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Clinical characteristics and risk factors of preventable hospital readmissions within 30 days
Elsemieke A I M Meurs1, Carl E H Siegert2, Elien Uitvlugt1
1Department of Clinical Pharmacy, OLVG, Noord-Holland, Amsterdam, The Netherlands.
Insights
Potentially preventable hospital readmissions (PPRs) are common across all departments. Risk factors for PPRs include older age and higher socioeconomic status, indicating a multifactorial cause.
Area of Science:
- Healthcare Management
- Patient Safety
- Clinical Epidemiology
Background:
- Knowledge regarding preventable hospital readmissions (PPRs) is limited.
- Understanding the characteristics and risk factors of PPRs is crucial for improving patient outcomes and reducing healthcare costs.
Purpose of the Study:
- To compare clinical characteristics of potentially preventable readmissions (PPRs) with non-PPRs.
- To identify risk factors associated with PPRs.
Main Methods:
- A retrospective study analyzing 1120 readmissions within 30 days across 7 hospital departments.
- Preventability of readmissions was assessed by multidisciplinary meetings.
- Clinical characteristics and 23 potential risk factors were collected and analyzed.
Main Results:
- 11% (125/1120) of readmissions were identified as PPRs, occurring uniformly across departments.
- PPRs were more frequent within 7 days of discharge (54% vs. 44%).
- Associated risk factors for PPRs included higher age, higher socioeconomic status, fewer prior admissions, and lack of a pre-readmission outpatient visit.
Conclusions:
- Potentially preventable readmissions can occur in any hospital department.
- PPRs are multifactorial, with no single patient profile easily identifiable as high-risk.
- Further research into the complex factors influencing PPRs is warranted.
Abstract:
Knowledge regarding preventable hospital readmissions is scarce. Our aim was to compare the clinical characteristics of potentially preventable readmissions (PPRs) with non-PPRs. Additionally, we aimed to identify risk factors for PPRs. Our study included readmissions within 30 days after discharge from 1 of 7 hospital departments. Preventability was assessed by multidisciplinary meetings. Characteristics of the readmissions were collected and 23 risk factors were analyzed. Of the 1120 readmissions, 125 (11%) were PPRs. PPRs occurred equally among different departments (p = 0.21). 29.6% of PPRs were readmitted by a practitioner of a different medical specialty than the initial admission (IA) specialist. The PPR group had more readmissions within 7 days (PPR 54% vs. non-PPR 44%, p = 0.03). The median LOS was 1 day longer for PPRs (p = 0.16). Factors associated with PPR were higher age (p = 0.004), higher socio-economic status (p = 0.049), fewer prior hospital admissions (p = 0.004), and no outpatient visit prior to readmission (p = 0.025). This study found that PPRs can occur at any department in the hospital. There is not a single type of patient that can easily be pinpointed to be at risk of a PPR, probably due to the multifactorial nature of PPRs.
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