Factors associated with unplanned readmissions within 1 day of acute care discharge: a retrospective cohort study
Background Unplanned hospital readmissions are a quality and safety indicator. In Australian, 8% to 11.1% of unplanned readmissions occur ≤1 day of acute care discharge. The aim of this study was to explore the reasons for unplanned hospital readmissions ≤1 day of acute care discharge, and determine what proportion of such unplanned hospital readmissions were potentially preventable. Methods A retrospective exploratory cohort design was used to conduct this two phase study. In Phase 1, organisational data from 170 readmissions ≤1 day and 1358 readmissions between 2 and 28 days were compared using the Cochran-Mantel-Haenszel test. Binary logistic regression was used to examine factors associated with unplanned readmission ≤1 day. In Phase 2, a medical record audit of 162 Phase 1 readmissions ≤1 day was conducted and descriptive statistics used to summarise the study data. Index discharges occurred between 1 August and 31 December 2015. Results In Phase 1, unplanned readmissions ≤1 day were more likely in paediatric patients (< 0.001); index discharges on weekends (p = 0.006), from short stay unit (SSU) (p < 0.001) or against health professional advice (p = 0.010); or when the readmission was for a Diagnosis Related Group (p < 0.001). The significant predictors of unplanned readmission ≤1 day were index discharge against advice or from SSU, and 1–5 hospital admissions in the 6 months preceding index admission. In Phase 2, 88.3% readmissions were unpreventable and 11.7% were preventable. The median patient age was 57 years and comorbidities were uncommon (3.1%). Most patients (94.4%) lived at home and with others (78.9%). Friday was the most common day of index discharge (17.3%) and Saturday was the most common day of unplanned readmission (19.1%). The majority (94.4%) of readmissions were via the emergency department: 58.5% were for a like diagnosis and pain was the most common reason for readmission. Conclusions Advanced age, significant comorbidities and social isolation did not feature in patients with an unplanned readmission ≤1 day. One quarter of patients were discharged on a Friday or weekend, one quarter of readmissions occurred on a weekend, and pain was the most common reason for readmission raising issues about access to services and weekend discharge planning..
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2018 |
|---|---|
| Erschienen: |
2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:18 |
|---|---|
| Enthalten in: |
BMC health services research - 18(2018), 1 vom: 14. Sept. |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Considine, Julie [VerfasserIn] |
|---|
| Links: |
Volltext [kostenfrei] |
|---|
| Themen: |
Discharge planning |
|---|
| Anmerkungen: |
© The Author(s). 2018 |
|---|
| doi: |
10.1186/s12913-018-3527-6 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
SPR028302850 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | SPR028302850 | ||
| 003 | DE-627 | ||
| 005 | 20230519232257.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 201007s2018 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1186/s12913-018-3527-6 |2 doi | |
| 035 | |a (DE-627)SPR028302850 | ||
| 035 | |a (SPR)s12913-018-3527-6-e | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Considine, Julie |e verfasserin |0 (orcid)0000-0003-3801-2456 |4 aut | |
| 245 | 1 | 0 | |a Factors associated with unplanned readmissions within 1 day of acute care discharge: a retrospective cohort study |
| 264 | 1 | |c 2018 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a Computermedien |b c |2 rdamedia | ||
| 338 | |a Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a © The Author(s). 2018 | ||
| 520 | |a Background Unplanned hospital readmissions are a quality and safety indicator. In Australian, 8% to 11.1% of unplanned readmissions occur ≤1 day of acute care discharge. The aim of this study was to explore the reasons for unplanned hospital readmissions ≤1 day of acute care discharge, and determine what proportion of such unplanned hospital readmissions were potentially preventable. Methods A retrospective exploratory cohort design was used to conduct this two phase study. In Phase 1, organisational data from 170 readmissions ≤1 day and 1358 readmissions between 2 and 28 days were compared using the Cochran-Mantel-Haenszel test. Binary logistic regression was used to examine factors associated with unplanned readmission ≤1 day. In Phase 2, a medical record audit of 162 Phase 1 readmissions ≤1 day was conducted and descriptive statistics used to summarise the study data. Index discharges occurred between 1 August and 31 December 2015. Results In Phase 1, unplanned readmissions ≤1 day were more likely in paediatric patients (< 0.001); index discharges on weekends (p = 0.006), from short stay unit (SSU) (p < 0.001) or against health professional advice (p = 0.010); or when the readmission was for a Diagnosis Related Group (p < 0.001). The significant predictors of unplanned readmission ≤1 day were index discharge against advice or from SSU, and 1–5 hospital admissions in the 6 months preceding index admission. In Phase 2, 88.3% readmissions were unpreventable and 11.7% were preventable. The median patient age was 57 years and comorbidities were uncommon (3.1%). Most patients (94.4%) lived at home and with others (78.9%). Friday was the most common day of index discharge (17.3%) and Saturday was the most common day of unplanned readmission (19.1%). The majority (94.4%) of readmissions were via the emergency department: 58.5% were for a like diagnosis and pain was the most common reason for readmission. Conclusions Advanced age, significant comorbidities and social isolation did not feature in patients with an unplanned readmission ≤1 day. One quarter of patients were discharged on a Friday or weekend, one quarter of readmissions occurred on a weekend, and pain was the most common reason for readmission raising issues about access to services and weekend discharge planning. | ||
| 650 | 4 | |a Patient safety |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Patient readmission |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Hospital readmission |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Discharge planning |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Hospitalization |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Health services |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Berry, Debra |4 aut | |
| 700 | 1 | |a Newnham, Evan |4 aut | |
| 700 | 1 | |a Jiang, Matthew |4 aut | |
| 700 | 1 | |a Fox, Karen |4 aut | |
| 700 | 1 | |a Plunkett, David |4 aut | |
| 700 | 1 | |a Mecner, Melissa |4 aut | |
| 700 | 1 | |a Darzins, Peteris |4 aut | |
| 700 | 1 | |a O’Reilly, Mary |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t BMC health services research |d London : BioMed Central, 2001 |g 18(2018), 1 vom: 14. Sept. |w (DE-627)SPR028228308 |w (DE-600)2050434-2 |x 1472-6963 |7 nnns |
| 773 | 1 | 8 | |g volume:18 |g year:2018 |g number:1 |g day:14 |g month:09 |
| 856 | 4 | 0 | |u https://dx.doi.org/10.1186/s12913-018-3527-6 |z kostenfrei |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_SPRINGER | ||
| 912 | |a SSG-OLC-PHA | ||
| 951 | |a AR | ||
| 952 | |d 18 |j 2018 |e 1 |b 14 |c 09 | ||