Determinants of Hospital Readmission of Medical Conditions in Developing Countries

Hospital readmission is a high priority health care quality measure and target for cost reduction. Nearly one fifth of Medicare beneficiaries discharged from hospitals are readmitted within 30 days thus incurring additional cost of several billions of dollars annually. The problems associated with readmissions are more pronounced in developing countries due to limited resources to grapple with these effects. Contrary to previous research done which focused on specific medical conditions, this research placed emphasis on general medical conditions. The paper sought to identify socio demographic and system related factors that predispose individuals to hospital readmissions in developing countries. Literature was searched from Scopus, Web of science, ProQuest, PubMed and Google Scholar from 1993 to 2015. Articles found eligible examined the relationship between social factors and readmission, and socio demographic factors and readmissions. 45 articles met the inclusion criteria with 80% examining readmission among the elderly (>65 years), 20% examined readmission among young groups (<65 years). 50% examined the relationship between social factors and readmission while 30% examined the impact of system related factors on readmission. 20% evaluated interventions for readmission reduction. Policies aimed at improving follow up are likely to reduce readmission rate in majority of the determinants. Follow up could be strengthened through the development of a database of contact details of public or community health nurses in catchment area of each district or sub district so that during discharge, the traceable address of patients can be communicated with the health worker either through phone calls or sending of text messages. In addition, introduction of software for discharge can be implemented so that an automatic email including brief history about client, traceable address and the need to follow up within the first – second week post discharge will be sent.