scholarly journals Disparities in Potentially Preventable Hospitalizations: Near-National Estimates for Hispanics

2017 ◽  
Vol 53 (3) ◽  
pp. 1349-1372 ◽  
Author(s):  
Chen Feng ◽  
Michael K. Paasche-Orlow ◽  
Nancy R. Kressin ◽  
Jennifer E. Rosen ◽  
Lenny López ◽  
...  
Keyword(s):  
Preventable Hospitalizations ◽  
National Estimates ◽  
Potentially Preventable Hospitalizations

Post-Hospital Syndrome (PHS) and Potentially Preventable Hospitalizations(PPH) in Adults. MonashWatch adult cohort patient telehealth journeys (Preprint)

2018 ◽  
Author(s):  
Associate Professor Martin ◽  
Narelle Hinckley ◽  
Keith Stockman ◽  
Donadl Campbell
Keyword(s):  
Adverse Outcomes ◽  
Phone Call ◽  
Post Discharge ◽  
Patient Journey ◽  
Preventable Hospitalizations ◽  
Acute Admission ◽  
Avoidable Hospitalizations ◽  
Self Rated Health ◽  
Phone Calls ◽  
Potentially Preventable Hospitalizations

BACKGROUND Monash Watch (MW) aims to reduce avoidable hospitalizations in a cohort above a risk ‘threshold’ identified by HealthLinks Chronic Care (HLCC) algorithms using personal, diagnostic, and service data, excluding surgical and psychiatric admissions. MW conducted regular patient monitoring through outbound phone calls using the Patient Journey Record System (PaJR). PaJR alerts are intended to act as a self-reported barometer of health perceptions with more alerts per call indicating greater risk of Potentially Preventable Hospitalizations (PPH) and Post Hospital Syndrome (PHS). Most knowledge of PPH and PHS occurs at a macro-level with little understanding of fine-grained dynamics. OBJECTIVE To describe patterns of self-reported concerns and self-rated health 10 days before and after acute hospital admission in the telehealth intervention cohort of MonashWatch in the context of addressing PPH and PHS. METHODS Participants: 173 who had an acute admission of the of the 232 HLCC cohort with predicted 3+ admissions/year, in MW service arm for >40 days. Measures: Self-reported health and health care status in 764 MW phone call records which were classified into Total Alerts (all concerns - self-reported) and Red Alerts (concerns judged to be higher risk of adverse outcomes/admissions -acute medical and illness symptoms). Acute (non-surgical) admissions from Victorian Admitted Episode database. Analysis: Descriptive Timeseries homogeneity metrics using XLSTAT. RESULTS Self-reported problems (Total Alerts) statistically shifted to a higher level 3 days before an acute admission and stayed at a high level for the 10 days post discharge; reported acute medical and illness symptoms (Red Alerts) increased 1 day prior to admission and but remained at a higher level than before admission. Symptoms of concern did not change before admission or after discharge. Self-rated health and feeling depressed were reported to worsen 5 days post discharge. Patients reported more medication changes up to 2 days before acute admission. CONCLUSIONS These descriptive findings in a cohort of high risk individuals suggest a prehospital phase of what is termed PHS, which persisted on discharge and possibly worsened 5 days after discharge with worse self-rated health and depressive symptoms. Further research is needed. The role and place of community and hospital in such a cohort needs further investigation and research into PPH and PHS.

scholarly journals Potentially preventable hospitalizations for acute and chronic conditions in Alaska, 2010–2012

2016 ◽  
Vol 4 ◽  
pp. 614-621 ◽  
Author(s):  
Prabhu P. Gounder ◽  
Sara M. Seeman ◽  
Robert C. Holman ◽  
Alice Rarig ◽  
Mary K. McEwen ◽  
...  
Keyword(s):  
Chronic Conditions ◽  
Preventable Hospitalizations ◽  
Potentially Preventable Hospitalizations

scholarly journals Potentially Preventable Hospitalizations and the Burden of Healthcare-Associated Infections

