Purpose: This study aimed to identify the risk factors for unplanned hospital readmissions (UHR) within 30 days of discharge among medical oncology patients at a tertiary hospital in Singapore.
Methods: This study is a retrospective, case-control medical record review of patients admitted to a medical oncology unit at a tertiary hospital between 1 June and October 31, 2017. During the study period, there were 1559 adult patients discharged alive from the medical oncology unit. Of this, 359 patients had experienced at least a 30-day UHR (cases). The cases were matched to those without a 30-day UHR (controls) by their primary reason for index admission and discharge date. After matching, 312 medical records (cases: 156; controls: 156) were analysed.
Results: Of the 156 cases with a 30-day UHR, 46.2% (n = 72) were readmitted within the first 10 days of discharge. The top reasons contributing to the UHR were non-neutropenic infection (n = 41) and pain (n = 23). Multivariate analyses identified three independent risk factors that were associated with the 30-day UHR: (1) single marital status, (2) emergency department visit(s) in the past six months, and (3) recent decline in activities of daily living.
Conclusion: The study results can guide risk stratification to identify medical oncology patients at high risk for 30-day UHR. In addition, the results warrant the need to refine the inpatient assessments and discharge planning, as well as ensure the accurate referral to and allocation of community and outpatient resources so as to reduce the risk of UHR.
Keywords: Cancer; Discharge; Medical oncology; Nursing; Patient; Retrospective; Review; Risk factor; Unplanned hospital readmission.
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