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COVID-19–Related Circumstances for Hospital Readmissions: A Case Series From 2 New York City Hospitals

2021; Lippincott Williams & Wilkins; Volume: 17; Issue: 4 Linguagem: Inglês

10.1097/pts.0000000000000870

1549-8425

Justin J. Choi, Jigar H. Contractor, Amy Shaw, Youmna Abdelghany, Jesse Frye, Madelyn Renzetti, Emily Smith, Leland Soiefer, Shuting Lu, Justin R. Kingery, Jamuna K. Krishnan, William J. Levine, Monika M. Safford, Martin F. Shapiro,

Geriatric Care and Nursing Homes

Objective The aim of the study was to determine the main factors contributing to hospital readmissions and their potential preventability after a coronavirus disease 2019 (COVID-19) hospitalization at 2 New York City hospitals. Methods This was a retrospective study at 2 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 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 2 hospitals within 30 days of discharge. Results Among 53 readmissions after hospitalization for COVID-19, 44 (83%) were deemed not preventable and 9 (17%) were potentially preventable. Nonpreventable 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. Conclusions Most readmissions after 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 because of 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.