Importance of previous hospital stays on the risk of hospital re-admission in older adults: a real-life analysis of the PAERPA study population

Visade, Fabien; Babykina, Génia; Lamer, Antoine; Defebvre, Marguerite-Marie; Verloop, David; Ficheur, Grégoire; Génin, Michaël; Puisieux, François; Beuscart, Jean‐Baptiste

doi:10.1093/ageing/afaa139

Cited by 8 publications

(7 citation statements)

References 27 publications

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“…In older adults, the rate of hospital readmission 1 month after the initial discharge can vary from 10% to 24%, depending on the type of readmission and the patient's characteristics (age, comorbidities, frailty, etc) 8 . Hospital readmission is associated with an elevated risk of subsequent hospital readmissions and death 8–10 …”

Section: Introductionmentioning

confidence: 99%

The impact of including a medication review in an integrated care pathway: A pilot study

Payen

Godard‐Sebillotte

Sourial

et al. 2022

Brit J Clinical Pharma

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Aim:The objective of the present study was to measure the impact of the intervention of combining a medication review with an integrated care approach on potentially inappropriate medications (PIMs) and hospital readmissions in frail older adults.Methods: A cohort of hospitalized older adults enrolled in the French PAERPA integrated care pathway (the exposed cohort) was matched retrospectively with hospitalized older adults not enrolled in the pathway (unexposed cohort) between January 1st, 2015, and December 31st, 2018. The study was an analysis of French health administrative database. The inclusion criteria for exposed patients were admission to an acute care department in a general hospital, age 75 years or over, at least three comorbidities or the prescription of diuretics or oral anticoagulants, discharge alive and performance of a medication review.Results: For the study population (n = 582), the mean ± standard deviation age was 82.9 ± 4.9 years, and 380 (65.3%) were women. Depending on the definition used, the overall median number of PIMs ranged from 2 [0;3] on admission to 3 [0;3] at discharge. The intervention was not associated with a significant difference in the mean number of PIMs. Patients in the exposed cohort were half as likely to be readmitted to hospital within 30 days of discharge relative to patients in the unexposed cohort. Conclusion:Our results show that a medication review was not associated with a decrease in the mean number of PIMs. However, an integrated care intervention including the medication review was associated with a reduction in the number of hospital readmissions at 30 days.

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Section: Introductionmentioning

confidence: 99%

The impact of including a medication review in an integrated care pathway: A pilot study

Payen

Godard‐Sebillotte

Sourial

et al. 2022

Brit J Clinical Pharma

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“…1,3,4,[6][7][8][9][10][11] We have previously reported that the risks of hospital readmission and death were strongly influenced by the hospital readmission process. 13 However, this analysis was limited by the number of available adjustment variables (ie age, sex, and the CCI). Our present results confirmed the importance of the rank and time to hospital readmission on the change in the risks of hospital readmission and death.…”

Section: Discussionmentioning

confidence: 99%

“…The use of statistical models designed for studying recurrent events is therefore more appropriate when a patient has been admitted to hospital several times. 13 Hospital readmissions should thus be analyzed precisely because they reflect a frequent clinical picture among older adults. Most of the studies of patient pathways in this population have focused on the occurrence of events like hospital readmission or death.…”

Section: Discussionmentioning

confidence: 99%

“…We have used this type of model to show that each hospital readmission during the follow-up period is a major risk factor for further hospital readmission and death in older patients. 13 However, the number of adjustment variables was limited, and the model suggested that the study population was heterogeneous. It therefore remained to be determined whether hospital readmission per se is a major risk factor for further hospital readmissions or whether it is an indirect marker of other risk factors.…”

Section: Introductionmentioning

confidence: 99%

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Risk Factors for Hospital Readmission and Death After Discharge of Older Adults from Acute Geriatric Units: Taking the Rank of Admission into Account

Visade¹,

Babykina²,

Puisieux³

et al. 2021

CIA

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“…Avoidable hospitalisations of older people remain a global challenge for health care systems [1][2][3]. Additionally, the number of unplanned visits to emergency departments (ED) has continued to grow even though many countries have achieved substantial health care improvements in recent decades [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

An integrated knowledge translation approach to address avoidable rehospitalisations and unplanned admissions for older people in South Australia: implementation and evaluation program plan

Harvey

Pham

Inacio

et al. 2021

Implement Sci Commun

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Background Repeated admission to hospital can be stressful for older people and their families and puts additional pressure on the health care system. While there is some evidence about strategies to better integrate care, improve older patients’ experiences at transitions of care, and reduce preventable hospital readmissions, implementing these strategies at scale is challenging. This program of research comprises multiple, complementary research activities with an overall goal of improving the care for older people after discharge from hospital. The program leverages existing large datasets and an established collaborative network of clinicians, consumers, academics, and aged care providers. Methods The program of research will take place in South Australia focusing on people aged 65 and over. Three inter-linked research activities will be the following: (1) analyse existing registry data to profile individuals at high risk of emergency department encounters and hospital admissions; (2) evaluate the cost-effectiveness of existing ‘out-of-hospital’ programs provided within the state; and (3) implement a state-wide quality improvement collaborative to tackle key interventions likely to improve older people’s care at points of transitions. The research is underpinned by an integrated approach to knowledge translation, actively engaging a broad range of stakeholders to optimise the relevance and sustainability of the changes that are introduced. Discussion This project highlights the uniqueness and potential value of bringing together key stakeholders and using a multi-faceted approach (risk profiling; evaluation framework; implementation and evaluation) for improving health services. The program aims to develop a practical and scalable solution to a challenging health service problem for frail older people and service providers.

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Importance of previous hospital stays on the risk of hospital re-admission in older adults: a real-life analysis of the PAERPA study population

Cited by 8 publications

References 27 publications

The impact of including a medication review in an integrated care pathway: A pilot study

The impact of including a medication review in an integrated care pathway: A pilot study

Risk Factors for Hospital Readmission and Death After Discharge of Older Adults from Acute Geriatric Units: Taking the Rank of Admission into Account

An integrated knowledge translation approach to address avoidable rehospitalisations and unplanned admissions for older people in South Australia: implementation and evaluation program plan

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