Discharge Disposition Affects Transplant Patient Readmission Risk
Patients discharged with home health or to a skilled nursing facility also were more likely to be readmitted.
PHILADELPHIA—Patients discharged with home health (HH) or to a skilled nursing facility (SNF) after receiving a kidney transplant are more likely those discharged home to be readmitted to a hospital within 30 days, according to a study presented at the 2015 American Transplant Congress.
The study, led by Maha Mohamed, MD, Assistant Professor of Medicine at the University of Wisconsin in Madison, showed that the 30-day readmission rate for patients discharged home was 17.6%. By comparison, the rate for patients discharged with HH or to a SNF were 28.1% and 32.4%, respectively.
“Patients discharged home may be healthier and therefore have a lower readmission rate,” the researchers concluded in a poster presentation.
The authors suggested that the higher risk of readmission found among patients discharged with HH or to an SNF could be related to frequent patient assessments by HH nurse or SNF nurses, enabling them to catch complications and call providers. Dr. Mohamed and her colleagues also pointed out that healthcare providers and families may not want to send patients to an SNF so that the patients can have more independence, and instead opt for HH, which may not be the correct decision.
Dr. Mohamed's group studied 529 initial kidney transplant recipients, with 781 hospital discharges. Of these, 158 (20.2%) were readmitted within 30 days. Readmission rates did not differ significantly by race, sex, or marital status.
The researchers also looked at the effect of comorbidities—diabetes, hypertension, chronic kidney disease (CKD), coronary artery disease, peripheral vascular disease, and chronic obstructive pulmonary disease—on readmission risk. Results showed that CKD was associated with a decreased risk. Patients with CKD had a 17.7% rate of readmission within 30 days compared with a 24.5% rate among those without CKD. None of the other comorbidities were associated with readmission risk.