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Article: Hospital Readmissions of Discharged Patients with COVID-19.

Parra, Lina Marcela / Cantero, Mireia / Morrás, Ignacio / Vallejo, Alberto / Diego, Itziar / Jiménez-Tejero, Elena / Múñez, Elena / Asensio, Ángel / Fermández-Cruz, Ana / Ramos-Martinez, Antonio

International journal of general medicine

2020 Volume 13, Page(s) 1359–1366

Abstract: ... with readmission of patients who had previously been discharged after admission for COVID-19.: Setting ... of patients discharged after suffering COVID-19 and identification of the clinical variables associated ... University hospital in Madrid (Spain).: Participants: Sixty-one patients (74% male) who presented COVID-19 were ...

Abstract	Objective: To analyse the rate of occurrence and the clinical variables associated with readmission of patients who had previously been discharged after admission for COVID-19. Setting: University hospital in Madrid (Spain). Participants: Sixty-one patients (74% male) who presented COVID-19 were readmitted during the 3 weeks after discharge from hospital. Interventions: Nested case-control study paired (1:1 ratio) by age, sex and period of admission. Outcome measures: Rate of readmission rate of patients discharged after suffering COVID-19 and identification of the clinical variables associated with it. Results: Out of 1368 patients who were discharged during the study period, 61 patients (4.4%) were readmitted. Immunocompromised patients (N=10.2%) were at increased risk for readmission (p=0.04). There was also a trend towards a higher probability of readmission in hypertensive patients (p=0.07). Cases had had a shorter hospital stay and a higher prevalence of fever during the 48 hours prior to discharge. There were no significant differences in oxygen levels measured at admission and discharge by pulse oximetry intra-subject or between the groups. Neutrophil-to-lymphocyte ratio at hospital admission tended to be higher in cases than in controls (p=0.06). Neither glucocorticoids nor anticoagulants prescribed at hospital discharge were associated with a lower readmission rate. Patients who were readmitted due to a thrombotic event (8 patients, 13.1%) presented a higher level of D-dimer at discharge of initial admission. Conclusion: The rate of readmission after discharge from hospital for COVID-19 was low. Immunocompromised patients and those presenting with fever during the 48 hours prior to discharge were at greater risk of readmission to hospital.
Language	English
Publishing date	2020-12-02
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2452220-X
ISSN	1178-7074
ISSN	1178-7074
DOI	10.2147/IJGM.S275775
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Article ; Online: Hospital readmissions of discharged patients with COVID-19

Parra, Lina Marcela / Cantero, MIreia / Morras, Ignacio / Vallejo, Alberto / Diego, Itziar / Jimenez-Tejero, Elena / Munez, Elena / Asensio, Angel / Fernandez-Cruz, Ana / Ramos-Martinez, Antonio

Abstract: ... of patients who had previously been discharged after admission for COVID-19. Design and methods ... The rate of readmission after discharge from hospital for COVID-19 was low. Immunocompromised patients and ... period of admission. Results. Out of 1368 patients who were discharged during the study period, 61 ...

Abstract	Background. COVID-19 infection has led to an overwhelming effort by health institutions to meet the high demand for hospital admissions. Aim. To analyse the clinical variables associated with readmission of patients who had previously been discharged after admission for COVID-19. Design and methods. We studied a retrospective cohort of patients with laboratory-confirmed SARS-CoV-2 infection who were admitted and subsequently discharged alive. We then conducted a nested case-control study paired (1:1 ratio) by age, sex and period of admission. Results. Out of 1368 patients who were discharged during the study period, 61 patients (4.4%) were readmitted. Immunocompromised patients were at increased risk for readmission. There was also a trend towards a higher probability of readmission in hypertensive patients (p=0.07). Cases had had a shorter hospital stay and a higher prevalence of fever during the 48 hours prior to discharge. There were no significant differences in oxygen levels measured at admission and discharge by pulse oximetry intra-subject or between the groups. Neutrophil/lymphocyte ratio at hospital admission tended to be higher in cases than in controls (p=0.06). The motive for readmission in 10 patients (16.4%), was a thrombotic event in venous or arterial territory (p<0.001). Neither glucocorticoids nor anticoagulants prescribed at hospital discharge were associated with a lower readmission rate. Conclusions. The rate of readmission after discharge from hospital for COVID-19 was low. Immunocompromised patients and those presenting with fever during the 48 hours prior to discharge are at greater risk of readmission to hospital.
Keywords	covid19
Publisher	MedRxiv; WHO
Document type	Article ; Online
Note	WHO #Covidence: #20118455
DOI	10.1101/2020.05.31.20118455
Database	COVID19

