National trends in emergency readmission rates: a longitudinal analysis of administrative data for England between 2006 and 2016

Funded by

The Health Foundation Logo

30 August 2018


National trends in emergency readmission rates: a longitudinal analysis of administrative data for England between 2006 and 2016


Rocco Friebel, Katharina Hauck, Paul Aylin

Published journal

BMJ Open


Objective To assess trends in 30-day emergency readmission rates across England over one decade.

Design Retrospective study design.

Setting 150 non-specialist hospital trusts in England.

Participants 23 069 134 patients above 18 years of age who were readmitted following an initial admission (n=62 584 297) between April 2006 and February 2016.

Primary and secondary outcomes We examined emergency admissions that occurred within 30 days of discharge from hospital (‘emergency readmissions’) as a measure of healthcare quality. Presented are overall readmission rates, and disaggregated by the nature of the indexed admission, including whether it was elective or emergency, and by clinical health condition recorded. All rates were risk-adjusted for patient age, gender, ethnicity, socioeconomic status, comorbidities and length of stay.

Results The average risk-adjusted, 30-day readmission rate increased from 6.56% in 2006/2007 to 6.76% (P<0.01) in 2012/2013, followed by a small decrease to 6.64% (P<0.01) in 2015/2016. Emergency readmissions for patients discharged following elective procedures decreased by 0.13% (P<0.05), whereas those following emergency admission increased by 1.27% (P<0.001). Readmission rates for hip or knee replacements decreased (−1.29%; P<0.001); for acute myocardial infarction (−0.04%; P<0.49), stroke (+0.62%; P<0.05), chronic obstructive pulmonary disease (+0.41%; P<0.05) and heart failure (+0.15%; P<0.05) remained stable; and for pneumonia (+2.72%; P<0.001), diabetes (+7.09%; P<0.001), cholecystectomy (+1.86%; P<0.001) and hysterectomy (+2.54%; P<0.001) increased.

Conclusions Overall, emergency readmission rates in England remained relatively stable across the observation period, with trends of slight increases contained post 2012/2013. However, there were large variations in trends across clinical areas, with some experiencing marked increases in readmission rates. This highlights the need to better understand variations in outcomes across clinical subgroups to allow for targeted interventions that will ensure highest standards of care provided for all patients.

You might also like...

Journal article

Safety analysis over time

Journal article in Implementation Science on seven major changes to adverse event investigation.

Journal article

Emergency departments and minor illness

Why do parents bring their children to the PED with minor illness, and what can be done to better understand the drivers and ...


Children’s A&E attendances: Linking data to explore why parents’ mental health matters

A new data linkage study examines drivers of children's use of health care services such as who they live with and the health...


BMJ Open 2018;8:e020325. doi: 10.1136/bmjopen-2017-020325
Kjell-bubble-diagramArtboard 101

Work with us

We look for talented and passionate individuals as everyone at the Health Foundation has an important role to play.

View current vacancies
Artboard 101 copy 2

The Q Community

Q is an initiative connecting people with improvement expertise across the UK.

Find out more