OBJECTIVES : Hospital readmissions are one of the significant indicators of poor quality in healthcare. This study aimed to determine the predictors of 30-day preventable hospital readmission in the US.

METHODS : A retrospective study was conducted using 2016 Healthcare Cost and Utilization Project- National Readmission Database. The study included patients aged ≥ 18 years with at least one index event for hospitalization. Patients, who died, had missing length of stay (LOS) or had <30 days of follow-up, were excluded. Preventable readmissions were defined by the Agency for Healthcare Research and Quality (AHRQ) Prevention Quality Indicators using ICD-10-CM codes. Multivariable logistic regression was used to examine the predictors of preventable 30-day readmissions after controlling for patient demographics and comorbidities.

RESULTS : Among 13.9 million patients that were admitted with at least one index event in 2016, 1.36 million (9.75%) had preventable 30-day hospital readmissions. Hospitalized patients were predominantly ≥65 years (56.13%) and were covered by Medicare (66.06%). Hypertension (39.15%), diabetes (31.86%) and COPD (14.65%) were the frequently reported patient comorbidities. Multivariable analyses revealed that males (Odds Ratio (OR): 1.30), patients in higher age groups (40-64 years, OR: 3.24; ≥ 65 years, OR: 3.80) and with Medicare (OR: 0.94) were significantly associated with 30-day preventable readmissions. The strongest predictors of preventable 30-day readmissions were clinical comorbidities such as congestive heart failure (OR: 138.00), hypertension (OR: 16.63), chronic obstructive pulmonary disease (OR: 58.03), fluid and electrolyte disorder (OR: 23.39), obesity (OR: 14.69), psychoses (OR: 6.15; 6.09-6.29), depression (OR: 6.60), other neurological disorders (OR: 4.95), rheumatoid arthritis (OR: 4.87), paralysis (OR: 4.46; 4.30-4.63) and solid tumors (OR: 5.85).

CONCLUSIONS : The study identified several demographic and clinical factors associated with 30-day hospital readmissions, which could potentially help health care systems to target interventions to reduce preventable hospital readmission.