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Master Thesis

Réadmissions à 30 jours par le service des urgences : fréquence, pertinence et déterminants de la prise en charge à l'aide de deux grilles d'évaluation

Abstract : INTRODUCTION: The aim of this study was to assess which information can prevent or promote early readmissions within thirty days of a previous hospital discharge. The secondary objective was to describe the causes of these readmissions. METHOD: This retrospective single-centered study reviewed the discharge summaries and the admission files of all inpatients readmitted through the emergency ward in January 2013 in Grenoble teaching hospital. The appropriateness of each admission was evaluated with the Appropriateness evaluation protocol (AEP) and its avoidability was rated using a classification of admission for a previously known affection derived from Halfon et al. RESULTS: Of the 4169 emergency admissions, 112 patients had been discharged during the previous thirty days. 30% were inappropriate and 20% were avoidable. The quality of the discharge summary and a history of hypertension was significantly linked to the appropriateness of early revisits. DISCUSSION: the rate of avoidable readmissions was similar to the predicted value from the largest meta-analysis to-date. The importance of the discharge summary has been reported in the literature. Previous studies found cancer, congestive heart failure and renal failure independently linked to avoidable readmissions. CONCLUSION: this study stresses the impact of the discharge summary in the communication between hospital and primary care. It also points out that although, the quality of the summaries has improved over the years in Grenoble teaching hospital, some improvements are still to be achieved.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-00983004
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Submitted on : Thursday, April 24, 2014 - 4:06:37 PM
Last modification on : Tuesday, May 11, 2021 - 11:36:17 AM
Long-term archiving on: : Thursday, July 24, 2014 - 11:35:55 AM

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  • HAL Id : dumas-00983004, version 1

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Benoit Besse. Réadmissions à 30 jours par le service des urgences : fréquence, pertinence et déterminants de la prise en charge à l'aide de deux grilles d'évaluation. Médecine humaine et pathologie. 2014. ⟨dumas-00983004⟩

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