May Ee Png1, Joanne Yoong1,2, Cynthia Chen1, Chuen Seng Tan1, E Shyong Tai1,3,4, Eric Y H Khoo3,4, Hwee Lin Wee1,5. 1. a National University of Singapore , Saw Swee Hock School of Public Health , Singapore. 2. b University of Southern California, Center for Economic and Social Research , Washington , DC , USA. 3. c National University of Singapore , Yong Loo Lin School of Medicine , Singapore. 4. d National University Health System , Division of Endocrinology , University Medicine Cluster , Singapore. 5. e National University of Singapore , Department of Pharmacy, Faculty of Science , Singapore.
Abstract
OBJECTIVE: To examine the risk factors and direct medical costs associated with early (≤30 days) versus late (31-180 days) unplanned readmissions among patients with type 2 diabetes in Singapore. METHODS: Risk factors and associated costs among diabetes patients were investigated using electronic medical records from a local tertiary care hospital from 2010 to 2012. Multivariable logistic regression was used to identify risk factors associated with early and late unplanned readmissions while a generalized linear model was used to estimate the direct medical cost. Sensitivity analysis was also performed. RESULTS: A total of 1729 diabetes patients had unplanned readmissions within 180 days of an index discharge. Length of index stay (a marker of acute illness burden) was one of the risk factors associated with early unplanned readmission while patient behavior-related factors, like diabetes-related medication adherence, were associated with late unplanned readmission. Adjusted mean cost of index admission was higher among patients with unplanned readmission. Sensitivity analysis yielded similar results. CONCLUSIONS: Existing routinely captured data can be used to develop prediction models that flag high risk patients during their index admission, potentially helping to support clinical decisions and prevent such readmissions.
OBJECTIVE: To examine the risk factors and direct medical costs associated with early (≤30 days) versus late (31-180 days) unplanned readmissions among patients with type 2 diabetes in Singapore. METHODS: Risk factors and associated costs among diabetespatients were investigated using electronic medical records from a local tertiary care hospital from 2010 to 2012. Multivariable logistic regression was used to identify risk factors associated with early and late unplanned readmissions while a generalized linear model was used to estimate the direct medical cost. Sensitivity analysis was also performed. RESULTS: A total of 1729 diabetespatients had unplanned readmissions within 180 days of an index discharge. Length of index stay (a marker of acute illness burden) was one of the risk factors associated with early unplanned readmission while patient behavior-related factors, like diabetes-related medication adherence, were associated with late unplanned readmission. Adjusted mean cost of index admission was higher among patients with unplanned readmission. Sensitivity analysis yielded similar results. CONCLUSIONS: Existing routinely captured data can be used to develop prediction models that flag high risk patients during their index admission, potentially helping to support clinical decisions and prevent such readmissions.
Authors: Huaqing Zhao; Samuel Tanner; Sherita H Golden; Susan G Fisher; Daniel J Rubin Journal: BMC Med Res Methodol Date: 2020-11-25 Impact factor: 4.615