Les réadmissions évitables des « pneumopathies communautaires » : utilité et fiabilité d’un indicateur de la qualité du parcours de soins du patient

Dely, Claire; Sellier, Pierre; Dozol, Adrien; Ségouin, Christophe; Moret, L.

doi:10.1016/j.lpm.2011.06.007

Cited by 4 publications

(7 citation statements)

References 23 publications

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“…As in the US, there are some French studies that calculate rehospitalization rates following discharge for specific medical diagnoses. 16,17 However, such studies are not comparable to recent Medicare studies of all-cause rehospitalization, within 30 days following discharge. Similarly, because Medicare includes severely disabled patients under 65 years old as well as those with end stage renal disease (ESRD), this could possibly result in an underestimate of the comparable French rate, but this is likely to be slight as most such patients are over 64 years of age.…”

Section: Discussionmentioning

confidence: 84%

Comparison of rehospitalization rates in France and the United States

Gusmano

Rodwin

Weisz

et al. 2014

J Health Serv Res Policy

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Section: Discussionmentioning

confidence: 84%

Comparison of rehospitalization rates in France and the United States

Gusmano

Rodwin

Weisz

et al. 2014

J Health Serv Res Policy

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show abstract

“…By contrast, our main finding is in line with other studies investigating the rate of avoidable readmissions for pneumonia, which ranged from 6.3% to 12.5%. [12][13][14][15][16]23 Nevertheless, these studies were characterized by heterogeneous approaches to defining key terms, data collection, and data analysis.…”

Section: Discussionmentioning

confidence: 99%

“…The median (IQR) delay between the index hospitalization discharge and the readmission was notably shorter when the readmission was deemed avoidable (4 [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] days vs 12 [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] days, P = .02) (Table 4). None of the other factors related to preadmission, functional and cognitive status, and postdischarge were found as significantly associated with avoidability.…”

Section: Factors Associated With Avoidabilitymentioning

confidence: 99%

“…10,11 Moreover, most of the studies aimed at assessing avoidability have not used recommended guidelines and have reported heterogeneous results. [12][13][14][15][16] Subjectivity always exists when determining the extent to which readmissions are avoidable, despite guidelines intended to minimize error. To counteract this, the parameters required for reviewing readmissions must include precise clinical information, and multiple reviewers are essential when dealing with avoidability.…”

Section: Introductionmentioning

confidence: 99%

“…Several models have sought out correlation with baseline characteristics but have not been able to precisely identify the circumstances of readmission that could be deemed avoidable . Moreover, most of the studies aimed at assessing avoidability have not used recommended guidelines and have reported heterogeneous results . Subjectivity always exists when determining the extent to which readmissions are avoidable, despite guidelines intended to minimize error.…”

Section: Introductionmentioning

confidence: 99%

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Incidence of Avoidable 30-Day Readmissions Following Hospitalization for Community-Acquired Pneumonia in France

et al. 2022

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IMPORTANCE Rates of 30-day readmissions following hospitalization for pneumonia are used to publicly report on hospital performance and to set financial penalties for the worst-performing hospitals. However, the rate of avoidable readmission following hospitalization for pneumonia is undefined. OBJECTIVETo assess how often 30-day readmissions following hospitalization for communityacquired pneumonia (CAP) are avoidable. DESIGN, SETTING, AND PARTICIPANTS This cohort study analyzed the results of an independent review of readmissions following hospitalization for CAP within 30 days among patients discharged from 2 large hospitals in France in 2014. Structured clinical records including clinical information (ie, baseline characteristics, physical examination, laboratory findings, x-ray or computed tomography scan findings, discharge plan, and treatments) for both index and readmission stays were independently reviewed by 4 certified board physicians. All consecutive adult patients hospitalized in 2014 with a diagnosis of CAP in our 2 eligible hospitals were eligible. All analyses presented were performed in March 2021. MAIN OUTCOMES AND MEASURESAvoidable readmission within 30 days of discharge from index hospitalization. The likelihood that a readmission was avoidable was quantified using latent class analysis based on the independent reviews. A readmission was considered avoidable if Bayes posterior probability exceeded 50%. RESULTSThe total analytical sample consisted of 1150 index hospital stays with a diagnosis of CAP, which included 651 (56.6%) male patients. The median (IQR) age for all patients was 77.8 (IQR, 62.7-86.4) years. Out of the 1150 index hospital stays, 98 patients (8.5%) died in hospital, and 108 (9.4%) unplanned readmissions were found. Overall, 15 readmissions had a posterior probability of avoidability exceeding 0.50 (13.9% of the 108 unplanned readmissions; 95% CI, 8.0%-21.9%). The median (IQR) delay between the hospital discharge index and readmission was considerably shorter when readmission was deemed avoidable (4 [6-21] days vs 12 [2-18] days; P = .02). CONCLUSIONS AND RELEVANCEOnly a small number of readmissions following hospitalization for CAP were deemed avoidable, comprising less than 10% of all readmissions. Shorter time interval between hospitalization discharge and readmission was associated with avoidability.

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Development of a risk prediction model of potentially avoidable readmission for patients hospitalised with community-acquired pneumonia: study protocol and population

et al. 2020

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Introduction30-day readmission rate is considered an adverse outcome reflecting suboptimal quality of care during index hospitalisation for community-acquired pneumonia (CAP). However, potentially avoidable readmission would be a more relevant metric than all-cause readmission for tracking quality of hospital care for CAP. The objectives of this study are (1) to estimate potentially avoidable 30-day readmission rate and (2) to develop a risk prediction model intended to identify potentially avoidable readmissions for CAP.Methods and analysisThe study population consists of consecutive patients admitted in two hospitals from the community or nursing home setting with pneumonia. To qualify for inclusion, patients must have a primary or secondary discharge diagnosis code of pneumonia. Data sources include routinely collected administrative claims data as part of diagnosis-related group prospective payment system and structured chart reviews. The main outcome measure is potentially avoidable readmission within 30 days of discharge from index hospitalisation. The likelihood that a readmission is potentially avoidable will be quantified using latent class analysis based on independent structured reviews performed by four panellists. We will use a two-stage approach to develop a claims data-based model intended to identify potentially avoidable readmissions. The first stage implies deriving a clinical model based on data collected through retrospective chart review only. In the second stage, the predictors comprising the medical record model will be translated into International Classification of Diseases, 10th revision discharge diagnosis codes in order to obtain a claim data-based risk model.The study sample consists of 1150 hospital stays with a diagnosis of CAP. 30-day index hospital readmission rate is 17.5%.Ethics and disseminationThe protocol was reviewed by the Comité de Protection des Personnes Sud Est V (IRB#6705). Efforts will be made to release the primary study results within 6 months of data collection completion.Trial registration numberClinicalTrials.gov Registry (NCT02833259).

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Les réadmissions évitables des « pneumopathies communautaires » : utilité et fiabilité d’un indicateur de la qualité du parcours de soins du patient

Cited by 4 publications

References 23 publications

Comparison of rehospitalization rates in France and the United States

Comparison of rehospitalization rates in France and the United States

Incidence of Avoidable 30-Day Readmissions Following Hospitalization for Community-Acquired Pneumonia in France

Development of a risk prediction model of potentially avoidable readmission for patients hospitalised with community-acquired pneumonia: study protocol and population

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