Patients' Characteristics, Length of Stay, Costs Charge and Outcomes among Patients with Unplanned Readmission within 28 days at Faculty of Medicine Ramathibodi Hospital

Thursday, 15 July 2010

Hataikorn Kittimanont, RN, MS1
Worranan Prasanatikom, RN, PhD1
Mali Rungreungvanich, MD2
1Utilization Management Unit, Dean Office, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
2Department of Anesthesiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Learning Objective 1: to understand the characteristics of the patients who had unplanned readmission within 28 days and how they utilized the hospital resources.

Learning Objective 2: to compare the results of this study from Thailand to others from his/her country.

Unplanned readmission within 28 days with the same disease is one of the quality indicators of the hospital but little is known about this. Purpose: To describe patients’ characteristics, length of stay, costs charge, and outcomes among patients with unplanned readmission within 28 days Methods: The design was retrospective study. The sample was the patient with unplanned readmission to the Ramathibodi Hospital within 28 days after discharged during January 1, 2007 to September 30, 2008. The data of 1,682 subjects were extracted from the hospital information system. Results: Among 1,682 patients, 52% were male and 48% were female. Forty percent were adult, 30% were older persons, 23% were children and 7% were newborn and infant. The subjects were divided into 2 groups, 64% were unplanned readmitted within 28 days with the same disease and 36% were unplanned readmitted within 28 days with a new disease. There were statistically significant differences of age, length of stay (LOS), costs charge, and principle diagnosis between these 2 groups at alpha .001. The patients readmitted to the hospital within 28 days with same disease were older (43 vs. 37 years), had longer LOS (12 vs.8 days), had higher costs charge (67,650 vs. 42,768 Bahts) than the other group. The most common principle diagnosis of the patients with unplanned readmission within 28 days with the same disease was cancer (21%) and of the other group was infectious disease (6%). The outcomes measured as discharge status were not different. Most of the patients had improved status at discharged. Conclusion: The patients with unplanned readmission within 28 days with the same disease were mostly adults with cancer diseases and utilized more resources than the other group. Discharge planning should be evaluated to improve quality of care. Factors related to unplanned readmission should be studied.