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Tackling 30-Day Readmissions in Patients with Cirrhosis

  • Management of Cirrhotic Patient (A Cardenas and P Tandon, Section Editors)
  • Published:
Current Hepatology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Many patients with decompensated cirrhosis will be re-admitted within 30 days after discharge. Why many of these readmissions reflect the severity of the patients underlying disease—and can be lifesaving—others may be preventable, revealing gaps in systems of care. This review summarizes reasons for and interventions designed to improve readmission rates and why they work (or do not).

Recent Findings

The principle reasons for readmission include hepatic encephalopathy, symptomatic ascites, complications of medical management, and substance abuse-related admissions. Strategies to reduce readmissions generally succeed in two ways: (1) developing and providing viable alternatives to hospitalization for early decompensations and (2) optimal utilization of proven therapeutic modalities for the treatment of hepatic encephalopathy. Interventions can be targeted (aiming to improve one component of care), structural (reorganizing care delivery to improve quality), and comprehensive (structural with multiple targeted approaches). Recent literature has shown how smartphone applications may be developed to help reduce readmissions.

Summary

Interventions that aim to reduce readmissions among patients with decompensated cirrhosis should be developed with reference to the lessons from prior published reports.

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Authors and Affiliations

  1. Division of Gastroenterology/Hepatology, Division of Gastroenterology and Hepatology, University of Michigan, 3912 Taubman, SPC 5362, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA

    Elliot B. Tapper

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Correspondence to Elliot B. Tapper.

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Conflicts of Interest

Elliot B. Tapper reports grants from Valeant, grants from Gilead, personal fees from Novartis, and personal fees from Dova, outside the submitted work.

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This article does not contain any studies with human or animal subjects performed by the author.

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This article is part of the Topical Collection on Management of Cirrhotic Patient

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Tapper, E.B. Tackling 30-Day Readmissions in Patients with Cirrhosis. Curr Hepatology Rep 17, 8–14 (2018). https://doi.org/10.1007/s11901-018-0384-z

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  • DOI: https://doi.org/10.1007/s11901-018-0384-z

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