ReCAP: Insights Into the Potential Preventability of Oncology Readmissions [CARE DELIVERY]

CONCLUSION: Three independent reviewers analyzed 72 hospital readmissions and found that 22 (31%) of the 72 readmissions were preventable. The most common causes of preventability were overwhelming symptoms in patients who qualified for hospice but were not participating and insufficient communication between patients and the care team about symptom burden. The most common reason for nonpreventability were high symptom burden among patients not appropriate for hospice or for whom aggressive outpatient management was inadequate despite extensive efforts (Table). Readmissions from nursing facilities—where there is little oncology supervision—accounted for 35% of the total. METHODS: Standardized criteria to define preventability/nonpreventability were developed before data collection began. The records of sequential nonsurgical readmissions were reviewed independently by two experienced oncology reviewers. When the reviewers disagreed about assignment, a third reviewer broke the tie. Seventy-two readmissions from 69 patients were analyzed. The first two reviewers agreed that 18 (25%) were preventable and that 29 (40%) were not. A third reviewer found four of the split 25 cases to be preventable, so the consensus preventability rate was 22 (31%) of 72. BIAS, CONFOUNDING FACTOR(S), DRAWBACKS: A large minority of readmissions can be viewed as a failure of some aspect of the medical care system: symptom management, communication, psychosocial support, education or expe...
Source: Journal of Oncology Practice - Category: Cancer & Oncology Authors: Tags: Quality of care, Outcomes Research, Quality of Care, Efficiency of Care CARE DELIVERY Source Type: research