Factors positively associated with readmission being assessed as predictable and preventable per interviewed group*
| Final models | Patient predictable (n=1240) | Patient preventable (n=1067) | Physician predictable (n=1216) | Physician preventable (n=978) | Nurse predictable (n=945) | Nurse preventable (n=961) | Carer predictable (n=860) | Carer preventable (n=816) | Researcher predictable (n=1171) | Researcher preventable (n=1011) |
| AUROC final model† | 0.72 | 0.74 | 0.71 | 0.65 | 0.74 | 0.70 | 0.68 | 0.71 | 0.71 | 0.68 |
| Characteristics |
OR (95% CI), p value | OR (95% CI), p value | OR (95% CI), p value | OR (95% CI), p value | OR (95% CI), p value | OR (95% CI), p value | OR (95% CI), p value | OR (95% CI), p value | OR (95% CI), p value | OR (95% CI), p value |
| Patient age, year | 2.34 (1.42 to 4.02), p<0.001 | – | – | 1.01 (1.00 to 1.02), p=0.058 | 0.98 (0.96 to 0.99), p<0.001 | – | – | – | – | – |
| Male sex | – | – | – | – | – | – | – | – | – | – |
| Partnered/Married | – | – | – | 0.67 (0.48 to 0.94), p=0.02 | – | 0.53 (0.38 to 0.75), p<0.001 | – | 0.58 (0.42 to 0.81), p=0.001 | – | 0.73 (0.53 to 1.01), p=0.054 |
| IA type‡, non-elective | 2.34 (1.42 to 4.02), p<0.001 | – | 2.21 (1.44 to 3.38), p<0.001 | – | 2.03 (1.25 to 3.23), p=0.004 | 1.81 (1.03 to 3.18), p<0.039 | 1.63 (1.06 to 2.51), p=0.026 | – | 1.95 (1.29 to 2.93), p=0.001 | – |
| LOS IA‡, day | – | – | – | – | – | – | – | – | – | – |
| Length between IA and RA‡, day | – | – | – | – | – | – | – | 0.96 (0.94 to 0.98), p<0.001 | 0.96 (0.94 to 0.98), p<0.001 | |
| Clinical Frailty Scale33 | – | – | 1.31 (1.20 to 1.43), p<0.001 | – | 1.38 (0.96 to 1.98), p=0.087 | – | 1.18 (1.07 to 1.30), p=0.001 | – | 1.30 (1.19 to 1.42), p<0.001 | |
| Charlson Comorbidity Index32 | – | – | 1.07 (1.01 to 1.13), p=0.029 | – | – | 0.92 (0.85 to 0.99), p=0.035 | – | – | 1.09 (1.03 to 1.16), p=0.004 | 0.92 (0.86 to 1.00), p=0.036 |
| HOSPITAL score17‡ | – | – | – | – | – | – | – | – | – | 1.12 (1.03 to 1.212), p=0.007 |
| Number of medicine at discharge (chronic and non-chronic use) | – | – | – | – | p=0.082 | – | p=0.001 | p=0.094 | – | – |
| 0–4 | – | – | – | – | – | – | – | |||
| 5–8 | – | – | – | – | 1.70 (1.06 to 2.72), p=0.028 | – | 0.74 (0.48 to 1.15), p=0.178 | 1.00 (0.63 to 1.59), p=0.97 | – | – |
| More than 8 | – | – | – | – | 1.55 (0.98 to 2.45), p=0.059 | – | 1.45 (0.96 to 2.19), p=0.75 | 1.41 (0.93 to 2.15), p=0.11 | – | – |
| Patient’s DNR order at discharge IA‡, do resuscitate | – | 1.44 (1.00 to 2.07), p=0.048 | – | – | 0.62 (0.42 to 0.92), p=0.018 | – | – | – | – | – |
| ICU/CCU/HDU admission during IA‡, yes | – | – | – | – | – | – | – | – | – | – |
| Cognitive impairment (official diagnosis), yes | – | – | – | – | – | – | – | – | 2.03 (0.89 to 4.63), p=0.091 | |
| Fallen at least once in last half year, yes | – | – | – | – | – | 1.37 (0.95 to 1.95), p=0.089 | – | – | – | – |
| Total admissions year prior to IA, elective and non-elective | – | – | p<0.001 | – | p=0.002 | p=0.096 | p=0.090 | – | p<0.001 | – |
| 0 | – | – | – | – | – | |||||
| 1–5 | – | – | 1.24 (0.93 to 1.67), p=0.149 | – | 1.45 (1.03 to 2.04), p=0.031 | 1.39 (0.94 to 2.04), p=0.096 | 0.98 (0.71 to 1.34), p=0.876 | 1.40 (1.04 to 1.88), p=0.026 | – | |
| >5 | – | – | 2.97 (1.92 to 4.59), p<0.001 | – | 2.37 (1.44 to 3.88), p=0.001 | 1.79 (1.03 to 3.11), p=0.039 | 1.68 (1.00 to 2.80), p=0.049 | – | 3.40 (2.17 to 5.34), p<0.001 | – |
| Discharge letter issued at time RA, yes | – | – | – | – | – | – | – | – | – | – |
| Follow-up planned at discharge IA, yes | – | – | – | 0.62 (0.41 to 0.94), p=0.026 | – | 0.56 (0.37 to 0.85), p=0.006 | – | 0.66 (0.43 to 1.01), p=0.057 | – | 0.42 (0.22 to 0.61), p<0.001 |
| Has patient been seen by a doctor between IA and RA? Yes | 2.08 (1.47 to 2.93), p<0.001 | – | – | – | – | – | – | – | – | – |
| Was a summary provided at discharge? Yes | – | – | – | 0.67 (0.46 to 0.98), p=0.04 | 1.38 (0.96 to 1.98), p=0.087 | – | – | – | – | – |
| Did you (the patient) suggest doctors to stay longer at IA? Yes | – | 2.18 (1.35 to 3.53), p=0.002 | 1.56 (0.99 to 2.46), p=0.056 | – | – | – | – | – | – | – |
| Did you (the patient) feel better at discharge (IA)? Yes | 0.68 (0.47 to 0.98), p=0.039 | 0.69 (0.48 to 0.98), p=0.039 | – | 0.62 (0.44 to 0.87), p=0.006 | – | – | – | – | – | – |
| Did you (the patient) feel ready at discharge (IA)? Yes | 0.29 (0.20 to 0.42), p<0.001 | 0.22 (0.15 to 0.32), p<0.001 | 0.71 (0.52 to 0.97), p=0.033 | – | 0.46 (0.33 to 0.65), p<0.001 | 0.47 (0.33 to 0.68), p<0.001 | 0.42 (0.30 to 0.60), p<0.001 | 0.24 (0.17 to 0.34), p<0.001 | 0.48 (0.36 to 0.65), p<0.001 | 0.46 (0.33 to 0.65), p<0.001 |
*Corrected for country for all
†AUROC, area under the receiver operating characteristic curves.
‡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.