Socioeconomic Predictors of Hospital Readmission in Patients Receiving Outpatient Parenteral Antimicrobial Therapy

Outpatient parenteral antimicrobial therapy (OPAT) is a convenient way for completion of intravenous antibiotic courses outside the hospital setting, leading to shorter duration of hospitalization and reduced healthcare expenditure. Few studies have looked at the predictors of readmission among OPAT patients. Researchers conducted a retrospective review of 412 OPAT patients treated at a major tertiary care medical center (Barnes Jewish Hospital) from September 2016 through March 2017 to identify risk factors for unplanned readmission among patients discharged on OPAT therapy. The at-risk period for readmission was defined as duration of OPAT plus 7 days.

Of the 412 patients, 101 (25%) experienced an unplanned readmission during the at-risk period (41% females; mean age, 56 years). OPAT-related admissions were primarily due to worsening infection (n = 36) or adverse drug reactions (n = 16), but 41% of readmissions were unrelated to OPAT or underlying infection. Significant socioeconomic factors contributing to readmission included living in an urban setting, lower income, and not having Medicare with secondary private insurance. In a multivariate logistic regression model, factors that remained significant included race, age 18 to 30 years, age 60 to 70 years, peripheral vascular disease, and >1 hospitalization in the past year. Having Medicare coverage with supplemental private insurance was protective.

Socioeconomic factors are associated with unplanned hospital readmissions among OPAT patients, and should be included when identifying high-risk patients for targeted risk-reduction interventions.

Source: Hamad Y, Burnett Y. IDWeek 2018. Abstract 1939.

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