Is readmission to hospital an indicator of poor process of care for patients with heart failure?

Details

Serval ID
serval:BIB_CA3FD8669D77
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Is readmission to hospital an indicator of poor process of care for patients with heart failure?
Journal
Quality and Safety in Health Care
Author(s)
Luthi Jean-Christophe, Burnand Bernard, McClellan William M., Pitts Stephen R., Flanders W. Dana 
ISSN
1475-3898
Publication state
Published
Issued date
2004
Volume
13
Number
1
Pages
46-51
Notes
Réf. IUMSP: R 04/41et 04/42 Type de document : Evaluation Studies SAPHIRID:44704
Abstract
BACKGROUND: Controversy exists about the appropriateness of using readmission as an indicator of the quality of care. A study was undertaken to measure the validity and predictive ability of readmission in this context. METHODS: An evaluation study was performed in patients discharged alive with heart failure from three Swiss academic medical centres. Process quality indicators were derived from evidence based guidelines for the management and treatment of heart failure. Readmissions were calculated from hospital administrative data. The predictive ability of readmissions was evaluated using bivariate and multivariate analyses, and validity by calculating sensitivity, specificity, positive and negative predictive value, using process indicators as the "gold standard". RESULTS: Of 1055 eligible patients discharged alive, 139 (13.2%) were readmitted within 30 days. The adjusted odds ratio (OR) for absence of measurement of left ventricular function was 0.70 (95% CI 0.45 to 1.08) for readmissions. In patients with left ventricular systolic dysfunction, three dose categories of angiotensin converting enzyme inhibitor were examined using ordinal logistic regression. The adjusted OR for these categories was 1.07 (95% CI 0.56 to 2.06) for readmissions. When using process indicators as the gold standard to assess the validity of readmissions, sensitivity ranged from 0.08 to 0.17 and specificity from 0.86 to 0.93. CONCLUSIONS: Readmission did not predict and was not a valid indicator of the quality of care for patients with heart failure admitted to three Swiss university hospitals. [Authors]
Keywords
Cardiac Output, Low , Patient Readmission , Quality Indicators, Health Care
Pubmed
Web of science
Open Access
Yes
Create date
05/03/2008 15:56
Last modification date
20/08/2019 15:45
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