Please use this identifier to cite or link to this item: https://doi.org/10.1136/bmjqs-2017-006645
Title: Patients' and providers' perceptions of the preventability of hospital readmission: a prospective, observational study in four European countries
Authors: van Galen, Louise S
Brabrand, Mikkel
Cooksley, Tim
van de Ven, Peter M
Merten, Hanneke
So, Ralph KL
van Hooff, Loes
Haak, Harm R
Kidney, Rachel M
Nickel, Christian H
Soong, John TY 
Weichert, Immo
Kramer, Mark HH
Subbe, Christian P
Nanayakkara, Prabath WB
Keywords: Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
Health Policy & Services
CARE TRANSITIONS MEASURE
MEDICAL PATIENTS
DISCHARGE
QUALITY
VALIDATION
PREDICTION
REHOSPITALIZATION
DISADVANTAGE
PREPAREDNESS
INDICATOR
Issue Date: 1-Dec-2017
Publisher: BMJ PUBLISHING GROUP
Citation: van Galen, Louise S, Brabrand, Mikkel, Cooksley, Tim, van de Ven, Peter M, Merten, Hanneke, So, Ralph KL, van Hooff, Loes, Haak, Harm R, Kidney, Rachel M, Nickel, Christian H, Soong, John TY, Weichert, Immo, Kramer, Mark HH, Subbe, Christian P, Nanayakkara, Prabath WB (2017-12-01). Patients' and providers' perceptions of the preventability of hospital readmission: a prospective, observational study in four European countries. BMJ QUALITY & SAFETY 26 (12) : 958-969. ScholarBank@NUS Repository. https://doi.org/10.1136/bmjqs-2017-006645
Abstract: Objectives Because of fundamental differences in healthcare systems, US readmission data cannot be extrapolated to the European setting: To investigate the opinions of readmitted patients, their carers, nurses and physicians on predictability and preventability of readmissions and using majority consensus to determine contributing factors that could potentially foresee (preventable) readmissions. Design Prospective observational study. Readmitted patients, their carers, and treating professionals were surveyed during readmission to assess the discharge process and the predictability and preventability of the readmission. Cohen's Kappa measured pairwise agreement of considering readmission as predictable/preventable by patients, carers and professionals. Subsequently, multivariable logistic regressionidentified factors associated with predictability/preventability. Setting 15 hospitals in four European countries Participants 1398 medical patients readmitted unscheduled within 30 days Main Outcome(s) and Measure(s) (1) Agreement between the interviewed groups on considering readmissions likely predictable or preventable;(2) Factors distinguishing predictable from non-predictable and preventable from non-preventable readmissions. Results The majority deemed 27.8% readmissions potentially predictable and 14.4% potentially preventable. The consensus on predictability and preventability was poor, especially between patients and professionals (kappas ranged from 0.105 to 0.173). The interviewed selected different factors as potentially associated with predictability and preventability. When a patient reported that he was ready for discharge during index admission, the readmission was deemed less likely by the majority (predictability: OR 0.55; 95% CI 0.40 to 0.75; preventability: OR 0.35; 95% CI 0.24 to 0.49). Conclusions There is no consensus between readmitted patients, their carers and treating professionals about predictability and preventability of readmissions, nor associated risk factors. A readmitted patient reporting not feeling ready for discharge at index admission was strongly associated with preventability/predictability. Therefore, healthcare workers should question patients' readiness to go home timely before discharge.
Source Title: BMJ QUALITY & SAFETY
URI: https://scholarbank.nus.edu.sg/handle/10635/214577
ISSN: 20445415
20445423
DOI: 10.1136/bmjqs-2017-006645
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