Association of cognitive impairment severity with potentially avoidable readmissions: A retrospective cohort study of 8897 older patients

Abstract

Introduction: Understanding the association between cognitive impairment severity and potentially avoidable readmissions (PARs) in older patients may facilitate the identification of at-risk individuals who would benefit from readmission prevention measures. Methods: This retrospective cohort study was conducted using claims data linked with routinely collected cognitive impairment assessment results from a general acute care hospital in Tokyo, Japan. Patients were 65 years or age or older who were discharged from the subject hospital to home or a facility between July 2016 and September 2018. Results: A multivariable logistic regression analysis adjusted for covariates showed that the odds of PARs within 90 days to the subject hospital for patients with moderate and severe cognitive impairment were 1.418 times (95% confidence interval: 1.005-2.002) and 2.212 times (95% confidence interval: 1.206-4.058) higher, respectively, that for patients with normal cognition. Discussion: Older inpatients with later-stage cognitive impairment may represent a suitable target population for transitional care programs aimed at reducing readmissions.