Hospital Readmissions from Patients' Perspectives.

Area of Science:

• Health Services Research
• Population Health Management
• Patient-Centered Care

Background:

• Hospital care constitutes a significant portion of escalating US healthcare expenditures.
• Approximately 18% of Medicare beneficiaries face hospital readmission within 30 days of discharge.
• Effective patient engagement in discharge planning is crucial for identifying post-discharge needs and preventing readmissions.

Purpose of the Study:

• To identify patient-reported factors contributing to hospital readmissions.
• To understand patient perspectives on barriers to successful post-discharge recovery.
• To inform strategies for reducing hospital readmission rates in an urban community hospital setting.

Main Methods:

• Evaluation of consecutive, unplanned 30-day readmissions to a hospitalist service.
• Utilized the STate Action on Avoidable Rehospitalizations (StAR) diagnostic worksheet.
• Employed face-to-face patient interviews and retrospective chart reviews for data collection.

Main Results:

• 80 patients experienced 30-day readmissions, with 28 having multiple readmissions.
• Sickle cell disease was the most frequent diagnosis for index admissions and readmissions (11.3%).
• Identified modifiable patient barriers including medication access, follow-up scheduling, transportation, housing, and social support issues. Nearly one-third of patients struggled with self-management and disease comprehension despite documented understanding at discharge.

Conclusions:

• Engaging patients in discharge planning effectively reveals process barriers.
• Addressing socioeconomic and environmental determinants of health can prevent future hospitalizations and readmissions.
• Patient-centered discharge strategies are vital for improving health outcomes and reducing healthcare costs.