OBJECTIVE: To determine clinical and patient-centered factors predicting non-elective hospital readmissions. DESIGN: Secondary analysis from a randomized clinical trial. CLINICAL SETTING: Nine VA medical centers. PARTICIPANTS: Patients discharged from the medical service with diabetes mellitus, congestive heart failure, and/or chronic obstructive pulmonary disease (COPD). MAIN OUTCOME MEASUREMENT: Non-elective readmission within 90 days. RESULTS: Of 1378 patients discharged, 23.3% were readmitted. After controlling for hospital and intervention status, risk of readmission was increased if the patient had more hospitalizations and emergency room visits in the prior 6 months, higher blood urea nitrogen, lower mental health function, a diagnosis of COPD, and increased satisfaction with access to emergency care assessed on the index hospitalization. CONCLUSIONS: Both clinical and patient-centered factors identifiable at discharge are related to non-elective readmission. These factors identify high-risk patients and provide guidance for future interventions. The relationship of patient satisfaction measures to readmission deserves further study.
RCT Entities:
OBJECTIVE: To determine clinical and patient-centered factors predicting non-elective hospital readmissions. DESIGN: Secondary analysis from a randomized clinical trial. CLINICAL SETTING: Nine VA medical centers. PARTICIPANTS: Patients discharged from the medical service with diabetes mellitus, congestive heart failure, and/or chronic obstructive pulmonary disease (COPD). MAIN OUTCOME MEASUREMENT: Non-elective readmission within 90 days. RESULTS: Of 1378 patients discharged, 23.3% were readmitted. After controlling for hospital and intervention status, risk of readmission was increased if the patient had more hospitalizations and emergency room visits in the prior 6 months, higher blood ureanitrogen, lower mental health function, a diagnosis of COPD, and increased satisfaction with access to emergency care assessed on the index hospitalization. CONCLUSIONS: Both clinical and patient-centered factors identifiable at discharge are related to non-elective readmission. These factors identify high-risk patients and provide guidance for future interventions. The relationship of patient satisfaction measures to readmission deserves further study.
Authors: Matthew J Press; Jeffrey H Silber; Amy K Rosen; Patrick S Romano; Kamal M F Itani; Jingsan Zhu; Yanli Wang; Orit Even-Shoshan; Michael J Halenar; Kevin G Volpp Journal: J Gen Intern Med Date: 2010-11-06 Impact factor: 5.128
Authors: Jia-Rong Wu; Darren A DeWalt; David W Baker; Dean Schillinger; Bernice Ruo; Kristen Bibbins-Domingo; Aurelia Macabasco-O'Connell; George M Holmes; Kimberly A Broucksou; Brian Erman; Victoria Hawk; Crystal W Cene; Christine DeLong Jones; Michael Pignone Journal: J Clin Nurs Date: 2013-12-20 Impact factor: 3.036
Authors: S Nicole Hastings; Kenneth E Schmader; Richard J Sloane; Morris Weinberger; Kenneth C Goldberg; Eugene Z Oddone Journal: J Gen Intern Med Date: 2007-09-08 Impact factor: 5.128
Authors: Omar Hasan; David O Meltzer; Shimon A Shaykevich; Chaim M Bell; Peter J Kaboli; Andrew D Auerbach; Tosha B Wetterneck; Vineet M Arora; James Zhang; Jeffrey L Schnipper Journal: J Gen Intern Med Date: 2009-12-15 Impact factor: 5.128