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Updated: Jan 4, 2026

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
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Are readmissions avoidable?

A Clarke1

  • 1Health Service Research Unit, London School of Hygiene and Tropical Medicine.

BMJ (Clinical Research Ed.)
|November 17, 1990
PubMed
Summary
This summary is machine-generated.

Hospital readmission rates are not reliable indicators of inpatient care quality. A study found that even the highest category of potentially avoidable readmissions was only rated as avoidable by 49.3% of assessors.

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Area of Science:

  • Healthcare quality assessment
  • Hospital performance metrics
  • Patient safety research

Background:

  • Readmission rates are frequently used to evaluate hospital inpatient care quality.
  • However, the avoidability of unplanned readmissions requires further investigation to validate this metric.

Purpose of the Study:

  • To assess the utility of readmission rates as an outcome indicator for hospital inpatient care.
  • To investigate the avoidability of unplanned hospital readmissions within 28 days of discharge.

Main Methods:

  • A retrospective analysis was conducted on a random sample of patient case notes.
  • Nine clinical assessors evaluated 263 unplanned readmissions occurring between 0-6 and 21-27 days post-discharge.
  • Readmissions were categorized as avoidable, unavoidable, or unclassifiable.

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Main Results:

  • Readmissions within 0-6 days of discharge were more frequently deemed avoidable than those at 21-27 days (32% medical, 49% surgical vs. 6% medical, 19% surgical).
  • General surgical readmissions showed a higher rate of avoidability compared to general medical and geriatric readmissions.
  • Inter-assessor agreement varied, with the greatest variability observed for general medical and geriatric readmissions occurring 21-27 days post-discharge.

Conclusions:

  • Significant differences exist in the avoidability of readmissions across patient groups.
  • Even in the highest-risk group (surgical readmissions at 0-6 days), only 49.3% were classified as avoidable.
  • The study concludes that readmission rates should not be used as a sole outcome indicator for hospital inpatient care due to inconsistencies in avoidability assessments.