TY - JOUR T1 - Patients’ and providers’ perceptions of the preventability of hospital readmission: a prospective, observational study in four European countries JF - BMJ Quality & Safety JO - BMJ Qual Saf SP - 958 LP - 969 DO - 10.1136/bmjqs-2017-006645 VL - 26 IS - 12 AU - Louise S van Galen AU - Mikkel Brabrand AU - Tim Cooksley AU - Peter M van de Ven AU - Hanneke Merten AU - Ralph KL So AU - Loes van Hooff AU - Harm R Haak AU - Rachel M Kidney AU - Christian H Nickel AU - John TY Soong AU - Immo Weichert AU - Mark HH Kramer AU - Christian P Subbe AU - Prabath WB Nanayakkara A2 - , Y1 - 2017/12/01 UR - http://qualitysafety.bmj.com/content/26/12/958.abstract N2 - Objectives Because of fundamental differences in healthcare systems, US readmission data cannot be extrapolated to the European setting: To investigate the opinions of readmitted patients, their carers, nurses and physicians on predictability and preventability of readmissions and using majority consensus to determine contributing factors that could potentially foresee (preventable) readmissions.Design Prospective observational study. Readmitted patients, their carers, and treating professionals were surveyed during readmission to assess the discharge process and the predictability and preventability of the readmission. Cohen’s Kappa measured pairwise agreement of considering readmission as predictable/preventable by patients, carers and professionals. Subsequently, multivariable logistic regressionidentified factors associated with predictability/preventability.Setting 15 hospitals in four European countriesParticipants 1398 medical patients readmitted unscheduled within 30 daysMain Outcome(s) and Measure(s) (1) Agreement between the interviewed groups on considering readmissions likely predictable or preventable;(2) Factors distinguishing predictable from non-predictable and preventable from non-preventable readmissions.Results The majority deemed 27.8% readmissions potentially predictable and 14.4% potentially preventable. The consensus on predictability and preventability was poor, especially between patients and professionals (kappas ranged from 0.105 to 0.173). The interviewed selected different factors as potentially associated with predictability and preventability. When a patient reported that he was ready for discharge during index admission, the readmission was deemed less likely by the majority (predictability: OR 0.55; 95% CI 0.40 to 0.75; preventability: OR 0.35; 95% CI 0.24 to 0.49).Conclusions There is no consensus between readmitted patients, their carers and treating professionals about predictability and preventability of readmissions, nor associated risk factors. A readmitted patient reporting not feeling ready for discharge at index admission was strongly associated with preventability/predictability. Therefore, healthcare workers should question patients’ readiness to go home timely before discharge. ER -