Contributing Factors to Short‐Term Readmissions to an Academic Center Hospital Medicine Program

1Division of Hospital Medicine, UCSD Medical Center, San Diego, CA
2Division of Hospital Medicine, UCSD Medical Center, San Diego, CA

Meeting: Hospital Medicine 2008, April 3-5, San Diego, Calif.

Abstract number: 94

Background:

The literature on hospital medicine emphasizes length of stay, resource utilization, and readmission rates. However, investigation into reasons for readmissions to hospital medicine services remains minimal.

Purpose:

To describe the ongoing experience of a hospital medicine program with respect to readmissions within 7 days of discharge.

Description:

Readmissions to our hospital medicine service within 7 days of discharge between October 2005 and June 2006 were reviewed. One hundred and five readmissions were identified and reviewed to determine what factors (patient factors, physician factors, and health care system factors) contributed to readmission. Multiple factors could be considered to contribute to a given read‐mission. In October 2005, our medical center introduced an online discharge documentation module comprising a brief discharge summary, patient instructions, and arrangement of follow‐up appointments and outpatient lab tests. This set of short‐term readmis‐sions was compared to a previously analyzed cohort (November 2004 to September 2005, also 105 cases) to look for any differences in readmission factors since implementation of the module. The readmission rate for the hospital medicine service was stable over the time periods of both cohorts. Case review showed that most short‐term readmissions resulted from patient factors: 41% of cases were due to exacerbations of chronic illness, and 47% of cases to new diagnoses. Patient factors contributed at least in part to 76% of re‐admissions. System factors such as lack of timely follow‐up contributed to 6% of readmissions, and physician factors such as an incomplete diagnosis contributed to 20% of readmissions. Twenty‐two percent of readmissions involved patients with chronic liver disease, and 9% of readmissions involved homeless patients. Sixteen percent of readmissions involved patients previously discharged to a skilled nursing facility. Rates of various factor contributions were not found to be significantly different between the 2 cohorts.

Conclusions:

Most short‐term readmissions to our hospital medicine service continue to be due to patient factors. Introduction of an electronic discharge documentation module has not had an obvious effect on short‐term readmission patterns. However, several patient populations were identified where opportunities likely exist for interventions to prevent short‐term readmission.

Author Disclosure:

B. Clay, none; L. Martin‐Armstrong, none.

To cite this abstract:

Clay B, Martin‐Armstrong L. Contributing Factors to Short‐Term Readmissions to an Academic Center Hospital Medicine Program. Abstract published at Hospital Medicine 2008, April 3-5, San Diego, Calif. Abstract 94. Journal of Hospital Medicine. 2008; 3 (suppl 1). https://www.shmabstracts.com/abstract/contributing-factors-to-shortterm-readmissions-to-an-academic-center-hospital-medicine-program/. Accessed July 17, 2019.

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