Healthy ageing status and risk of readmission among acutely hospitalised older people
Background: Hospital readmissions are most common in older people and associated with adverse outcomes and increased health system costs. Understanding who is most at risk informs strategies to reduce readmission. Aim: To investigate associations between the healthy ageing status of acutely hospitalised older people and risk of hospital readmission. Methods: A prospective cohort study combining medical record and survey data from older people admitted to acute hospitals. The Kaplan–Meier approach was used to estimate probability of readmission within 60 days and Cox's proportional-hazards model was used to assess the relationship between healthy ageing status and risk of readmission. Findings: Of the 143 participants, 56 (39%) were readmitted within 60 days. Those in the lowest healthy ageing index quartile had a 30.6% (95% CI 0.14–0.44) probability of readmission. After adjusting for potential confounders, increasing healthy ageing index was independently associated with a decreased risk of readmission. Those in the highest quartile for healthy ageing had an 82% (95% CI 0.07–0.52) reduced relative risk of readmission, compared with the lowest quartile. Participants reporting mobility problems, inadequate physical activity, and problems with mood and energy were more likely to be readmitted. Those who were married were less likely to be readmitted. Conclusion: The findings highlight that readmission risk is multidimensional. The findings suggest nurses may reduce the risk of readmission among older people through strategies that optimise the biopsychosocial factors of healthy ageing. Strategies that enhance physical activity, improve mobility, and reduce depression and anxiety may have the greatest effect on reducing readmission risk.
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