Background: Cancer is a risk factor for readmissions. We aimed to describe the potentially preventable 7-day unplanned readmissions in patients admitted to the hospital medicine service at a tertiary comprehensive cancer center. There is currently no defined criteria for potentially preventable readmissions among the cancer population.
Methods: This was a retrospective analysis performed by a multidisciplinary team for all 7-day unplanned readmissions to the hospital medicine service at MD Anderson Cancer Center from September 1, 2020 to February 28, 2021. Readmissions were independently analyzed by two randomly selected individuals to determine preventability. Discordant reviews were resolved by a third reviewer to reach consensus. We described the clinical and demographic characteristics of patients who were deemed to have a potentially preventable readmission and the most common reasons a readmission was deemed potentially preventable.
Results: 138 unplanned readmissions were included for statistical analysis. The estimated potentially preventable unplanned 7-day readmission rate was 15.9% (N=22). The mean age of the study population was 62 years old; 53% were female and 47% were male. The most common type of cancer was non-colon GI malignancy. 68.8% of patients had stage 4 cancer. 72% of readmitted patients were discharged home. Age ≤ 60 years was significantly associated with larger odds of having a potentially preventable readmission (odds ratio (95% CI) = 3.34 (1.27, 8.82), p=.015). Premature discharge and potentially missed opportunities for goals of care discussions during the index hospitalization were most commonly associated with potentially preventable readmissions by our reviewers.
Conclusions: Our study found a potentially preventable readmission rate of 15.9% among 7-day unplanned readmissions to our hospitalist service. While a majority of the 7-day unplanned readmissions were deemed not preventable, there are opportunities for improvement for potentially preventable readmissions based on our reviewers’ analysis of the encounters. Our findings provide inpatient teams insight into focus areas where care delivery can be improved to help mitigate the risk of readmissions.