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Article ; Online: Hospital Readmissions of Discharged Patients with COVID-19

Parra LM / Cantero M / Morrás I / Vallejo A / Diego I / Jiménez-Tejero E / Múñez E / Asensio / Fermández-Cruz A / Ramos-Martinez A

International Journal of General Medicine, Vol Volume 13, Pp 1359-

2020 Volume 1366

Abstract: ... of readmission rate of patients discharged after suffering COVID-19 and identification of the clinical variables ... for COVID-19.Setting: University hospital in Madrid (Spain).Participants: Sixty-one patients (74% male ... variables associated with readmission of patients who had previously been discharged after admission ...

Abstract	Lina Marcela Parra,1 Mireia Cantero,1 Ignacio Morrás,2 Alberto Vallejo,1 Itziar Diego,2 Elena Jiménez-Tejero,1 Elena Múñez,3 Ángel Asensio,1 Ana Fermández-Cruz,3,4 Antonio Ramos-Martinez3,4 On behalf of Puerta de Hierro Hospital Admission Study Group1Servicio de Medicina Preventiva, HU Puerta de Hierro-Majadahonda, Madrid, Spain; 2Servicio de Medicina Interna, HU Puerta de Hierro-Majadahonda, Madrid, Spain; 3Servicio de Medicina Interna, HU Puerta de Hierro-Majadahonda, Unidad de Enfermedades Infecciosas, UAM, Madrid, Spain; 4Instituto Investigación Sanitaria Puerta de Hierro - Segovia de Arana (IDIPHSA), Madrid, SpainCorrespondence: Antonio Ramos-MartinezServicio de Medicina Interna, HU Puerta de Hierro-Majadahonda, Unidad de Enfermedades Infecciosas, Calle Joaquín Rodrigo 2, Majadahonda, Madrid 28222, SpainTel +34 638 211 120Fax +34 91191 6807Email aramos2202@gmail.comObjective: To analyse the rate of occurrence and the clinical variables associated with readmission of patients who had previously been discharged after admission for COVID-19.Setting: University hospital in Madrid (Spain).Participants: Sixty-one patients (74% male) who presented COVID-19 were readmitted during the 3 weeks after discharge from hospital.Interventions: Nested case–control study paired (1:1 ratio) by age, sex and period of admission.Outcome Measures: Rate of readmission rate of patients discharged after suffering COVID-19 and identification of the clinical variables associated with it.Results: Out of 1368 patients who were discharged during the study period, 61 patients (4.4%) were readmitted. Immunocompromised patients (N=10.2%) were at increased risk for readmission (p=0.04). There was also a trend towards a higher probability of readmission in hypertensive patients (p=0.07). Cases had had a shorter hospital stay and a higher prevalence of fever during the 48 hours prior to discharge. There were no significant differences in oxygen levels measured at admission and discharge by pulse oximetry intra-subject or between the groups. ...
Keywords	coronavirus ; pneumonia ; viral ; patient readmission ; pulmonary embolism ; heparin ; Medicine (General) ; R5-920
Language	English
Publishing date	2020-12-01T00:00:00Z
Publisher	Dove Medical Press
Document type	Article ; Online
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Article ; Online: Characteristics of Hospitalized COVID-19 Patients Discharged and Experiencing Same-Hospital Readmission - United States, March-August 2020.

