Preventability of emergent hospital readmission

Abstract

To determine whether emergent readmissions within 30 days of discharge are potentially preventable, we prospectively studied all readmissions to the medical service of a university teaching hospital during a 4-month period. The 327 readmissions, including 42 patients who were readmitted more than once during the study period, accounted for 12% of medical admissions. Nearly 75% of readmissions were due to previously diagnosed medical conditions; complications of drugs or therapeutic procedures caused 29%, and patient compliance contributed to 11%. Three reviewers judged 28 (9%) readmissions to be potentially preventable. These 28 readmissions constituted 1% of all admissions to the medical service and did not result in any fatalities, indicating that the quality of care was generally very good. One third of the potentially preventable readmissions were thought to be related to medical system failures, one third to an unfulfilled hope that the patient would improve after discharge, and one third to other suboptimal judgements in evaluation or treatment. Of the 28 potentially preventable readmissions, 89% occurred within 10 days of discharge. We conclude that potentially preventable readmissions would nearly always be detected by review of readmissions within 10 days of discharge and that many may be amenable to systematic interventions such as standardized predischarge assessment and better coordination of post-discharge follow-up.

Effectiveness of a pilot project of discharge planning in Taiwan

“…However, in a rigorously designed randomized clinical trial, Naylor and associates (1999) found that within 24 weeks after discharge the readmission rate in the intervention group was lower than that in the control group (6.2% vs. 14.5%). In another article researchers reported the finding that only 8.8% of readmissions are preventable (Frankl, Breeling, & Goldman, 1991); in contrast, Graham and Some data were missing in these variables of family caregiver characteristics. Livesley (1983) stated that 47.7% of readmissions are preventable.…”

Proportion of hospital readmissions deemed avoidable: a systematic review

“…Four studies did not specify the criteria used to classify readmissions, stating that reviewers judged which readmissions were avoidable. 12,17,25,26 Eleven studies described criteria that were subjective, citing few or no qualifiers or guides for reviewers. 6,13,14,16,21,22,24,31,35,37,38 Three studies used criteria that focused exclusively on adverse drug reactions.…”

Reingreso hospitalario en Medicina Interna

“…No obstante, en parte relacionado con la diferente terminología empleada, también se ha dudado de su utilidad como índi-ce general (6,10), aunque en determinados procesos clínicos (p. ej., insuficiencia cardiaca, asma bronquial) la tasa de reingreso puede identificar problemas en la calidad asistencial (5,7,(11)(12)(13).…”