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CURIOS@ is a prospective multi-centre cross-sectional study to investigate readmissions in participating units. The data collected is derived from two clinical episodes: the episode containing the re-admission and the previous admission (index admission).
The main aims are:
Outcomes:
Data will be derived directly from patients, from the clinical notes of the previous admission and records of discharge communication. Also information from treating physicians, nurses and immediate caregivers will be collected. The data set will contain no directly identifiable variables (data will be registered by using a research code for each patient).
Data collection will include: Hospital-related data, patient-related data, health-related data, time-related data, and physician related data. Also patient feedback is requested.
After obtaining written informed consent, the researcher will ask the patient 7 questions about the (preventability of their) readmission. Also the patient will be asked if one of the direct carers can be approached with 2 questions. The carer will most often be a sibling, a good friend or someone from the neighborhood. We will approach the carer in person or by telephone, and only after explicit permission from the patient. Lastly, we will ask a doctor and nurse (responsible for the patient in the first 24 hours of his readmission) similar questions.
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| Measure | Description | Time Frame |
|---|---|---|
| Percentage of readmissions deemed preventable by patients, their informal carers, nurses and physicians | Of all the readmissions in the study, we will look at the readmissions which are deemed potentially preventable (YES or NO) by all partners of care chain. In the end this will give us a percentage of readmissions judged as potentially preventable by all partners of care chain. | 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Causes of preventable readmissions | We will ask all partners in the care chain about the causes of the readmissions. These will be categorised: Disease-related: Natural progress disease, out of control/influence physician or patient - for example: metastasis cancer. Patient-related: Related to control/influence patient, out of control/influence professionals - for example: a patient who refused extra home care after the index admission. Human/caregiver-related: Related to the control/influence professionals - for example: poor medication handover after index inclusion. Organisational: Readmission related to organisational problems - for example: no beds available, transfer from other hospital etc. Technical: Readmission related to technical defects of materials or equipment - for example: IV-drip home infusion antibiotics broken. |
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Inclusion criteria:
Exclusion criteria:
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All patients readmitted for at least one night for a medical specialism after any type of admission at any ward in the previous 30 days, with an overnight stay. This could be from any ward, for any procedure (elective/non-elective)
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Prabath Nanayakkara, MD, PhD, FRCP | Contact | 031204444444 | 6791 | p.nanayakkara@vumc.nl |
| Louise van Galen, MD | Contact | 031613767381 | 6185 |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospital of South West Jutland | Esbjerg | 5270 Odense N | Denmark |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25642907 | Background | Greysen SR, Stijacic Cenzer I, Auerbach AD, Covinsky KE. Functional impairment and hospital readmission in Medicare seniors. JAMA Intern Med. 2015 Apr;175(4):559-65. doi: 10.1001/jamainternmed.2014.7756. | |
| 16608138 | Background | Zanocchi M, Maero B, Martinelli E, Cerrato F, Corsinovi L, Gonella M, Ponte E, Luppino A, Margolicci A, Molaschi M. Early re-hospitalization of elderly people discharged from a geriatric ward. Aging Clin Exp Res. 2006 Feb;18(1):63-9. doi: 10.1007/BF03324642. |
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| 1 year |
