Department of Hospital Pharmacy, OLVG, Amsterdam, The Netherlands.
Department of Internal Medicine, OLVG, Amsterdam, The Netherlands.
Health Expect. 2020 Feb;23(1):212-219. doi: 10.1111/hex.12993. Epub 2019 Nov 16.
Hospital readmissions are increasingly used as an indicator of quality in health care. One potential risk factor of readmissions is polypharmacy. No studies have explored the patients' perspectives on the medication relatedness and potential preventability of their readmissions.
To compare the patients' perspectives on the medication relatedness and potential preventability of their readmissions with the providers' perspectives.
Patients unplanned readmitted within 30 days after discharge at one of the participating departments of OLVG Hospital in Amsterdam were interviewed during their readmission. Patients' perspectives regarding medication relatedness of their readmissions, the potential preventability, possible preventable interventions, and satisfaction with medication information were examined. Health-care providers also reviewed files of these readmitted patients. Primary outcome was the percentage of medication-related and potentially preventable readmissions according to the patient vs the provider. Descriptive data analysis was used.
According to patients, 36 of 172 (21%) readmissions were medication-related, and of these, 21 (58%) were potentially preventable. According to providers, 26 (15%) readmissions were medication-related and 6 (23%) of these were potentially preventable. Patients and providers agreed on the medication relatedness in 11 of the 172 readmissions, and in two of these, agreement on the potential preventability existed. According to patients, preventive interventions belonged mostly to the hospital level, followed by the primary care level and patient level.
Patients and providers differ substantially on their perspectives regarding the medication relatedness and preventability of readmissions. Patients were more likely to view medication-related readmissions as preventable.
医院再入院率越来越多地被用作医疗质量的指标。再入院的一个潜在风险因素是多种药物治疗。目前还没有研究探讨患者对再入院相关药物和潜在可预防因素的看法。
比较患者对再入院相关药物和潜在可预防因素的看法与提供者的看法。
在阿姆斯特丹 OLVG 医院参与科室之一出院后 30 天内计划外再入院的患者在再入院期间接受了采访。评估患者对再入院相关药物、潜在可预防因素、可能的可预防干预措施以及对药物信息的满意度。医疗保健提供者也对这些再入院患者的病历进行了审查。主要结局是根据患者与提供者评估的药物相关和潜在可预防再入院的百分比。采用描述性数据分析。
根据患者的说法,172 例再入院中有 36 例(21%)与药物有关,其中 21 例(58%)是潜在可预防的。根据提供者的说法,172 例再入院中有 26 例(15%)与药物有关,其中 6 例(23%)是潜在可预防的。患者和提供者在 172 例再入院中有 11 例的药物相关性看法一致,在这 11 例中,有 2 例对潜在可预防因素的看法一致。根据患者的说法,预防干预措施主要属于医院层面,其次是初级保健层面和患者层面。
患者和提供者在再入院相关药物和可预防因素的看法上存在很大差异。患者更倾向于认为与药物相关的再入院是可以预防的。