Katikireddi and Cloud listed factors which should alert a clinician that a patient being discharged from the hospital is at significant risk for being readmitted. These factors can help to identify patients who may benefit from more aggressive management as an outpatient. The patients are from St. George's Hospital in London.
Parameters:
(1) personal factors
(2) specific medical disorders
(3) disability and comorbidity
(4) healthcare resource utilization
Personal factors:
(1) male gender
(2) living alone with no or limited social support
(3) age > 80 years
Specific medical disorders:
(1) coronary artery disease (CAD)
(2) moderate to severe heart failure
(3) moderate to severe chronic obstructive pulmonary disease (COPD)
(4) advanced malignancy
(5) dysphagia
(6) diabetes mellitus
(7) end-stage renal failure
Disability and comorbidity:
(1) 4 or more comorbid conditions
(2) moderate to severe disability
(3) poor self-rated or clinician-rated general health
Healthcare resource utilization:
(1) 2 or more hospital admissions in the previous year (including current one)
(2) >= 7 visits to a primary care provider in the past 12 months
A patient who is not stable at discharge would also be at risk for readmission.
