Background: While international data exists on hospitalisation and its associated mortality among endstage renal disease (ESRD) population on maintenance renal replacement therapy (RRT), local data is not known. The objective of this single centre retrospective observational study is to determine the burden of hospital admission and readmission among the ESRD population and the mortality outcome after hospitalisation. Methods: We obtained our study data from the HSNI Batu Pahat nephrology service inpatient database, patients’ medical records and Jabatan Pendaftaran Negara (JPN) registry of death. Results: There were 195 index admissions identified from January to June 2016. We found that hospital readmission rate was high at 19.5% within 30 days, 34.4% within 60 days, and 44.6% within 90 days of discharge. Commonest reason of admission was fluid overload (20.7%). Overload was also the commonest reason of readmissions within 30 and 60 days (28.9% and 23.8% respectively), whereas vascular access related issues were the commonest reason of readmission within 90 days of discharge (21.8%). The 90-day mortality rate after index admission was also high at around 18%. The commonest cause of mortality was Infection and Sepsis (42.9%), followed by Acute Coronary Syndrome (22.9%). Conclusions: This study demonstrated the heavy burden of hospitalisation and high mortality rate among ESRD populations. Further larger researches are welcomed to look into the factors associated and the problems faced, in order to improve not only individual morbidity and mortality outcomes, but also on hospitalisation cost and healthcare resources.
Patient Readmission

Background and Objectives: Patients on dialysis are twice as likely to have early readmissions. This study aimed to identify risk factors for 30-day unplanned readmission among patients on maintenance dialysis in a tertiary hospital. Methods: We conducted a retrospective, unmatched, case-control study. Data were taken from patients on maintenance hemodialysis admitted in the University of the Philippines–Philippine General Hospital (UP-PGH) between January 2018 and December 2020. Patients with 30-day readmission were included as cases and patients with >30-day readmissions were taken as controls. Multivariable regression with 30-day readmission as the outcome was used to identify significant predictors of early readmission. Results: The prevalence of 30-day unplanned readmission among patients on dialysis is 36.96%, 95%CI [31.67, 42.48]. In total, 119 cases and 203 controls were analyzed. Two factors were significantly associated with early readmission: the presence of chronic glomerulonephritis [OR 2.35, 95% CI 1.36 to 4.07, p-value=0.002] and number of comorbidities [OR 1.34, 95% CI 1.12 to 1.61, p-value=0.002]. The most common reasons for early readmission are infection, anemia, and uremia/underdialysis. Conclusion Patients with chronic glomerulonephritis and multiple comorbidities have significantly increased odds of early readmission. Careful discharge planning and close follow up of these patients may reduce early readmissions.
Patient Readmission ; Dialysis ; Risk Factors

No abstract available.
Patient Readmission* ; Vertebral Artery Dissection* ; Vertebral Artery*

Humans ; Patient Discharge ; Patient Readmission ; Risk Factors ; Technology

Asians ; China/epidemiology* ; Humans ; Patient Discharge ; Patient Readmission

The hospital readmission rate has been widely used as an indicator of the quality of hospital care in many countries. However, the transferrability of this indicator that has been developed in a different health care system can be questioned. We reviewed what should be considered when using the risk-standardized readmission rate (RSRR) as a generic quality indicator in the Korean setting. We addressed the relationship between RSRR and the quality of hospital care, methodological aspects of RSRR, and use of RSRR for external purposes. These issues can influence the validity of the readmission rate as a generic quality indicator. Therefore RSRR should be used with care and further studies are needed to enhance the validity of the readmission rate indicator.
Delivery of Health Care ; Patient Readmission ; Quality Indicators, Health Care

INTRODUCTION: Analysis of risk factors can pave the way for reducing unscheduled hospital readmissions and improve resource utilisation. METHODS: This was a concurrent nested, mixed method study. Factors associated with patients readmitted within 30 days between 2011 and 2015 at the National University Hospital, Singapore (N=104,496) were examined. Fifty patients were sampled in 2016 to inform an embedded qualitative study. Narrative interviews explored the periods of readmissions and related experiences, contrasted against those of non-readmitted patients. RESULTS: Neoplastic disease (odds ratio [OR] 1.91, 95% confidence interval [CI] 1.70-2.15), number of discharged medications (5 to 10 medications OR 1.21, 95% CI 1.14-1.29; ≥11 medications OR 1.80, 95% CI 1.66-1.95) and length of stay >7 days (OR 1.46, 95% CI 1.36-1.58) were most significantly associated with readmissions. Other factors including number of surgical operations, subvention class, number of emergency department visits in the previous year, hospital bill size, gender, age, Charlson comorbidity index and ethnicity were also independently associated with hospital readmissions. Although readmitted and non-readmitted patients shared some common experiences, they reported different psychological reactions to their illnesses and viewed hospital care differently. Negative emotions, feeling of being left out by the healthcare team and perception of ineffective or inappropriate treatment were expressed by readmitted patients. CONCLUSION Patient, hospital and system-related factors were associated with readmissions, which may allow early identification of at-risk patients. Qualitative analysis suggested several areas of improvement in care including greater empowerment and involvement of patients in care and decision making.
Hospitals ; Humans ; Length of Stay ; Patient Readmission ; Retrospective Studies ; Risk Factors