Lavery, Amy M / Preston, Leigh Ellyn / Ko, Jean Y / Chevinsky, Jennifer R / DeSisto, Carla L / Pennington, Audrey F / Kompaniyets, Lyudmyla / Datta, S Deblina / Click, Eleanor S / Golden, Thomas / Goodman, Alyson B / Mac Kenzie, William R / Boehmer, Tegan K / Gundlapalli, Adi V

MMWR. Morbidity and mortality weekly report

2020 Volume 69, Issue 45, Page(s) 1695–1699

Abstract: ... hospital readmissions among large groups of patients after an initial COVID-19 hospitalization (4-7). Using ... patients with an index COVID-19 admission during March-July 2020, 15% died during the index hospitalization ... needed for acute and follow-up care of COVID-19 patients. With the recent increases in cases nationwide ...

Abstract	Coronavirus disease 2019 (COVID-19) is a complex clinical illness with potential complications that might require ongoing clinical care (1-3). Few studies have investigated discharge patterns and hospital readmissions among large groups of patients after an initial COVID-19 hospitalization (4-7). Using electronic health record and administrative data from the Premier Healthcare Database,* CDC assessed patterns of hospital discharge, readmission, and demographic and clinical characteristics associated with hospital readmission after a patient's initial COVID-19 hospitalization (index hospitalization). Among 126,137 unique patients with an index COVID-19 admission during March-July 2020, 15% died during the index hospitalization. Among the 106,543 (85%) surviving patients, 9% (9,504) were readmitted to the same hospital within 2 months of discharge through August 2020. More than a single readmission occurred among 1.6% of patients discharged after the index hospitalization. Readmissions occurred more often among patients discharged to a skilled nursing facility (SNF) (15%) or those needing home health care (12%) than among patients discharged to home or self-care (7%). The odds of hospital readmission increased with age among persons aged ≥65 years, presence of certain chronic conditions, hospitalization within the 3 months preceding the index hospitalization, and if discharge from the index hospitalization was to a SNF or to home with health care assistance. These results support recent analyses that found chronic conditions to be significantly associated with hospital readmission (6,7) and could be explained by the complications of underlying conditions in the presence of COVID-19 (8), COVID-19 sequelae (3), or indirect effects of the COVID-19 pandemic (9). Understanding the frequency of, and risk factors for, readmission can inform clinical practice, discharge disposition decisions, and public health priorities such as health care planning to ensure availability of resources needed for acute and follow-up care of COVID-19 patients. With the recent increases in cases nationwide, hospital planning can account for these increasing numbers along with the potential for at least 9% of patients to be readmitted, requiring additional beds and resources.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; COVID-19 ; Coronavirus Infections/epidemiology ; Coronavirus Infections/therapy ; Female ; Hospitalization/statistics & numerical data ; Humans ; Male ; Middle Aged ; Pandemics ; Patient Discharge/statistics & numerical data ; Patient Readmission/statistics & numerical data ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/therapy ; Risk Factors ; United States/epidemiology ; Young Adult
Keywords	covid19
Language	English
Publishing date	2020-11-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	412775-4
ISSN	1545-861X ; 0149-2195
ISSN (online)	1545-861X
ISSN	0149-2195
DOI	10.15585/mmwr.mm6945e2
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Article ; Online: Thirty-day readmission rate of COVID-19 patients discharged from a tertiary care university hospital in Turkey: an observational, single-center study.

