OBJECTIVES: Short-term readmission rates are critical quality of care measures valued by both healthcare providers and federal agencies. This study seeks to identify and describe characteristics associated with adult patients having a non-elective or unplanned hospital readmission within 30-days of an initial hospital admission index visit for pneumonia.

METHODS: The 2017 National Readmission Database from the Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality, was used to identify adult patients who had an eligible non-elective index visit involving hospital admission related to pneumonia. Those who had an unplanned hospital readmission within 30-days were flagged. Descriptive statistics were reported and an adjusted logistic regression was completed to identify patient and treating facility characteristics associated with readmission.

RESULTS: 266,576 eligible index visits were identified. Of the total sample of index visits, over 18% were flagged for having a 30-day readmission event. Characteristics associated with having an unplanned readmission included patient age, particularly being between 41-64 years old (aOR: 1.53; 95% CI: 1.39-1.67), those covered by Medicaid (aOR: 1.33; 95% CI: 1.27-1.40), patients whose index visit was for ≥8 days (aOR: 1.83; 95% CI: 1.70-1.97), and those whose index visit discharge was against medical advice (aOR: 1.81; 95% CI: 1.68-1.96). The Elixhauser comorbidity score was also statistically significant (p ≤ 0.001) in all analyses. Older adults made up 65.04% of the patient sample, but they were less likely to have a readmission event compared to younger adults (aOR: 0.87; 95% CI: 0.84-0.90).

CONCLUSIONS: In a national, weighted representative sample of US pneumonia patients, 30-day readmissions were common. Middle-aged adults and those with comorbidities were at particular risk. Ongoing analysis within these demographics may improve patient care and institutional quality of care in the future.