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Education, Teaching, and Quality Improvement |

Hospital Readmission From Hospice Identifying Causes and Demographics

Ali Eskandar, MBBCh; Feras Mahdi, MD; Rajeesh Punnakkattu, MD
Author and Funding Information

Casa Grande Regional Medical Center, Casa Grande, AZ


Chest. 2013;144(4_MeetingAbstracts):534A. doi:10.1378/chest.1702395
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Abstract

SESSION TITLE: Cost and Quality Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: Our project aims to identify patients who were admitted from hospice to Casa Grande Medical Center, in Pinal County, Arizona between 2009 and 2011. We will also analyze for demographics, risk factors, and causes for readmission.

METHODS: We did a retrospective chart review. We included all patients admitted from Casa Grande Medical Center to hospice between 2009-2011. Patients who left the hospice facility for outpatient procedures, tests, or died at the hospital while being admitted to hospice where excluded from the study while hospice patients who came to the emergency room but not admitted where included.

RESULTS: There was total of 428 patients admitted to hospice from our facility. Median age 74, Caucasians were the majority 324 (76%), Hispanic 77 (17%), American indian 24 (5%), African americans, Asians and other races 13 (2%). Thirty day readmission rate was 4% (18). Six of the eighteen were secondary to procedures mostly paracentesis 3, orthopedic surgeries 2, and pacemaker 1. Other causes for readmission include respiratory distress 4, infections 2, pain control 1, bleeding 1, constipation 1, heart failure 1, psychiatric 1, seizure 1. Eight patients (2%) were readmitted to the hospital after 30 days causes include infections 5, pancreatitis 1, chest pain 1, postoperative complication 1. Three patients expired durning hospital stay. Nine patients had ER visits within 30 days causes include trauma 3, ascitis 2, pleural effusion 1, dehydration 1, constipation 1, urinary retention 1. Four patients had ER visits after 30 days causes include uncontrolled DM 1, respiratory distress 1, trauma 1, syncope 1.

CONCLUSIONS: In the first 30 days procedures take major reason for readmission and the infection was the leading cause after 30 days. ER visits were mainly caused by trauma and procedures during the first 30 days after admission to hospice while no specific cause was identified for subsequent admissions.

CLINICAL IMPLICATIONS: By further understanding the causes of readmission from hospice we will be able to target preventable causes and reduce hospital readmission rates.

DISCLOSURE: Rajeesh Punnakkattu: Employee: I am a medical director for one of the hospices in the community. The following authors have nothing to disclose: Ali Eskandar, Feras Mahdi

No Product/Research Disclosure Information


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