BMC Med Inform Decis Mak - Manual and automated methods for identifying potentially preventable readmissions: a comparison in a large healthcare system.

Tópicos

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Resumo

CKGROUND: Identification of potentially preventable readmissions is typically accomplished through manual review or automated classification. Little is known about the concordance of these methods.METHODS: We manually reviewed 459 30-day, all-cause readmissions at 18 Kaiser Permanente Northern California hospitals, determining potential preventability through a four-step manual review process that included a chart review tool, interviews with patients, their families, and treating providers, and nurse reviewer and physician evaluation of findings and determination of preventability on a five-point scale. We reassessed the same readmissions with 3 M's Potentially Preventable Readmission (PPR) software. We examined between-method agreement and the specificity and sensitivity of the PPR software using manual review as the reference.RESULTS: Automated classification and manual review respectively identified 78% (358) and 47% (227) of readmissions as potentially preventable. Overall, the methods agreed about the preventability of 56% (258) of readmissions. Using manual review as the reference, the sensitivity of PPR was 85% and specificity was 28%.CONCLUSIONS: Concordance between methods was not high enough to replace manual review with automated classification as the primary method of identifying preventable 30-day, all-cause readmission for quality improvement purposes.

Resumo Limpo

ckground identif potenti prevent readmiss typic accomplish manual review autom classif littl known concord methodsmethod manual review day allcaus readmiss kaiser permanent northern california hospit determin potenti prevent fourstep manual review process includ chart review tool interview patient famili treat provid nurs review physician evalu find determin prevent fivepoint scale reassess readmiss ms potenti prevent readmiss ppr softwar examin betweenmethod agreement specif sensit ppr softwar use manual review referenceresult autom classif manual review respect identifi readmiss potenti prevent overal method agre prevent readmiss use manual review refer sensit ppr specif conclus concord method high enough replac manual review autom classif primari method identifi prevent day allcaus readmiss qualiti improv purpos

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