Thirty-Day Hospital Readmissions: A Predictor of Higher All-cause Mortality for Up to Two Years

Shaw, Jawaid; Stiliannoudakis, Spiro; Qaiser, Rabia; Layman, Erynn; Šíma, Adam; Ali, Asghar

doi:10.7759/cureus.9308

Cited by 18 publications

(17 citation statements)

References 12 publications

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“…1 Readmission to the hospital within 30 days of discharge (30-day readmission) is a standard metric of quality of care. High 30-day readmission rates are associated with increased mortality 2 as well as financial penalties for hospitals under the Centers for Medicare and Medicaid Services’ Hospital Readmissions Reduction Program. 3 Therefore, it is of interest to all stakeholders involved to reduce 30-day readmission rates as much as possible.…”

Section: Introductionmentioning

confidence: 99%

Use of Continuous Glucose Monitors Upon Hospital Discharge of People With Diabetes: Promise, Barriers, and Opportunity

Tian,

Aaron,

Seley

et al. 2023

J Diabetes Sci Technol

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Continuous glucose monitors (CGMs) have increasingly been used in ambulatory and inpatient or hospital settings to improve glycemic outcomes for people with diabetes. Given their capacity to aid individuals in avoiding hypo- and hyperglycemia, they may also be useful when transitioning from hospital to home by reducing rates of hospital readmissions and emergency department visits. Several types of barriers presently exist that make the deployment of CGMs at the time of hospital discharge problematic, including (1) regulatory, (2) behavioral, (3) logistical, (4) technical, (5) staffing, and (6) systemic issues. In this commentary, we review the literature, discuss these barriers, and propose possible solutions to facilitate the use of CGMs in people with diabetes at the time of hospital discharge.

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Section: Introductionmentioning

confidence: 99%

Use of Continuous Glucose Monitors Upon Hospital Discharge of People With Diabetes: Promise, Barriers, and Opportunity

Tian,

Aaron,

Seley

et al. 2023

J Diabetes Sci Technol

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“…Kristensen, 2017). AHRs are an increasing challenge globally, resulting in adverse physical and psychosocial outcomes for patients, including feelings of powerlessness and increased risk of hospital‐acquired complications and death (Blakey et al, 2017; Shaw et al, 2020). Readmissions are also expensive and resource‐intensive for healthcare systems (e.g.…”

Section: Introductionmentioning

confidence: 99%

Why reducing avoidable hospital readmissions is a ‘wicked’ problem for leaders: A qualitative exploration of nursing and allied health perceptions

Feo

Urry

Conroy

et al. 2022

Journal of Advanced Nursing

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Aims:To investigate nursing and allied health professional perceptions of the interrelationship between avoidable hospital readmissions and fundamental care delivery. Design:A qualitative, exploratory study using a critical realist approach.Method: One-to-one semi-structured interviews with 14 nursing and allied health professionals conducted between May and September 2019.Results: Several tensions and contradictions were identified in the data, which demonstrated clinicians' perceptions about the priority of both fundamental care and two avoidable readmission conditions (aspiration pneumonia and constipation). These tensions are illustrated in two major themes: Avoidable versus inevitable; and everyone versus no one. The first theme demonstrates clinicians' perceptions that readmissions for aspiration pneumonia and constipation are not common, despite acknowledging that they generally lacked knowledge on readmission rates; and that these conditions may not be preventable in acute settings. The second theme demonstrates clinicians' perception that preventing readmissions is everyone's responsibility, however, this was coupled with a lack of articulation around how this multidisciplinary approach could be achieved, leading to a distinct lack of agency for care delivery.

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“…Approximately 20% of patients in the United States experience unplanned readmissions within 30 days after discharge ( Jencks et al, 2009 ). These readmissions impact both patients and healthcare providers since they are associated with an increase in morbidity, mortality, health expenditures, and increased workload and stress for healthcare providers ( Carter et al, 2018 ; Upadhyay et al, 2019 ; Shaw et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Medication-Related Readmissions: Documentation of the Medication Involved and Communication in the Care Continuum

2022

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Background: Of all readmissions, 21% are medication-related readmissions (MRRs). However, it is unknown whether MRRs are recognized at the time of readmission and are communicated in the care continuum.Objectives: To identify the prevalence of MRRs that contain a documentation on the medication involved (and therefore are regarded as recognized), and the proportion of communicated MRRs.Setting: The study was performed in a teaching hospital.Methods: In a previous study, a multidisciplinary team of physicians and pharmacists assessed the medication-relatedness, the medication involved and preventability of unplanned readmissions from seven departments. In the current cross-sectional study, two pharmacy team members evaluated the patient records independently. An MRR was regarded as recognized when the medication involved was documented in patient records. An MRR was regarded as communicated to the patient and/or the next healthcare provider when the medication involved or a description was mentioned in discharge letters or discharge prescriptions. The relationship between documented MRRs and whether the MRR was preventable as well as the relationship between (un)documented MRRs and the length of stay (LOS) were assessed. Descriptive data analysis was used.Results: Of 181 included MRRs, 72 (40%) were deemed preventable by the multidisciplinary team. For 159 of 181 MRRs (88%), a documentation on the medication involved was present. Of 159 documented MRRs, 93 (58%) were communicated to patients and/or caregivers, 137 (86%) to the general practitioner, and 4 (3%) to the community pharmacy. The medication involved was documented less often for potentially preventable MRRs than for non-preventable MRRs (78 vs. 95%; p = 0.002). The LOS was longer for MRRs where the medication involved was undocumented (median 8 vs. 5 days; p = 0.062).Conclusion: The results of this study imply that MRRs are not always recognized, which could impact patients’ well-being. In this study an increased LOS was observed with unrecognized MRRs. Communication of MRRs to the patients and/or the next healthcare providers should be improved.

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Thirty-Day Hospital Readmissions: A Predictor of Higher All-cause Mortality for Up to Two Years

Cited by 18 publications

References 12 publications

Use of Continuous Glucose Monitors Upon Hospital Discharge of People With Diabetes: Promise, Barriers, and Opportunity

Use of Continuous Glucose Monitors Upon Hospital Discharge of People With Diabetes: Promise, Barriers, and Opportunity

Why reducing avoidable hospital readmissions is a ‘wicked’ problem for leaders: A qualitative exploration of nursing and allied health perceptions

Medication-Related Readmissions: Documentation of the Medication Involved and Communication in the Care Continuum

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