Aims The growing hospital readmission rate among patients with heart failure (HF) has imposed a substantial economic burden on healthcare systems. Therefore, it is essential to identify readmission associating factors to reduce hospital readmission. This study aimed to investigate the relationship of family functioning and family health with hospital readmission rates over 6 months in patients with HF and identify the sociodemographic and/or clinical variables associated with hospital readmission.

Methods and results This international multicentre cross-sectional study involved a sample of 692 patients with HF from three countries (Denmark 312, Iran 288, and Iceland 92) recruited from January 2015 to May 2020. The Family Functioning, Health, and Social Support questionnaire was used to collect the data. The number of patients' hospital readmissions during the 6-month period was retrieved from patients' hospital records. Of the total sample, 184 (26.6%) patients were readmitted during the 6-month period. Of these, 111 (16%) had one readmission, 68 (9.9%) had two readmissions, and 5 (0.7%) had three readmissions. Family functioning, family health, being unemployed, and country of residence were significant factors associated with hospital readmission for the patients.

Conclusions This study highlights the critical roles of family functioning and family health in 6-month hospital readmission among patients with HF. Moreover, the strategy of healthcare systems in the management of HF is a key determinant that influences hospital readmission. Our findings may assist the investigation of potential strategies to reduce hospital readmission in patients with HF.