(HealthDay News) — For patients readmitted within 30 days of discharge, the risk of death is higher with readmission to an alternative hospital, according to a study published in the May 1 issue of CMAJ Open.

John A. Staples, MD, MPH, from the Institute for Clinical Evaluative Sciences in Toronto, and colleagues conducted a retrospective cohort analysis to examine whether readmission to an alternative hospital is associated with increased mortality compared with readmission to the original hospital. The analysis included data for adults readmitted through the emergency department within 30 days after hospital discharge at all 21 acute care general hospitals in the greater Toronto and Hamilton Area between 1995–2010.

The study included 198,149 patients, 19.2% of whom died within 30 days after readmission. The researchers found that patients readmitted to an alternative hospital were more likely to be older, reside in a chronic-care facility, and arrive by ambulance than those readmitted to the original hospital. Admission to an alternative hospital correlated with increased risk of death within 30 days (22.3 vs. 18.6%; odds ratio, 1.26; P<0.001). After adjustment for patient- and hospital-level variables, the increased risk was reduced (adjusted odds ratio, 1.06).

“Among patients readmitted within 30 days after discharge, readmission to an alternative hospital was associated with a higher risk of death than readmission to the original hospital,” the authors write. “Whether this adverse prognosis reflects a true causal relation or residual confounding is unknown.”

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