Factors associated with hospital readmission and emergency visits among older adults–5-year experience in a busy acute hospital

Background/Objective: We aimed to identify and compare factors associated with 30-day readmission and visit to mergency Department (ED) post-discharge among elderly patients.Methods: This was a retrospective cohort study of patients ≥65 years old who were admitted to a regional acute hospital in Singapore in 2011-2015. Data on demographics, admission and discharge details, comorbidity and functional status were extracted from the hospital’s electronic clinical records and linked to data on emergency visits and death. The outcomes were (1) unplanned inpatient readmissions within 30 days of inpatient discharge, and (2) visit to ED within 30 days of inpatient discharge. Backward stepwise multivariable logistic regression was used to examine the association between patient characteristics and outcomes.Results: There were 45,349 admissions for the analysis. Overall, 19.2% were readmitted and 22.2% visited ED post-30 day discharge. Several factors associated with 30-day readmissions and ED visits were shared, including males, functional impairment, higher number of hospital admissions, time of discharge, discharge to nursing home, Charlson cormorbidity index, length of stay and congestive heart failure.Conclusion: The outcomes were predicted by multiple risk factors, some of which were shared and modifiable. Identification of these factors could aid in tailoring of prevention strategies and intensification of efforts at this growing group.