Readmission and its Causes and Costs in Inpatients of a General University Hospital in East of Iran

Readmission is a hospital quality and outcome measure. The aim of this study was to investigate the rate of readmission and its causes and costs in inpatient wards of a university hospital in Iran.

One-year data from a 320-bed training center were extracted to determine readmission, admission, final diagnosis, and costs. According to a specialized study, readmission cases were classified into one of 20 groups, and one of the 10 causes of the disease. Data analysis was performed using chi-square and logistic regression tests via SPSS software.

Out of a total of 17,542 hospitalizations, 1214 (6.92%) were readmitted, accounting for 8.27% of the total hospitalization costs. Among the classes of causes of readmission, unrelated complications of disease and recurrence of the disease were the most common causes of readmission, respectively. Among the inpatient wards, the highest percentage of readmission was related to the gynecology ward. The results of multiple logistic regression showed that the chances of readmission in the age groups between 15 to 65 years and under 15 years, was respectively 32.3% [confidence interval (CI): 0.78-0.58; odds ratio (OR) = 0.67] and 58.1% (CI: 0.51-0.32; OR = 0.41) lower than the age group over 65 years (P < 0.050). The chance of readmission in patients covered by social security, accidental, health and miscellaneous insurance was respectively 35.0% (CI: 0.50-0.84; OR = 0.65), 37.8% (CI: 0.43-0.89; OR = 0.62), 23.1% (CI: 0.98-0.59; OR = 0.76) and 68.9% (CI: 0.89-0.11; OR = 0.32) lower than patients with armed insurance coverage (P < 0.050).

The results of the study indicate the importance of monitoring the rate, process, and costs of readmission as one of the key indicators of hospital performance quality.