Poster 169 Assessment and Discussion of Acute Care Hospital Readmission Etiologies from Acute Inpatient Rehabilitation Units: A Quality of Care Analysis

PM&R ◽  
2014 ◽  
Vol 6 (9) ◽  
pp. S244
Author(s):  
Brian J. Williams ◽  
Pratik Gandhi ◽  
Arthur Jimenez
Keyword(s):  
Quality Of Care ◽  
Acute Care ◽  
Hospital Readmission ◽  
Acute Care Hospital ◽  
Inpatient Rehabilitation ◽  
Care Hospital

Evaluation of a Hospital-Based Utilization Management Program

1995 ◽  
Vol 8 (1) ◽  
pp. 38-45 ◽  
Author(s):  
Karen Cardiff ◽  
Geoffrey Anderson ◽  
Samuel Sheps
Keyword(s):  
Quality Of Care ◽  
Acute Care Hospital ◽  
Severity Of Illness ◽  
Management Program ◽  
Measurement Tool ◽  
Care Hospital ◽  
Readmission Rates ◽  
Utilization Management ◽  
The Impact

The objective of this study was to evaluate the impact of a utilization management (UM) program designed to decrease inappropriate use of acute care hospital beds while maintaining quality of care. The measure used to define appropriateness was the ISD-A, a diagnosis-independent measurement tool which relies on severity of illness and intensity of service criteria. The outcome measures for the study included appropriate admission to hospital and continued days of stay in hospital, 30-day readmission rates and physician perceptions of the impact of the intervention on quality of care, access to services and patient discharge patterns. The sample frame for the study included two control and two intervention community hospitals, involving 1,800 patient charts. Readmission rates were determined by analyzing all separations from medical services (N=42,014) in the two experimental and two control hospitals. All physicians with admitting privileges (N=312) at the intervention hospitals were surveyed; obstetricians, pediatricians, and psychiatrists were excluded from the survey. The results of the study demonstrated that the proportion of inappropriate admissions did not decrease significantly in any of the hospitals, but there were significant decreases in inappropriate continued stay in the intervention hospitals (p < 0.05). Both intervention and one of the control hospitals had lower 30-day readmission rates in the “after” period than in the “before” period (p < 0.05). Eighty-six percent believed that there had been no adverse impact on access to care and, although 25% thought the program may have led to premature discharge, this was not supported by the readmission data.

Analysis of 30-Day Unexpected Readmissions from Inpatient Rehabilitation at an Academic Acute-Care Hospital

2015 ◽  
Vol 96 (12) ◽  
pp. e15-e16
Author(s):  
David S. Kushner ◽  
Estin Kelly ◽  
Rachael Morrison ◽  
Katherine Camfield
Keyword(s):  
Acute Care ◽  
Acute Care Hospital ◽  
Inpatient Rehabilitation ◽  
Care Hospital

Readmission rate as an indicator of hospital performance: The case of Spain

2004 ◽  
Vol 20 (3) ◽  
pp. 385-391 ◽  
Author(s):  
Alberto Jiménez-Puente ◽  
Javier García-Alegría ◽  
Jorge Gómez-Aracena ◽  
Luis Hidalgo-Rojas ◽  
Luisa Lorenzo-Nogueiras ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Sensitivity And Specificity ◽  
Readmission Rate ◽  
Acute Care Hospital ◽  
Hospital Performance ◽  
Care Hospital ◽  
Cross Sectional ◽  
Clinical Records ◽  
Avoidable Readmissions

Objectives:Hospital readmission rate is currently used as a quality of care indicator, although its validity has not been established. Our aims were to identify the frequency and characteristics of potential avoidable readmissions and to compare the assessment of quality of care derived from readmission rate with other measure of quality (judgment of experts).Methods:Design: cross-sectional observational study; Setting: acute care hospital located in Marbella, South of Spain; Study participants: random sample of patients readmitted at the hospital within six months from discharge (n=363); Interventions: review of clinical records by a pair of observers to assess the causes of readmissions and their potential avoidability; Main measures: logistic regression analysis to identify the variables from the databases of hospital discharges which are related to avoidability of readmissions. Determination of sensitivity and specificity of different definitions of readmission rate to detect avoidable situations.Results:Nineteen percent of readmissions were considered potentially avoidable. Variables related to readmission avoidability were (i) time elapsed between index admission and readmission and (ii) difference in diagnoses of both episodes. None of the definitions of readmission rate used in this study provided adequate values of sensitivity and specificity in the identification of potentially avoidable readmissions.Conclusions:Most readmissions in our hospital were unavoidable. Thus, readmission rate might not be considered a valid indicator of quality of care.

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