Table 2 Studies of preventable readmissions with any cause index admission followed by any cause readmission among adults, United States, 2000-2009
From: Determinants of preventable readmissions in the United States: a systematic review
Citation | Reported readmission type (and explanation if provided) | Index condition* | Readmit condition | Timeframe | Population and Setting | Design and Sample size | Data source(s) | Risk factors/associated factors | Conceptually linked admissions†| Strategy for patient linkage‡ | Used multivariate statistics§ |
|---|---|---|---|---|---|---|---|---|---|---|---|
Anderson, Clarke et al [53] | Unplanned | Any condition | Any condition | 31 days | Home health patients ≥65 years at home health agency in IL | Case series and qualitative (76) | Chart review, Interviews | Patient Elderly** Female** Development of new condition** Worsening of discharge condition** Respiratory conditions** Cardiac conditions** Gastrointestinal** Neurologic symptoms** | No | Yes | No |
Anderson, Tyler et al [54] | Unplanned | Any condition | Any condition | Up to 39 days | Transitional care unit patients after ≥3 day acute care stay at transitional care unit in IL | Case series (68) | Chart review | Patient Circulatory disorders** Respiratory disorders** Worsening of conditions** Multiple diagnoses** | No | Yes | No |
Arbaje et al [22] | Early | Any condition | Any nonelective readmission | 60 days | Medicare patients nationwide | Retrospective cohort (1,351) | Medicare Beneficiary Survey, Medicare claim files | Patient Living alone Lack self-management skills Unmet functional need No high school diploma Encounter Increasing length of stay | Yes | Yes | Yes |
Friedman et al [2] | Potentially preventable (preventable in most cases by ambulatory care of standard quality in the several weeks or months prior to admission) | AHRQ's prevention quality indicators | AHRQ's prevention quality indicators | 6 months | All patients in the Healthcare Cost and Utilization Project from NY, TN, PA, WI | Retrospective cohort (345,651) | Hospital discharge data, Healthcare Cost and Utilization Project | Patient African American Hispanic Encounter Medicaid Self-payer | Yes | Yes | No |
Goldfield et al [26] | Potentially preventable (which types of admissions were at risk of generating a readmission) | Any condition | Clinically related to index admission | 7, 15 and 30 days | All inpatient encounters in FL | Retrospective cohort (242,991) | Hospital discharge data | Patient Age greater than 75 years old Organizational Hospital | Yes | Yes | Yes |
Hasan et al [30] | Early | Any condition | Any condition | 30 days | ≥18 years and admitted by hospitalist or internist in six academic medical centers | Retrospective cohort (10,946) | Interviews from multicenter trial, Hospital databases | Patient Married Has regular physician Increasing Charlson index Increasing admission in last year Encounter Medicaid Medicare Self-pay Length of stay >2 days | No | Yes | Yes |
Novotny and Anderson [44] | Early | Any condition | Any condition | 41 days | English speaking patients ≥18 years from single IL medical center | Prospective cohort (1,077) | Interviews, Hospital databases | Patient Diabetes Increasing number of doctor visits in past year Increasing number of hospitalizations in past year Poor self-rated health status Increasing Charlson score Unemployed Depression Heart failure Marital status Encounter Increasing length of stay Medicare/Medicaid Discharge to home healthcare Discharge to healthcare facility | Yes | Yes | No |
Parker et al [39] | Unplanned | Any non-maternal, substance abuse or against medical advice discharge | Emergent or urgent admissions | 30 days | Kaiser Permanente pharmaceutical patients from multiple CA hospitals | Retrospective cohort (6,721) | Existing study database | Patient COPD Diabetes Diabetes with complications Paraplegia Metastatic solid tumor | No | No | Yes |
Schwarz [45] | Early | Multiple chronic illnesses | Any condition | 3 to 4 months | Patients ≥65 years and functionally impaired in 2 ADL from two hospitals | Prospective cohort (60) | Chart review, Interviews | Environment Social support negatively associated with readmission | Yes | Yes | Yes |
Timms et al [55] | Early | Any condition | Any condition | 30 days | Patients ≥65 years from single SC hospital | Case series (127) | Chart review | Patient Female** Heart disease** | No | No | No |
Weeks et al [5] | Unplanned | Any acute, short-stay admission | Any unexpected admission | 30 days | VA enrollees ≥65 years nationwide | Retrospective cohort (3,513,912) | VA/Medicare combined dataset | Patient Increasing age Male Increasing comorbidity (Elixhauser score) Index admission as a readmission (history of readmits) Encounter Increasing length of stay Organizational Index admission to VA hospital Environment Rural | No | Yes | Yes|| |