All Journals from Rachel Kidney
Unplanned medical 30 day readmissions place a burden on the provision of acute hospital services and are increasingly used as quality indicators to assess quality of care in hospitals. Multivariable logistic regression of a 10 year database showed that four factors were most strongly associated with early readmission: Charlson comorbidity index >=1, respiratory disease as a principal diagnosis, liver disease and alcohol-related illness as an additional diagnosis, and the number of previous readmissions. Disease and patient-related factors beyond control of the hospital are the factors most strongly associated with 30 day readmission to hospital, suggesting that this may not be an appropriate quality indicator.
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Abstract
Background: Hospital readmissions are increasingly used as a quality indicator. Patients with cancer have an increased risk of readmission.
The purpose of this study was to develop an in depth understanding of the causes of readmissions in patients undergoing cancer treatment using PRISMA methodology and was subsequently used to identify any potentially preventable causes of readmission in this cohort.
Methods: 50 consecutive 30 day readmissions from the 1st November 2014 to the medical admissions unit (MAU) at a specialist tertiary cancer hospital in the Northwest of England were analysed retrospectively.
Results: 25(50%) of the patients were male with a median age of 59 years (range 19-81). PRISMA analysis showed that active (human) factors contributed to the readmission of 4 (8%) of the readmissions, which may have been potentially preventable. All of the readmissions were driven by a medical condition related to the patient’s underlying cancer and ongoing cancer treatment.
Conclusion: The majority of readmissions of patients undergoing cancer treatment appear to be related to the underlying condition and, as such, are predictable but not preventable. This suggests that hospital readmission is not a good quality indicator in this cohort of patients.
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