Incidence rates, causes and strategies to prevent hospital readmissions at National Hospital Galle, Sri Lanka

BACKGROUND: A readmission is defined as an unplanned subsequent hospital admission in the same or a different hospital within 30 days after discharge from hospital due to the same illness. Readmission rates and its causative factors could be used to measure the quality of health care and accountability. Present study was undertaken to determine the incidence and causative factors of hospital readmissions at National Hospital Galle, Sri Lanka and to study the ongoing strategies for their prevention. METHODS: This is a descriptive cross-sectional study. A pre-tested interviewer-administered questionnaire was used to collect data from re-admitted patients for consecutive seven days. Further data were collected from nursing officers (n = 102) who are participated in the patient discharge process at the same hospital to assess the strategies to prevent re-admissions. Data were analyzed using SPSS version 25.0, by using descriptive statistics, Pearson's test and Chi-square tests wherever applicable. RESULTS: This study assessed seven-day hospital readmissions among 4,492 patients admitted to the National Hospital Galle. A total of 946 patients were readmitted, during the study period giving an overall readmission rate of 21.06%. Most readmissions were planned (19.08%), while 1.98% were unplanned. Elderly patients (≥ 65 years) and those with multiple chronic conditions, including diabetes, hypertension, and heart failure, had higher readmission rates. Patients discharged within five days showed an increased risk of readmission. Readmitted patients reported lower satisfaction, particularly regarding communication and discharge instructions. Nursing staff surveys revealed dissatisfaction with discharge processes, inadequate patient education, limited post-discharge follow-up, and insufficient time and training for discharge counselling. CONCLUSIONS: Findings concluded that National Hospital Galle experienced a notable rate of general readmissions, while unplanned readmissions remained low. These return visits were heavily driven by patient dissatisfaction with post-discharge support and discharge communication. Consequently, this highlights a critical need to enhance patient education and follow-up protocols.