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avoidable readmission in hong kong - system, clinician, patient or social factor可以避免重新接纳在香港u2014u2014系统中,临床医生,病人或社会因素
Yam et al. BMC Health Services Research 2010, 10:311
/1472-6963/10/311
RESEARCH ARTICLE Open Access
Avoidable readmission in Hong Kong - system,
clinician, patient or social factor?
*
Carrie HK Yam, Eliza LY Wong , Frank WK Chan, Michael CM Leung, Fiona YY Wong, Annie WL Cheung, EK Yeoh
Abstract
Background: Studies that identify reasons for readmissions are gaining importance in the light of the changing
demographics worldwide which has led to greater demand for hospital beds. It is essential to profile the
prevalence of avoidable readmissions and understand its drivers so as to develop possible interventions for
reducing readmissions that are preventable. The aim of this study is to identify the magnitude of avoidable
readmissions, its contributing factors and costs in Hong Kong.
Methods: This was a retrospective analysis of 332,453 inpatient admissions in the Medical specialty in public
hospital system in Hong Kong in year 2007. A stratified random sample of patients with unplanned readmission
within 30 days after discharge was selected for medical record reviews. Eight physicians reviewed patients’ medical
records and classified whether a readmission was avoidable according to an assessment checklist. The results were
correlated with hospital inpatient data.
Results: It was found that 40.8% of the 603 unplanned readmissions were judged avoidable by the reviewers.
Avoidable readmissions were due to: clinician factor (42.3%) including low threshold for admission and premature
discharge etc.; patient factor (including medical and health factor) (41.9%) such as relapse or progress of previous
complaint, and compliance problems etc., followed by system factor (14.6%) including inadequate discharge
planning, inadequate palliative care/terminal care, etc., and social factor (1
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