literature review: readmissions and how geographical location of the hospitals affects the rate of...
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![Page 1: Literature Review: Readmissions and how geographical location of the hospitals affects the rate of readmissions -Shubhshankar](https://reader035.vdocuments.net/reader035/viewer/2022070411/56649cda5503460f949a45a0/html5/thumbnails/1.jpg)
Literature Review: Readmissions and how geographical location of the hospitals affects the rate of
readmissions
-Shubhshankar
![Page 2: Literature Review: Readmissions and how geographical location of the hospitals affects the rate of readmissions -Shubhshankar](https://reader035.vdocuments.net/reader035/viewer/2022070411/56649cda5503460f949a45a0/html5/thumbnails/2.jpg)
What are Readmissions?
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What are Readmissions?
CMS defines readmission as an admission to a hospital 30 days within the previous discharge. Patient transferred to another hospital are not counted under readmission [1].
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Why is it a problem?
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Is readmission rate indicator of quality of Health Care?
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Is readmission rate indicator of quality of Health Care?
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Reasons for Readmission:-Higher Propensity to get readmitted
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Reasons for Readmission.
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Reasons for Readmission.
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Detailed review: Geographical location of hospitals[6].
•Boston :4.5 beds per thousand people.•New Haven : 2.9 beds per thousand.
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Division into cohorts
•Five cohorts:- myocardial infarction, stroke, gastrointestinal bleeding, curative surgery for lung, colon etc.
•Rate of admission for these illness are similar as physicians agree on the need to hospitalize.
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Results
•Readmission rates in Boston were 1.64 times the readmission rates in New Haven.
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Results
•Higher readmission rates were not related to length of stay. index admission :14.8 vs 13.5 daysreadmission :11.3 vs 11.2 days
The mortality rate was similar at both places
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Explanations?
•Severity of illness?
•Nursing home care vs inpatient care?
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ResultsAssociation between availability of hospital beds and overall discharge rate.
Possible explanation:- threshold of availability of beds plays a role in clinical decision making.
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Solutions
Weekly home visits or phone calls to monitor progress of the patient.
Identify population with high propensity to get readmitted
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Solutions
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SolutionsFollow up appointment with the patient’s physician.
Complete discharge summaries within 24 hours
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Solutions
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Questions?References :-• [1] Reducing hospital readmissions. By Jenny Minott• [2] Catlin, A. et al. “National Health Spending in 2006: A Year of Change for
Prescription Drugs,” Health Affairs, January/February 2008, Vol. 27, No. 1, pp. 14-29.
• [3] Medicare Payment Advisory Commission. 2007. Report to the Congress: Promoting Greater Efficiency in Medicare. Washington, DC: Medicare Payment Advisory Commission, p. 103.
• [4] Can readmission rates be used as an outcome indicator? Ruairidh Milne, Aileen Clarke
• [5] Benbassat, J. and M. Taragin. “Hospital Readmissions as a Measure of Quality of Health Care,” Archives of Internal Medicine, Vol. 160, No. 8, 2000, pp. 1074-81.
• [6] Hospital readmission rates for cohorts of medicare beneficiaries in Boston and New Haven by: E. S. Fisher, J. E. Wennberg, T. A. Stukel, S. M. Sharp