UyaroĞlu, Oğuz Abdullah / BaŞaran, Nursel Çalik / ÖziŞik, Lale / Dİzman, Gülçİn Tellİ / EroĞlu, İmdat / Şahİn, Taha Koray / TaŞ, Zahİt / İnkaya, Ahmet Çağkan / TanriÖver, Mıne Durusu / Metan, Gökhan / GÜven, Gülay Saİn / Ünal, Serhat

International journal for quality in health care : journal of the International Society for Quality in Health Care

2021 Volume 33, Issue 1

Abstract: ... patients discharged from COVID-19 wards, of which 11 (7.1%) were readmitted. The median time of readmission ... severity coronavirus disease of 2019 (COVID-19) patients discharged from a tertiary care ... patients (≥18 years old) hospitalized in COVID-19 wards with a diagnosis of mild or moderate COVID-19 ...

Abstract	Background: The 30-day readmission rate is an important indicator of patient safety and hospital's quality performance. In this study, we aimed to find out the 30-day readmission rate of mild and moderate severity coronavirus disease of 2019 (COVID-19) patients discharged from a tertiary care university hospital and to demonstrate the possible factors associated with readmission. Methods: This is an observational, single-center study. Epidemiological and clinical data of patients who were hospitalized with a diagnosis of COVID-19 were retrieved from a research database where patient information was recorded prospectively. Readmission data were sought from the hospital information management system and the National Health Information System to detect if the patients were readmitted to any hospital within 30 days of discharge. Adult patients (≥18 years old) hospitalized in COVID-19 wards with a diagnosis of mild or moderate COVID-19 between 20 March 2020 (when the first case was admitted to our hospital) and 26 April 2020 were included. Results: From 26 March to 1 May, there were 154 mild or moderate severity (non-critical) COVID-19 patients discharged from COVID-19 wards, of which 11 (7.1%) were readmitted. The median time of readmission was 8.1 days (interquartile range [IQR] = 5.2). Two patients (18.1%) were categorized to have mild disease and the remaining 9 (81.9%) as moderate disease. Two patients who were over 65 years of age and had metastatic cancers and hypertension developed sepsis and died in the hospital during the readmission episode. Malignancy (18.7% vs. 2.1%, P = 0.04) and hypertension (45.5% vs. 14%, P = 0.02) were more common in those who were readmitted. Conclusions: This is one of the first studies to report on 30-day readmission rate of COVID-19 in the literature. More comprehensive studies are needed to reveal the causes and predictors of COVID-19 readmissions.
MeSH term(s)	Adult ; Aged ; COVID-19/epidemiology ; COVID-19/mortality ; Female ; Hospitals, University ; Humans ; Male ; Middle Aged ; Pandemics ; Patient Readmission/statistics & numerical data ; Quality Indicators, Health Care ; SARS-CoV-2 ; Tertiary Healthcare ; Turkey/epidemiology
Keywords	covid19
Language	English
Publishing date	2021-02-25
Publishing country	England
Document type	Journal Article ; Observational Study
ZDB-ID	1194150-9
ISSN	1464-3677 ; 1353-4505
ISSN (online)	1464-3677
ISSN	1353-4505
DOI	10.1093/intqhc/mzaa144
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Article: Characteristics of Hospitalized COVID-19 Patients Discharged and Experiencing Same-Hospital Readmission - United States, March-August 2020

MMWR Morb Mortal Wkly Rep

Abstract: ... hospital readmissions among large groups of patients after an initial COVID-19 hospitalization (4-7). Using ... patients with an index COVID-19 admission during March-July 2020, 15% died during the index hospitalization ... to ensure availability of resources needed for acute and follow-up care of COVID-19 patients ...

