Introduction: Unplanned readmission rates are increasingly being used as a metric of the quality and integration of care. Monitoring of, and interventions to reduce, readmissions are commonly disease-focussed, and limited to those with the same physical morbidities at index admission and readmission.
The aim of this study was to describe morbidity and multimorbidity patterns among adults admitted to a regional health service, in terms of the occurrence and co-occurrence of the same and different morbidities at index admission and readmission.
Methods: This cross-sectional study estimated unplanned readmission rates by selected sociodemographic, admission and diagnostic (morbidity) characteristics. Proportions of readmissions (`early’ within 30 days, and `late’ within 1-6 months, of discharge) were calculated for the same and different morbidities recorded as the index admission.
Results: The risk of readmission increases with age, disadvantage, and the severity, frequency and co-occurrence of physical and mental health conditions. The majority of early and late readmissions are in different diagnostic groups and specialties and for different primary morbidities to the index admission. Overall 61% of readmissions were in a different Major Diagnostic Category to the index admission, and 82% in a different Adjacent Diagnosis Related Group.
Conclusion and Recommendations: The complex picture of multimorbidity and other vulnerabilities among people at increased readmission risk highlights the need to move beyond a single disease focus in the design of hospital avoidance and chronic disease programs. More holistic person-focussed interventions that address the prevention and management of multiple physical and mental health conditions are required.