Factors Contributing to All-cause 30-day Readmissions
Medical CarePublished 18 February 2012
Paul Feigenbaum, Estee Neuwirth, Linda Trowbridge, Serge Teplitsky, Carol A. Barnes, Emily Fireman
Citations140
SJR quartileQ1
SJR score1.57
SNIP1.38
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
Multiple factors contributed to potentially preventable readmissions in an integrated health care system with low baseline readmission rates, and reducing all-cause 30-day readmissions may require a comprehensive approach addressing these areas.
Abstract
Multiple factors contributed to potentially preventable readmissions in an integrated health care system with low baseline readmission rates. Reducing all-cause 30-day readmissions may require a comprehensive approach addressing these areas. Future quality improvement efforts and research should identify existing and new tactics that can best prevent readmissions by addressing missed opportunities we identified.
Keywords
MedicineHealth Professions
New England Journal of MedicineRehospitalizations among Patients in the Medicare Fee-for-Service Program
5,122 Citations2009Stephen F. Jencks, Mark V. Williams +1 more
Rehospitalizations among Medicare beneficiaries are prevalent and costly and about 10% of rehospitalizations were likely to have been planned.
JAMARelationship Between Early Physician Follow-up and 30-Day Readmission Among Medicare Beneficiaries Hospitalized for Heart Failure
1,016 Citations2010Adrian F. Hernandez
Among patients who are hospitalized for heart failure, substantial variation exists in hospital-level rates of early outpatient follow-up after discharge, and Patients who are discharged from hospitals that have higher early follow- up rates have a lower risk of 30-day readmission.
New England Journal of MedicineDoes Increased Access to Primary Care Reduce Hospital Readmissions?
806 Citations1996Morris Weinberger, Eugene Ž. Oddone +1 more
For veterans discharged from Veterans Affairs hospitals, the primary care intervention studied increased rather than decreased the rate of rehospitalization, although patients in the intervention group were more satisfied with their care.
Archives of Internal MedicineHospital Readmissions as a Measure of Quality of Health Care
600 Citations2000Jochanan Benbassat, Mark I. Taragin
It is concluded that most readmissions seem to be caused by unmodifiable causes, and, pending an agreed-on method to adjust for confounders, global readmission rates are not a useful indicator of quality of care, however, high readmissions rates of patients with defined conditions, such as diabetes and bronchial asthma, may identify quality-of-care problems.
Archives of Internal MedicineStatistical Models and Patient Predictors of Readmission for Heart Failure<subtitle>A Systematic Review</subtitle>
345 Citations2008Joseph S. Ross
A systematic review of the published English-language literature identified no model designed to compare hospital rates of readmission, while models designed to predict patients' readmission risk used heterogeneous approaches and found substantial inconsistencies regarding which patient characteristics were predictive.
Journal of General Internal MedicineEffect of discharge summary availability during post-discharge visits on hospital readmission
320 Citations2002Carl Walraven, Ratika Seth +2 more
The risk of rehospitalization may decrease when patients are assessed following discharge by physicians who have received the discharge summary, and further research is required to determine if better continuity of patient information improves patient outcomes.
CHEST JournalPredictors of Rehospitalization and Death After a Severe Exacerbation of COPD
286 Citations2007Ryan M. McGhan, Tiffany A. Radcliff +4 more
Age, male gender, prior hospitalizations, and certain comorbid conditions were risk factors for death and rehospitalization in patients discharged after a severe COPD exacerbation in a large cohort of Veterans Affairs patients.
Journal of Clinical EpidemiologyMeasuring potentially avoidable hospital readmissions
239 Citations2002Patricia Halfon, Yves Eggli +4 more
A computerized method to screen for potentially avoidable hospital readmissions using routinely collected data and a prediction model to adjust rates for case mix offers satisfactory predictive performance and a good medical plausibility.
Archives of Internal MedicineEffect of an Electronic Medication Reconciliation Application and Process Redesign on Potential Adverse Drug Events
239 Citations2009Jeffrey L. Schnipper, Claus Hamann +14 more
A computerized medication reconciliation tool and process redesign were associated with a decrease in unintentional medication discrepancies with potential for patient harm.
