Trends in hospital readmissions in Multiple Sclerosis patients between 2009 and 2015

Mult Scler Relat Disord. 2020 Oct:45:102396. doi: 10.1016/j.msard.2020.102396. Epub 2020 Jul 12.

Abstract

Background: Readmission rate is an important healthcare quality metric and remains a problem in Multiple Sclerosis (MS) patients, nonetheless information about this issue is scarce. We present the first study to estimate hospital readmissions in a MS hospital-based European cohort.

Methods: Retrospective cohort study of patients with at least one hospitalization with a primary discharge of MS from August 1, 2009 and July 31, 2015. The primary outcome was hospitalization within 30 days post-discharge (30-DR). The secondary outcomes included length of stay during index and readmission, total hospital readmissions during the study period, predictors and causes of readmission.

Results: Forty-four (41.5%) patients had a hospital readmission during the six years of this study, 11.3% of them 30-DR, mainly due to infections (58.5%). The two most common comorbidities in these patients were neurogenic bladder (47.7%) and ischemic heart disease (18.1%). Progressive MS subtype was the main predictor of 30-DR, even after adjustment for therapy (OR: 6.29; p = 0.016), with an area under the curve of 0.73.

Conclusion: Progressive MS subtypes and "second-line drugs" carry a higher risk of hospital readmission soon after discharge. The impact and cost-effectiveness of strategies to lower readmission rates in MS should be the focus of upcoming studies.

Keywords: Cost-effectiveness; Healthcare quality; Hospital readmissions; Multiple Sclerosis.

MeSH terms

  • Aftercare
  • Humans
  • Length of Stay
  • Multiple Sclerosis* / epidemiology
  • Multiple Sclerosis* / therapy
  • Patient Discharge
  • Patient Readmission*
  • Retrospective Studies
  • Risk Factors