an initial COVID-19 hospitalization (4-7). Using electronic health record and administrative data from the Premier Healthcare Database,* CDC assessed patterns of hospital discharge, readmission, and demographic and clinical characteristics associated with hospital readmission after a patient's initial COVID-19 hospitalization (index hospitalization). Among 126,137 unique patients with an index COVID-19 admission during March-July 2020, 15% died during the index hospitalization. Among the 106,543 (85%) surviving patients, 9% (9,504) were readmitted to the same hospital within 2 months of discharge through August 2020. More than a single readmission occurred among 1.6% of patients discharged after the index hospitalization. Readmissions occurred more often among patients discharged to a skilled nursing facility (SNF) (15%) or those needing home health care (12%) than among patients discharged to home or self-care (7%). The odds of hospital readmission increased with age among persons aged ≥65 years, presence of certain chronic conditions, hospitalization within the 3 months preceding the index hospitalization, and if discharge from the index hospitalization was to a SNF or to home with health care assistance. These results support recent analyses that found chronic conditions to be significantly associated with hospital readmission (6,7) and could be explained by the complications of underlying conditions in the presence of COVID-19 (8), COVID-19 sequelae (3), or indirect effects of the COVID-19 pandemic (9). Understanding the frequency of, and risk factors for, readmission can inform clinical practice, discharge disposition decisions, and public health priorities such as health care planning to ensure availability of resources needed for acute and follow-up care of COVID-19 patients. With the recent increases in cases nationwide, hospital planning can account for these increasing numbers along with the potential for at least 9% of patients to be readmitted, requiring additional beds and resources.
. 2020 Nov 13;69(45):1695-1699.
doi: 10.15585/mmwr.mm6945e2.
Characteristics of Hospitalized COVID-19 Patients Discharged and Experiencing Same-Hospital Readmission - United States, March-August 2020
Amy M Lavery[SUP] 1 [/SUP], Leigh Ellyn Preston[SUP] 1 [/SUP], Jean Y Ko[SUP] 1 [/SUP], Jennifer R Chevinsky[SUP] 1 [/SUP], Carla L DeSisto[SUP] 1 [/SUP], Audrey F Pennington[SUP] 1 [/SUP], Lyudmyla Kompaniyets[SUP] 1 [/SUP], S Deblina Datta[SUP] 1 [/SUP], Eleanor S Click[SUP] 1 [/SUP], Thomas Golden[SUP] 1 [/SUP], Alyson B Goodman[SUP] 1 [/SUP], William R Mac Kenzie[SUP] 1 [/SUP], Tegan K Boehmer[SUP] 1 [/SUP], Adi V Gundlapalli[SUP] 1 [/SUP]
Affiliations
- PMID: 33180754
- DOI: 10.15585/mmwr.mm6945e2
Abstract
Coronavirus disease 2019 (COVID-19) is a complex clinical illness with potential complications that might require ongoing clinical care (1-3). Few studies have investigated discharge patterns and hospital readmissions among large groups of patients after an initial COVID-19 hospitalization (4-7). Using electronic health record and administrative data from the Premier Healthcare Database,* CDC assessed patterns of hospital discharge, readmission, and demographic and clinical characteristics associated with hospital readmission after a patient's initial COVID-19 hospitalization (index hospitalization). Among 126,137 unique patients with an index COVID-19 admission during March-July 2020, 15% died during the index hospitalization. Among the 106,543 (85%) surviving patients, 9% (9,504) were readmitted to the same hospital within 2 months of discharge through August 2020. More than a single readmission occurred among 1.6% of patients discharged after the index hospitalization. Readmissions occurred more often among patients discharged to a skilled nursing facility (SNF) (15%) or those needing home health care (12%) than among patients discharged to home or self-care (7%). The odds of hospital readmission increased with age among persons aged ≥65 years, presence of certain chronic conditions, hospitalization within the 3 months preceding the index hospitalization, and if discharge from the index hospitalization was to a SNF or to home with health care assistance. These results support recent analyses that found chronic conditions to be significantly associated with hospital readmission (6,7) and could be explained by the complications of underlying conditions in the presence of COVID-19 (8), COVID-19 sequelae (3), or indirect effects of the COVID-19 pandemic (9). Understanding the frequency of, and risk factors for, readmission can inform clinical practice, discharge disposition decisions, and public health priorities such as health care planning to ensure availability of resources needed for acute and follow-up care of COVID-19 patients. With the recent increases in cases nationwide, hospital planning can account for these increasing numbers along with the potential for at least 9% of patients to be readmitted, requiring additional beds and resources.