Risk factors for hospital readmission among home health care patients at PSMMC, Riyadh, Saudi Arabia, 2019

Abstract
Background: Worldwide the home health care (HHC) has many benefits. It improves countries health systems and clinical outcomes of patients, it is good solution for bed occupancy in hospitals. Home Health care (HHC) provides nursing services supported with Medicare for patients with chronic medical issues that prevent them from leaving the home. Objectives: This study aimed to describe frequency and rate of readmission to hospital by HHC patients according to diagnoses, and identify the factors associated with non-elective, readmission of HHC patients, at PSMMC, Riyadh, Kingdom of Saudi Arabia, 2019. Methods: Cross-sectional study with a total number of participants 213 done by using self-administered chart review. Result: A total of 213 Saudi health care patients participated, and most of them were in the age group of 75-85 years. The overall prevalence of readmission was 43.66%, and it was significantly higher among males at 55.81%. Poly-pharmacy and diabetes mellitus were the highest frequent causes of readmission at 75.27% and 65.59%, respectively. A significantly higher percentage of readmitted subjects have urinary tract infection and on NGT at 8.60% and 13.89% vs. 1.67% and 5% on the not readmitted group, respectively. On the other hand, the functional disability severity frequency and hypothyroidism were higher in the not readmitted groups compared to the readmitted one at 46.67%, and 27.5% vs. 32.26 and 12.9%, respectively. There was a significant difference between the two groups in the distance 25Km from central Riyadh. Male gender is associated with more than two folds risk of non-elective readmission of HHC compared to females, with OR =2.30, and a P-value of 0.004. Patients with urinary tract infections were more than five folds (OR= 5.55, P= 0.033) at risk of readmission, and those with surgical interventions have 6.91 folds increased risk of readmission. Besides, patients on NGT and those treated with a multidisciplinary team have OR of 3.09, and 3.41to be readmitted with a significant P-value (