An investigation published in CMAJ (Canadian Medical Association Journal) discovered avoidable readmissions after discharge from hospital are relatively uncommon and are not an accurate measure of quality of care. In Canada, urgent or unplanned hospital readmissions are being used more frequently as a measure of quality of hospital care. As a result, it is crucial to understand how many of these readmissions are avoidable, as that is a better measure of quality.
11 Ontario hospitals in five cities, including 6 teaching and 5 community hospitals were looked at by investigators. The investigation included 4,812 patients admitted with a wide range of illnesses. 649 (13.5%) of discharged patients were readmitted through the emergency department. 104 (16%) of these readmissions (2.2% of the total number) were considered avoidable by physicians peer review. Even though rates between hospitals varied considerably from 7.5% to 22.5%, they did not vary drastically by avoidable readmission rates. This questions the use of urgent readmission rates to measure quality of care.
Dr. Carl van Walraven, Ottawa Hospital Research Institute, and colleagues wrote,
“The proportion of patients who had an urgent readmission was not associated with the proportion of patients who had an avoidable readmission.”
The researchers write, urgent readmissions considered potentially avoidable were fairly uncommon, comprising less than 20% of all urgent readmissions following hospital discharge. Hospital-specific proportions of patients who were readmitted were not related to proportions with a potentially avoidable readmission.
They concluded that these discoveries also reveal that measures to reduce readmissions must be multifaceted and be tailored to specific situations, and urgent readmission rates should only be used cautiously as a measure of quality of hospital care.
Written by Grace Rattue