The Centers for Medicare and Medicaid Services’ Hospital Readmissions Reduction Program penalizes hospitals for excess 30-day hospital readmissions.1 Readmission reduction efforts have focused on patient-level factors. Whether organizational factors contribute to readmission risk is largely unknown. Intensive care unit (ICU) survivors are particularly at risk for hospital readmissions.2, 3 ICU capacity strain, when demand for ICU resources exceeds availability, is associated with short-term ICU patient outcomes.4, 5 However, most ICU survivors are transferred to general wards prior to hospital discharge and are therefore subjected to ward-level exposures that could impact readmission risk.

Our objective was to determine if ward capacity strain6 on the last day of hospitalization is associated with increased 30-day hospital readmission rates, as pressures on staff and resources may impede optimal discharge planning for complex patients.