Readmission after hospitalization for stroke in Taiwan: results from a national sample.

BACKGROUND: Data on hospital readmission after stroke, which reflects burden of disease, are limited. Our aim was to evaluate readmission and readmission diagnosis within one year after stroke.
METHODS: We studied administrative claims data of a randomly sampled cohort (n=200,000) of National Health Insurance beneficiaries in Taiwan. Patients aged > or = 18 years and admitted with stroke (International Classification of Diseases, 9th revision, Clinical Modification codes 430 to 438) as principal (first-listed) discharge diagnosis in 2000 were selected for analysis. Each patient's data from January 2000 to December 2001 were obtained. Data analysis was undertaken using descriptive statistics and logistic regression.
RESULTS: Among 515 patients identified, 50.1% were ischemic, 20.4% hemorrhagic, 18.3% ill-defined, 10.3% TIA and 1.0% the remainder. Neurologists were admitting physicians for 45.2% of patients. Patients died in hospital (n=11) and those who were presumed dead during study period (n=29) or without sufficient follow-up data (n=7) were excluded. Within one year following discharge from the index admission, approximately half of the patients (232 of 468) were readmitted. The most frequently reported readmission diagnosis was stroke (26.3%), followed by infection (15.1%). Multivariable regression analysis showed that factors significantly associated with increased risk of readmission included age, length of stay of the index admission, medical specialty of admission other than neurology/neurosurgery, and level of hospital, after adjustment for sex, Charlson comorbidity index score, and primary discharge diagnosis (ischemic/hemorrhagic stroke versus others).
CONCLUSIONS: Stroke patients who were admitted to disciplines other than neurology/neurosurgery seemed to have higher risk of readmission.