Unreadiness for hospital discharge predicts readmission among cardiac patients: results from the national DenHeart survey

Aims: Readiness for hospital discharge describes a patient's perception of feeling prepared to leave the hospital. In mixed patient populations, readiness for hospital discharge has shown to predict readmission and mortality in the short term. The objectives of a population of men and women with cardiac diseases, were to investigate: (i) whether readiness for hospital discharge predicts readmission and mortality within 1-year post-discharge, as well as (ii) the association between 'physical stability', 'adequate support', 'psychological ability', and 'adequate information and knowledge' and readiness for hospital discharge.

Methods and results: Data from the national cross-sectional survey DenHeart were used and included patients with cardiac diseases at hospital discharge. Readiness for hospital discharge was evaluated by one self-reported question, and attributes were illuminated by Short-Form-12, the Edmonton Symptom Assessment Scale and ancillary questions. Data were combined with national registries at baseline and at 1-year follow-up. Cox proportional-hazards model were used to regress readmission and mortality. The analysis included 13 114 patients (response rate: 52%). The majority responded that they felt ready for hospital discharge (95%). Feeling unready (n = 618) was a predictor of 1 year, all-cause readmission among women and men [hazard ratio (HR) = 1.43, 95% confidence interval (CI) 1.18-1.74; HR = 1.59, 95% CI 1.34-1.90]. No significant results were found on all-cause mortality. The four attributes were associated with unreadiness at hospital discharge.

Conclusion: Not feeling ready for hospital discharge was a predictor of increased readmission risk in women and men with cardiac disease during 1 year after hospital discharge. Four attributes were significantly impaired in patients feeling unready for hospital discharge.