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Journal of General Internal Medicine

, Volume 24, Issue 3, pp 374–380 | Cite as

Hospital Readmissions: Physician Awareness and Communication Practices

  • Christopher L. RoyEmail author
  • Allen Kachalia
  • Seth Woolf
  • Elisabeth Burdick
  • Andrew Karson
  • Tejal K. Gandhi
Original Article

Abstract

Background

Patients requiring early hospital readmission may be readmitted to different physicians, potentially without the knowledge of the prior caregivers. This lost opportunity to share information about readmitted patients may be detrimental to quality of care and resident education.

Objective

To measure physician awareness of and communication about readmissions.

Design

Cross-sectional study.

Setting

Two academic medical centers.

Participants

A total of 432 patients discharged from the general medicine services and readmitted within 14 days.

Measurements

We identified patients discharged from the general medicine services and readmitted within 14 days, excluding patients readmitted to the same physician(s) and planned readmissions. We surveyed discharging and readmitting physicians 48 h after the time of readmission.

Results

Discharging physician teams were aware of 48.5% (95% CI 41.5%-55.5%) of patient readmissions. Communication between teams occurred on 43.7% (95% CI 37.1%-50.3%). Higher medical complexity was associated with an increased likelihood of physician communication (adjusted OR 1.12, 95% CI 1.06–1.19). When communication occurred, readmitting physicians received information about the discharging team’s overall assessment (61.9%, 95% CI 51.9%-71.9%), psychosocial issues (52.6%, 95% CI 42.4%-62.8%), pending tests (34.0%, 95% CI 24.2%-43.8%), and discharge medications (30.9%, 95% CI 21.5%-40.3%). When communication did not occur, most physicians (60.8%, 95% CI 56.7%-64.9%) responded it would have been desirable to communicate.

Conclusions

Physicians are frequently unaware of patient readmissions and often do not communicate when readmissions occur. This communication is often desired and frequently results in the exchange of important patient information. Further work is needed to design systems to address this potential discontinuity of care.

KEY WORDS

hospital readmission physician awareness communication practice quality of care 

Notes

Acknowledgements

This study was supported by a grant from the Harvard Risk Management Foundation and was presented at the Society of Hospital Medicine Annual Meeting on April 3, 2008. The authors are indebted to Jason Lee for assistance with data management and Gordon Schiff, MD, for critical review of the manuscript.

Conflict of Interest

None disclosed.

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Copyright information

© Society of General Internal Medicine 2008

Authors and Affiliations

  • Christopher L. Roy
    • 1
    Email author
  • Allen Kachalia
    • 1
  • Seth Woolf
    • 1
  • Elisabeth Burdick
    • 1
  • Andrew Karson
    • 2
  • Tejal K. Gandhi
    • 1
  1. 1.Division of General Internal MedicineBrigham and Women’s HospitalBostonUSA
  2. 2.Center for Quality and SafetyMassachusetts General HospitalBostonUSA

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