Some Hospital Readmissions Avoidable

Hospital readmissions may often be avoidable with a change of focus after discharge

(RxWiki News) Hospital readmissions can be costly for both patients and the health care system. One new study may shine a light on areas for doctors to focus on after discharge to reduce readmissions.

This study looked at the diagnoses of patients readmitted to the hospital within 30 days of their original discharge.

The researchers found that the most common reasons for readmission were related to existing chronic medical conditions.

These researchers suggested a change in care after releasing patients from the hospital might help prevent many readmission cases.

"Ask your doctor about possible complications related to your condition."

This study was led by Jacques Donzé, MD, MSc, a research associate in the Division of General Internal Medicine at Brigham and Women's Hospital in Boston, MA.

Dr. Donzé and colleagues analyzed the discharges of 10,731 patients admitted for at least 24 hours within the Brigham and Women’s Hospital system between July 1, 2009 and June 30, 2010.

This study looked at patients readmitted within 30 days because of possibly avoidable causes.

Of the 10,731 discharges that the researchers followed during this period, 22 percent were readmitted within 30 days.

These researchers considered 8 percent (858 patients) of readmissions to be potentially avoidable.

The researchers found that the most common diagnoses of 30-day readmissions were cancer (16.8 percent), infection (10.9 percent), heart failure (4.9 percent), liver disorders (4.4 percent) and gastrointestinal (3.6 percent).

The study broke the results down further and showed the three most common reasons for potentially avoidable 30-day readmission were infection (11.6 percent), cancer (8.4 percent) and heart failure (7.1 percent). Infection and heart failure accounted for 21 to 34 percent of the total readmissions.

The researchers also noted that patients originally admitted because of cancer, heart failure and chronic kidney disease had a much higher risk of potentially avoidable readmissions.

These researchers concluded that care after discharge should include a focus on related complications as well as care of the primary diagnosis.

The researchers listed several limitations to this study, including using data from a single hospital system and the difficulty of distinguishing between potentially avoidable and unavoidable readmissions.

This study was published December 16 in BMJ.

This research was funded by the Swiss National Science Foundation and the Swiss Foundation for Medical-Biological Scholarships.

Dr. Donzé was supported by the Swiss National Science Foundation and the Swiss Foundation for Medical-Biological Scholarships. Study co-author Jeffrey L. Schnipper, MD, MPH, is a consultant to QuantiaMD, for whom he has helped to create online educational materials for both providers and patients. Dr. Schnipper also has received grant funding from Sanofi Aventis for an investigator-initiated study to design and evaluate an intensive discharge and follow-up intervention in patients with diabetes.

Review Date: 
December 23, 2013