Patient-Reported Discharge Readiness and 30-Day Risk of Readmission or Death: A Prospective Cohort Study
Abstract Background Early readmissions to hospital after discharge are common, and clinicians cannot accurately predict their occurrence. We examined whether patients who feel unready at the time of discharge have increased readmissions or death within 30 days. Methods This was a prospective cohort...
Gespeichert in:
| Veröffentlicht in: | The American journal of medicine 2016, Vol.129 (1), p.89-95 |
|---|---|
| Hauptverfasser: | , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 95 |
|---|---|
| container_issue | 1 |
| container_start_page | 89 |
| container_title | The American journal of medicine |
| container_volume | 129 |
| creator | Lau, Darren, MD, PhD Padwal, Raj S., MD, MSc Majumdar, Sumit R., MD, MPH Pederson, Jenelle L., BA Belga, Sara, MD Kahlon, Sharry, MD Fradette, Miriam, BscPharm Boyko, Debbie, RN McAlister, Finlay A., MD, MSc |
| description | Abstract Background Early readmissions to hospital after discharge are common, and clinicians cannot accurately predict their occurrence. We examined whether patients who feel unready at the time of discharge have increased readmissions or death within 30 days. Methods This was a prospective cohort study of adult patients discharged home from 2 tertiary care hospitals in Edmonton, Alberta, Canada, between October 2013 and November 2014. Patient-reported discharge readiness was measured with an 11-point Likert response scale, with scores |
| doi_str_mv | 10.1016/j.amjmed.2015.08.018 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1751994281</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0002934315008244</els_id><sourcerecordid>3936366481</sourcerecordid><originalsourceid>FETCH-LOGICAL-c515t-4788bc2ef35e8d460c61bc3dbda4714a56c2c093a2daddda10c2b45b1c932e213</originalsourceid><addsrcrecordid>eNqFks9u1DAQxi0EokvhDRCyxIVLgv8n4YBU7UKLVKnVFs6WY8-yTrPxYieV9m14Fp4Mh22F1EtP1mh-83lmvkHoLSUlJVR97Eqz63bgSkaoLEldElo_QwsqpSwqqthztCCEsKLhgp-gVyl1OSSNVC_RCVNcCMXpAvlrM3oYxmIN-xBHcHjlk92a-BPwGozzA6SEzeAwJ8XKHPDap1scNv-SO5-SDwMOEa_AjNtP-OzP7-sY0h7s6O8AL8M2i-KbcXKH1-jFxvQJ3ty_p-jH1y_flxfF5dX5t-XZZWEllWMhqrpuLYMNl1A7oYhVtLXctc6IigojlWWWNNwwZ5xzhhLLWiFbahvOgFF-ij4cdfcx_JogjTq3aaHvzQBhSppWkjaNYPWMvn-EdmGKQ-4uU4oSVdWiyZQ4UjZPliJs9D76nYkHTYmerdCdPlqhZys0qXW2Ipe9uxef2jn3UPSw-wx8PgKQt3HnIepksxUWnI95f9oF_9QPjwVs7wdvTX8LB0j_Z9GJaaJv5nOYr4FKQmomBP8L8-iwjw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1761067849</pqid></control><display><type>article</type><title>Patient-Reported Discharge Readiness and 30-Day Risk of Readmission or Death: A Prospective Cohort Study</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><creator>Lau, Darren, MD, PhD ; Padwal, Raj S., MD, MSc ; Majumdar, Sumit R., MD, MPH ; Pederson, Jenelle L., BA ; Belga, Sara, MD ; Kahlon, Sharry, MD ; Fradette, Miriam, BscPharm ; Boyko, Debbie, RN ; McAlister, Finlay A., MD, MSc</creator><creatorcontrib>Lau, Darren, MD, PhD ; Padwal, Raj S., MD, MSc ; Majumdar, Sumit R., MD, MPH ; Pederson, Jenelle L., BA ; Belga, Sara, MD ; Kahlon, Sharry, MD ; Fradette, Miriam, BscPharm ; Boyko, Debbie, RN ; McAlister, Finlay A., MD, MSc</creatorcontrib><description>Abstract Background Early readmissions to hospital after discharge are common, and clinicians cannot accurately predict their occurrence. We examined whether patients who feel unready at the time of discharge have increased readmissions or death within 30 days. Methods This was a prospective cohort study of adult patients discharged home from 2 tertiary care hospitals in Edmonton, Alberta, Canada, between October 2013 and November 2014. Patient-reported discharge readiness was measured with an 11-point Likert response scale, with scores <7 indicating subjective unreadiness. The primary outcome was readmission or death within 30 days. Logistic regression models were adjusted for age, sex, and a validated risk prediction score for postdischarge events (LACE index). Results Of 495 patients (mean age 62 years, 51% female, mean Charlson comorbidity index 2.8), 112 (23%) reported being unready for discharge. Risk factors for being unready at