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August 22, 2011Canadian Medical Association JournalOpen Access

Incidence of potentially avoidable urgent readmissions and their relation to all-cause urgent readmissions

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Key result

Potentially avoidable readmissions were relatively uncommon, comprising 16.0% of all urgent readmissions following hospital discharge, and hospital-specific readmission rates were not related to the proportion deemed avoidable.

Population

4812 patients discharged to the community from 11 teaching and community hospitals between October 2002 and…

Design

Cohort

Follow-up

six months

Authors

CWCarl van WalravenGeneral CardiologyAJAlison JenningsHealth CanadaMTMonica TaljaardNatural Sciences and Engineering Research Council

Discussion

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Implication

Hospital readmission rates may not reflect care quality; leaves open need for better quality metrics.

Study Design

Type

Cohort (n=4,812)

Multicenter

Yes

Structured PICO

P
Population
4812 patients discharged to the community from 11 teaching and community hospitals between October 2002 and July 2006
O
Outcome
Urgent readmissions within six months and whether they were potentially avoidable

Potentially avoidable urgent readmissions are relatively uncommon and do not correlate with overall hospital readmission rates, suggesting total readmission rates may be a poor proxy for quality of care.

Limitations

  • Identified readmissions that were potentially, and not definitely, avoidable
  • Did not include a random sample of index hospital admissions
  • Did not include a random sample of physician reviewers
  • Uncertain how representative the 11 hospitals are of other hospitals
  • Patient population was younger and healthier than elderly patients in Medicare studies
  • Broad inclusion criteria precluded diagnostic-specific analyses
  • Reviewers requested additional information for their judgment in 20% of the reviews

Cite This Study

Walraven et al. (2011) conducted a cohort in Patients discharged to the community after elective or urgent hospital care (n=4,812). None (Observational) was evaluated on Potentially avoidable urgent readmission (probability >50% by latent class model) (95% CI 13.3%-19.1%). Potentially avoidable readmissions were relatively uncommon, comprising 16.0% of all urgent readmissions following hospital discharge, and hospital-specific readmission rates were not related to the proportion deemed avoidable.

synapsesocial.com/papers/6a1dd2edef3fa0b4c0ef6e5bhttps://doi.org/10.1503/cmaj.110400
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