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Avoidable readmissions seem to be reduced by early follow-up visits for geriatric patients discharged from hospital

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Abstract

Purpose

The aim of this study was to look specifically at patients readmitted in our previously published study. We wanted to assess the percentage of avoidable readmissions among patients receiving an early geriatric follow-up visit compared to a control group receiving usual care.

Method

The original population was geriatric patients primarily admitted to hospital with one of nine medical diagnoses and included in a quasi randomized controlled trial. They received either an early geriatric follow-up visit or usual care after hospital discharge. Only patients with an unplanned readmission were included in this subgroup analysis. Medical records of the readmitted patients were assessed by two reviewers. Each readmission was classified as either avoidable or unavoidable. An avoidable readmission was defined as being clinically related to index admissions.

Results

Between June 2014 and November 2015, 2076 patients were included in the original study. Of these, 216 patients were readmitted. Almost half of avoidable readmissions happened during the first week after hospital discharge. Thirty-four (41%) of 83 readmissions in the intervention group were assessed as avoidable compared to 72 (54%) of 133 readmissions in the control group (p = 0.06).

Conclusion

An early follow-up visit after hospital discharge seems to reduce avoidable readmissions among geriatric patients.

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References

  1. Pedersen MK, Nielsen GL, Uhrenfeldt L, Rasmussen OS, Lundbye-Christensen S (2017) Description of OPRA: a danish database designed for the analyses of risk factors associated with 30-day hospital readmission of people aged 65 + years. Scand J Public Health 45(6):595–604. https://doi.org/10.1177/1403494817715399

    Article  PubMed  Google Scholar 

  2. Benbassat J, Taragin M (2000) Hospital readmissions as a measure of quality of health care: advantages and limitations. Arch Intern Med 160(8):1074–1081

    Article  CAS  Google Scholar 

  3. Burke D, Link N, Bails D, Fang Y, Janjigian MP (2016) A taxonomy of seven-day readmissions to an urban teaching hospital. J Hosp Med 11(1):33–38. https://doi.org/10.1002/jhm.2481

    Article  PubMed  Google Scholar 

  4. Goldfield NI, McCullough EC, Hughes JS et al (2008) Identifying potentially preventable readmissions. Health Care Financ Rev 30(1):75–91

    PubMed  PubMed Central  Google Scholar 

  5. Clarke A (1990) Are readmissions avoidable? BMJ 301(6761):1136–1138

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. van Walraven C, Bennett C, Jennings A, Austin PC, Forster AJ (2011) Proportion of hospital readmissions deemed avoidable: a systematic review. CMAJ 183(7):E391–E402. https://doi.org/10.1503/cmaj.101860

    Article  PubMed  PubMed Central  Google Scholar 

  7. van Walraven C, Jennings A, Forster AJ (2012) A meta-analysis of hospital 30-day avoidable readmission rates. J Eval Clin Pract 18(6):1211–1218. https://doi.org/10.1111/j.1365-2753.2011.01773.x

    Article  PubMed  Google Scholar 

  8. Koekkoek D, Bayley KB, Brown A, Rustvold DL (2011) Hospitalists assess the causes of early hospital readmissions. J Hosp Med 6(7):383–388. https://doi.org/10.1002/jhm.909

    Article  PubMed  Google Scholar 

  9. Balla U, Malnick S, Schattner A (2008) Early readmissions to the department of medicine as a screening tool for monitoring quality of care problems. Medicine (Baltimore) 87(5):294–300. https://doi.org/10.1097/md.0b013e3181886f93

    Article  Google Scholar 

  10. Auerbach AD, Kripalani S, Vasilevskis EE et al (2016) Preventability and causes of readmissions in a national cohort of general medicine patients. JAMA Intern Med 176(4):484–493. https://doi.org/10.1001/jamainternmed.2015.7863

    Article  PubMed  Google Scholar 

  11. Edmans J, Bradshaw L, Franklin M, Gladman J, Conroy S (2013) Specialist geriatric medical assessment for patients discharged from hospital acute assessment units: randomised controlled trial. BMJ 347:f5874. https://doi.org/10.1136/bmj.f5874

    Article  PubMed  PubMed Central  Google Scholar 

  12. Naylor MD, Hirschman KB, Hanlon AL et al (2014) Comparison of evidence-based interventions on outcomes of hospitalized, cognitively impaired older adults. J Comp Eff Res 3(3):245–257. https://doi.org/10.2217/cer.14.14