2017 ◽  
Vol 4 ◽  
pp. 233339281772110 ◽  
Author(s):  
Andrea L. Lorden ◽  
Luohua Jiang ◽  
Tiffany A. Radcliff ◽  
Kathleen A. Kelly ◽  
Robert L. Ohsfeldt
Keyword(s):  
Clostridium Difficile ◽  
Lower Extremity ◽  
Clostridium Difficile Infection ◽  
Lower Extremity Amputation ◽  
Diabetic Patients ◽  
Healthcare Associated Infections ◽  
Preventable Hospitalizations ◽  
Potentially Preventable Hospitalizations ◽  
Healthcare Associated ◽  
Extremity Amputation

Background: An estimated 4% of hospital admissions acquired healthcare-associated infections (HAIs) and accounted for $9.8 (USD) billion in direct cost during 2011. In 2010, nearly 140 000 of the 3.5 million potentially preventable hospitalizations (PPHs) may have acquired an HAI. There is a knowledge gap regarding the co-occurrence of these events. Aims: To estimate the period occurrences and likelihood of acquiring an HAI for the PPH population. Methods: Retrospective, cross-sectional study using logistic regression analysis of 2011 Texas Inpatient Discharge Public Use Data File including 2.6 million admissions from 576 acute care hospitals. Agency for Healthcare Research and Quality Prevention Quality Indicator software identified PPH, and existing administrative data identification methodologies were refined for Clostridium difficile infection, central line–associated bloodstream infection, catheter-associated urinary tract infection, and ventilator-associated pneumonia. Odds of acquiring HAIs when admitted with PPH were adjusted for demographic, health status, hospital, and community characteristics. Findings: We identified 272 923 PPH, 14 219 HAI, and 986 admissions with PPH and HAI. Odds of acquiring an HAI for diabetic patients admitted for lower extremity amputation demonstrated significantly increased odds ratio of 2.9 (95% confidence interval: 2.16-3.91) for Clostridium difficile infection. Other PPH patients had lower odds of acquiring HAI compared to non-PPH patients, and results were frequently significant. Conclusions: Clinical implications include increased risk of HAI among diabetic patients admitted for lower extremity amputation. Methodological implications include identification of rare events for inpatient subpopulations and the need for improved codification of HAIs to improve cost and policy analyses regarding allocation of resources toward clinical improvements.

Abstract TP383: Creating Educational Modules for Family Caregivers to Reduce Potentially Preventable Hospitalizations in Stroke Survivors

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Linda L Pierce ◽  
Victoria Steiner
Keyword(s):  
Family Caregivers ◽  
Nurse Practitioners ◽  
Reading Level ◽  
Community Dwelling ◽  
Chronic Obstructive ◽  
Stroke Survivors ◽  
Comorbid Conditions ◽  
Preventable Hospitalizations ◽  
Potentially Preventable Hospitalizations ◽  
Educational Modules

Background and Issues: Preventable hospitalization utilization among stroke survivors is common. Although about 1/3 of potentially preventable hospitalizations are attributed to recurrent ischemic stroke, other comorbidities that lead to hospitalization are prevalent and need to be monitored. Timely and appropriate care for community-dwelling stroke survivors is critical. Since family caregivers provide the majority of care in the home, support and education of caregivers is essential to monitoring comorbid conditions. Purpose: This project’s aim was to develop brief educational modules on common comorbid conditions (e.g. chronic obstructive pulmonary disease, congestive heart failure, gastroenteritis); have family caregivers and nurse practitioners (NPs) review the content for validity; and then construct 8-10 minute voice-over PowerPoint presentations for each module. Methods: Based on evidence from randomized controlled trials, these modules were developed to provide caregivers with needed information to competently care for stroke survivors. Each module was concisely written at an 8th grade reading level and consists of: 1) a short introduction to the topic and key points; 2) what caregivers can do to alleviate the condition, should watch for, and should report to healthcare providers; 3) linked websites for more information and references; and 4) a four-question assessment about what they learned. Results: Once developed, these modules were evaluated by family caregiver (n=10) and NP (n=5) reviewers. The caregivers thought that the modules were appropriate in length to facilitate easy reading and understanding. The NPs noted that some content needed to be added, such as additional websites and drug information, but overall believed the modules contained supportive resources for caregivers. To provide an alternate learning modality, audio-presentations that highlight pertinent information for each module were then constructed. Conclusions: Registered nurses are well-suited to assess, teach, and support family caregivers. These modules are appropriate for inclusion in web-based or in-person education/support for these caregivers.

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