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The quality of transitions from hospital to home: A hospital-based cohort study of patient groups with high and low readmission rates

The quality of transitions from hospital to home: A hospital-based cohort study of patient groups... IntroductionThe quality of transitions from the hospital to home is critical for preventing readmissions. The aims of this study were to evaluate variations in the quality of transitions across groups of patients and across hospitals with high and low readmission rates and to study the impact of transitions on postdischarge outcomes.MethodsA multicenter cohort study was conducted at 12 Flemish hospitals between June 2013 and September 2015 to examine transitions for patients with heart failure, pneumonia, or total hip/knee arthroplasty. Hospitals with high and low readmission rates were selected based on readmission rates in 2008. The quality of the transitions was assessed based on readiness for discharge, patient education, general practitioner contributions to the discharge process, and timeliness and completeness of discharge summaries.ResultsA total of 233 patients were included in the study. Readiness for discharge was better in patients with total hip/knee arthroplasty than in those with heart failure or pneumonia (mean differences 11.1 (95% CI 5.3–16.9) (p = 0.001) and 5.8 (95% CI 1.2–10.5) (p = 0.016), respectively). Heart failure patients had better readiness scores in low readmission rates than in high readmission rates hospitals (mean difference 13.5 (95% CI 2.5–24.5)) (p = 0.017). Insufficient timeliness of discharge summaries was a risk factor for postdischarge events (OR 10.564; 95% CI 1.476–75.603; p = 0.019).DiscussionTo improve the quality of transitions from hospital to home, communication with general practitioner s must occur in a timely manner and with a focus on the continuity of care. Particularly, in patients with complex postdischarge needs, preparing patients for discharge is essential to prevent readmissions. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png International Journal of Care Coordination SAGE

The quality of transitions from hospital to home: A hospital-based cohort study of patient groups with high and low readmission rates

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Publisher
SAGE
Copyright
© The Author(s) 2016
ISSN
2053-4345
eISSN
2053-4353
DOI
10.1177/2053434516656149
Publisher site
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Abstract

IntroductionThe quality of transitions from the hospital to home is critical for preventing readmissions. The aims of this study were to evaluate variations in the quality of transitions across groups of patients and across hospitals with high and low readmission rates and to study the impact of transitions on postdischarge outcomes.MethodsA multicenter cohort study was conducted at 12 Flemish hospitals between June 2013 and September 2015 to examine transitions for patients with heart failure, pneumonia, or total hip/knee arthroplasty. Hospitals with high and low readmission rates were selected based on readmission rates in 2008. The quality of the transitions was assessed based on readiness for discharge, patient education, general practitioner contributions to the discharge process, and timeliness and completeness of discharge summaries.ResultsA total of 233 patients were included in the study. Readiness for discharge was better in patients with total hip/knee arthroplasty than in those with heart failure or pneumonia (mean differences 11.1 (95% CI 5.3–16.9) (p = 0.001) and 5.8 (95% CI 1.2–10.5) (p = 0.016), respectively). Heart failure patients had better readiness scores in low readmission rates than in high readmission rates hospitals (mean difference 13.5 (95% CI 2.5–24.5)) (p = 0.017). Insufficient timeliness of discharge summaries was a risk factor for postdischarge events (OR 10.564; 95% CI 1.476–75.603; p = 0.019).DiscussionTo improve the quality of transitions from hospital to home, communication with general practitioner s must occur in a timely manner and with a focus on the continuity of care. Particularly, in patients with complex postdischarge needs, preparing patients for discharge is essential to prevent readmissions.

Journal

International Journal of Care Coordination – SAGE

Published: Jun 1, 2016

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