Integrating the Principles of Evidence Based Medicine and Evidence Based Public Health: Impact on the Quality of Patient Care and Hospital Readmission Rates in Jordan

Abstract

Introduction:Hospital readmissions impose not only an extra burden on health care systems but impact patient health outcomes. Identifying modifiable behavioural risk factors that are possible causes of potentially avoidable readmissions can lower readmission rates and healthcare costs.Methods:Using the core principles of evidence based medicine and public health, the purpose of this study was to develop a heuristic guide that could identify what behavioural risk factors influence hospital readmissions through adopting various methods of analysis including regression models, t-tests, data mining, and logistic regression. This study was a retrospective cohort review of internal medicine patients admitted between December 1, 2012 and December 31, 2013 at King Abdullah University Hospital, in Jordan.Results:29% of all hospitalized patients were readmitted during the study period. Among all readmissions, 44% were identified as potentially avoidable. Behavioural factors including smoking, unclear follow-up and discharge planning, and being non-compliant with treatment regimen as well as discharge against medical advice were all associated with increased risk of avoidable readmissions.Conclusion:Implementing evidence based health programs that focus on modifiable behavioural risk factors for both patients and clinicians would yield a higher response in terms of reducing potentially avoidable readmissions, and could reduce direct medical costs.

Assessing the Impact of an Advanced Clinical Decision Support System on Medication Safety and Hospital Readmissions in an Innovative Transitional Care Model: A Pilot Study

“…The inappropriate use of medication increases the risk of adverse drug events (ADEs) [1]. While ADEs are associated with an increased risk of hospital readmission [2,3], studies also suggest that most events are predictable and preventable [4][5][6], particularly through the integration of transitional care services [7,8] and the use of medication risk prediction tools [6].…”

The course of readmission in frail older cardiac patients

“…Various system‐ and patient‐related factors increase the risk of hospital readmission of frail older cardiac patients (Alyahya et al, 2016; Donaghy et al, 2018; Osnard, 2016; Riegel et al, 2009; Toles et al, 2016; Walsh et al, 2016). A conceptual framework was developed, based on these system‐ and patient‐related factors to explore CCB patients’ and (in)formal caregivers’ perspectives on their role(s) and contributing factors in the course of unplanned hospital readmission, see Figure 1 and Appendix S1.…”