Preventing emergency readmissions to hospital

Preventing emergency readmissions to hospital: A scoping review

Ellen Nolte
Martin Roland
Susan Guthrie
Laura Brereton
Copyright Date: 2012
Published by: RAND Corporation
Pages: 67
https://www.jstor.org/stable/10.7249/j.ctt3fh1t4
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  • Book Info
    Preventing emergency readmissions to hospital
    Book Description:

    The study reports on the evidence and potential for use of ‘emergency readmissions within 28 days of discharge from hospital’ as an indicator within the NHS Outcomes Framework, drawing on a rapid review of systematic reviews.

    eISBN: 978-0-8330-7954-1
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-ii)
  2. Preface
    (pp. iii-iv)
  3. Table of Contents
    (pp. v-vi)
  4. List of figures
    (pp. vii-viii)
  5. List of tables
    (pp. ix-x)
  6. Summary
    (pp. xi-xiv)

    1. In its 2010 White Paper ‘Equity and excellence: liberating the NHS’ the Coalition Government expressed a commitment to create a mechanism whereby the NHS in England is held accountable for improving healthcare outcomes. The proposed NHS Outcomes Framework comprises a set of national goals for outcomes in five domains; one domain, capturing effectiveness, is centred around ‘Helping people to recover from episodes of ill health or following injury’, and the Framework proposes using ‘emergency readmissions within 28 days of discharge from hospital’ as one of the indicators to measure progress in this domain.

    2. Emergency readmission to hospital is...

  7. Acknowledgements
    (pp. xv-xvi)
  8. CHAPTER 1 Background
    (pp. 1-4)

    In its 2010 White Paper ‘Equity and excellence: liberating the NHS’ the Coalition Government expressed a commitment to create a mechanism whereby the NHS in England is held accountable for improving healthcare outcomes.¹ Its proposed NHS Outcomes Framework comprises a set of national goals for outcomes in five domains around effectiveness, patient experience and safety, involving the development of a total of 51 indicators, with corresponding data to be published in April 2012.² One domain, capturing effectiveness, is centred around ‘Helping people to recover from episodes of ill health or following injury’, and the Framework proposes using ‘emergency readmissions within...

  9. CHAPTER 2 Evidence review
    (pp. 5-32)

    We have undertaken a rapid evidence review to provide data, where available, on:

    the proportion and type of all emergency readmissions that are potentially avoidable (and, vice-versa, that are expected or inevitable)

    the extent to which emergency readmissions that are considered avoidable can be attributed to deficiencies in the original hospital care

    the extent to which emergency readmissions that are considered avoidable can be attributed to deficiencies in primary and community care or social care or both

    the proportion and type of emergency admissions that are potentially avoidable and can be attributed to factors other than health and social care...

  10. CHAPTER 3 Experience in four countries
    (pp. 33-38)

    This chapter aims to provide a synopsis of work in a small sample of countries designed to better understand current patterns of readmissions and the interpretation of observed patterns and trends within the context of the relevant healthcare system. We consider four countries: England, the USA, Australia and the Netherlands. The chapter draws on a combination of sources, including documented evidence (England) and consultation with experts in the field (the USA, Australia and the Netherlands).

    Rates of emergency readmission to hospital within 28 days following discharge have been published by the National Centre for Health Outcomes Development (NCHOD) since 1998/99.⁸⁵...

  11. CHAPTER 4 Discussion
    (pp. 39-42)

    Our review of the literature shows wide variation in definitions of readmission, assessments of the avoidability of readmissions, and identification of factors that may prevent readmission. The proposed 28-day readmission rate is likely to reflect a balance between hospital and community factors that might influence readmission.

    Using a 28-day readmission rate, it seems likely that around 15 percent to up to 20 percent of readmissions could be regarded as avoidable. The most promising interventions to prevent readmission appear to be those that concentrate on coordination and communication around the time of discharge.

    As with any high stakes assessment, the introduction...

  12. REFERENCES
    (pp. 43-51)