How do studies assess the preventability of readmissions? A systematic review with narrative synthesis

BMC Medical Research Methodology

Eva-Linda Kneepkens¹  Fatma Karapinar-Çarkit¹  Corline Brouwers²  Richelle Glory Singotani²  Martine C. de Bruijne² 

[1] Department of Clinical Pharmacy, OLVG Hospital;Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute;

关键词: Hospital readmission;    Avoidability;    Preventability;    Assessment;    Review;    Patient interview;   

DOI  :  10.1186/s12874-019-0766-0

来源: DOAJ

【 摘 要 】

Abstract Background A large number of articles examined the preventability rate of readmissions, but comparison and interpretability of these preventability rates is complicated due to the large heterogeneity of methods that were used. To compare (the implications of) the different methods used to assess the preventability of readmissions by means of medical record review. Methods A literature search was conducted in PUBMED and EMBASE using “readmission” and “avoidability” or “preventability” as key terms. A consensus-based narrative data synthesis was performed to compare and discuss the different methods. Results Abstracts of 2504 unique citations were screened resulting in 48 full text articles which were included in the final analysis. Synthesis led to the identification of a set of important variables on which the studies differed considerably (type of readmissions, sources of information, definition of preventability, cause classification and reviewer process). In 69% of the studies the cause classification and preventability assessment were integrated; meaning specific causes were predefined as preventable or not preventable. The reviewers were most often medical specialist (67%), and 27% of the studies added interview as a source of information. Conclusion A consensus-based standardised approach to assess preventability of readmission is warranted to reduce the unwanted bias in preventability rates. Patient-related and integrated care related factors are potentially underreported in readmission studies.

【 授权许可】

Unknown