Emergency readmissions are substantially determined by acute illness severity and chronic debilitating illness: A single centre cohort study

European Journal of Internal Medicine

Volumn 26, Issue 1, 2015, Pages 12-17

  Conway, Richard ^a   Byrne, Declan ^a   O'Riordan, Deirdre ^a   Silke, Bernard ^a  

^a ST JAMES S HOSPITAL   (Ireland)

Author keywords

Emergency medical admissions; Prediction; Readmission

Indexed keywords

ACUTE DISEASE; ADULT; AGED; ARTICLE; CHARLSON COMORBIDITY INDEX; CHRONIC DISEASE; COHORT ANALYSIS; COMORBIDITY; CONTROLLED STUDY; DISEASE SEVERITY; EMERGENCY; EMERGENCY CARE; EMERGENCY WARD; FEMALE; HOSPITAL READMISSION; HUMAN; INCIDENCE; LENGTH OF STAY; MAJOR CLINICAL STUDY; MALE; MORTALITY; AGE; EMERGENCY HEALTH SERVICE; FACTUAL DATABASE; IRELAND; MIDDLE AGED; MULTIVARIATE ANALYSIS; SECONDARY CARE CENTER; SEVERITY OF ILLNESS INDEX; STATISTICAL MODEL; STATISTICS AND NUMERICAL DATA;

ACUTE DISEASE; ADULT; AGE FACTORS; AGED; CHRONIC DISEASE; COHORT STUDIES; COMORBIDITY; DATABASES, FACTUAL; EMERGENCY SERVICE, HOSPITAL; FEMALE; HUMANS; IRELAND; LENGTH OF STAY; LOGISTIC MODELS; MALE; MIDDLE AGED; MULTIVARIATE ANALYSIS; PATIENT READMISSION; SECONDARY CARE CENTERS; SEVERITY OF ILLNESS INDEX;

EID: 84921552768     PISSN: 09536205     EISSN: 18790828     Source Type: Journal    
DOI: 10.1016/j.ejim.2014.12.013     Document Type: Article

References (38)

