Clinical identification of patients readmitted to hospitals: why patients return

BACKGROUND: Increased interest in hospital outcomes has supported the need for clear and useful identification of patients who are readmitted. These patients have frequently been identified by the principal diagnosis of the initial admission. FINDINGS: In order to evaluate the effectiveness of identifying patients who were subsequently readmitted, those with two frequently encountered conditions, principal diagnoses of congestive heart failure and pneumonia, in the hospitals of Syracuse New York were evaluated. Both populations had large proportions of readmissions involved with principal diagnoses other than pneumonia. For patients with heart failure, a majority of readmitted patients had other diagnoses for two of the hospitals. For patients with pneumonia, a majority of patients had other diagnoses for all of the hospitals. CONCLUSIONS: The data suggested that many patients who were subsequently readmitted are best identified as medicine patients with multiple diagnoses, rather than a single one. This approach addresses the need to manage a wide range of conditions for hospital readmissions, rather than a narrow approach on individual diagnosis.