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Patient and hospital factors associated with 30-day unplanned readmission in patients with stroke
  1. Sang Ah Lee1,2,
  2. Eun-Cheol Park2,3,
  3. Jaeyong Shin2,3,
  4. Yeong Jun Ju1,2,
  5. Young Choi1,2,
  6. Hoo-Yeon Lee4
  1. 1Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
  2. 2Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
  3. 3Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
  4. 4Department of Social Medicine, College of Medicine, Dankook University, Chungnam, Republic of Korea
  1. Correspondence to Dr Hoo-Yeon Lee, Department of Social Medicine, College of Medicine, Dankook University, Chungnam 31116, Republic of Korea; hylee{at}dankook.ac.kr

Abstract

Stroke is frequently associated with readmission; moreover, readmission is regarded as an important indicator of the quality of stroke care. Thus, we investigated factors associated with 30-day readmission in patients with stroke in South Korea. We used claims data from 2013 for stroke (I60–I62) patients (n=44 729) in 94 hospitals and classified unplanned readmission according to the Centers for Medicare and Medicaid guidelines. We used multilevel models to investigate patient (age, gender, type of insurance, admission via emergency room, length of stay, type of stroke, Elixhauser Index Score) and hospital (stroke care quality grade, location of hospital, type of hospital, number of doctors and nurses per 100 beds) factors associated with readmission within 30 days of discharge. Among the 44 729 patients admitted due to stroke, 9.2% (n=4124) were readmitted to hospital and 7.6% (n=3379) had unplanned readmissions. Regarding patient characteristics, medical aid and longer hospital stay were associated with 30-day readmission rate. Among hospital factors, patients admitted to a low-grade hospital or a non-capital area hospital were more likely to be readmitted within 30 days of discharge. We identified patient and hospital factors associated with 30-day readmission among stroke patients. In particular, patients admitted to hospitals with higher quality stroke care showed lower readmission rates.

  • stroke

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Footnotes

  • Contributors SAL designed the study and directed its implementation, including quality assurance and control. JYS and YJJ participated in the design of the study and performed the statistical analysis. H-YL helped supervise the field activities and designed the study’s analytic strategy. YC helped conduct the literature review and prepare the Methods and the Discussion sections of the text. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Correction notice This article has been corrected since it was published Online First. The author name Jaeyong shin has been amended to read Jaeyong Shin.

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