Factors Associated Readmission Following Hospitalization for Pneumonia in South Korea

Background Community-acquired pneumonia is a frequent, potentially serious disease in people aged >65 years and one of the leading causes of hospitalization and mortality worldwide. Hospital readmissions are an indicator of poor health care quality. Patient-, hospital-, and healthcare system related factors are associated with pneumonia readmissions. The aim of this evaluation was to assess several factors associated with pneumonia-readmission in South Korea. Methods A retrospective cohort study was designed using the National Health Insurance Service-Elderly Cohort Database (NHIS-ECD). During study the period between January 2013 and December 2015, we estimated the incidence rate of hospitalized CAP in adults ≥ 70 years in South Korea using the NHIS-ECD. This study included demographic information, principal diagnosis or comorbidities based on the International Classification of Disease, 10th Revision (ICD-10), date of admission and discharge, drug prescription, and treatment fees through computerized management. Readmission was defined as hospitalization within 30 days of discharge. Results During the study period, 21,149 patients were diagnosed to have pneumonia admission. When gender is compared, male readmission rate for pneumonia was 16%(n=1628), higher than 13.1%(n=1433) for female. In addition, the readmission rate for age; 70-74yr, 75-79yr, 80-84yr, ≥85yr, were 12.6%, 13.6%, 15.2%, and 15.7%, respectively. The readmission rate was higher in hospitals (16.5%) than in general hospitals (13.5%). The longer the treatment period was 29 Days and More (31.2%), the higher the pneumonia readmission rate. And Readmissions were higher in rural area (15.5%) than in urban area (13.3%). Conclusions Pneumonia-specific 30-day readmission was significantly associated with the gender, age, hospital type, treatment period, patient’s residence. A range of patient factor and social factors affect the risk of pneumonia readmission in South Korea.