Social Factors and Patient Perceptions Associated With Preventable Hospital Readmissions.

hospital medicine patient perspectives readmission preventability readmissions social determinants of health

Journal

Journal of patient experience
ISSN: 2374-3735
Titre abrégé: J Patient Exp
Pays: United States
ID NLM: 101688338

Informations de publication

Date de publication:
Feb 2020
Historique:
entrez: 5 3 2020
pubmed: 5 3 2020
medline: 5 3 2020
Statut: ppublish

Résumé

Preventable hospital readmissions are costly and erode the quality of care delivery. Few efforts to incorporate the patient perspectives and social factors associated with readmission preventability exist. To identify patient perceptions and social barriers to care related to readmission. Prospective cohort study of 202 respondents readmitted within 30 days of hospital discharge from 2 inpatient adult medicine units at Massachusetts General Hospital, Boston, Massachusetts between January 2012 and January 2016. Few participants indicated that their readmission was due to unattainable health care after discharge. Almost half indicated that they needed more general assistance to stay well outside the hospital. Those reporting a barrier related to at least 2 measures of social determinants of health were more likely to have preventable readmissions (34% vs 17%, Strengthening nonmedical support systems and general social policy may be required to reduce preventable readmissions.

Sections du résumé

BACKGROUND BACKGROUND
Preventable hospital readmissions are costly and erode the quality of care delivery. Few efforts to incorporate the patient perspectives and social factors associated with readmission preventability exist.
OBJECTIVE OBJECTIVE
To identify patient perceptions and social barriers to care related to readmission.
METHODS METHODS
Prospective cohort study of 202 respondents readmitted within 30 days of hospital discharge from 2 inpatient adult medicine units at Massachusetts General Hospital, Boston, Massachusetts between January 2012 and January 2016.
RESULTS RESULTS
Few participants indicated that their readmission was due to unattainable health care after discharge. Almost half indicated that they needed more general assistance to stay well outside the hospital. Those reporting a barrier related to at least 2 measures of social determinants of health were more likely to have preventable readmissions (34% vs 17%,
CONCLUSION CONCLUSIONS
Strengthening nonmedical support systems and general social policy may be required to reduce preventable readmissions.

Identifiants

pubmed: 32128367
doi: 10.1177/2374373518825143
pii: 10.1177_2374373518825143
pmc: PMC7036679
doi:

Types de publication

Journal Article

Langues

eng

Pagination

19-26

Informations de copyright

© The Author(s) 2019.

Déclaration de conflit d'intérêts

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Références

J Gen Intern Med. 2017 Jan;32(1):71-80
pubmed: 27848189
Health Care Financ Rev. 2008 Fall;30(1):75-91
pubmed: 19040175
Gerontologist. 2008 Aug;48(4):495-504
pubmed: 18728299
BMJ Qual Saf. 2018 Sep;27(9):683-690
pubmed: 29146680
J Hosp Med. 2012 Nov-Dec;7(9):709-12
pubmed: 23212980
N Engl J Med. 2013 Mar 28;368(13):1175-7
pubmed: 23465069
Health Aff (Millwood). 2016 May 1;35(5):760-8
pubmed: 27140980
J Healthc Qual. 2018 Jan/Feb;40(1):44-50
pubmed: 28786846
JAMA Intern Med. 2016 Apr;176(4):484-93
pubmed: 26954564
J Hosp Med. 2007 Sep;2(5):297-304
pubmed: 17935257
Arch Intern Med. 2006 Sep 25;166(17):1822-8
pubmed: 17000937
Am Heart J. 2001 Oct;142(4):E7
pubmed: 11579371
Health Aff (Millwood). 2014 May;33(5):778-85
pubmed: 24799574
J Biomed Inform. 2009 Apr;42(2):377-81
pubmed: 18929686
Ann Intern Med. 2009 Feb 3;150(3):178-87
pubmed: 19189907
Circulation. 2015 May 19;131(20):1796-803
pubmed: 25986448
Am Heart J. 2007 Feb;153(2):313-9
pubmed: 17239695
Popul Health Manag. 2018 Aug;21(4):291-295
pubmed: 29140747
South Med J. 2016 Jun;109(6):383-9
pubmed: 27255098
Soc Work Health Care. 2015;54(1):1-15
pubmed: 25588093
BMJ Qual Saf. 2011 Oct;20(10):826-31
pubmed: 21447501
J Interprof Care. 2014 Nov;28(6):507-12
pubmed: 24913271
BMJ Innov. 2015 Jul;1(3):75-80
pubmed: 26246901
J Gen Intern Med. 2013 Feb;28(2):269-82
pubmed: 23054925

Auteurs

Jocelyn Carter (J)

Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.

Charlotte Ward (C)

Center for Healthcare Studies, Northwestern University, Chicago, IL, USA.
Center for Health Statistics, University of Chicago, Chicago, IL, USA.

Anne Thorndike (A)

Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.

Karen Donelan (K)

Harvard Medical School, Boston, MA, USA.
Mongan Institute for Health Policy Center, Massachusetts General Hospital, Boston, MA, USA.

Deborah J Wexler (DJ)

Harvard Medical School, Boston, MA, USA.
MGH Diabetes Center, Boston, MA, USA.

Classifications MeSH