Hospital readmissions: Difference between revisions
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==Epidemiology== | ==Epidemiology== | ||
Among [[Medicare (United States)|Medicare]] patients in the United States receiving care in a [[fee-for-service]] setting during 2003-2004, 19.6% were rehospitalized within 30 days.<ref name="pmid19339721">{{cite journal| author=Jencks SF, Williams MV, Coleman EA| title=Rehospitalizations among patients in the Medicare fee-for-service program. | journal=N Engl J Med | year= 2009 | volume= 360 | issue= 14 | pages= 1418-28 | pmid=19339721 | doi=10.1056/NEJMsa0803563 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19339721 }} </ref> | |||
==Causes== | |||
In a study of [[Medicare (United States)|Medicare]] patients in the United States, most of the variation in rates of readmission are due to characteristics of patients.<ref name="pmid24307260">{{cite journal| author=Singh S, Lin YL, Kuo YF, Nattinger AB, Goodwin JS| title=Variation in the risk of readmission among hospitals: the relative contribution of patient, hospital and inpatient provider characteristics. | journal=J Gen Intern Med | year= 2014 | volume= 29 | issue= 4 | pages= 572-8 | pmid=24307260 | doi=10.1007/s11606-013-2723-7 | pmc=PMC3965757 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24307260 }} </ref> A much smaller degree of variation is due to characteristics of hospitals or health care providers.<ref name="pmid24307260"/> | |||
==Costs== | ==Costs== | ||
==Prediction== | ==Prediction== | ||
A number of methods have been developed to predict which patients will be readmitted.<ref name="pmid22009101">{{cite journal| author=Kansagara D, Englander H, Salanitro A, Kagen D, Theobald C, Freeman M et al.| title=Risk prediction models for hospital readmission: a systematic review. | journal=JAMA | year= 2011 | volume= 306 | issue= 15 | pages= 1688-98 | pmid=22009101 | doi=10.1001/jama.2011.1515 | pmc=PMC3603349 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22009101 }} </ref> | |||
Two or more hospitalizations within a year is simple predictor of readmission.<ref name="pmid24227707">{{cite journal| author=Baillie CA, VanZandbergen C, Tait G, Hanish A, Leas B, French B et al.| title=The readmission risk flag: using the electronic health record to automatically identify patients at risk for 30-day readmission. | journal=J Hosp Med | year= 2013 | volume= 8 | issue= 12 | pages= 689-95 | pmid=24227707 | doi=10.1002/jhm.2106 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24227707 }} </ref> A study of adult patients in the University of Pennsylvania Health System found that ≥ 2 inpatient admissions in the past 12 months had a [[sensitivity]] and [[specificity]] of 39% and 84%, respectively, for predicting readmission. In populations similar to those in this study which had a prevalence of hospital readmission of 15%, the probabilities of hospital readmission among patients with and without ≥ 2 inpatient admissions in the past 12 months were 30.0% and 11.0%, respectively.<ref name="pmid24227707"/> [http://sumsearch.org/calc/calc.aspx?calc_dx_SnSp.aspx?prevalence=15.0&sensitivity=39.0&specificity=84.0 Click here] to estimate predictive values in populations with different rates of readmission. | |||
==Prevention== | ==Prevention== | ||
Revision as of 02:59, 12 September 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Epidemiology
Among Medicare patients in the United States receiving care in a fee-for-service setting during 2003-2004, 19.6% were rehospitalized within 30 days.[1]
Causes
In a study of Medicare patients in the United States, most of the variation in rates of readmission are due to characteristics of patients.[2] A much smaller degree of variation is due to characteristics of hospitals or health care providers.[2]
Costs
Prediction
A number of methods have been developed to predict which patients will be readmitted.[3]
Two or more hospitalizations within a year is simple predictor of readmission.[4] A study of adult patients in the University of Pennsylvania Health System found that ≥ 2 inpatient admissions in the past 12 months had a sensitivity and specificity of 39% and 84%, respectively, for predicting readmission. In populations similar to those in this study which had a prevalence of hospital readmission of 15%, the probabilities of hospital readmission among patients with and without ≥ 2 inpatient admissions in the past 12 months were 30.0% and 11.0%, respectively.[4] Click here to estimate predictive values in populations with different rates of readmission.
Prevention
References
- ↑ Jencks SF, Williams MV, Coleman EA (2009). "Rehospitalizations among patients in the Medicare fee-for-service program". N Engl J Med. 360 (14): 1418–28. doi:10.1056/NEJMsa0803563. PMID 19339721.
- ↑ 2.0 2.1 Singh S, Lin YL, Kuo YF, Nattinger AB, Goodwin JS (2014). "Variation in the risk of readmission among hospitals: the relative contribution of patient, hospital and inpatient provider characteristics". J Gen Intern Med. 29 (4): 572–8. doi:10.1007/s11606-013-2723-7. PMC 3965757. PMID 24307260.
- ↑ Kansagara D, Englander H, Salanitro A, Kagen D, Theobald C, Freeman M; et al. (2011). "Risk prediction models for hospital readmission: a systematic review". JAMA. 306 (15): 1688–98. doi:10.1001/jama.2011.1515. PMC 3603349. PMID 22009101.
- ↑ 4.0 4.1 Baillie CA, VanZandbergen C, Tait G, Hanish A, Leas B, French B; et al. (2013). "The readmission risk flag: using the electronic health record to automatically identify patients at risk for 30-day readmission". J Hosp Med. 8 (12): 689–95. doi:10.1002/jhm.2106. PMID 24227707.