How do studies assess the preventability of readmissions? A systematic review with narrative synthesis

E.L. Kneepkens, C Brouwers, Richelle Singotani, Martine de Bruijne, Fatma Karapinar

Research output: Contribution to JournalReview articleAcademicpeer-review

Abstract

Background: A large number of articles examined the preventability rate of readmissions, but comparison and interpretability of these preventability rates is complicated due to the large heterogeneity of methods that were used. To compare (the implications of) the different methods used to assess the preventability of readmissions by means of medical record review. Methods: A literature search was conducted in PUBMED and EMBASE using "readmission" and "avoidability" or "preventability" as key terms. A consensus-based narrative data synthesis was performed to compare and discuss the different methods. Results: Abstracts of 2504 unique citations were screened resulting in 48 full text articles which were included in the final analysis. Synthesis led to the identification of a set of important variables on which the studies differed considerably (type of readmissions, sources of information, definition of preventability, cause classification and reviewer process). In 69% of the studies the cause classification and preventability assessment were integrated; meaning specific causes were predefined as preventable or not preventable. The reviewers were most often medical specialist (67%), and 27% of the studies added interview as a source of information. Conclusion: A consensus-based standardised approach to assess preventability of readmission is warranted to reduce the unwanted bias in preventability rates. Patient-related and integrated care related factors are potentially underreported in readmission studies.
Original languageEnglish
JournalBMC Medical Research Methodology
Publication statusPublished - 2019

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title = "How do studies assess the preventability of readmissions? A systematic review with narrative synthesis",
abstract = "Background: A large number of articles examined the preventability rate of readmissions, but comparison and interpretability of these preventability rates is complicated due to the large heterogeneity of methods that were used. To compare (the implications of) the different methods used to assess the preventability of readmissions by means of medical record review. Methods: A literature search was conducted in PUBMED and EMBASE using {"}readmission{"} and {"}avoidability{"} or {"}preventability{"} as key terms. A consensus-based narrative data synthesis was performed to compare and discuss the different methods. Results: Abstracts of 2504 unique citations were screened resulting in 48 full text articles which were included in the final analysis. Synthesis led to the identification of a set of important variables on which the studies differed considerably (type of readmissions, sources of information, definition of preventability, cause classification and reviewer process). In 69{\%} of the studies the cause classification and preventability assessment were integrated; meaning specific causes were predefined as preventable or not preventable. The reviewers were most often medical specialist (67{\%}), and 27{\%} of the studies added interview as a source of information. Conclusion: A consensus-based standardised approach to assess preventability of readmission is warranted to reduce the unwanted bias in preventability rates. Patient-related and integrated care related factors are potentially underreported in readmission studies.",
author = "E.L. Kneepkens and C Brouwers and Richelle Singotani and {de Bruijne}, Martine and Fatma Karapinar",
year = "2019",
language = "English",
journal = "BMC Medical Research Methodology",
issn = "1471-2288",
publisher = "BioMed Central",

}

How do studies assess the preventability of readmissions? A systematic review with narrative synthesis. / Kneepkens, E.L.; Brouwers, C; Singotani, Richelle; de Bruijne, Martine; Karapinar, Fatma.

In: BMC Medical Research Methodology, 2019.

Research output: Contribution to JournalReview articleAcademicpeer-review

TY - JOUR

T1 - How do studies assess the preventability of readmissions? A systematic review with narrative synthesis

AU - Kneepkens, E.L.

AU - Brouwers, C

AU - Singotani, Richelle

AU - de Bruijne, Martine

AU - Karapinar, Fatma

PY - 2019

Y1 - 2019

N2 - Background: A large number of articles examined the preventability rate of readmissions, but comparison and interpretability of these preventability rates is complicated due to the large heterogeneity of methods that were used. To compare (the implications of) the different methods used to assess the preventability of readmissions by means of medical record review. Methods: A literature search was conducted in PUBMED and EMBASE using "readmission" and "avoidability" or "preventability" as key terms. A consensus-based narrative data synthesis was performed to compare and discuss the different methods. Results: Abstracts of 2504 unique citations were screened resulting in 48 full text articles which were included in the final analysis. Synthesis led to the identification of a set of important variables on which the studies differed considerably (type of readmissions, sources of information, definition of preventability, cause classification and reviewer process). In 69% of the studies the cause classification and preventability assessment were integrated; meaning specific causes were predefined as preventable or not preventable. The reviewers were most often medical specialist (67%), and 27% of the studies added interview as a source of information. Conclusion: A consensus-based standardised approach to assess preventability of readmission is warranted to reduce the unwanted bias in preventability rates. Patient-related and integrated care related factors are potentially underreported in readmission studies.

AB - Background: A large number of articles examined the preventability rate of readmissions, but comparison and interpretability of these preventability rates is complicated due to the large heterogeneity of methods that were used. To compare (the implications of) the different methods used to assess the preventability of readmissions by means of medical record review. Methods: A literature search was conducted in PUBMED and EMBASE using "readmission" and "avoidability" or "preventability" as key terms. A consensus-based narrative data synthesis was performed to compare and discuss the different methods. Results: Abstracts of 2504 unique citations were screened resulting in 48 full text articles which were included in the final analysis. Synthesis led to the identification of a set of important variables on which the studies differed considerably (type of readmissions, sources of information, definition of preventability, cause classification and reviewer process). In 69% of the studies the cause classification and preventability assessment were integrated; meaning specific causes were predefined as preventable or not preventable. The reviewers were most often medical specialist (67%), and 27% of the studies added interview as a source of information. Conclusion: A consensus-based standardised approach to assess preventability of readmission is warranted to reduce the unwanted bias in preventability rates. Patient-related and integrated care related factors are potentially underreported in readmission studies.

M3 - Review article

JO - BMC Medical Research Methodology

JF - BMC Medical Research Methodology

SN - 1471-2288

ER -