COVID-19-Related Circumstances for Hospital Readmissions: A Case Series From 2 New York City Hospitals.
COVID-19-Related Circumstances for Hospital Readmissions: A Case Series From 2 New York City Hospitals.
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DOI：
10.1097/pts.0000000000000870
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发表时间：
2021-06-01
影响因子：
2.2
通讯作者：
Shapiro MF
中科院分区：
文献类型：
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作者：
Choi JJ;Contractor JH;Shaw AL;Abdelghany Y;Frye J;Renzetti M;Smith E;Soiefer LR;Lu S;Kingery JR;Krishnan JK;Levine WJ;Safford MM;Shapiro MF
确定导致纽约市两家医院COVID-19住院后再入院的主要因素及其潜在可预防性。这是一项回顾性研究，在位于上东和曼哈顿下城的两家附属纽约市医院进行。我们使用医院医学再造网络（HOMERuN）框架进行了病例审查，以确定2020年3月3日（首例病例发生日期）至2020年4月27日期间因COVID-19住院并在出院后30天内再次入住两家医院的患者中可能可预防的再入院情况。在53例因COVID-19住院后再次入院的患者中，44例（83%）被认为是不可预防的，9例（17%）是可能预防的。不可预防的再入院主要是由于疾病进展或COVID-19并发症（37/44，84%）。导致可能可预防的再入院的主要因素是初始处置问题（5/9，56%）、提前出院（3/9，33%）和可能不需要再住院的人的不适当再入院（1/9，11%）。COVID-19住院后的大多数再入院都是不可预防的，是疾病自然进展的结果，特别是呼吸困难或低氧血症恶化。部分再入院是可以预防的，主要是由于与持续的COVID-19疫情带来的挑战直接相关的处置问题。临床医生应了解与COVID-19大流行情况相关的处置挑战。
To determine the main factors contributing to hospital readmissions and their potential preventability following a COVID-19 hospitalization at two New York City hospitals. This was a retrospective study at two affiliated New York City hospitals located in the Upper East Side and Lower Manhattan neighborhoods. We performed case reviews using the Hospital Medicine Reengineering Network (HOMERuN) framework to determine potentially-preventable readmissions among patients hospitalized for COVID-19 between March 3, 2020 (date of first case) and April 27, 2020, and readmitted to either of the two hospitals within 30 days of discharge. Among 53 readmissions following hospitalization for COVID-19, 44 (83%) were deemed not preventable and 9 (17%) were potentially-preventable. Non-preventable readmissions were mostly due to disease progression or complications of COVID-19 (37/44, 84%). Main factors contributing to potentially-preventable readmissions were issues with initial disposition (5/9, 56%), premature discharge (3/9, 33%), and inappropriate readmission (1/9, 11%) for someone who likely did not require rehospitalization. Most readmissions following a COVID-19 hospitalization were not preventable and a consequence of the natural progression of the disease, specifically worsening dyspnea or hypoxemia. Some readmissions were potentially-preventable, mostly due to issues with disposition that were directly related to challenges posed by the ongoing COVID-19 pandemic. Clinicians should be aware of challenges with disposition related to circumstances of the COVID-19 pandemic.