Volume 7, Issue 9 p. 709-712
Brief Report

Perceptions of readmitted patients on the transition from hospital to home

Shreya Kangovi MD

Corresponding Author

Shreya Kangovi MD

Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania

Robert Wood Johnson Foundation Clinical Scholars Program, University of Pennsylvania, Philadelphia, Pennsylvania

Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania

Telephone: 215-520-5309; Fax: 215-573-2742

University of Pennsylvania, 423 Guardian Dr, 13th Floor, Blockley Hall, Philadelphia, PA 19104Search for more papers by this author
David Grande MD, MPA

David Grande MD, MPA

Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania

Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania

Search for more papers by this author
Patricia Meehan LSW

Patricia Meehan LSW

Department of Social Work, University of Pennsylvania Health System, Philadelphia, Pennsylvania

Search for more papers by this author
Nandita Mitra PhD

Nandita Mitra PhD

Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania

Search for more papers by this author
Richard Shannon MD

Richard Shannon MD

Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania

Search for more papers by this author
Judith A. Long MD

Judith A. Long MD

Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania

Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania

Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania

Philadelphia VA Center for Health Equities Research and Promotion, Philadelphia, Pennsylvania

Search for more papers by this author
First published: 07 August 2012
Citations: 54

Abstract

BACKGROUND:

Hospital leaders have had mixed success reducing readmissions Little is known about the readmitted patient's perspective.

METHODS:

A cross-sectional 36-item survey was administered to 1084 readmitted inpatients of The Hospital of the University of Pennsylvania (an urban academic medical center) and Penn Presbyterian Medical Center (an urban community hospital) between November 10, 2010 and July 5, 2011. The survey response rate was 32.9%.

RESULTS:

The most commonly reported issues contributing to readmission were: 1) feeling unprepared for discharge (11.8%); 2) difficulty performing activities of daily living (ADLs) (10.6%); 3) trouble adhering to discharge medications (5.7%); 4) difficulty accessing discharge medications (5.0%); and 5) lack of social support (4.7%). Low-socioeconomic status (SES) (defined as uninsured or Medicaid) patients were more likely than high-SES patients to report difficulty understanding (odds ratio [OR] 2.7; 95% confidence interval [CI] 1.1, 6.6) and executing (OR 2.2; 95% CI 1.1, 4.4) discharge instructions, difficulty adhering to medications (OR 1.8; 95% CI 1.2, 3.0), lack of social support (OR 2.0; 95% CI 1.2, 3.6), lack of basic resources (OR 2.6; 95% CI 1.1, 6.1), and substance abuse (OR 6.7; 95% CI 2.3, 19.2).

CONCLUSIONS:

Patients reported transition challenges which they believe contribute to illness relapse and readmission. Interventions designed to address these challenges, and tailored for patient characteristics such as SES, may better address the root causes of readmission. Journal of Hospital Medicine 2012. © 2012 Society of Hospital Medicine