Patient characteristics*†
| Characteristics | Total (n=1398) | Predictable majority Total (n=1398) | p Value for majority Non-predictable versus predictable | Preventable majority Total (n=1398) | p Value for majority Non-preventable versus preventable | ||
| Non-predictable (n=1008) | Predictable (n=390) | Non-preventable (n=1196) | Preventable (n=202) | ||||
| Country, n (%) | |||||||
| The Netherlands | 911 (65.2) | 679 (67.4) | 232 (59.5) | p<0.001 | 785 (65.6) | 126 (62.4) | p<0.001 |
| Denmark | 262 (18.7) | 191 (18.9) | 71 (18.2) | 242 (20.2) | 20 (9.9) | ||
| UK and Ireland | 225 (16.1) | 225 (16.1) | 87 (22.3) | 169 (14.1) | 56 (27.7) | ||
| Patient age, median (range), year | 70 (18–96) | 70 (18–96) | 69 (18–96) | p=0.03 | 70 (18–96) | 70.5 (18–96) | p=0.62 |
| Male sex, n (%) | 737 (52.7) | 538 (53.4) | 199 (51.0) | p=0.43 | 627 (52.4) | 110 (54.5) | p=0.59 |
| Partnered/Married, n (%) | 828 (59.2) | 61.3 (61.1) | 53.8 (48.0) | p=0.011 | 731 (61.1) | 97 (48.0) | p<0.001 |
| IA type‡, non-elective, n (%) | 1195 (85.2) | 830 (82.3) | 361 (92.6) | p<0.001 | 830 (82.3) | 361 (92.6) | p=0.21 |
| LOS IA‡, median (range), day | 4 (0–191) | 4 (0–136) | 4 (0–191) | p<0.001 | 4 (1–191) | 4 (1–136) | p=0.94 |
| Length between IA and RA‡, median (range), day | 9 (0–30) | 9 (0–30) | 10 (0–30) | p=0.032 | 9 (0–30) | 7 (0–30) | p=0.007 |
| Clinical Frailty Scale, mean (SD)33 | 4.4 (1.6) | 4.2 (1.6) | 4.9 (1.7) | p<0.001 | 4.4 (1.6) | 4.5 (1.6) | p=0.33 |
| Charlson Comorbidity Index, median (range)32 | 2 (0–11) | 4 (0–11) | 4 (0–10) | p<0.001 | 2 (0–11) | 2.5 (0–9) | p=0.68 |
| HOSPITAL score17‡§, mean (SD) | 4.4 (2.1) | 4.2 (2.0) | 5.0 (2.2) | p<0.001 | 4.4 (2.1) | 4.6 (2.2) | p=0.08 |
| Number of medicine at discharge (chronic and non-chronic use), n (%) | |||||||
| 0–4 | 257 (18.4) | 201 (20.0) | 56 (14.4) | p=0.001 | 222 (18.6) | 35 (17.3) | p=0.062 |
| 5–8 | 395 (28.3) | 299 (29.7) | 96 (24.7) | 342 (28.7) | 53 (26.2) | ||
| >8 | 743 (53.3) | 506 (50.3) | 237 (60.9) | 629 (52.7) | 114 (56.4) | ||
| Patient’s DNR order at discharge IA‡¶, do resuscitate, n (%) | 961 (73.1) | 712 (74.9) | 249 (68.8) | p=0.022 | 821 (73.1) | 140 (73.3) | p=0.96 |
| ICU/CCU/HDU admission during IA‡, yes, n (%) | 115 (8.2) | 94 (9.4) | 21 (5.4) | p=0.015 | 102 (8.5) | 13 (6.5) | p=0.32 |
| Cognitive impairment (official diagnosis)** yes, n (%) | 41 (3.0) | 23 (2.3) | 18 (4.7) | p=0.02 | 30 (2.5) | 11 (5.6) | p=0.02 |
| Fallen at least once in the last half year, yes, n (%) | 380 (28.9) | 279 (29.6) | 101 (27.3) | p=0.42 | 309 (27.6) | 71 (36.2) | p=0.014 |
| Total admissions year prior to IA, elective and non-elective, n (%) | |||||||
| 0 | 507 (36.3) | 404 (40.1) | 103 (26.4) | p<0.001 | 440 (36.8) | 67 (33.2) | p=0.61 |
| 1–5 | 745 (53.3) | 534 (53.0) | 211 (54.1) | 632 (52.8) | 113 (55.9) | ||
| >5 | 146 (10.4) | 70 (6.9) | 76 (19.5) | 124 (10.4) | 22 (10.9) | ||
| Discharge letter issued at time RA, yes, n (%) | 1045 (75.8) | 759 (76.5) | 286 (74.1) | p=0.35 | 76.9 (905) | 140 (69.7) | p=0.027 |
| Follow-up planned at discharge IA, yes, n (%) | 1134 (84.1) | 824 (85.0) | 310 (81.6) | p=0.12 | 992 (86.1) | 142 (72.1) | p<0.001 |
| Has patient been seen by a doctor between IA and RA? Yes, n (%) | 867 (66.8) | 615 (66.1) | 252 (68.9) | p=0.34 | 735 (66.6) | 132 (68.4) | p=0.62 |
| Was a summary provided at discharge? Yes, n (%) | 994 (72.6) | 720 (78.5) | 274 (79.0) | p=0.86 | 860 (80.2) | 134 (69.8) | p=0.001 |
| Did you (the patient) suggest doctors to stay longer at IA? Yes, n (%) | 131 (9.4) | 74 (7.4) | 57 (14.9) | p<0.001 | 103 (8.7) | 28 (13.9) | p<0.001 |
| Did you (the patient) feel better at discharge (IA)? Yes, n (%) | 950 (69.3) | 707 (71.9) | 243 (63.3) | p=0.002 | 839 (71.9) | 111 (55.5) | p<0.001 |
| Did you (the patient) feel ready at discharge (IA)? Yes, n (%) | 1014 (75.1) | 772 (78.9) | 242 (63.9) | p<0.001 | 900 (77.7) | 114 (57.3) | p=0.002 |
§For P (procedure) one point was given to all non-medical index admissions, 0 to medical IAs; missing data were considered as normal.
‡IA, index admission; RA, readmission; LOS IA, length of stay index admission; HOSPITAL, prediction score 30-day readmission17; DNR, do not resuscitate; ICU, intensive care unit; CCU, coronary care unit; HDU, high dependency unit.
*Missing data include the following: did you feel better for discharge (n=3), did you feel ready for discharge (n=1), was a summary provided at discharge?(n=12).
**Official diagnosis of cognitive impairment in medical history, but assessed as mentally competent to answer the questions (ie, using Minimal-mental state examination (MMSE)>20).
¶The patient had a ‘do resuscitate’ DNR policy during index admission (as opposed to a do not resuscitate DNR policy).
†Variables where ‘unknown’ or ‘don’t know’ was answered; these were regarded as missing since they were below 10% (see Methods): number of medicine at discharge (n=3), DNR policy at discharge (n=84), ICU/CCU/HDU admission during IA (n=4), cognitive impairment (official diagnosis) (n=16), fallen at least once in the last half year (n=84), discharge letter issued at time of RA (n=20), follow-up planned at discharge IA (n=49), has patient been seen by a doctor between IA and RA (n=101), was a summary provided at discharge (n=122) were answered with ‘unknown’ by the executive researcher. Did you suggest doctors to stay longer at IA? (n=9), did you feel better at discharge? (n=28), did you feel ready at discharge? (n=40) were answered with ‘don’t know’ by the patient surveyed.