NI2012 Classification of Reasons for Hospital Readmission.

Hospital readmission is a focus of efforts to improve quality and reduce cost in our healthcare system. Use of a standard readmission classification in a clinical information system would facilitate examination and analysis of reasons for hospital readmission and provide direction for targeting interventions. The purpose of this quality improvement project was to examine coverage of reasons for readmission in three existing classification schemes compared with a "gold standard" conceptual framework. Data were obtained from five data sources about reasons for readmission for a select group of patients using a modified Institute for Healthcare Improvement (IHI) tool. Both the structure and the level of granularity of the three classifications had an impact on the classification of reasons. Between 53% and 65% of the reasons for readmission could be coded in the three readmission classifications, leaving 35% to 47% of the reasons uncoded, when compared with the conceptual framework.