OBJECTIVE: To investigate the length of hospital stay (LOS) after stroke using the database of the Korean Health Insurance Review & Assessment Service. METHODS: We matched the data of patients admitted for ischemic stroke onset within 7 days in the Departments of Neurology of 12 hospitals to the data from the database of the Korean Health Insurance Review & Assessment Service. We recruited 3,839 patients who were hospitalized between January 2011 and December 2011, had a previous modified Rankin Scale of 0, and no acute hospital readmission after discharge. The patients were divided according to the initial National Institute of Health Stroke Scale score (mild, ≤5; moderate, >5 and ≤13; severe, >13); we compared the number of hospitals that admitted patients and LOS after stroke according to severity, age, and sex. RESULTS: The mean LOS was 115.6±219.0 days (median, 19.4 days) and the mean number of hospitals was 3.3±2.1 (median, 2.0). LOS was longer in patients with severe stroke (mild, 65.1±146.7 days; moderate, 223.1±286.0 days; and severe, 313.2±336.8 days). The number of admitting hospitals was greater for severe stroke (mild, 2.9±1.7; moderate, 4.3±2.6; and severe, 4.5±2.4). LOS was longer in women and shorter in patients less than 65 years of age. CONCLUSION: LOS after stroke differed according to the stroke severity, sex, and age. These results will be useful in determining the appropriate LOS after stroke in the Korean medical system.
Female ; Humans ; Insurance, Health ; Length of Stay* ; Neurology ; Patient Acuity ; Patient Readmission ; Stroke*

Many findings suggest that chronic obstructive pulmonary disease (COPD) imposes an enormous burden on patients, health-care professionals and society. COPD contributes to morbidity and mortality and to a significant use of health-care resources. In spite of a higher prevalence of COPD in Korea, the result of COPD treatment is not effective. The purpose of this article was to review recent advances in the study of COPD in Korea with the aim of improving effective management. This review highlights articles pertaining to the following topics; prevalence, assessment of COPD, risk factors for hospitalization, co-morbid diseases, phenotypes, and treatment issues.
Comorbidity ; Hospitalization ; Humans ; Korea ; Patient Readmission ; Phenotype ; Prevalence ; Pulmonary Disease, Chronic Obstructive ; Risk Factors

OBJECTIVE: To investigate the current status of readmission of neonates with hyperbilirubinemia and risk factors for readmission. METHODS: From January 2017 to December 2019, a total of 85 infants who were readmitted due to hyperbilirubinemia were enrolled as the study group. A total of 170 neonates with hyperbilirubinemia but without readmission during the same period of time were randomly selected as the control group. The medical data were compared between the two groups. Multivariate logistic regression was used to assess the risk factors for readmission due to hyperbilirubinemia. RESULTS: The readmission rate was 2.30%, and the interval between readmission and initial admission was 5 days. Compared with the control group, the study group had significantly higher levels of total bilirubin and indirect bilirubin at discharge (P<0.05) and a significantly longer duration of phototherapy during the first hospitalization (P<0.05). The univariate analysis showed that compared with the control group, the study group had significantly lower birth weight, gestational age, and age on initial admission (P<0.05) and a significantly higher proportion of infants with glucose-6-phosphate dehydrogenase (G-6-PD) deficiency or hemolytic disease (P<0.05). The multivariate analysis showed that low gestational age (OR=1.792, P<0.05), young age on initial admission (OR=1.415, P<0.05), and G-6-PD deficiency (OR=2.829, P<0.05) were independent risk factors for readmission of neonates with hyperbilirubinemia. CONCLUSIONS The infants with hyperbilirubinemia who have lower gestational age, younger age on initial admission, and G-6-PD deficiency have a higher risk of readmission due to hyperbilirubinemia. It is thus important to strengthen the management during hospitalization and after discharge for these infants to prevent the occurrence of readmission.
Bilirubin ; Glucosephosphate Dehydrogenase Deficiency ; Humans ; Hyperbilirubinemia, Neonatal ; Infant, Newborn ; Patient Readmission ; Risk Factors