Different Perspectives on Predictability and Preventability of Surgical Readmissions

Area of Science:

• Healthcare Quality
• Patient Safety
• Surgical Outcomes

Background:

• Unscheduled readmissions are key quality indicators, yet surgical patient readmissions are understudied.
• Focus on surgical patient readmissions is limited despite their impact.

Purpose of the Study:

• To investigate patient and physician perspectives on the predictability and preventability of unscheduled surgical readmissions.
• To identify risk factors and root causes of surgical readmissions from both patient and physician viewpoints.

Main Methods:

• An observational study (CURIOS@) surveyed 237 readmitted surgical patients and their doctors in the Netherlands.
• Assessed discharge process, perceived predictability/preventability of readmission, and identified risk factors.
• Used Cohen's kappa for agreement analysis and PRISMA categories for root cause analysis.

Main Results:

• Patients (28.7%) were more likely than doctors (6.8%) to view readmissions as preventable, with low agreement (kappa=0.071).
• Disagreement existed on risk factors and root causes; patient-reported readiness for discharge correlated with perceived preventability.
• Health-care worker failures were significantly linked to preventable readmissions.

Conclusions:

• A significant consensus gap exists between patients and physicians regarding surgical readmission predictability and preventability.
• Enhanced patient involvement in the discharge process and improved communication are crucial for safe and effective care transitions.
• Addressing health-care worker-related factors is vital for reducing preventable surgical readmissions.