New England Journal of MedicinePublic Reporting of Discharge Planning and Rates of Readmissions
238 Citations2009Ashish K. Jha, E. John Orav +1 more
The findings suggest that current efforts to collect and publicly report data on discharge planning are unlikely to yield large reductions in unnecessary readmissions.
Journal of General Internal MedicineRedefining and Redesigning Hospital Discharge to Enhance Patient Care: A Randomized Controlled Study
212 Citations2008Richard Balaban, Joel S. Weissman +2 more
SA low-cost discharge–transfer intervention may improve the rates of outpatient follow-up and of completed workups after hospital discharge.
BMJFactors affecting early unplanned readmission of elderly patients to hospital.
181 Citations1988E. Idris Williams, F Fitton
Patients in the study group and in the control group showed significant differences in certain characteristics--such as low income, previous hospital admission, already having nursing care, and admission by general practitioners--and this might help to identify patients who are likely to be readmitted in an emergency.
Journal of the American Geriatrics SocietyA Quality Improvement Intervention to Facilitate the Transition of Older Adults from Three Hospitals Back to Their Homes
170 Citations2009Param Dedhia, Steve Kravet +6 more
The objective is to study the feasibility and effectiveness of a discharge planning intervention and to establish a baseline for this intervention in the United States.
The American Journal of MedicinePreventability of emergent hospital readmission
166 Citations1991Susan E. Frankl, James L. Breeling +1 more
It is concluded 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.
Journal of Cardiac FailureObjectively Measured, but Not Self-Reported, Medication Adherence Independently Predicts Event-Free Survival in Patients With Heart Failure
157 Citations2008Jia-Rong Wu, Debra K. Moser +2 more
Dose-count and dose-day predicted event-free survival and neither dose-time nor self-reported adherence predicted outcomes, suggesting health care providers should assess specific behaviors related to medication taking rather than a global patient self-assessment of patient adherence.
Journal of Hospital MedicineProblems after discharge and understanding of communication with their primary care physicians among hospitalized seniors: A mixed methods study
147 Citations2010Vineet M. Arora, Megan Prochaska +7 more
This study suggests that many frail, older patients reported problems after discharge and were twice as likely to do so when the patient's PCP was not aware of the hospitalization.
Journal of Hospital MedicineCreating a better discharge summary: Improvement in quality and timeliness using an electronic discharge summary
139 Citations2009Kevin J. O’Leary, David Liebovitz +6 more
The use of an electronic discharge summary significantly improved the quality and timeliness of discharge summaries.
Journal of General Internal MedicineClassifying general medicine readmissions
121 Citations1996E.Z. Oddone, Miles Weinberger +13 more
Focusing efforts to identify preventable hospitalizations may yield better methods for managing patients' total health care needs; however, the content of those efforts will vary by institution.
American Journal of Health-System PharmacyImplementation of an electronic system for medication reconciliation
108 Citations2007Joan Kramer, Paula J. Hopkins +7 more
Patients who had their medications electronically reconciled reported a greater understanding of the medications they were to take after discharge from the hospital, including medication administration instructions and potential adverse effects.
INQUIRY The Journal of Health Care Organization Provision and FinancingCostly Hospital Readmissions and Complex Chronic Illness
107 Citations2008Bernard Friedman, Hui Jiang +1 more
This study aims to clarify how the rate of hospital readmissions and hospital cost per person in a year depend on a patient's number of different chronic conditions, severity of illness, principal diagnosis at discharge, payer group, and other variables.
Archives of Internal MedicineEffect of Hospital Follow-up Appointment on Clinical Event Outcomes and Mortality
81 Citations2010C. A. Grafft
Improved discharge processes, including arrangement of hospital follow-up appointments, do not appear to improve readmission rates or survival in general medicine patients, and national efforts to ensure follow- up for all patients after hospital dismissal may not be beneficial or cost-effective.
The American Journal of MedicineAssessing the preventability of emergency hospital admissions
77 Citations1987JudyAnn Bigby, Jocelyn Dunn +5 more
It is concluded that a small percentage of emergency hospitalizations may be preventable and that systematic review of emergencyhospitalizations may provide a means of measuring the quality of primary medical care.
