Background: Hospital readmission is detrimental and is often a consequence of patient vulnerabilities, social factors and inadequate health system safeguards. The current 30-day readmission rate for Internal Medicine patients at the University Hospital is 13.43%. Historically, little has been known about patients’ perspective on factors that contributed to their readmission. Previous studies have shown that insufficient discharge readiness can correlate with avoidable readmission, and that patients can offer meaningful insights into what led to readmission and what could have prevented it.
Methods: Patients discharged between March 2023 and April 2024 with a 30-day readmission were evaluated for eligibility. 60 patients consented to be interviewed. For each, demographic and clinical information (FIN, Name, Discharge Date, Discharge Diagnoses, Disposition Destination, Date of Readmission, Readmission Source, Readmission Chief Complaint and Readmission Diagnosis) was collected from chart review. Patients were then asked a series of standardized questions and a summary of their responses was entered into RedCap. These responses were categorized and analyzed. The study is IRB approved.
Results: Of the 60 patients interviewed, 24 (40%) did not feel ready for discharge, 23 (38%) reported receiving either no or unclear discharge instructions, 13 (22%) reported discharge medication issues, and 11 (18%) felt they had no clear follow up plan. 14 (23%) felt that home factors (insufficient support, transportation, etc.) contributed to their readmission while 25 (42%) felt that their chronic medical condition or its treatment contributed to their readmission. 23 (38%) cited physician communication issues, 15 (25%) cited nurse communication issues, and 14 (14%) expressed insufficient care management involvement as contributing to their readmission.
Conclusions: Patient perspective is an important, but underutilized, source of information about healthcare processes and workflows that contribute to 30-day readmission. If optimized, avoidable readmissions could be reduced.