How specialist aftercare impacts long-term readmission risks in elderly patients with metabolic, cardiac, and chronic obstructive pulmonary diseases: Cohort study using administrative data

Abstract

Background: The health state of elderly patients is typically characterized by multiple co-occurring diseases requiring the involvement of several types of health care providers. Objective: We aimed to quantify the benefit for multimorbid patients from seeking specialist care in terms of long-term readmission risks. Methods: From an administrative database, we identified 225,238 elderly patients with 97 different diagnosis (ICD-10 codes) from hospital stays and contact with 13 medical specialties. For each diagnosis associated with the first hospital stay, we used multiple logistic regression analysis to quantify the sex-specific and age-adjusted long-term all-cause readmission risk (hospitalizations occurring between 3 months and 3 years after the first admission) and how specialist contact impacts these risks. Results: Men have a higher readmission risk than women (mean difference over all first diagnoses 1.9%, P