    Article  PubMed  PubMed Central  Google Scholar 

  13. Caplan GA, Williams AJ, Daly B, Abraham K (2004) A randomized, controlled trial of comprehensive geriatric assessment and multidisciplinary intervention after discharge of elderly from the emergency department—the DEED II study. J Am Geriatr Soc 52(9):1417–1423. https://doi.org/10.1111/j.1532-5415.2004.52401.x

    Article  PubMed  Google Scholar 

  14. Coleman EA, Parry C, Chalmers S, Min SJ (2006) The care transitions intervention: results of a randomized controlled trial. Arch Intern Med 166(17):1822–1828. https://doi.org/10.1001/archinte.166.17.1822

    Article  PubMed  Google Scholar 

  15. Sejr Kirring L, Gregersen M, Damsgaard EM (2013) Can readmissions be reduced by a hospital-at-home multidisciplinary geriatric team? Eur Geriatr Med 4:S170

    Article  Google Scholar 

  16. Pedersen LH, Gregersen M, Barat I, Damsgaard EM (2016) Early geriatric follow-up after discharge reduces readmissions—a quasi-randomised controlled trial. Eur Geriatr Med 7(5):443–448. https://doi.org/10.1016/j.eurger.2016.03.009

    Article  Google Scholar 

  17. Ouslander JG, Bonner A, Herndon L, Shutes J (2014) The interventions to reduce acute care transfers (INTERACT) quality improvement program: an overview for medical directors and primary care clinicians in long term care. J Am Med Dir Assoc 15(3):162–170. https://doi.org/10.1016/j.jamda.2013.12.005

    Article  PubMed  PubMed Central  Google Scholar 

  18. Kane RL, Huckfeldt P, Tappen R et al (2017) Effects of an intervention to reduce hospitalizations from nursing homes: a randomized implementation trial of the INTERACT program. JAMA Intern Med 177(9):1257–1264. https://doi.org/10.1001/jamainternmed.2017.2657

    Article  PubMed  PubMed Central  Google Scholar 

  19. Bianco A, Mole A, Nobile CG, Di Giuseppe G, Pileggi C, Angelillo IF (2012) Hospital readmission prevalence and analysis of those potentially avoidable in southern Italy. PLoS One 7(11):e48263. https://doi.org/10.1371/journal.pone.0048263

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Munshi SK, Lakhani D, Ageed A, Evans SN, Mackness E (2002) Readmissions of older people to acute medical units. Nurs Older People 14(1):14–16. https://doi.org/10.7748/nop2002.03.14.1.14.c2195

    Article  PubMed  Google Scholar 

  21. van Walraven C, Jennings A, Taljaard M et al (2011) Incidence of potentially avoidable urgent readmissions and their relation to all-cause urgent readmissions. CMAJ 183(14):E1067–E1072. https://doi.org/10.1503/cmaj.110400

    Article  PubMed  PubMed Central  Google Scholar 

  22. Gohil SK, Datta R, Cao C et al (2015) Impact of hospital population case-mix, including poverty, on hospital all-cause and infection-related 30-day readmission rates. Clin Infect Dis 61(8):1235–1243. https://doi.org/10.1093/cid/civ539

    Article  PubMed  PubMed Central  Google Scholar 

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Funding

The research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Department of Geriatrics, Aarhus University Hospital, Palle-Juul Jensens Boulevard 99, Building J, 8200, Aarhus N, Denmark

    Lene Holst Pedersen, Peter Brynningsen, Catherine Hauerslev Foss, Merete Gregersen & Else Marie Damsgaard

  2. The Regional Hospital in Horsens, Sundvej 30, 8700, Horsens, Denmark

    Ishay Barat

Authors
  1. Lene Holst Pedersen
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  2. Peter Brynningsen
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  3. Catherine Hauerslev Foss
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  4. Merete Gregersen
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  5. Ishay Barat
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  6. Else Marie Damsgaard
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Corresponding author

Correspondence to Lene Holst Pedersen.

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Conflict of interest

There were no conflicts of interest.

Ethical approval

The study was reviewed by The Ethical Committee in The Central Denmark Region and was performed in accordance to the ethical standards of the Helsinki declaration. The Ethical committee approved that patients did not sign a consent form, because of the organizational design. Patients could decline to participate in the study at any time.

Informed consent

For this type of study formal consent is not required.

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Pedersen, L.H., Brynningsen, P., Foss, C.H. et al. Avoidable readmissions seem to be reduced by early follow-up visits for geriatric patients discharged from hospital. Eur Geriatr Med 9, 613–621 (2018). https://doi.org/10.1007/s41999-018-0078-7

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  • DOI: https://doi.org/10.1007/s41999-018-0078-7

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