The American Journal of MedicinePreventability of emergent hospital readmission
64 Citations1991Susan E. Frankl, James L. Breeling +1 more
Journal of General Internal MedicineElectronic Versus Dictated Hospital Discharge Summaries: a Randomized Controlled Trial
61 Citations2009David M. Maslove, Richard E. Leiter +5 more
An EDS program can be used by housestaff to more easily create hospital discharge summaries, and there was no difference in PCP satisfaction.
Journal of Advanced NursingCan home visits help reduce hospital readmissions? Randomized controlled trial
51 Citations2008Frances Kam Yuet Wong, Susan Ka Yee Chow +5 more
Preventive home visits were not effective in reducing hospital readmissions, but satisfaction with care was enhanced, and Subjective well-being is a key variable that warrants attention in the planning and evaluation of postdischarge home care.
Medical CarePost-Acute Referral Decisions Made by Multidisciplinary Experts Compared to Hospital Clinicians and the Patients’ 12-Week Outcomes
47 Citations2008Kathryn H. Bowles, Sarah J. Ratcliffe +4 more
Negative outcomes reflect the costly results of this gap in quality and support the need to improve data presentation and referral decision making.
PubMedUnplanned readmissions of elderly patients.
42 Citations1996PL Gautam, Colin Macduff +2 more
The use of rates of unplanned readmission as a measure of clinical outcome in care of the elderly is unsatisfactory as they do not accurately reflect the quality of in-patient care.
Archives of Internal MedicinePredictors of Early Hospital Readmission After Acute Pulmonary Embolism
40 Citations2009Drahomir Aujesky, Maria K. Mor +4 more
African American race, Medicaid insurance, severity of illness, discharge status, and hospital region are significantly associated with readmission, suggesting that readmission may be linked to suboptimal quality of care in the management of PE.
Journal of Hospital MedicineFailure at the transition of care: Challenges in the discharge of the vulnerable elderly patient
38 Citations2008Ethan Cumbler, Jeff Carter +1 more
Review of the literature reveals interventions such as involvement of advance practice nurses or family members in the transition may overcome some of the difficulties inherent in discharge of the vulnerable geriatric patient.
Journal of Hospital MedicinePatient and physician perceptions after software‐assisted hospital discharge: Cluster randomized trial
37 Citations2009James F. Graumlich, Nancy L. Novotny +2 more
Discharge software with CPOE caused small improvements in discharge perceptions by patients and their outpatient physicians, and these small improvements might balance the difficulty perceived by hospital physicians who used discharge software.
Journal for Healthcare QualityMedication Reconciliation: A Necessity in Promoting a Safe Hospital Discharge
33 Citations2006D Poole, Juliane N. Chainakul +2 more
Through the use of the PDMW, medication reconciliation has been dramatically improved and is found to greatly reduce adverse drug and medication events.
The Joint Commission Journal on Quality and Patient SafetyImplementing Online Medication Reconciliation at a Large Academic Medical Center
27 Citations2008Douglas Bails, Karen Clayton +2 more
Successful implementation of admission and discharge MR suggested several lessons, including (1) mandatory functionality leads to adaptation and integration of MR into housestaff work flows and (2) an electronic MR is preferable to a paper-based process in organizations with an EHR and computerized physician order entry.
Journal of the American College of CardiologyPrior Aspirin Use and Outcomes in Elderly Patients Hospitalized With Acute Myocardial Infarction
23 Citations2005Edward L. Portnay, JoAnne M. Foody +5 more
Prior aspirin use is not a marker of increased mortality in patients > or =65 years old hospitalized with MI and is found to reduce all-cause or coronary artery disease readmissions at one month or six months.
BMC Health Services ResearchRapid spread of complex change: a case study in inpatient palliative care
23 Citations2009Maria Pietronilla Penna, Helene Martel +5 more
A complex, hospital-based, interdisciplinary intervention in a large health care organization spread rapidly due to a synergy between organizational 'push' strategies and grassroots-level pull.
Health Information Management JournalElectronic Discharge Summaries: The Current State of Play
22 Citations2007J Kinnear Craig, Joanne Callen +3 more
While eDRS appear to be beneficial, further improvements are needed before systems are dependable, and through prospective enhancements and increased availability of eDRS internationally, electronic discharge referral systems have the potential to facilitate effective communication exchange across the primary-secondary care interface.