Patients with alcohol-related diagnoses at initial hospitalization are at high risk of 30-day readmission. Understanding risk factors for 30-day readmission among these patients may help to identify those who would benefit from efforts to reduce risk of readmission. The Nationwide Readmissions Database was used to estimate 30-day all-cause readmissions among United States patients with an alcohol-related index hospitalization and to evaluate risk factors and costs associated with these readmissions. Included patients were 18 years of age or older at initial hospitalization, had an alcohol-related primary diagnosis (based on ICD-9-CM codes), and were discharged between 2010 and 2015. They were followed for 30 days after initial hospitalization within the calendar year to identify all-cause readmissions. A logistic regression analysis assessed the association between risk factors and 30-day readmission. Average costs of initial admissions and readmissions were estimated. Among 113,931,723 adult index hospitalizations, 1,124,228 had alcohol-related diagnoses. Patients had a mean age of 49 years, 73% were male, and 45% had public insurance coverage. The annual rate of 30-day readmissions among patients with index alcohol-related hospitalizations increased from 119 readmissions per 1000 admissions in 2010 to 140 per 1000 in 2015, while the rate of readmissions among patients with all-cause hospitalizations declined from 103 to 98 per 1000. The regression analysis suggested that age, male sex, comorbid conditions, discharge against medical advice, admission to large and teaching hospitals, and Medicaid vs. non-Medicaid payment were all risk factors for 30-day readmission. Mean costs of initial alcohol-related hospitalizations were greater among those with a 30-day readmission than without a 30-day readmission, and the mean cost of 30-day readmission was even greater. Mitigating the upward trend in rates of readmission following alcohol-related initial hospitalizations may be addressed through better identification of high-risk patients who are admitted with an alcohol-related diagnosis and greater use of existing evidence-based psychosocial and pharmacotherapy treatment methods.

初次住院时被诊断为酒精相关的患者有 30 天再入院的高风险。了解这些患者 30 天再入院的风险因素可能有助于确定哪些人将从降低再入院风险的努力中受益。全国再入院数据库用于估计美国酒精相关指数住院患者 30 天的全因再入院，并评估与这些再入院相关的风险因素和成本。纳入的患者在初次住院时为 18 岁或以上，具有酒精相关的初步诊断（基于 ICD-9-CM 代码），并在 2010 年至 2015 年期间出院。他们在初次住院后在日历年，以确定全因再入院。逻辑回归分析评估了风险因素与 30 天再入院之间的关联。估计了初次入院和再入院的平均成本。在 113,931,723 名成人指数住院患者中，1,124,228 人有酒精相关诊断。患者的平均年龄为 49 岁，73% 为男性，45% 有公共保险。指标酒精相关住院患者的 30 天再入院率从 2010 年的每 1000 次入院 119 次增加到 2015 年的 140 次/1000 次，而全因住院患者的再入院率从 103 次下降到 98 次。 1000. 回归分析表明，年龄、男性、合并症、违反医疗建议出院、入住大型和教学医院以及医疗补助与医疗补助。非医疗补助支付是 30 天再入院的所有风险因素。与没有再入院 30 天的患者相比，有 30 天再入院的患者因酒精相关的初始住院平均成本更高，而再入院 30 天的平均成本更高。通过更好地识别因酒精相关诊断入院的高危患者并更多地使用现有的循证心理社会和药物治疗方法，可以缓解与酒精相关的初次住院后再入院率的上升趋势。