Discharge to healthcare facilities increased 6-month readmission risk in Chinese heart failure patients compared to home dischargeDischarge to healthcare facilities linked to higher heart failure readmission risk

BackgroundThe high readmission rate among heart failure (HF) patients is a significant concern, but limited research has explored the relationship between discharge destination and readmission rates in Chinese HF patients.ObjectiveTo examine the association between discharge destination and readmission in HF patients.MethodsThis retrospective cohort study analyzed data from 2,008 HF patients admitted to the Fourth People's Hospital of Zigong City, China, between December 2016 and June 2019. Patients were divided into two groups based on their discharge destination: home and healthcare facility. The primary outcome was readmission within 6 months, with secondary outcomes at 3 months and 28 days. Cox proportional hazards regression and Kaplan–Meier curves were used to assess the relationship, with additional subgroup and interaction analyses for robustness.ResultsA total of 836 patients with HF were enrolled in this study. Among them, 638 patients were discharged to home, while 198 patients were discharged to healthcare facilities. The multivariable Cox proportional hazards regression model revealed that discharge to healthcare facilities were independently associated with a higher readmission risk compared with discharge to home, adjusted HR 1.26, 95% CI 1.06–1.50, P = 0.009 for readmission within 6 months. Similar trends were observed for readmission within 3 months (HR: 1.26, 95% CI: 1.02–1.55, P = 0.034) and 28 days (HR: 1.53, 95% CI: 1.04–2.26, P = 0.032). Kaplan–Meier analysis (log-rank test P = 0.011) supported the above findings, and the association remained robust in subgroup and sensitivity analyses.ConclusionThis study demonstrated that discharge to a healthcare facility was independently associated with an increased readmission risk among HF patients. Discharge destination should be considered as a potential indicator of readmission risk in clinical practice.