Premium
Perceptions of readmitted patients on the transition from hospital to home
Author(s) -
Kangovi Shreya,
Grande David,
Meehan Patricia,
Mitra Nandita,
Shan Richard,
Long Judith A.
Publication year - 2012
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.1002/jhm.1966
Subject(s) - medicine , medicaid , socioeconomic status , psychological intervention , feeling , odds ratio , hospital medicine , confidence interval , cross sectional study , family medicine , social support , medline , emergency medicine , psychiatry , health care , population , environmental health , law , economics , psychotherapist , economic growth , psychology , social psychology , pathology , political science
BACKGROUND: Hospital leaders have had mixed success reducing readmissions Little is known about the readmitted patient's perspective. METHODS: A cross‐sectional 36‐item survey was administered to 1084 readmitted inpatients of The Hospital of the University of Pennsylvania (an urban academic medical center) and Penn Presbyterian Medical Center (an urban community hospital) between November 10, 2010 and July 5, 2011. The survey response rate was 32.9%. RESULTS: The most commonly reported issues contributing to readmission were: 1) feeling unprepared for discharge (11.8%); 2) difficulty performing activities of daily living (ADLs) (10.6%); 3) trouble adhering to discharge medications (5.7%); 4) difficulty accessing discharge medications (5.0%); and 5) lack of social support (4.7%). Low‐socioeconomic status (SES) (defined as uninsured or Medicaid) patients were more likely than high‐SES patients to report difficulty understanding (odds ratio [OR] 2.7; 95% confidence interval [CI] 1.1, 6.6) and executing (OR 2.2; 95% CI 1.1, 4.4) discharge instructions, difficulty adhering to medications (OR 1.8; 95% CI 1.2, 3.0), lack of social support (OR 2.0; 95% CI 1.2, 3.6), lack of basic resources (OR 2.6; 95% CI 1.1, 6.1), and substance abuse (OR 6.7; 95% CI 2.3, 19.2). CONCLUSIONS: Patients reported transition challenges which they believe contribute to illness relapse and readmission. Interventions designed to address these challenges, and tailored for patient characteristics such as SES, may better address the root causes of readmission. Journal of Hospital Medicine 2012. © 2012 Society of Hospital Medicine