Urgent Hospital Readmissions are Avoidable in Nearly One out of Five Cases

The Canadian Medical Association Journal has published a study of the causes of urgent hospital readmissions. The study was undertaken as urgent, unplanned hospital readmissions are increasingly being used to gauge the quality of care. The study team, comprised mainly of physicians, reviewed all urgent readmissions that occurred within 6 months of discharge from 11 teaching and community hospitals in Ontario between October 2002 and July 2006. The physicians adjudged whether the readmission was an adverse event and whether the adverse event could have been avoided. For purposes of the study an adverse event was defined as a poor clinical outcome due to medical care. For more information concerning medical adverse events please refer to our medical adverse event study page.

The study reviewed the history of almost 5000  patients of which 13.5 % were readmitted to hospital on an urgent basis within 6 months of their discharge. The study team concluded that 16 per cent of these patients were readmitted due to an outcome that was avoidable. The authors use the word “potentially” in describing this statistic but clearly report that they used a statistical  model that required the probability that each readmission was truly avoidable exceeded 50%. Even then the vast majority of these occurrences had a 90% probability of being avoidable. From a legal perspective a probability exceeding 50% is sufficient to attract legal liability. The authors of the study chose to state that urgent readmissions that are potentially avoidable are relatively uncommon. However their analysis demonstrates that one out of 50 people admitted to hospital will require an urgent readmission to hospital within 6 months of discharge because of a poor outcome caused by medical care that was avoidable to a degree sufficient to affix legal liability. The study also showed that the closer in time the readmission was to the date of discharge the more likely that it was avoidable.