Patient-Reported Discharge Readiness and 30-Day Risk of Readmission or Death: A Prospective Cohort Study

The American Journal of Medicine
Darren LauFinlay A McAlister

Abstract

Early readmissions to hospital after discharge are common, and clinicians cannot accurately predict their occurrence. We examined whether patients who feel unready at the time of discharge have increased readmissions or death within 30 days. This was a prospective cohort study of adult patients discharged home from 2 tertiary care hospitals in Edmonton, Alberta, Canada, between October 2013 and November 2014. Patient-reported discharge readiness was measured with an 11-point Likert response scale, with scores <7 indicating subjective unreadiness. The primary outcome was readmission or death within 30 days. Logistic regression models were adjusted for age, sex, and a validated risk prediction score for postdischarge events (LACE index). Of 495 patients (mean age 62 years, 51% female, mean Charlson comorbidity index 2.8), 112 (23%) reported being unready for discharge. Risk factors for being unready at discharge were cognitive impairment (mild vs none), low satisfaction with health care services, depression, lower education, previous hospital admissions (12 months), and persistent symptoms or disability. At 30 days, 85 patients (17%) had been readmitted or died, with no significant difference between patients who felt unready or ...Continue Reading

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Citations

Jan 12, 2016·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Darren LauFinlay A McAlister
Mar 2, 2016·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Amanda S MixonSunil Kripalani
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Jan 23, 2020·Journal of General Internal Medicine·Tristan StrujaPhilipp Schuetz
Sep 28, 2020·Journal of Psychiatric and Mental Health Nursing·Mengmeng WangXiaolin Li
Jun 12, 2021·The Journal of the Association of Nurses in AIDS Care : JANAC·Xiaoxia ZhangHonghong Wang
Mar 14, 2021·European Journal of Cardiovascular Nursing : Journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology·Camilla RotvigSelina Kikkenborg Berg

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