Modern Perspectives on 30-Day Hospital Readmission Reviews

Background Hospital readmissions are costly and impact healthcare quality. Accurate identification of preventable readmissions is crucial for targeted interventions.  Objective We aimed to determine the proportion of preventable readmissions and identify the most common causes of readmission at a large academic medical center in New York City, United States of America. Methods We conducted a retrospective study of patients readmitted within 30 days of discharge from the hospital medicine service in 2022. Preventability was defined through a structured physician review process considering gaps in transitions of care, medication reconciliation, and clinical management.  Results Of the 481 readmissions reviewed, 28% (133) were classified as preventable. Among the preventable readmissions, the most common causes were: medical management (26%, n=34), including clinical decisions and issues with medication reconciliation; misalignment of goals of care (20%, n=26), and lack of timely post-discharge follow-up (16%, n=21).  Conclusions Approximately 28% of readmissions were preventable, highlighting opportunities for improvement in clinical decision-making, medication management, transition of care, and timely follow-up. Our findings support the use of validated readmission review methods and targeted interventions to address these key areas and reduce healthcare costs.