Quality of care factors associated with unplanned readmissions of older medical patients: a case–control study

Scott, Ian A; Shohag, H.; Ahmed, Md Ashfaq

doi:10.1111/imj.12334

Cited by 23 publications

(61 citation statements)

References 55 publications

(119 reference statements)

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“…These findings suggest that an involved inpatient medical and psychosocial assessment, including a focus on the transition of care and adherence to ART, may impact readmissions in this population. Some prior studies have identified similar quality issues during the inpatient stay as contributing to readmissions, 45,46 whereas others found that preventable causes of readmission were present during the index stay, discharge process and follow-up care. 32 Our study has several limitations.…”

Section: Discussionmentioning

confidence: 98%

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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Section: Discussionmentioning

confidence: 98%

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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“…In Australian populations, multimorbidity increases admissions, readmissions and ambulatory‐care‐sensitive admissions . There is scant literature on the role multimorbidity may play in unplanned admissions among PWH in Australia.…”

Section: Introductionmentioning

confidence: 99%

Multimorbidity, not human immunodeficiency virus (HIV) markers predicts unplanned admission among people with HIV in regional New South Wales

Edmiston¹,

Petoumenos

Smith³

2018

Internal Medicine Journal

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“…Patient characteristics such as age, main diagnosis, co-morbidities, and race have been studied and shown to be well-known risk factors [6789]. Patients who receive inappropriate or inadequate medical assessment and treatment are more likely to be readmitted, indicating not only are patient characteristics but quality of care is associated with readmission [10]. But, how other clinical factors impact readmission has been elusive and the results vary based on specific medical indicators and clinical conditions [1112].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2016

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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.

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Quality of care factors associated with unplanned readmissions of older medical patients: a case–control study

Cited by 23 publications

References 55 publications

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

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

Multimorbidity, not human immunodeficiency virus (HIV) markers predicts unplanned admission among people with HIV in regional New South Wales

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

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