Abstract	Coronavirus disease 2019 (COVID-19) is a complex clinical illness with potential complications that might require ongoing clinical care (1-3). Few studies have investigated discharge patterns and hospital readmissions among large groups of patients after an initial COVID-19 hospitalization (4-7). Using electronic health record and administrative data from the Premier Healthcare Database,* CDC assessed patterns of hospital discharge, readmission, and demographic and clinical characteristics associated with hospital readmission after a patient's initial COVID-19 hospitalization (index hospitalization). Among 126,137 unique patients with an index COVID-19 admission during March-July 2020, 15% died during the index hospitalization. Among the 106,543 (85%) surviving patients, 9% (9,504) were readmitted to the same hospital within 2 months of discharge through August 2020. More than a single readmission occurred among 1.6% of patients discharged after the index hospitalization. Readmissions occurred more often among patients discharged to a skilled nursing facility (SNF) (15%) or those needing home health care (12%) than among patients discharged to home or self-care (7%). The odds of hospital readmission increased with age among persons aged ≥65 years, presence of certain chronic conditions, hospitalization within the 3 months preceding the index hospitalization, and if discharge from the index hospitalization was to a SNF or to home with health care assistance. These results support recent analyses that found chronic conditions to be significantly associated with hospital readmission (6,7) and could be explained by the complications of underlying conditions in the presence of COVID-19 (8), COVID-19 sequelae (3), or indirect effects of the COVID-19 pandemic (9). Understanding the frequency of, and risk factors for, readmission can inform clinical practice, discharge disposition decisions, and public health priorities such as health care planning to ensure availability of resources needed for acute and follow-up care of COVID-19 patients. With the recent increases in cases nationwide, hospital planning can account for these increasing numbers along with the potential for at least 9% of patients to be readmitted, requiring additional beds and resources.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #922986
Database	COVID19

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Article: 30-Day Readmission Rate Of Covid-19 Patients Discharged From A Tertiary Care University Hospital In Turkey; An Observational, Single-Center Study

Uyaroglu, Oguz Abdullah / Basaran, Nursel Çalik / Özisik, Lale / Dizman, Gülçin Telli / Eroglu, Imdat / Sahin, Taha Koray / Tas, Zahit / Inkaya, Ahmet Çagkan / Tanriover, Mine Durusu / Metan, Gökhan / Güven, Gülay Sain / Ünal, Serhat

Int. j. qual. health care

Abstract: ... severity COVID-19 patients discharged from a tertiary care university hospital and to demonstrate ... there were 154 mild or moderate severity (non-critical) COVID-19 patients discharged from COVID-19 wards ... Epidemiological and clinical data of patients who were hospitalized with a diagnosis of COVID-19 were retrieved ...

Abstract	BACKGROUND: The 30-day readmission rate is an important indicator of patient safety and hospital's quality performance. In this study, we aimed to find out the 30-day readmission rate of mild and moderate severity COVID-19 patients discharged from a tertiary care university hospital and to demonstrate the possible factors associated with readmission. METHODS: This is an observational, single-center study. Epidemiological and clinical data of patients who were hospitalized with a diagnosis of COVID-19 were retrieved from a research database where patient information was recorded prospectively. Readmission data was sought from the hospital information management system and National Health Record System to detect if the patients were readmitted to any hospital within 30 days of discharge. Adult patients (≥18 years-old) hospitalized in COVID-19 wards with a diagnosis of mild or moderate COVID-19 between March 20, 2020 (when the first case was admitted to our hospital), and April 26, 2020 were included. RESULTS: From March 26 to May 1, there were 154 mild or moderate severity (non-critical) COVID-19 patients discharged from COVID-19 wards, of which 11 (7.1%) were readmitted The median time of readmission was 8.1 days (IQR=5.2). Two patients (18.1%) were categorized to have mild disease and the remaining 9 (81.9%) as moderate disease. Two patients who were over 65 years of age and had metastatic cancers and hypertension developed sepsis and died in the hospital during the readmission episode. Malignancy (18.7% vs 2.1%, P = 0.04) and hypertension (45.5% vs 14%, P = 0.02) were more common in those who were readmitted. CONCLUSIONS: This is one of the first studies to report on 30-day readmission rate of COVID-19 in the literature. More comprehensive studies are needed to reveal the causes and predictors of COVID-19 readmissions.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #892084
Database	COVID19