discharge were cognitive impairment (mild vs none), low satisfaction with health care services, depression, lower education, previous hospital admissions (12 months), and persistent symptoms or disability. At 30 days, 85 patients (17%) had been readmitted or died, with no significant difference between patients who felt unready or ready (15% vs 18%, adjusted odds ratio 0.84, 95% confidence interval 0.46-1.54, P = .59). Conclusions Although nearly one-quarter of hospitalized medical patients reported being unready at the time of discharge, they did not experience any higher risk of readmission or death in the first 30 days after discharge, compared with patients who felt ready for discharge.</description><identifier>ISSN: 0002-9343</identifier><identifier>EISSN: 1555-7162</identifier><identifier>DOI: 10.1016/j.amjmed.2015.08.018</identifier><identifier>PMID: 26344631</identifier><identifier>CODEN: AJMEAZ</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Canada - epidemiology ; Cognition Disorders - psychology ; Depression - psychology ; Female ; General internal medicine ; Health services ; Health Services Research ; Humans ; Internal Medicine ; Male ; Middle Aged ; Mortality ; Patient Discharge - statistics & numerical data ; Patient Outcome Assessment ; Patient Readmission - statistics & numerical data ; Patient Satisfaction ; Patient-reported outcomes ; Prospective Studies ; Quality of Life ; Readmissions ; Risk Factors ; Socioeconomic Factors ; Studies</subject><ispartof>The American journal of medicine, 2016, Vol.129 (1), p.89-95</ispartof><rights>Elsevier Inc.</rights><rights>2016 Elsevier Inc.</rights><rights>Copyright © 2016 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Science Ltd. Jan 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c515t-4788bc2ef35e8d460c61bc3dbda4714a56c2c093a2daddda10c2b45b1c932e213</citedby><cites>FETCH-LOGICAL-c515t-4788bc2ef35e8d460c61bc3dbda4714a56c2c093a2daddda10c2b45b1c932e213</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.amjmed.2015.08.018$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,4025,27925,27926,27927,45997</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26344631$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lau, Darren, MD, PhD</creatorcontrib><creatorcontrib>Padwal, Raj S., MD, MSc</creatorcontrib><creatorcontrib>Majumdar, Sumit R., MD, MPH</creatorcontrib><creatorcontrib>Pederson, Jenelle L., BA</creatorcontrib><creatorcontrib>Belga, Sara, MD</creatorcontrib><creatorcontrib>Kahlon, Sharry, MD</creatorcontrib><creatorcontrib>Fradette, Miriam, BscPharm</creatorcontrib><creatorcontrib>Boyko, Debbie, RN</creatorcontrib><creatorcontrib>McAlister, Finlay A., MD, MSc</creatorcontrib><title>Patient-Reported Discharge Readiness and 30-Day Risk of Readmission or Death: A Prospective Cohort Study</title><title>The American journal of medicine</title><addtitle>Am J Med</addtitle><description>Abstract Background Early readmissions to hospital after discharge are common, and clinicians cannot accurately predict their occurrence. We examined whether patients who feel unready at the time of discharge have increased readmissions or death within 30 days. Methods This was a prospective cohort study of adult patients discharged home from 2 tertiary care hospitals in Edmonton, Alberta, Canada, between October 2013 and November 2014. Patient-reported discharge readiness was measured with an 11-point Likert response scale, with scores <7 indicating subjective unreadiness. The primary outcome was readmission or death within 30 days. Logistic regression models were adjusted for age, sex, and a validated risk prediction score for postdischarge events (LACE index). Results Of 495 patients (mean age 62 years, 51% female, mean Charlson comorbidity index 2.8), 112 (23%) reported being unready for discharge. Risk factors for being unready at discharge were cognitive impairment (mild vs none), low satisfaction with health care services, depression, lower education, previous hospital admissions (12 months), and persistent symptoms or disability. At 30 days, 85 patients (17%) had been readmitted or died, with no significant difference between patients who felt unready or ready (15% vs 18%, adjusted odds ratio 0.84, 95% confidence interval 0.46-1.54, P = .59). Conclusions Although nearly one-quarter of hospitalized medical patients reported being unready at the time of discharge, they did not experience any higher risk of readmission or death in the first 30 days after discharge, compared with patients who felt ready for discharge.