Precipitating factors and avoidability of 7-day readmissions after hospitalization for heart failure
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Health record review of precipitating factors and avoidability of 7-day heart failure readmissions; a quality-of-care question about clinical services, not about research.
This health-record audit studies avoidable heart-failure readmissions, not research methodology or governance.
Health-services audit of avoidable heart-failure readmissions; clinical care quality, not research practice.
Résumé
Abstract Background Hospital readmissions within 7 days after discharge are considered highly avoidable and undesirable for the patient and hospital. It is important to clarify gaps in the quality of inpatient care to identify strategies to address this problem. Aims We aimed to describe the precipitating factors and determine the potential avoidability of 7-day readmissions after hospitalization for heart failure (HF). Methods A health record audit was undertaken of patients discharged after hospitalization for HF from Calgary, Alberta hospitals. Content analysis was undertaken to identify factors precipitating readmission, and readmission’s avoidability was qualitatively examined and scored based on descriptive categories. Results Of 18,590 patients admitted to the hospital for HF during the study period, 191 HF patients were readmitted within 7 days (50% female; mean age 78 years). Potentially avoidable readmissions (57%) were due to unresolved symptoms, unaddressed social or self-care issues, adverse events from the index admission, high disability without added services, and discussions of palliative care without added services. Readmissions deemed less avoidable (43%) were due to new health issues, recurring symptoms post-stability at discharge, or refusal of care. Conclusion Only half of hospital readmissions within 7 days after HF discharge were related to HF and more than half were scored as avoidable. We provide novel criteria for identifying the avoidability of 7-day readmissions that could be used for assessing HF patients’ readiness for discharge and potentially reducing readmission rates.
Conservé avec la notice de tri, où il sert de preuve aux étiquettes ci-dessus.
La notice
- Revue
- medRxiv
- Thématique
- Heart Failure Treatment and Management
- Domaine
- Medicine
- Établissements canadiens
- —
- Organismes subventionnaires
- —
- Mots-clés
- Heart failureAuditMedical recordAdverse effectHospital readmissionHospital admission
- Résumé présent dans OpenAlex
- oui