Quality

More readmissions with delays in discharge summaries


 

 

Clinical question: Is there an association between time to completion of discharge summary and hospital readmission?

Background: Thirty-day hospital readmission is one of the quality indicators for inpatient care and a higher rate can result in monetary penalties. Several interventions aimed at reducing this occurrence have been studied in different settings with variable success. Timely completion of discharge summary can possibly affect readmissions by providing crucial information to outpatient providers caring for patients across the care continuum.

Study design: Retrospective cohort study.

Setting: Johns Hopkins University, Baltimore.

Dr. Jean-Sebastien Rachoin
Dr. Jean-Sebastien Rachoin
Synopsis: 87,994 consecutive discharges led to 14,248 readmissions (16.2%). After controlling for patient characteristics, delays in completion of discharge summaries of greater than 3 days were associated with readmission (odds ratio, 1.09; 95% confidence interval, 1.04-1.13; P = .001). Every additional 3 days of delayed completion increased the adjusted odds of readmission by 1%.

Bottom line: Delays in completion of discharge summaries was significantly associated with higher rates of hospital readmission. It’s unclear however whether timely completion is a surrogate indicator of other important causative factors.

Citations: Hoyer EH, Odonkor CA, Bhatia SN, et al. Association between days to complete inpatient discharge summaries with all-payer hospital readmissions in Maryland. J Hosp Med. 2016; 11(6):393-400.

Dr. Rachoin is an assistant professor of clinical medicine and associate division head, Hospital Medicine, at Cooper Medical School at Rowan University. He works as a hospitalist at Cooper University Hospital in Camden, N.J.

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