Potentially avoidable hospitalisations in Australia: Causes for hospitalisations and primary health care interventions – Primary Health Care Research & Information Service – July 2012

Posted on September 4, 2012. Filed under: Primary Hlth Care | Tags: , |

Potentially avoidable hospitalisations in Australia: Causes for hospitalisations and primary health care interventions – Primary Health Care Research & Information Service – July 2012

Katterl R, Anikeeva O, Butler C, Brown L, Smith B, Bywood P. (2012). Potentially avoidable hospitalisations in Australia: Causes for hospitalisations and primary health care interventions.  PHC RIS Policy Issue Review. Adelaide: Primary Health Care Research & Information Service.

ISBN 978-0-9808191-9-9

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All-Cause Readmission to Acute Care and Return to the Emergency Department – Canadian Institute for Health Information – 14 June 2012

Posted on June 18, 2012. Filed under: Clin Governance / Risk Mgmt / Quality, Emergency Medicine | Tags: , , , |

All-Cause Readmission to Acute Care and Return to the Emergency Department – Canadian Institute for Health Information – 14 June 2012

“One in 12 patients readmitted to Canadian hospitals within 30 days
Study examines who is returning and why

June 14, 2012—Soon after their discharge from hospital, more than 180,000 Canadians were readmitted to acute care in 2010, reveals a study from the Canadian Institute for Health Information (CIHI). In those jurisdictions where detailed emergency department (ED) data was available—Alberta, Ontario and Yukon—nearly 1 in 10 acute care patients returned to the ED within seven days of hospital discharge. The study, All-Cause Readmission to Acute Care and Return to the Emergency Department, included more than 2.1 million hospitalizations across the country. It looked at surgical, medical, pediatric and obstetric patients to better understand who returned to acute care after discharge and for what clinical reason.

“Better understanding of the factors influencing readmission rates is an important step for improving the quality of care for Canadians,” says Jeremy Veillard, Vice President of Research and Analysis at CIHI. “Although readmissions cannot always be avoided, research suggests that in many cases they may be prevented.”

Reasons for readmission varied by patient group”

… continues

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Preventing emergency readmissions to hospital. A scoping review – RAND – 2012

Posted on February 3, 2012. Filed under: Emergency Medicine, Patient Journey, Patient Safety | Tags: , , |

Preventing emergency readmissions to hospital. A scoping review – RAND – 2012

by Ellen Nolte, Martin Roland, Susan Guthrie, Laura Brereton

“The report reviews the evidence and potential for use of ’emergency readmissions within 28 days of discharge from hospital’ as an indicator within the NHS Outcomes Framework. It draws on a rapid review of systematic reviews, complemented by a synopsis of work in four countries designed to better understand current patterns of readmissions and the interpretation of observed patterns. Reviewed studies suggest that between 5 percent and 59 percent of readmissions may be avoidable. Studies are highly heterogeneous, but based on the evidence reviewed, about 15 percent up to 20 percent may be considered reasonable although previous authors have advised against producing a benchmark figure for the percentage of readmissions that can be avoided. The majority of published studies focus on clinical factors associated with readmission. Studies are needed of NHS organisational factors which are associated with readmission or might be altered to prevent readmission.

The introduction of new performance indicators always has the potential to produce gaming. Observers from the USA cite experience which suggests hospitals might increase income by admitting less serious cases, thus simultaneously increasing their income and reducing their rate of readmission. There is also the possibility that there may be some shift in coding of admissions between ’emergency’ and ‘elective’ depending on the incentives. If hospitals are performance managed on the basis of readmission rates, it would be reasonable to expect that some behaviour of this type would occur.”

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Risk Stratification and next steps with DH Risk Prediction tools – Patients at Risk of Re-hospitalisation and the Combined Predictive Model – NHS – 4 August 2011

Posted on August 10, 2011. Filed under: Chronic Disease Mgmt | Tags: |

Risk Stratification and next steps with DH Risk Prediction tools – Patients at Risk of Re-hospitalisation and the Combined Predictive Model – NHS – 4 August 2011

“As you will be aware, stratifying patients according to need continues to be a vital component of the Long Term Conditions (LTC) generic model and key to the delivery of good LTC management. By using a risk prediction approach it is possible to identify those people who are the most regular users of hospital services (and are at risk of re-admissions), then stratify them according to complexity of need and commission cost effective interventions to meet those needs.

There are a wide range of risk stratification models in use across the NHS. These models range from the two freely available DH tools Patients at Risk of Re-hospitalisation (PARR) and the Combined Predictive Model (CPM), to tools developed by commercial organisations like the RISC model that has been show cased as part of the LTC QIPP workstream.”  … continues

 

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