According to readmissions data published by Centers for Medicare and Medicaid Services (CMS) on their Hospital Compare site, 15.6% of all patients were readmitted within 30 days of discharge from the hospital during the period of July 2014 through June 2015. The overall 30-day readmission rate varied by hospital from 10.8% to 19.9%. That variation is significant: Patients treated at some hospitals are twice as likely to be readmitted within 30 days of discharge compared to patients treated at other hospitals.
Causes of Readmission in the United States
Some number of patients will always be readmitted after discharge. However, the wide range of readmission rates across hospitals suggests that there are addressable factors behind readmissions. In some cases, a readmission may be related to what happened during the original hospitalization. In many cases, however, patient readmission is tied to what happens after the patient is discharged from the hospital.
A study on preventability and causes of readmissions published in JAMA Internal Medicine in 2016 reviewed the cases of 1,000 general medicine patients readmitted within 30 days of discharge across twelve United States hospitals from April 1, 2012 to March 31, 2013. Of those 1,000 readmissions, 26.9% were considered to be potentially preventable.
According to the study, common factors in potentially preventable readmissions were largely related to what happened at the time of discharge and after the patient went home. The authors cited emergency department decision making at the time of readmission, patient failure to keep important follow-up appointments, premature discharge, and lack of patient awareness about who to contact after discharge as the most common factors.
The study’s authors concluded that: “High-priority areas for improvement efforts include improved communication among health care teams and between healthcare professionals and patients, greater attention to patients’ readiness for discharge, enhanced disease monitoring, and better support for patient self-management.”
Read Part 4 of Reducing Readmissions by Improving Clinical Communications - Post-Discharge Patient Education