Risk factors for potentially preventable readmissions: a case study of diseases of the circulatory system

Potentially preventable hospital readmission rates are considered an important indicator of quality of health care. These re-hospitalisations are likely to be harmful, costly and potentially avoidable. This research identifies the risk factors that cause potentially preventable readmissions. We analysed admissions to hospital of 7,044 patients with a circulatory system disease as principal diagnosis using a health insurance claim database collected between 2010 and 2016. We developed an algorithm that identifies preventable readmissions from the insurance claim records and subsequently a logistic regression model that allows us to identify the risk factors of these potentially preventable readmissions. The analysis gives a specific focus on examining whether cost-based measures can help explain the risk for patients readmit to hospital with preventable reasons. Our findings suggest that patients with circulatory system diseases were more likely to have a potentially preventable hospital readmission if they had one or more of the following factors at the time of the initial admission: being male, more complications (comorbidities) apart from the main diagnosis, stroke conditions, and having procedures of digital subtraction angiography of aorta and lower limb. Importantly, the more doctors charged over the schcduled fees for the medical service associated with a patient's initial admission, the less likely the patient would be readmitted for a preventable reason.