Rehospitalization Among Home Healthcare Patients: Results of a Prospective Study

Madigan, Elizabeth A.; Schott, Donna; Matthews, Carol

doi:10.1097/00004045-200105000-00012

Cited by 34 publications

(34 citation statements)

References 14 publications

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“…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. 20,34,36 Miles and Lowe used methods similar to those in studies of adverse events, with a defined six-point scale to determine whether readmissions were avoidable.…”

Section: −38mentioning

confidence: 99%

“…Clarke 10 Gautam 14 Halfon 23 Kirk 31 Shalchi 38 Williams 9 Ruiz 34 Oddone 16 Phelan 37 Halfon 30 Kelly 13 Kwok 19 MacDowell 7 Maurer 29 Vinson 11 Graham 5 Haines-Wood 15 Jimenez-Puente 28 McInness 8 Stanley 35 Madigan 22 Balla 32 Courtney 26 Frankl 12 Levy 21 McKay 17 Miles 20 Munshi 24 Popplewell 6 Sutton 25 Witherington 36 Experton 18 Friedman 27 Goldfield (Table 4). Error bars = 95% confidence intervals.…”

Section: % Readmissions Deemed Avoidablementioning

confidence: 99%

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Proportion of hospital readmissions deemed avoidable: a systematic review

Walraven¹,

Bennett²,

Jennings³

et al. 2011

Canadian Medical Association Journal

605

493

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In most instances, unplanned readmissions to hospital indicate bad health outcomes for patients. Sometimes they are due to a medical error or the provision of suboptimal patient care. Other times, they are unavoidable because they are due to the development of new conditions or the deterioration of refractory, severe chronic conditions.Hospital readmissions are frequently used to gauge patient care. Many organizations use them as a metric for institutional or regional quality of care.1 The widespread public reporting of hospital readmissions and their use in considerations for funding implicitly suggest a belief that readmissions indicate the quality of care provided by particular physicians and institutions.The validity of hospital readmissions as an indicator of quality of care depends on the extent that readmissions are avoidable. As the proportion of readmissions deemed to be avoidable decreases, the effort and expense required to avoid one readmission will increase. This de crease in avoidable admissions will also dilute the relation between the overall readmission rate and quality of care. Therefore, it is important to know the proportion of hospital readmissions that are avoidable.We conducted a systematic review of studies that measured the proportion of readmissions that were avoidable. We examined how such readmissions were measured and estimated their prevalence. Methods Literature searchWe consulted a local information scientist to develop a search strategy to identify studies that measured the proportion of readmissions deemed avoidable (Appendix 1, available at www .cmaj .ca /cgi /content /full /cmaj .101860 /DC1). We applied this strategy to search the MEDLINE and EMBASE databases for English-language papers published from 1966 to July 2010. Fulltext versions of citations were re trieved for complete review if they specified that hospital readmissions were counted; and the title or abstract used any term(s) indicating that re admissions were classified as avoidable (or "preventable,"

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Section: −38mentioning

confidence: 99%

Section: % Readmissions Deemed Avoidablementioning

confidence: 99%

Proportion of hospital readmissions deemed avoidable: a systematic review

Walraven¹,

Bennett²,

Jennings³

et al. 2011

Canadian Medical Association Journal

605

493

View full text Add to dashboard Cite

show abstract

“…Existing published reports regarding factors that increase the risk of hospitalization among Medicare home care patients are inconclusive, mainly because most research focuses on adult patients of all ages with a single clinical condition (e.g., heart failure) or primarily examines rehospitalization of patients admitted to home care from the hospital (Dennis, Blue, Stahl, Benge, & Shaw, 1996;Happ, Naylor, & Roe-Prior, 1997;Hoskins, WaltonMoss, Clark, Schroeder, & Thiel, 1999;Madigan et al, 2002;Madigan, Schott, & Matthews, 2001;Martens & Mellor, 1997;Rosati, Huang, NavaieWaliser, & Feldman, 2003).…”

Section: Conceptual Model and Study Relevance To Medicare Home Care Pmentioning

confidence: 99%

Risk Factors for Hospitalization Among Medicare Home Care Patients

et al. 2006

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This study determined factors associated with an increased risk of ending Medicare home health care because of hospitalization and examined specific types of and reasons for hospitalization. Sample members (N = 922) were followed from admission to discharge as they received home care from Ohio Medicare-certified home care agencies between December 1999 and March 2002. Potential patient-level risk factors were predisposing, enabling, or need variables, and an agency-level variable denoting hospital affiliation or free-standing status was examined as a second-level risk factor. Among those hospitalized (18.3%), more than 80.0% experienced emergency hospitalizations, mostly for acute exacerbations of chronic diseases. Statistically significant risk factors for hospitalization included dyspnea severity, functional disability level, skin or wound problems, diabetes, case mix score, and guarded rehabilitation prognosis. Home care agencies might reduce hospitalizations by using clinical prognosis as a key resource for team communication and by helping patients and families anticipate potential acute exacerbations of chronic diseases and manage these events at home.

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“…22 Several studies on preventable readmissions have used algorithms to analyze large administrative databases, 23,24 and although this allows for the analysis of large numbers of cases, this method lacks the ability to examine the detailed clinical and social reasons for readmission or to determine if and how readmissions may have been prevented. Several published studies that did perform detailed chart reviews [25][26][27] were limited by lack of a clear definition of preventable readmissions or rigorous review process.…”

mentioning

confidence: 99%

Half of 30-Day Hospital Readmissions Among HIV-Infected Patients Are Potentially Preventable

Nijhawan

Kitchell

Etherton

et al. 2015

AIDS Patient Care and STDs

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Thirty-day readmission rates, a widely utilized quality metric, are high among HIV-infected individuals. However, it is unknown how many 30-day readmissions are preventable, especially in HIV patients, who have been excluded from prior potentially preventable readmission analyses. We used electronic medical records to identify all readmissions within 30 days of discharge among HIV patients hospitalized at a large urban safety net hospital in 2011. Two independent reviewers assessed whether readmissions were potentially preventable using both published criteria and detailed chart review, how readmissions might have been prevented, and the phase of care deemed suboptimal (inpatient care, discharge planning, post-discharge). Of 1137 index admissions, 213 (19%) resulted in 30-day readmissions. These admissions occurred among 930 unique HIV patients, with 130 individuals (14%) experiencing 30-day readmissions. Of these 130, about half were determined to be potentially preventable using published criteria (53%) or implicit chart review (48%). Not taking antiretroviral therapy (ART) greatly increased the odds of a preventable readmission (OR 5.9, CI:2.4-14.8). Most of the preventable causes of readmission were attributed to suboptimal care during the index hospitalization. Half of 30-day readmission in HIV patients are potentially preventable. Increased focus on early ART initiation, adherence counseling, management of chronic conditions, and appropriate timing of discharge may help reduce readmissions in this vulnerable population.

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Rehospitalization Among Home Healthcare Patients: Results of a Prospective Study

Cited by 34 publications

References 14 publications

Proportion of hospital readmissions deemed avoidable: a systematic review

Proportion of hospital readmissions deemed avoidable: a systematic review

Risk Factors for Hospitalization Among Medicare Home Care Patients

Half of 30-Day Hospital Readmissions Among HIV-Infected Patients Are Potentially Preventable

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