Characteristics of hospitalized COVID-19 patients discharged and experiencing same-hospital readmission — United States, March–August 2020
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Characteristics of hospitalized COVID-19 patients discharged and experiencing same-hospital readmission — United States, March–August 2020

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    What is already known about this topic? Evidence suggests that potential health Complications after COVID-19 illness might require ongoing clinical care.

    What is added by this report? After discharge from an initial COVID-19 hospitalization, 9% of patients were readmitted to the same hospital within 2 months of discharge. Multiple readmissions occurred in 1.6% of patients. Risk factors for readmission included age ≥65 years, presence of certain chronic conditions, hospitalization within the 3 months preceding the first COVID-19 hospitalization, and discharge to a skilled nursing facility or with home health care.

    What are the implications for public health practice? Understanding frequency of, and potential reasons for, readmission after a COVID-19 hospitalization can inform clinical practice, discharge disposition decisions, and public health priorities, such as health care resource planning.

    CoronaVirus disease 2019 (COVID-19) is a complex clinical illness with potential Complications that might require ongoing clinical care (1–3). Few studies have investigated discharge patterns and hospital readmissions among large groups of patients after an initial COVID-19 hospitalization (4–7). Using electronic health record and administrative data from the Premier Healthcare Database,* CDC assessed patterns of hospital discharge, readmission, and demographic and clinical characteristics associated with hospital readmission after a patient’s initial COVID-19 hospitalization (index hospitalization). Among 126,137 unique patients with an index COVID-19 admission during March–July 2020, 15% died during the index hospitalization. Among the 106,543 (85%) surviving patients, 9% (9,504) were readmitted to the same hospital within 2 months of discharge through August 2020. More than a single readmission occurred among 1.6% of patients discharged after the index hospitalization. Readmissions occurred more often among patients discharged to a skilled nursing facility (SNF) (15%) or those needing home health care (12%) than among patients discharged to home or self-care (7%). The odds of hospital readmission increased with age among persons aged ≥65 years, presence of certain chronic conditions, hospitalization within the 3 months preceding the index hospitalization, and if discharge from the index hospitalization was to a SNF or to home with health care assistance. These results support recent analyses that found chronic conditions to be significantly associated with hospital readmission (6,7) and could be explained by the Complications of underlying conditions in the presence of COVID-19 (8), COVID-19 sequelae (3), or indirect effects of the COVID-19 pandemic (9). Understanding the frequency of, and risk factors for, readmission can inform clinical practice, discharge disposition decisions, and public health priorities such as health care planning to ensure availability of resources needed for acute and follow-up care of COVID-19 patients. With the recent increases in cases nationwide, hospital planning can account for these increasing numbers along with the potential for at least 9% of patients to be readmitted, requiring additional beds and resources.

    Data for this study were obtained from the Premier Healthcare Database, which includes discharge records from 865 nongovernmental, community, and teaching hospitals that contributed inpatient data during the study period. COVID-19 patients were identified through International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) discharge Diagnosis code of U07.1 (COVID-19, Virus identified) during April–July 2020 or B97.29 (Other coronaVirus as the cause of disease classified elsewhere [recommended before the April 2020 release of U07.1]†) during March–April 2020. Both codes were used for discharges during April. The patient’s first hospitalization with a COVID-19 discharge Diagnosis was defined as the index hospitalization. Any subsequent hospitalization occurring within 2 months of the index hospitalization discharge date through August 2020, whether for COVID-19 or other health Complications, was considered a hospital readmission.§ Hospital readmissions that occurred >2 months after the index hospitalization were excluded. In the Premier Healthcare Database, readmissions were only recorded if a patient returned to the same hospital where the index hospitalization occurred.

    Suggested citation for this article: Lavery AM, Preston LE, Ko JY, et al. Characteristics of Hospitalized COVID-19 Patients Discharged and Experiencing Same-Hospital Readmission — United States, March–August 2020. MMWR Morb Mortal Wkly Rep. ePub: 9 November 2020.

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