| Risk factors for preventable readmissions | For every readmission, we will ask researchers to fill out a dataset with potential risk factors. These are:
| 1 year |
| VU University Medical Centre | Amsterdam | North Holland | 1081 HV | Netherlands |
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| Academic Medical Centre (AMC) | Amsterdam | 1105AZ | Netherlands |
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| Albert Schweitzer | Dordrecht | 3300 AK | Netherlands |
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| Westfriesgasthuis | Hoorn | 1624 NP | Netherlands |
| VieCuri Hospital | Venlo | 5912 BL | Netherlands |
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| Ysbyty Gwynedd Hospital | Bangor | LL57 2PW | United Kingdom |
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| University Hospital of South Manchester | Manchester | M13 9WL | United Kingdom |
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| 23529115 | Background | Donze J, Aujesky D, Williams D, Schnipper JL. Potentially avoidable 30-day hospital readmissions in medical patients: derivation and validation of a prediction model. JAMA Intern Med. 2013 Apr 22;173(8):632-8. doi: 10.1001/jamainternmed.2013.3023. |
| 23696773 | Background | van Walraven C, Wong J, Forster AJ. LACE+ index: extension of a validated index to predict early death or urgent readmission after hospital discharge using administrative data. Open Med. 2012 Jul 19;6(3):e80-90. Print 2012. |
| 22608011 | Background | Drame M, Lang PO, Novella JL, Narbey D, Mahmoudi R, Laniece I, Somme D, Gauvain JB, Heitz D, Voisin T, de Wazieres B, Gonthier R, Ankri J, Saint-Jean O, Jeandel C, Couturier P, Blanchard F, Jolly D. Six-month outcome of elderly people hospitalized via the emergency department: the SAFES cohort. Rev Epidemiol Sante Publique. 2012 Jun;60(3):189-96. doi: 10.1016/j.respe.2011.11.004. Epub 2012 May 16. |
| 26163662 | Background | Cooksley T, Nanayakkara PW, Nickel CH, Subbe CP, Kellett J, Kidney R, Merten H, Van Galen L, Henriksen DP, Lassen AT, Brabrand M; safer@home consortium. Readmissions of medical patients: an external validation of two existing prediction scores. QJM. 2016 Apr;109(4):245-8. doi: 10.1093/qjmed/hcv130. Epub 2015 Jul 10. |
| 21105868 | Background | Hansen LO, Williams MV, Singer SJ. Perceptions of hospital safety climate and incidence of readmission. Health Serv Res. 2011 Apr;46(2):596-616. doi: 10.1111/j.1475-6773.2010.01204.x. Epub 2010 Nov 24. |
| 22885591 | Background | Billings J, Blunt I, Steventon A, Georghiou T, Lewis G, Bardsley M. Development of a predictive model to identify inpatients at risk of re-admission within 30 days of discharge (PARR-30). BMJ Open. 2012 Aug 10;2(4):e001667. doi: 10.1136/bmjopen-2012-001667. Print 2012. |
| 24708889 | Background | Jackson AH, Fireman E, Feigenbaum P, Neuwirth E, Kipnis P, Bellows J. Manual and automated methods for identifying potentially preventable readmissions: a comparison in a large healthcare system. BMC Med Inform Decis Mak. 2014 Apr 5;14:28. doi: 10.1186/1472-6947-14-28. |
| 23742056 | Background | Davies S, Saynina O, Schultz E, McDonald KM, Baker LC. Implications of metric choice for common applications of readmission metrics. Health Serv Res. 2013 Dec;48(6 Pt 1):1978-95. doi: 10.1111/1475-6773.12075. Epub 2013 Jun 6. |
| 24668396 | Background | Blunt I, Bardsley M, Grove A, Clarke A. Classifying emergency 30-day readmissions in England using routine hospital data 2004-2010: what is the scope for reduction? Emerg Med J. 2015 Jan;32(1):44-50. doi: 10.1136/emermed-2013-202531. Epub 2014 Mar 25. |
| 23133624 | Background | Bianco A, Mole A, Nobile CG, Di Giuseppe G, Pileggi C, Angelillo IF. Hospital readmission prevalence and analysis of those potentially avoidable in southern Italy. PLoS One. 2012;7(11):e48263. doi: 10.1371/journal.pone.0048263. Epub 2012 Nov 2. |
| 26305081 | Background | Cooksley T, Merten H, Kellett J, Brabrand M, Kidney R, Nickel CH, Nanayakkara PW, Subbe CP. PRISMA Analysis of 30 Day Readmissions to a Tertiary Cancer Hospital. Acute Med. 2015;14(2):53-6. |