Risk factors and direct medical cost of early versus late unplanned readmissions among diabetes patients at a tertiary hospital in Singapore.
Png ME., Yoong J., Chen C., Tan CS., Tai ES., Khoo EY., Wee HL.
To examine the risk factors and direct medical cost associated with early (≤30 days) versus late (31-180 days) unplanned readmissions among patients with type 2 diabetes in Singapore.Risk factors and its associated cost among diabetes patients were investigated using electronic medical records from a local tertiary care hospital from 2010 to 2012. Multivariable logistic regression was used to identify risk factors associated with early and late unplanned readmissions while a generalized linear model was used to estimate the direct medical cost. Sensitivity analysis was also performed.1,729 diabetes patients had unplanned readmissions within 180 days of an index discharge. Length of index stay (a marker of acute illness burden) was one of the risk factors associated with early unplanned readmission while patient behavior-related factors, like the diabetes-related medication adherence, was one of the factors associated with late unplanned readmission. Adjusted mean cost of index admission was higher among patients with unplanned readmission. Sensitivity analysis yield similar results.Existing routinely-captured data can be used to develop prediction models that flag out high risk patients during their index admission; potentially helping to support clinical decisions and prevent such readmissions.