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Classifying emergency 30-day readmissions in England using routine hospital data 2004-2010 : what is the scope for reduction?
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Blunt, Ian, Bardsley, Martin, Grove, Amy L. and Clarke, Aileen (2015) Classifying emergency 30-day readmissions in England using routine hospital data 2004-2010 : what is the scope for reduction? Emergency Medicine Journal, 32 (1). pp. 44-50. doi:10.1136/emermed-2013-202531 ISSN 1472-0205.
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WRAP_Clarke_Emerg Med J-2014-Blunt-emermed-2013-202531.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution Non-commercial. Download (1267Kb) | Preview |
Official URL: http://dx.doi.org/10.1136/emermed-2013-202531
Abstract
Background: Many health systems across the globe have introduced arrangements to deny payment for patients readmitted to hospital as an emergency. The purpose of this study was to develop an exploratory categorisation based on likely causes of readmission, and then to assess the prevalence of these different types.
Methods: Retrospective analysis of 82 million routinely collected National Health Service hospital records in England (2004–2010) was undertaken using anonymised linkage of records at person-level. Numbers of 30-day readmissions were calculated. Exploratory categorisation of readmissions was applied using simple rules relating to International Classification of Diseases (ICD) diagnostic codes for both admission and readmission.
Results: There were 5 804 472 emergency 30-day readmissions over a 6-year period, equivalent to 7.0% of hospital discharges. Readmissions were grouped into hierarchically exclusive categories: potentially preventable readmission (1 739 519 (30.0% of readmissions)); anticipated but unpredictable readmission (patients with chronic disease or likely to need long-term care; 1 141 987 (19.7%)); preference-related readmission (53 718 (0.9%)); artefact of data collection (16 062 (0.3%)); readmission as a result of accident, coincidence or related to a different body system (1 101 818 (19.0%)); broadly related readmission (readmission related to the same body system (1 751 368 (30.2%)).
Conclusions: In this exploratory categorisation, a large minority of emergency readmissions (eg, those that are potentially preventable or due to data artefacts) fell into groups potentially amenable to immediate reduction. For other categories, a hospital's ability to reduce emergency readmission is less clear. Reduction strategies and payment incentives must be carefully tailored to achieve stated aims.
Item Type: | Journal Article | ||||||||||
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Subjects: | R Medicine > R Medicine (General) | ||||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Hospitals -- Admission and discharge -- England | ||||||||||
Journal or Publication Title: | Emergency Medicine Journal | ||||||||||
Publisher: | BMJ Group | ||||||||||
ISSN: | 1472-0205 | ||||||||||
Official Date: | January 2015 | ||||||||||
Dates: |
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Volume: | 32 | ||||||||||
Number: | 1 | ||||||||||
Page Range: | pp. 44-50 | ||||||||||
DOI: | 10.1136/emermed-2013-202531 | ||||||||||
Status: | Peer Reviewed | ||||||||||
Publication Status: | Published | ||||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||||
Date of first compliant deposit: | 27 December 2015 | ||||||||||
Date of first compliant Open Access: | 27 December 2015 |
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