Readmission Risk Factors in Patients of General Surgery Wards in Shiraz Hospitals: Applying LACE Index as a Predictive Indicator

Today, the effective use of limited health care resources is increasingly regarded. Reduction of the readmission is one of the key tools can improve health outcomes and considered as one of the control levers that reduces health costs. Identifying the causes of readmission to the hospital helps to utilize hospital beds and facilities a more efficiently. This case-control study had been conducted in general surgery (GS) wards in 2011-2012. Using chisquare test, t-test, and multiple regressions, westudied risk factors associated with readmission in both groups of case and control. Finally, the predictive power of the Length ofstay, Acuity of illness, Co morbidity of the patient, Emergency (LACE) index was evaluated using receiver operating characteristic (ROC) curve. About 20% of patients in GS wards were admitted within 30 days. There is a significant difference between the two groups in the following variables: age, sex, length of hospital stay, marital status, discharge season, congestive heart failure, diabetes and renal failure. The rate of readmission with LACE index which is compared with the ROC curve shows that it is significant (P < 0.001 and Kappa = 0.22). Awareness of the prevalence and risk factors of readmission is effective in planning and decision making for using hospital facilities efficiently. Identifying patients at risk of readmission and performing training plan, discharging and following up medical programs can reduce the rate of readmission and costs of hospital. Predicting readmission can be very effective but identifying an effective index is very difficult.