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Article ; Online: 30-Day Readmission Rate Of Covid-19 Patients Discharged From A Tertiary Care University Hospital In Turkey; An Observational, Single-Center Study

Uyaroğlu, Oğuz Abdullah / Başaran, Nursel Çalık / Özişik, Lale / Dizman, Gülçin Telli / Eroğlu, İmdat / Şahin, Taha Koray / Taş, Zahit / Inkaya, Ahmet Çağkan / Tanriover, Mine Durusu / Metan, Gökhan / Güven, Gülay Sain / Ünal, Serhat

International Journal for Quality in Health Care ; ISSN 1353-4505 1464-3677

2020

Abstract: ... moderate severity COVID-19 patients discharged from a tertiary care university hospital and to demonstrate ... were 154 mild or moderate severity (non-critical) COVID-19 patients discharged from COVID-19 wards ... Epidemiological and clinical data of patients who were hospitalized with a diagnosis of COVID-19 were retrieved ...

Abstract	Abstract Background The 30-day readmission rate is an important indicator of patient safety and hospital’s quality performance. In this study, we aimed to find out the 30-day readmission rate of mild and moderate severity COVID-19 patients discharged from a tertiary care university hospital and to demonstrate the possible factors associated with readmission. Methods This is an observational, single-center study. Epidemiological and clinical data of patients who were hospitalized with a diagnosis of COVID-19 were retrieved from a research database where patient information was recorded prospectively. Readmission data was sought from the hospital information management system and National Health Record System to detect if the patients were readmitted to any hospital within 30 days of discharge. Adult patients (≥18 years-old) hospitalized in COVID-19 wards with a diagnosis of mild or moderate COVID-19 between March 20, 2020 (when the first case was admitted to our hospital), and April 26, 2020 were included. Results From March 26 to May 1, there were 154 mild or moderate severity (non-critical) COVID-19 patients discharged from COVID-19 wards, of which 11 (7.1%) were readmitted The median time of readmission was 8.1 days (IQR=5.2). Two patients (18.1%) were categorized to have mild disease and the remaining 9 (81.9%) as moderate disease. Two patients who were over 65 years of age and had metastatic cancers and hypertension developed sepsis and died in the hospital during the readmission episode. Malignancy (18.7% vs 2.1%, P = 0.04) and hypertension (45.5% vs 14%, P = 0.02) were more common in those who were readmitted. Conclusions This is one of the first studies to report on 30-day readmission rate of COVID-19 in the literature. More comprehensive studies are needed to reveal the causes and predictors of COVID-19 readmissions.
Keywords	Public Health, Environmental and Occupational Health ; Health Policy ; General Medicine ; covid19
Language	English
Publisher	Oxford University Press (OUP)
Publishing country	uk
Document type	Article ; Online
DOI	10.1093/intqhc/mzaa144
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Article ; Online: Prevalence of hospital-associated infections and its association with discharge destinations and hospital readmissions in Brussels, Belgium, from 2008 to 2020: A hospital-based, cross-sectional study.

Mahieu, Romain / Yannart, Melody / Dauby, Nicolas / Catry, Boudewijn / Newton, Sam

Infection control and hospital epidemiology

2023 Volume 45, Issue 4, Page(s) 434–442

Abstract: ... with the COVID-19 pandemic, monitoring the impact of HAIs should continue. ... to 2.19% (: Conclusions: Administrative data can be useful to detect HAIs trends, but they seem ... Methods: We calculated HAI prevalences and then, adjusting for confounders, the odds of being discharged ...

