Objective:

To examine characteristics and predictors of 30-day hospital readmissions for adult patients admitted to neurology services and their outcomes.

Background:

Thirty-day hospital readmission rates are associated with increased morbidity and mortality. In 2012, the Center for Medicaid and Medicare developed the Hospital Readmission Reduction Program to reduce preventable readmissions. Although readmission risk scores exist, other sociodemographic factors have not been examined as predictors and may be useful in guiding interventions to reduce readmissions.

Design/Methods:

We performed a retrospective review of all patients admitted to our inpatient neurology services at a large academic hospital from 2021 to 2022. Readmitted patients included those returning to any hospital within our electronic medical record. We collected information on age, sex, race, disposition plan, health insurance, Charlson Comorbidity Index and mortality. We performed Chi-square and Fisher’s Exact tests to analyze the relationship between patient variables and readmission risk.

Results:

We examined 3,915 admissions to our neurology services. After applying exclusion criteria, 2,897 patients were included. The readmission rate to both the academic hospital and satellite hospitals was 11.01%, compared to the 8.5% internally captured at the academic hospital. There was no statistically significant relationship between sex and age. Predictors for 30-day readmissions included black race when compared to all other races (OR 1.38, p=0.008), Charlson Comorbidity Index score of ≥4 when compared to <4 (OR 1.46, p=0.002), and Medicaid or Medicare when compared to private insurance (OR 1.63, p=0.001). Readmitted patients had an increased 1-year mortality rate compared to non-readmitted patients (OR 5.69, p=2.92e-19).

Conclusions:

We identified several sociodemographic variables which confer additional risk of readmission across neurology services. Furthermore, we showed that readmission rates are higher when including satellite hospitals than when considering only the academic hospital. Future work is needed to investigate how to support patients with higher readmission risk, given the associated substantial increase in mortality.