1. J. Benbassat, and M. Taragin Hospital readmissions as a measure of quality of health care: advantages and limitations Arch Intern Med 160 2000 1074 1081
2. E.D. Moloney, K. Bennett, and B. Silke Patient and disease profile of emergency medical readmissions to an Irish teaching hospital Postgrad Med J 80 2004 470 474
3. C.J. Zook, and F.D. Moore High-cost users of medical care N Engl J Med 302 1980 996 1002
4. M.A. Anderson, D. Tyler, L.B. Helms, K.S. Hanson, and K.J.H. Sparbel Hospital readmission from a transitional care unit J Nurs Care Qual 20 2005 26 35
5. M. Chambers, and A. Clarke Measuring readmission rates BMJ 301 1990 1134 1136
6. A.J. Tierney, and A. Worth Review: readmission of elderly patients to hospital Age Ageing 24 1995 163 166
7. C. Victor, and S. Jeffries Are re-admission rates a useful indication of outcome? Geriatr Med 20 1990 19 20
8. J. Gorman, A. Vellinga, J.J. Gilmartin, and S.T. O'Keeffe Frequency and risk factors associated with emergency medical readmissions in Galway University Hospitals Ir J Med Sci 179 2010 255 258
9. I. Blunt, M. Bardsley, A. Grove, and A. Clarke Classifying emergency 30-day readmissions in England using routine hospital data 2004-2010: what is the scope for reduction? Emerg Med J Mar 25 2014 10.1136/emermed-2013-202531 [Epub ahead of print]
10. C. van Walraven, A. Jennings, and A.J. Forster A meta-analysis of hospital 30-day avoidable readmission rates J Eval Clin Pract 18 2012 1211 1218
11. J.C. Luthi, B. Burnand, W.M. McClellan, S.R. Pitts, and W.D. Flanders Is readmission to hospital an indicator of poor process of care for patients with heart failure? Qual Saf Health Care 13 2004 46 51
12. C.M. Ashton, D.J. Del Junco, J. Souchek, N.P. Wray, and C.L. Mansyur The association between the quality of inpatient care and early readmission: a meta-analysis of the evidence Med Care 35 1997 1044 1059
13. S. DesHarnais, L.F. McMahon Jr., and R. Wroblewski Measuring outcomes of hospital care using multiple risk-adjusted indexes Health Serv Res 26 1991 425 445
14. S. Howell, M. Coory, J. Martin, and S. Duckett Using routine inpatient data to identify patients at risk of hospital readmission BMC Health Serv Res 9 2009 96
15. I. Laniece, P. Couturier, M. Drame, G. Gavazzi, S. Lehman, and D. Jolly Incidence and main factors associated with early unplanned hospital readmission among French medical inpatients aged 75 and over admitted through emergency units Age Ageing 37 2008 416 422
16. O. Hasan, D.O. Meltzer, S.A. Shaykevich, C.M. Bell, P.J. Kaboli, and A.D. Auerbach Hospital readmission in general medicine patients: a prediction model J Gen Intern Med 25 2010 211 219
17. C. van Walraven, I.A. Dhalla, C. Bell, E. Etchells, I.G. Stiell, and K. Zarnke Derivation and validation of an index to predict early death or unplanned readmission after discharge from hospital to the community CMAJ 182 2010 551 557
18. J. Billings, J. Dixon, T. Mijanovich, and D. Wennberg Case finding for patients at risk of readmission to hospital: development of algorithm to identify high risk patients BMJ 333 2006 327
19. T. Rooney, E.D. Moloney, K. Bennett, D. O'Riordan, and B. Silke Impact of an acute medical admission unit on hospital mortality: a 5-year prospective study QJM 101 2008 457 465
20. R. Conway, D. O'Riordan, and B. Silke Long-term outcome of an AMAU - a decade's experience QJM 107 2014 43 49
21. R. O'Loughlin, S. Allwright, J. Barry, A. Kelly, and C. Teljeur Using HIPE data as a research and planning tool: limitations and opportunities Ir J Med Sci 174 2005 40 45 [discussion 52-7]
22. A. O'Callaghan, M.P. Colgan, C. McGuigan, F. Smyth, N. Haider, and S. O'Neill A critical evaluation of HIPE data Ir Med J 105 2012 21 23
23. B. Silke, J. Kellett, T. Rooney, K. Bennett, and D. O'Riordan An improved medical admissions risk system using multivariable fractional polynomial logistic regression modelling QJM 103 2010 23 32
24. E. O'Sullivan, E. Callely, D. O'Riordan, K. Bennett, and B. Silke Predicting outcomes in emergency medical admissions - role of laboratory data and co-morbidity Acute Med 2 2012 59 65
25. M.E. Charlson, P. Pompei, K.L. Ales, and C.R. MacKenzie A new method of classifying prognostic comorbidity in longitudinal studies: development and validation J Chronic Dis 40 1987 373 383
26. S.H. Chotirmall, S. Picardo, J. Lyons, M. D'Alton, D. O'Riordan, and B. Silke Disabling disease codes predict worse outcomes for acute medical admissions Intern Med J 2 2014 12440
27. Manchester Triage Group Emergency triage 2nd ed. 2006 Blackwell Publishing Ltd London
28. O. Mikulich, E. Callaly, K. Bennett, B. Silke, and D. O'Riordan The increased mortality associated with a weekend emergency admission is due to increased illness severity and altered case-mix Acute Med 10 2011 181 186
29. J.M. Hilbe Negative binomial regression 2nd ed. 2011 Cambridge University Press Cambridge, UK
30. A.C. Cameron, and P.K. Trivedi Microeconometrics using Stata 2009 Stata Press College Station, TX
31. R. Williams Using the margins command to estimate and interpret adjusted predictions and marginal effects Stata J 12 2012 308 331
32. R. Conway, D. O'Riordan, and B. Silke Targets and the emergency medical system - intended and unintended consequences Eur J Emerg Med Apr 16 2014 [Epub ahead of print]
33. G.B. Hamar, E.Y. Rula, A. Wells, C. Coberley, J.E. Pope, and S. Larkin Impact of a chronic disease management program on hospital admissions and readmissions in an Australian population with heart disease or diabetes Popul Health Manag 16 2013 125 131
34. S. Kangovi, and D. Grande Transitional care management reimbursement to reduce COPD readmission Chest 145 2014 149 155
35. A. Tsiachristas, J.M. Cramm, A.P. Nieboer, and M.P. Rutten-van Mölken Changes in costs and effects after the implementation of disease management programs in the Netherlands: variability and determinants Cost Eff Resour Alloc 12 2014 17
36. S. Williams, A. Bottle, and P. Aylin Length of hospital stay and subsequent emergency readmission BMJ 331 2005 371
37. E. Daly, A. Mason, and M.J. Goldacre Using re-admissions as a health outcome indicator: literature review Report to the UK Department of Health 2009 [Available from: http://nchod.uhce.ox.ac.uk/Re-admission%20Rates%20Literature.pdf. Accessed 2 September 2014]
38. J. Billings, I. Blunt, A. Steventon, T. Georghiou, G. Lewis, and M. Bardsley Development of a predictive model to identify inpatients at risk of re-admission within 30 days of discharge (PARR-30) BMJ Open 2 2012 e001667