Hospital length of stay and 30-day readmissions in older people: their association in a 20-year cohort study in Italy
Abstract Background There are conflicting data on whether hospital length of stay (LOS) reduction affects readmission rates in older adults. We explored 20-year trends of hospital LOS and 30-day rehospitalizations in a cohort of Italian older people, and investigated their association. Methods Parti...
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | BMC Geriatrics |
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| Online Access: | https://doi.org/10.1186/s12877-023-03884-4 |
| _version_ | 1797863592337342464 |
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| author | Caterina Trevisan Marianna Noale Giancarlo Zatti Davide Liborio Vetrano Stefania Maggi Giuseppe Sergi |
| author_facet | Caterina Trevisan Marianna Noale Giancarlo Zatti Davide Liborio Vetrano Stefania Maggi Giuseppe Sergi |
| author_sort | Caterina Trevisan |
| collection | DOAJ |
| description | Abstract Background There are conflicting data on whether hospital length of stay (LOS) reduction affects readmission rates in older adults. We explored 20-year trends of hospital LOS and 30-day rehospitalizations in a cohort of Italian older people, and investigated their association. Methods Participants in the Pro.V.A. project (n = 3099) were followed-up from 1996 to 2018. LOS and 30-day rehospitalizations, i.e. new hospitalizations within 30 days from a previous discharge, were obtained from personal interviews and regional registers. Rehospitalizations in the 6 months before death were also assessed. Linear regressions evaluated the associations between LOS and the frequency of 30-day rehospitalizations, adjusting for the mean age of the cohort within each year. Results Over 20 years, 2320 (74.9%) participants were hospitalized. Mean LOS gradually decreased from 17.3 days in 1996 to 11.3 days in 2018, while 30-day rehospitalization rates increased from 6.6% in 1996 to 13.6% in 2018. LOS was inversely associated with 30-day rehospitalizations frequency over time (β = -2.33, p = 0.01), similarly in men and women. A total of 1506 individuals was hospitalized within 6 months before death. The frequency of 30-day readmissions at the end of life increased from 1.4% in 1997 to 8.3% in 2017 and was associated with mean LOS (β = -1.17, p = 0.03). Conclusions The gradual LOS reduction observed in the latter decades is associated with higher 30-day readmission rates in older patients in Italy. This suggests that a careful pre-discharge assessment is warranted in older people, and that community healthcare services should be improved to reduce the risk of readmission. |
| first_indexed | 2024-04-09T22:37:57Z |
| format | Article |
| id | doaj.art-2d89e93d5f7a41528ce49170822957a0 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-04-09T22:37:57Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-2d89e93d5f7a41528ce49170822957a02023-03-22T12:19:03ZengBMCBMC Geriatrics1471-23182023-03-012311910.1186/s12877-023-03884-4Hospital length of stay and 30-day readmissions in older people: their association in a 20-year cohort study in ItalyCaterina Trevisan0Marianna Noale1Giancarlo Zatti2Davide Liborio Vetrano3Stefania Maggi4Giuseppe Sergi5Geriatric Unit, Department of Medicine, University of PadovaNeuroscience Institute, National Research CouncilGeriatric Unit, Department of Medicine, University of PadovaAging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm UniversityNeuroscience Institute, National Research CouncilGeriatric Unit, Department of Medicine, University of PadovaAbstract Background There are conflicting data on whether hospital length of stay (LOS) reduction affects readmission rates in older adults. We explored 20-year trends of hospital LOS and 30-day rehospitalizations in a cohort of Italian older people, and investigated their association. Methods Participants in the Pro.V.A. project (n = 3099) were followed-up from 1996 to 2018. LOS and 30-day rehospitalizations, i.e. new hospitalizations within 30 days from a previous discharge, were obtained from personal interviews and regional registers. Rehospitalizations in the 6 months before death were also assessed. Linear regressions evaluated the associations between LOS and the frequency of 30-day rehospitalizations, adjusting for the mean age of the cohort within each year. Results Over 20 years, 2320 (74.9%) participants were hospitalized. Mean LOS gradually decreased from 17.3 days in 1996 to 11.3 days in 2018, while 30-day rehospitalization rates increased from 6.6% in 1996 to 13.6% in 2018. LOS was inversely associated with 30-day rehospitalizations frequency over time (β = -2.33, p = 0.01), similarly in men and women. A total of 1506 individuals was hospitalized within 6 months before death. The frequency of 30-day readmissions at the end of life increased from 1.4% in 1997 to 8.3% in 2017 and was associated with mean LOS (β = -1.17, p = 0.03). Conclusions The gradual LOS reduction observed in the latter decades is associated with higher 30-day readmission rates in older patients in Italy. This suggests that a careful pre-discharge assessment is warranted in older people, and that community healthcare services should be improved to reduce the risk of readmission.https://doi.org/10.1186/s12877-023-03884-4HospitalizationHospital readmissionLength of stay30-day readmission |
| spellingShingle | Caterina Trevisan Marianna Noale Giancarlo Zatti Davide Liborio Vetrano Stefania Maggi Giuseppe Sergi Hospital length of stay and 30-day readmissions in older people: their association in a 20-year cohort study in Italy BMC Geriatrics Hospitalization Hospital readmission Length of stay 30-day readmission |
| title | Hospital length of stay and 30-day readmissions in older people: their association in a 20-year cohort study in Italy |
| title_full | Hospital length of stay and 30-day readmissions in older people: their association in a 20-year cohort study in Italy |
| title_fullStr | Hospital length of stay and 30-day readmissions in older people: their association in a 20-year cohort study in Italy |
| title_full_unstemmed | Hospital length of stay and 30-day readmissions in older people: their association in a 20-year cohort study in Italy |
| title_short | Hospital length of stay and 30-day readmissions in older people: their association in a 20-year cohort study in Italy |
| title_sort | hospital length of stay and 30 day readmissions in older people their association in a 20 year cohort study in italy |
| topic | Hospitalization Hospital readmission Length of stay 30-day readmission |
| url | https://doi.org/10.1186/s12877-023-03884-4 |
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