All-Cause Readmission to Acute Care for Cancer Patients

Ji, Hong; Abushomar, Hani; Chen, Xi-Kuan; Qian, Cheng; Gerson, Darren

doi:10.12927/hcq.2013.23044

Cited by 23 publications

(25 citation statements)

References 10 publications

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“…One pan-Canadian study that examined readmission rates among patients with cancer after medical visits reported a readmission rate of 19.6%. 10 Although closer to our estimate, this study included hospitalizations at any acute care facility, and not cancer hospitals alone. The authors did note a lower readmission rate after surgical visits (9.3%), which may justify examining readmission rates after surgical and medical visits separately.…”

Section: Discussionmentioning

confidence: 89%

“…This is not surprising, as comorbidity is actually one of the most consistent predictors of readmission in both cancer and noncancer populations. 10,16,18,19 This emphasizes the need for strong chronic disease management especially in the outpatient setting, as well as the need to ensure that patients have a primary care provider who will be able to follow and manage other medical issues after discharge. Although different studies have observed variable outcomes in terms of the impact of outpatient follow-up and primary care access on readmission rates, patient-centered coordinated care is high-value and high-quality care and should be the best practice.…”

Section: Discussionmentioning

confidence: 99%

“…We excluded readmissions that were mainly for chemotherapy, radiotherapy, and rehabilitation services because these admissions are almost always planned. [9][10][11] Patients who died during the index hospitalization were excluded from the analysis. 12 The unit of analysis was a discharge encounter.…”

Section: Methodsmentioning

confidence: 99%

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Unplanned 30-Day Readmissions in a General Internal Medicine Hospitalist Service at a Comprehensive Cancer Center

Manzano

Gadiraju

Hiremath

et al. 2015

JOP

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Purpose: Hospital readmissions are considered by the Centers for Medicare and Medicaid as a metric for quality of health care delivery. Robust data on the readmission profile of patients with cancer are currently insufficient to determine whether this measure is applicable to cancer hospitals as well. To address this knowledge gap, we estimated the unplanned readmission rate and identified factors influencing unplanned readmissions in a hospitalist service at a comprehensive cancer center. Methods:We retrospectively analyzed unplanned 30-day readmission of patients discharged from the General Internal Medicine Hospitalist Service at a comprehensive cancer center between April 1, 2012, and September 30, 2012. Multiple independent variables were studied using univariable and multivariable logistic regression models, with generalized estimating equations to identify risk factors associated with readmissions. Results:We observed a readmission rate of 22.6% in our cohort. The median time to unplanned readmission was 10 days. Unplanned readmission was more likely in patients with metastatic cancer and those with three or more comorbidities. Patients discharged to hospice were less likely to be readmitted (all P values Ͻ .01). Conclusion:We observed a high unplanned readmission rate among our population of patients with cancer. The risk factors identified appear to be related to severity of illness and open up opportunities for improving coordination with primary care physicians, oncologists, and other specialists to manage comorbidities, or perhaps transition appropriate patients to palliative care. Our findings will be instrumental for developing targeted interventions to help reduce readmissions at our hospital. Our data also provide direction for appropriate application of readmission quality measures in cancer hospitals.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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Unplanned 30-Day Readmissions in a General Internal Medicine Hospitalist Service at a Comprehensive Cancer Center

Manzano

Gadiraju

Hiremath

et al. 2015

JOP

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“…The chronic conditions included in the PREADM are all known risk factors of readmission: CHF, 9,35-37 chronic obstructive pulmonary disease, 9,[35][36][37] chronic renal failure, 9,37,38 malignancy, 9,37,39 arrhythmia, 40 and disability. The chronic conditions included in the PREADM are all known risk factors of readmission: CHF, 9,35-37 chronic obstructive pulmonary disease, 9,[35][36][37] chronic renal failure, 9,37,38 malignancy, 9,37,39 arrhythmia, 40 and disability.…”

Section: Discussionmentioning

confidence: 99%

Predicting 30-Day Readmissions With Preadmission Electronic Health Record Data

et al. 2015

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“…Cancer patients are at increased risk for readmission, 3, 15 and the present study investigates readmission in this group at an institutional and national level in order to better elucidate potential areas for quality improvement. We identified a minority of patients re-admitted with potentially preventable conditions such as nausea, vomiting, dehydration, and pain.…”

Section: Discussionmentioning

confidence: 99%

Hospital Readmissions

Brown

Burgess

et al. 2014

Annals of Surgery

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OBJECTIVES To evaluate readmission rates and associated factors in order to identify potentially preventable readmissions. SUMMARY BACKGROUND DATA The decision to penalize hospitals for readmissions is compelling healthcare systems to develop processes to minimize readmissions. Research to identify preventable readmissions is critical to achieve these goals. METHODS We performed a retrospective review of University HealthSystem Consortium database for cancer patients hospitalized from 1/2010–9/2013. Outcome measures were 7-, 14-, and 30-day readmission rates and readmission diagnoses. Hospital and disease characteristics were evaluated to evaluate relationships with readmission. RESULTS 2,517,886 patients were hospitalized for cancer treatment. Readmission rates at 7, 14, and 30 days were 2.2%, 3.7%, and 5.6%. Despite concern that premature hospital discharge may be associated with increased readmissions, a shorter initial length of stay predicted lower readmission rates. Furthermore, high volume centers and designated cancer centers had higher readmission rates. Evaluating institutional data (N=2517 patients) demonstrated that factors associated with higher readmission rates include: discharge from a medical service, site of malignancy, emergent primary admission. When examining readmission within 7 days for surgical services, the most common readmission diagnoses were infectious causes (46.3%), nausea/vomiting/dehydration (26.8%), and pain (6.1%). CONCLUSIONS A minority of patients following hospitalization for cancer-related therapy are readmitted with potentially preventable conditions such as nausea, vomiting, dehydration and pain. However, most factors associated with readmission cannot be modified. Additionally, high volume centers and designated cancer centers have higher readmission rates, which may indicate that readmission rates may not be an appropriate marker for quality improvement.

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All-Cause Readmission to Acute Care for Cancer Patients

Cited by 23 publications

References 10 publications

Unplanned 30-Day Readmissions in a General Internal Medicine Hospitalist Service at a Comprehensive Cancer Center

Unplanned 30-Day Readmissions in a General Internal Medicine Hospitalist Service at a Comprehensive Cancer Center

Predicting 30-Day Readmissions With Preadmission Electronic Health Record Data

Hospital Readmissions

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