To determine the preventability of readmissions, researchers at UCSF conducted an observational study of 1,000 general medicine patients who were readmitted within 30 days of discharge at 12 U.S. academic medical centers between April 1, 2012 and March 31, 2013. The researchers surveyed both patients and physicians, reviewed documentation and performed two-physician case reviews to determine the factors most significantly contributing to readmission.
The patients’ median age was 55 years. Of the 1,000 patients readmitted to the hospital, 269 were considered potentially preventable.
The factors most strongly associated with the potentially preventable readmissions were emergency department decision-making regarding the readmission, failure to relay important information to outpatient healthcare professionals, discharge of patients too soon and lack of discussions about care goals for patients with serious illnesses.
The study found the most common factors associated with potentially preventable readmissions included emergency department decision-making, inability to keep appointments after discharge, premature discharge from the hospital and patient lack of awareness of whom to contact after discharge.
The study authors concluded high-priority areas for progress include improving communication among healthcare teams and between healthcare workers and patients, greater attention to patients’ readiness for discharge, better disease monitoring and enhanced support for patient self-management, according to the report.
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