Higher levels of multimorbidity are associated with increased risk of readmission for older people during post-acute transitional care.

Key summary points: Aim: To investigate the association between multimorbidity and readmission amongst patients on Transitional Aged Care Program (TACP). Findings: Hospital readmission rates increased with multimorbidity and the Charlson Comorbidity Index (CCI) is independently associated with a 30-day hospital readmission in TACP cohort. Message: Identifying vulnerability to readmission, such as multimorbidity may allow future exploration of targeted interventions to optimise transitional care and individualise patient care to improve functional independence and prevent premature Residential Aged Care Facilities (RACF) admissions in older people. Purpose: Older patients are at high risk for poor outcomes after an acute hospital admission. The Transitional Aged Care Programme (TACP) was established by the Australian government to provide a short-term care service aiming to optimise functional independence following hospital discharge. We aim to investigate the association between multimorbidity and readmission amongst patients on TACP. Methods: Retrospective cohort study of all TACP patients over 12 months. Multimorbidity was defined using the Charlson Comorbidity Index (CCI), and prolonged TACP (pTACP) as TACP ≥ 8 weeks. Results: Amongst 227 TACP patients, the mean age was 83.3 ± 8.0 years, and 142 (62.6%) were females. The median length-of-stay on TACP was 8 weeks (IQR 5–9.67), and median CCI 7 (IQR 6–8). 21.6% were readmitted to hospital. Amongst the remainder, 26.9% remained at home independently, 49.3% remained home with supports; < 1% were transferred to a residential facility (0.9%) or died (0.9%). Hospital readmission rates increased with multimorbidity (OR 1.37 per unit increase in CCI, 95% CI 1.18–1.60, p < 0.001). On multivariable logistic regression analysis, including polypharmacy, CCI, and living alone, CCI remained independently associated with 30-day readmission (aOR 1.43, 95% CI 1.22–1.68, p < 0.001). Conclusions: CCI is independently associated with a 30-day hospital readmission in TACP cohort. Identifying vulnerability to readmission, such as multimorbidity, may allow future exploration of targeted interventions. [ABSTRACT FROM AUTHOR]