Healthcare News & Insights

Closer look at what causes readmissions

Decreasing readmissions is a priority for hospitals, but it’s very complicated to do because multiple factors play a role in a patient returning to the hospital. One study provides new insight into several areas that could help hospitals cut their readmissions. 

Doctor Talking To Male Patient In Hospital Room

Researchers at Beth Israel Deaconess Medical Center in Boston looked at some of the risk factors for readmission and found that looking at readmission rates differently might be a better bet, according to a news release about the study, which was recently published in the Annals of Internal Medicine.

Instead of lumping all early readmissions together under 30-day readmissions, researchers found splitting them up into two categories (eight-day readmission rates and 30-day readmission rates) may paint a clearer picture of the problem.

Patients were readmitted to the hospital for different reasons during each time period. Those who were readmitted to the hospital within eight days were most likely experiencing complications from the original condition that caused their hospital stay.

But those who came back to the hospital closer to the 30-day mark were readmitted for other reasons, typically related to not receiving the proper follow-up care and developing a different illness or complication.

Important influences

Timing also played a significant role in readmission rates. If a person was discharged between 8 a.m. and 12:59 p.m., he or she was much less likely to be readmitted to the hospital.

Researchers speculated that time of discharge made a difference because patients and their families had easier access to resources required to stay healthy during the daytime. They could visit a doctor or the pharmacy directly after discharge, for example.

Patients’ access to such resources after discharge affected their recovery – and their likelihood of readmission. Those who had difficulty accessing care once they left the hospital were more likely to be readmitted.

The type of insurance patients had also made a difference in whether they’d be readmitted. Patients who had Medicare or Medicaid were more likely to be readmitted to the hospital eight or more days after discharge.

Also at risk for early readmission: People who didn’t have a high level of health literacy, which made it difficult for them to understand what they needed to do to maintain their health after discharge.

Coordination as prevention

According to one of the study’s authors, Dr. Kelly Graham, preventing readmissions in these vulnerable patients may become easier due to the rise of accountable care organizations (ACOs) and patient-centered medical homes.

Because hospitals are directly connected with primary care providers and other professionals in these arrangements, this can make it easier to coordinate patients’ care and get them set up with the proper follow-up appointments post discharge.

“The growing movement … may prove beneficial in preventing unnecessary hospital readmissions,” Dr. Graham said. “Patients discharged from the hospital need support from and teamwork among hospitalists, primary care physicians, nurse practitioners, visiting nurses, pharmacists and others.”

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