Title:Early Hospital Readmission in Patients With Tuberculosis: Social and Cultural Risk Factors
VOLUME: 16 ISSUE: 1
Author(s):Diana M. Valenzuela-Soltero, Jesús A. Güereca-Alvarado, Murielle Pacheco-Barajas, Nathaly Sánchez-Rebollar and Rafael Laniado-Laborín *
Affiliation:ClInica y Laboratorio de Tuberculosis, Hospital General Tijuana, ISESALUD, Tijuana, ClInica y Laboratorio de Tuberculosis, Hospital General Tijuana, ISESALUD, Tijuana, ClInica y Laboratorio de Tuberculosis, Hospital General Tijuana, ISESALUD, Tijuana, ClInica y Laboratorio de Tuberculosis, Hospital General Tijuana, ISESALUD, Tijuana, ClInica y Laboratorio de Tuberculosis, Hospital General Tijuana, ISESALUD, Tijuana
Keywords:Factors, hospital, readmission, socioeconomic, substance abuse, tuberculosis.
Abstract:
Background: Few studies have focused on risk factors for early readmission in patients
with tuberculosis.
Objective: Determine what are the risk factors for the early readmission of patients with tuberculosis
at General Tijuana Hospital, Mexico.
Materials and Methods: All patients aged ≥ 18 years who were admitted with the confirmed
diagnosis of pulmonary tuberculosis were prospectively included. Information was obtained on
demographic, socioeconomic variables, previous hospitalizations, clinical data, and laboratory and
radiographic studies.
Results: One hundred and thirty-four patients with tuberculosis were included, and 24 of them
(17.9%) corresponded to early hospital readmissions. The interval between initial admission and
readmission was 1.45 ± 0.183 months. The readmission group had used illicit drugs for more years
(11.3 ± 13.9 years) than the new cases group (8.01 ± 8.25 years; p = 0.03). Forty percent of the
patients who were readmitted did not go to their referral health unit after their initial hospital
discharge. The reasons argued by the patients included, among others, not having received
information regarding their illness during hospitalization, the abuse of illegal substances and the
perception of hostility by health personnel.
Discussion: One out of every five patients admitted for tuberculosis will be readmitted after only six
weeks of initial discharge. Sociocultural factors (addictions, comorbidities, poverty) and of the health
system (limited hours of medical care, accessibility) contribute to this phenomenon.
Conclusion: Loss of follow-up after hospital discharge is common in most settings and contributes to
an increase in morbidity and mortality, and transmission of infection in the community.