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PAM2 30 Day Readmissions of Patients with a Malnutrition Diagnosis: Exploration of the US Hospital Population

      Objectives

      Acute and chronic malnutrition is a serious condition known to worsen many healthcare outcomes, delay recovery, and slow return to desired quality of life. This study uses the National Readmission Database (NRD) 2017 data, from the Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality (AHRQ) to explore readmission events among patients with an index visit that included a malnutrition diagnosis.

      Methods

      Any patient in the NRD who had an ICD-10 code for malnutrition in the first ten diagnoses was included. Patients who had a non-elective hospital readmission within 30-days of discharge from the index visit were flagged for readmission. Major Diagnostic Categories (MDC) were used to classify causes for the index visit and adjusted Wald p-values were used to identify characteristics that were significantly different between those who had a readmission event and those who did not. A weighted, adjusted logistic regression was used to identify characteristics that increase the odds a patient who has an index visit will also have a readmission.

      Results

      407,440 eligible index visits were identified, 94,140 (22.97%) of which were followed by a readmission event. Infectious and parasitic disease and disorders (19.38%) and respiratory system (14.63%) were the most common MDCs assigned at the index visit. Characteristics associated with 30-day unplanned readmissions included age, male gender, and length of stay at the index visit. The presence of stage 2 (aOR: 1.20; 95% CI: 1.14 – 1.27) or stage 3 (aOR: 1.20; 95% CI: 1.13 – 1.26) pressure ulcer at the index event and discharge against medical advice (aOR: 1.84; 95% CI: 1.73 – 1.97) were also significant.

      Conclusions

      30-day readmissions are common following an index visit that included a diagnosis of malnutrition. Provision needs to be made towards patient discharge coordination to ensure patients feel equipped to continue post discharge care at home.