</description><subject>Adult</subject><subject>Aged</subject><subject>Canada - epidemiology</subject><subject>Cognition Disorders - psychology</subject><subject>Depression - psychology</subject><subject>Female</subject><subject>General internal medicine</subject><subject>Health services</subject><subject>Health Services Research</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Patient Discharge - statistics & numerical data</subject><subject>Patient Outcome Assessment</subject><subject>Patient Readmission - statistics & numerical data</subject><subject>Patient Satisfaction</subject><subject>Patient-reported outcomes</subject><subject>Prospective Studies</subject><subject>Quality of Life</subject><subject>Readmissions</subject><subject>Risk Factors</subject><subject>Socioeconomic Factors</subject><subject>Studies</subject><issn>0002-9343</issn><issn>1555-7162</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFks9u1DAQxi0EokvhDRCyxIVLgv8n4YBU7UKLVKnVFs6WY8-yTrPxYieV9m14Fp4Mh22F1EtP1mh-83lmvkHoLSUlJVR97Eqz63bgSkaoLEldElo_QwsqpSwqqthztCCEsKLhgp-gVyl1OSSNVC_RCVNcCMXpAvlrM3oYxmIN-xBHcHjlk92a-BPwGozzA6SEzeAwJ8XKHPDap1scNv-SO5-SDwMOEa_AjNtP-OzP7-sY0h7s6O8AL8M2i-KbcXKH1-jFxvQJ3ty_p-jH1y_flxfF5dX5t-XZZWEllWMhqrpuLYMNl1A7oYhVtLXctc6IigojlWWWNNwwZ5xzhhLLWiFbahvOgFF-ij4cdfcx_JogjTq3aaHvzQBhSppWkjaNYPWMvn-EdmGKQ-4uU4oSVdWiyZQ4UjZPliJs9D76nYkHTYmerdCdPlqhZys0qXW2Ipe9uxef2jn3UPSw-wx8PgKQt3HnIepksxUWnI95f9oF_9QPjwVs7wdvTX8LB0j_Z9GJaaJv5nOYr4FKQmomBP8L8-iwjw</recordid><startdate>2016</startdate><enddate>2016</enddate><creator>Lau, Darren, MD, PhD</creator><creator>Padwal, Raj S., MD, MSc</creator><creator>Majumdar, Sumit R., MD, MPH</creator><creator>Pederson, Jenelle L., BA</creator><creator>Belga, Sara, MD</creator><creator>Kahlon, Sharry, MD</creator><creator>Fradette, Miriam, BscPharm</creator><creator>Boyko, Debbie, RN</creator><creator>McAlister, Finlay A., MD, MSc</creator><general>Elsevier Inc</general><general>Elsevier Sequoia S.A</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7TO</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>2016</creationdate><title>Patient-Reported Discharge Readiness and 30-Day Risk of Readmission or Death: A Prospective Cohort Study</title><author>Lau, Darren, MD, PhD ; Padwal, Raj S., MD, MSc ; Majumdar, Sumit R., MD, MPH ; Pederson, Jenelle L., BA ; Belga, Sara, MD ; Kahlon, Sharry, MD ; Fradette, Miriam, BscPharm ; Boyko, Debbie, RN ; McAlister, Finlay A., MD, MSc</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c515t-4788bc2ef35e8d460c61bc3dbda4714a56c2c093a2daddda10c2b45b1c932e213</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Canada - epidemiology</topic><topic>Cognition Disorders - psychology</topic><topic>Depression - psychology</topic><topic>Female</topic><topic>General internal medicine</topic><topic>Health services</topic><topic>Health Services Research</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Patient Discharge - statistics & numerical data</topic><topic>Patient Outcome Assessment</topic><topic>Patient Readmission - statistics & numerical data</topic><topic>Patient Satisfaction</topic><topic>Patient-reported outcomes</topic><topic>Prospective Studies</topic><topic>Quality of Life</topic><topic>Readmissions</topic><topic>Risk Factors</topic><topic>Socioeconomic Factors</topic><topic>Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lau, Darren, MD, PhD</creatorcontrib><creatorcontrib>Padwal, Raj S., MD, MSc</creatorcontrib><creatorcontrib>Majumdar, Sumit R., MD, MPH</creatorcontrib><creatorcontrib>Pederson, Jenelle L., BA</creatorcontrib><creatorcontrib>Belga, Sara, MD</creatorcontrib><creatorcontrib>Kahlon, Sharry, MD</creatorcontrib><creatorcontrib>Fradette, Miriam, BscPharm</creatorcontrib><creatorcontrib>Boyko, Debbie, RN</creatorcontrib><creatorcontrib>McAlister, Finlay