Abstract	Objectives: To examine time trends of hospital-associated infections (HAIs) in people living in the Brussels-Capital Region, and to evaluate the consequences for hospitals and long-term care facilities (LTCFs). Design: Cross-sectional analyses of yearly hospital administrative data. Setting: All Belgian hospitals and discharge destinations, focusing on LTCFs. Participants: All individuals from the Brussels-Capital Region hospitalized for >1 day throughout Belgium between 2008 and 2020 (N = 1,915,572). Methods: We calculated HAI prevalences and then, adjusting for confounders, the odds of being discharged to a LTCF or being readmitted within 30 days postdischarge after an HAI. HAIs included hospital-associated bloodstream infections, hospital-associated urinary tract infections, hospital-associated pneumonia, ventilator-associated pneumonia, and surgical-site infections. Results: Between 2008 and 2020, we identified 77,004 HAIs. Changes in time trends occurred. We observed a decrease of all HAIs from 2012 to 2014 from 5.17% to 2.19% ( Conclusions: Administrative data can be useful to detect HAIs trends, but they seem to underestimate the burden compared to surveillance systems. Risk factors of readmission should be identified during hospital stays to ensure continuity of care. Considering the results from 2020 coinciding with the COVID-19 pandemic, monitoring the impact of HAIs should continue.
MeSH term(s)	Humans ; Cross-Sectional Studies ; Patient Readmission ; Belgium/epidemiology ; Patient Discharge ; Prevalence ; Aftercare ; Pandemics ; Hospitals ; Cross Infection/epidemiology ; Healthcare-Associated Pneumonia/epidemiology
Language	English
Publishing date	2023-11-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	639378-0
ISSN	1559-6834 ; 0195-9417 ; 0899-823X
ISSN (online)	1559-6834
ISSN	0195-9417 ; 0899-823X
DOI	10.1017/ice.2023.161
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Article ; Online: Funded hospital discharges to care homes: a cohort study.

Wilson, Carol L / Keevil, Victoria L / Goodman, Claire

Age and ageing

2023 Volume 52, Issue 7

Abstract: ... the Coronavirus disease 2019 (COVID-19) pandemic resulted in the United Kingdom Government implementing ... However, patients were placed in care homes further from admission addresses (17.3 vs. 9.8 km (P = 0.00001 ... P = 0.21) readmissions-per-patient over 6 months). No differences in key characteristics were found ...

Abstract	Background: Optimising timely discharge from hospitals is an international priority. In 2020, the Coronavirus disease 2019 (COVID-19) pandemic resulted in the United Kingdom Government implementing the Discharge to Assess (D2A) model across England. This funded temporary care home placement to allow further recovery and assessment of care needs outside of the hospital. Objectives: Determine if older adults discharged from hospital to care homes after implementation of D2A differ in their characteristics or outcomes. Design and methods: Two cohorts of older adults discharged from hospital to care homes pre- and post-implementation of the D2A model (n = 244), with 6 months of follow-up. Data were extracted from routinely collected healthcare records. Results: The mean duration of the hospital admission was reduced (29 vs. 23 days (P = 0.02)) but discharges to care homes did not increase with implementation of D2A (n = 161 in both cohorts prior to exclusions). In July-December 2020 (post-implementation), 28% of people were living in a private residence 6 months post-discharge, compared with 18% in the same period in 2019 (P = 0.09). When those who died were excluded, this changed to 40 vs. 28% (P = 0.19). There was no change in 6-month mortality (26 vs. 35% (P = 0.17)), and no increase in readmission rate (0.48 vs. 0.63 (P = 0.21) readmissions-per-patient over 6 months). No differences in key characteristics were found. However, patients were placed in care homes further from admission addresses (17.3 vs. 9.8 km (P = 0.00001)). Conclusions: Implementation of D2A did not result in poorer outcomes but was associated with a reduced length of hospital stay.
MeSH term(s)	Humans ; Aged ; Patient Discharge ; Cohort Studies ; Patient Readmission ; Aftercare ; COVID-19/therapy ; Length of Stay ; Hospitals
Language	English
Publishing date	2023-07-28
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	186788-x
ISSN	1468-2834 ; 0002-0729
ISSN (online)	1468-2834
ISSN	0002-0729
DOI	10.1093/ageing/afad135
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