Three primary variants of errant decision making were identified:
- Premature discharge in 16.3% of cases
- Inadequate treatment during hospital stay, 14.3%
- Missed diagnoses, 10.6%
Difficulty monitoring and managing symptoms was the number one cause of late readmissions, associated with 33.2% of cases. The researchers identified three primary variants of monitoring and managing difficulties:
- Lack of disease monitoring in 12.7% of cases
- Overly long wait times for follow-up appointments, 10.0%
- Inability to make follow-up appointments, 10.9%
The researchers say their data indicate several reasons why the HRRP timeframe should be switched from 30 days to seven days.
First, they found a significant difference in the preventability of early and late readmissions in the 30-day timeframe after discharge. "Early readmissions were associated with double the odds of preventability compared with late readmissions," the researchers wrote.
Second, a pair of physician adjudicators who reviewed the readmissions cases found hospitals were the best site to intervene and prevent early readmissions. The physician educators found outpatient clinics and home were the best settings to prevent late readmissions.
Christopher Cheney is the senior clinical care editor at HealthLeaders.