A., MD, MSc</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lau, Darren, MD, PhD</au><au>Padwal, Raj S., MD, MSc</au><au>Majumdar, Sumit R., MD, MPH</au><au>Pederson, Jenelle L., BA</au><au>Belga, Sara, MD</au><au>Kahlon, Sharry, MD</au><au>Fradette, Miriam, BscPharm</au><au>Boyko, Debbie, RN</au><au>McAlister, Finlay A., MD, MSc</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patient-Reported Discharge Readiness and 30-Day Risk of Readmission or Death: A Prospective Cohort Study</atitle><jtitle>The American journal of medicine</jtitle><addtitle>Am J Med</addtitle><date>2016</date><risdate>2016</risdate><volume>129</volume><issue>1</issue><spage>89</spage><epage>95</epage><pages>89-95</pages><issn>0002-9343</issn><eissn>1555-7162</eissn><coden>AJMEAZ</coden><abstract>Abstract Background Early readmissions to hospital after discharge are common, and clinicians cannot accurately predict their occurrence. We examined whether patients who feel unready at the time of discharge have increased readmissions or death within 30 days. Methods This was a prospective cohort study of adult patients discharged home from 2 tertiary care hospitals in Edmonton, Alberta, Canada, between October 2013 and November 2014. Patient-reported discharge readiness was measured with an 11-point Likert response scale, with scores <7 indicating subjective unreadiness. The primary outcome was readmission or death within 30 days. Logistic regression models were adjusted for age, sex, and a validated risk prediction score for postdischarge events (LACE index). Results Of 495 patients (mean age 62 years, 51% female, mean Charlson comorbidity index 2.8), 112 (23%) reported being unready for discharge. Risk factors for being unready at discharge were cognitive impairment (mild vs none), low satisfaction with health care services, depression, lower education, previous hospital admissions (12 months), and persistent symptoms or disability. At 30 days, 85 patients (17%) had been readmitted or died, with no significant difference between patients who felt unready or ready (15% vs 18%, adjusted odds ratio 0.84, 95% confidence interval 0.46-1.54, P = .59). Conclusions Although nearly one-quarter of hospitalized medical patients reported being unready at the time of discharge, they did not experience any higher risk of readmission or death in the first 30 days after discharge, compared with patients who felt ready for discharge.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26344631</pmid><doi>10.1016/j.amjmed.2015.08.018</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0002-9343 |
| ispartof | The American journal of medicine, 2016, Vol.129 (1), p.89-95 |
| issn | 0002-9343 1555-7162 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1751994281 |
| source | MEDLINE; Access via ScienceDirect (Elsevier) |
| subjects | Adult Aged Canada - epidemiology Cognition Disorders - psychology Depression - psychology Female General internal medicine Health services Health Services Research Humans Internal Medicine Male Middle Aged Mortality Patient Discharge - statistics & numerical data Patient Outcome Assessment Patient Readmission - statistics & numerical data Patient Satisfaction Patient-reported outcomes Prospective Studies Quality of Life Readmissions Risk Factors Socioeconomic Factors Studies |
| title | Patient-Reported Discharge Readiness and 30-Day Risk of Readmission or Death: A Prospective Cohort Study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-18T13%3A10%3A00IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Patient-Reported%20Discharge%20Readiness%20and%2030-Day%20Risk%20of%20Readmission%20or%20Death:%20A%C2%A0Prospective%20Cohort%20Study&rft.jtitle=The%20American%20journal%20of%20medicine&rft.au=Lau,%20Darren,%20MD,%20PhD&rft.date=2016&rft.volume=129&rft.issue=1&rft.spage=89&rft.epage=95&rft.pages=89-95&rft.issn=0002-9343&rft.eissn=1555-7162&rft.coden=AJMEAZ&rft_id=info:doi/10.1016/j.amjmed.2015.08.018&rft_dat=%3Cproquest_cross%3E3936366481%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1761067849&rft_id=info:pmid/26344631&rft_els_id=S0002934315008244&rfr_iscdi=true |