Poor, rural patients most likely to return to hospital

Reduction in readmissions may save at least $162M a year: report

Poor patients and those from rural areas are most likely to have an unplanned readmission to hospital, according to a new report.

The study by the Canadian Institute for Health Information estimates the country could save a minimum of $162 million a year by reducing the proportion of patients who are forced to return to hospital after discharge.

More than 180,000 Canadians were readmitted to acute care in 2010. Detailed emergency room data from provinces like Alberta, Ontario and Yukon also show nearly one in 10 of those discharged from a hospital end up in an ER within a week.

“Although readmissions cannot always be avoided,” CIHI vice-president Jeremy Veillard said in a release, “research suggests that in many cases they may be prevented.”

Only 7.9 per cent of patients who were top quintile earners were readmitted within 30 days of discharge, but 9.5 per cent of the bottom fifth on the income scale ended up back in hospital within a month of leaving. The study said the disparity may be due to the fact that the country’s poor are less likely to have a family doctor or access to primary care.

Only 8.3 per cent of patients from cities were readmitted, compared to 9.5 of rural residents. The study suggested a shortage of home-care services like palliative care and physiotherapy outside major centres could be to blame.

Medical patients, with ailments like chronic obstructive pulmonary

Although readmissions cannot always be avoided, research suggests that in many cases they may be prevented. JEREMY VEILLARD, CANADIAN INSTITUTE FOR HEALTH INFORMATION

disease and heart failure, were the most likely to be readmitted to hospital. Among surgical cases, the highest readmission rate was for colostomy patients, where one in six returned to an acute care facility.

No significant regional variations were noted, although Alberta’s readmission rate of 8.2 per cent was below the national average of 8.5 per cent. The study suggested improved patient education and better discharge planning and followup could reduce the overall proportion of patients readmitted.