Abstract
ObjectiveHospital care comprises nearly a third of US healthcare expenditures. Fifteen to 20 per cent of this spending is considered to be potentially preventable. Risk prediction models have suboptimal accuracy and typically exclude patient experience data. No studies have explored patient perceptions of the likelihood of readmission during index admission. Our objective was to examine associations between patient perceptions of care during index hospital admission and 30-day readmission.DesignProspective cohort study.SettingTwo inpatient adult medicine units at Massachusetts General Hospital, Boston, Massachusetts.ParticipantsEight hundred and forty-six patients admitted to study units between January 2012 and January 2016 who met eligibility criteria and consented to enrolment.Main outcomeOdds of 30-day readmission.ResultsOf 1754 eligible participants, 846 (48%) were enrolled and 201 (23.8%) were readmitted within 30 days. Readmitted participants were less likely to have a high school diploma/GED (44.3% not readmitted vs 53.5% readmitted, P=0.02). In multivariable models adjusting for baseline differences, respondents who reported being ‘very satisfied’ with the care received during the index hospitalisation were less likely to be readmitted (adjusted OR 0.61, 95% CI 0.43 to 0.88, P=0.007). Participants reporting doctors ‘always listened to them carefully’ were less likely to be readmitted (adjusted OR 0.68, 95% CI 0.48 to 0.97, P=0.03). Participants reporting they were ‘very likely’ to be readmitted were not more likely to be readmitted (adjusted OR 1.35, 95% CI 0.83 to 2.19, P=0.22).ConclusionParticipants reporting high satisfaction and good provider communication were less likely to be readmitted. Rates of readmission were increased among participants stating they were very likely to be readmitted though this association was not statistically significant. Incorporating patient-reported measures during index hospitalisations may improve readmission prediction.
Funder
Clinician-Teacher Development Award Sponsored by the Massahusetts General Hospital Physicians Organization
Reference37 articles.
1. HCUP Statistical Brief #172. Conditionswith the largest number of adult hospital readmissions by payer, 2011. April 2014. Agency for healthcare research and quality, Rockville, MD. http://www.hcup-us.ahrq.gov/reports/statbriefs/sb172-Conditions-Readmissions-Payer.pdf (accessed Aug 2016).
2. National Center for Health Statistics. Health, United States, 2014: With Special Feature on Adults Aged 55–64. Hyattsville MD, 2015.
3. Identifying potentially preventable readmissions;Goldfield;Health Care Financ Rev,2008
4. Predictors of Readmission for Complications of Coronary Artery Bypass Graft Surgery
5. Hospital Readmission in General Medicine Patients: A Prediction Model
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