Preventability of unplanned readmissions within 30 days of discharge. A cross-sectional, single-center study

Abstract

Objectives To identify the preventability, determinants and causes of unplanned hospital readmissions within 30 days of discharge using a multidisciplinary approach and including patients' perspectives. Design A prospective cross-sectional single-center study. Setting Urban teaching hospital in Amsterdam, the Netherlands. Participants 430 patients were included. Inclusion criteria were: age � 18 years, discharged from one of seven participating clinical departments and an unplanned readmission within 30 days. Methods Residents from the participating departments individually assessed whether the readmission was caused by healthcare, the preventability and possible causes of readmissions using a tool. Thereafter, the preventability of the cases was discussed in a multidisciplinary meeting with residents of all participating departments and clinical pharmacists. The primary outcome was the proportion of readmissions that were potentially preventable. Secondary outcomes were the determinants for a readmission, causes for preventable readmissions,

Medication-Related Hospital Readmissions Within 30 Days of Discharge: Prevalence, Preventability, Type of Medication Errors and Risk Factors

“…The data for this study were collected within the context of a larger study on all-cause readmissions (van der Does et al, 2020). The all-cause study and the current study used the same inclusion criteria.…”

“…All seven clinical departments and the hospital pharmacy assigned a resident to review readmissions. All residents received a group training prior to the start of the study regarding the assessment whether the readmission was caused by healthcare (i.e., causality) and the preventability of readmissions (van der Does et al, 2020). In case of replacement of a resident, the new resident received the same training.…”

“…Relevant information on included readmissions was collected from medical records and entered into a data processing program (Castor EDC). Potential risk factors were collected based on previous studies (Van Walraven et al, 2011;Feigenbaum et al, 2012;van der Does et al, 2020) (Table 1).…”

Clinical characteristics and risk factors of preventable hospital readmissions within 30 days

“…The study methodology has been published before; however, the previous study primarily focused on the method of assessing preventability and analyzed the causes of PPRs in a smaller cohort of patients 9 . In summary, to distinguish between PPR and non-PPR, the readmissions were manually reviewed by physicians and pharmacists in 2 phases.…”

“…A systematic review has identified median PPR rates of 27.1% of all readmissions, with a broad range varying from 5 to 79% 8 . Previous studies explored different mechanisms leading to PPRs, including management-related, medication-related, and diagnostics-related causes 9 , 10 .…”