Problem:
Tracking of rehospitalizations and associated patient characteristics is a recent focus of the federal government. To date, only payers such as Medicare and private health insurers such as Aetna and United have data access to identify situations where a patient discharges from hospital A only to be readmitted to hospital B within 30, 60, 90, or 120 days.
Objectives of the Project:
The objectives of this project were the following:
1. Provide hospitals themselves with data currently available only to Medicare and private health insurers such as Aetna and United.
2. Provide the information on a timelier basis than is available to Medicare and private health insurers such as Aetna and United.
3. Explore characteristics of those patients who demonstrated more than the average frequency of readmission pattern.
Methods:
Matching of patient admission records. Matching of patient records is conducted with a software application that uses a combination of deterministic and probabilistic matching. Rules automating the process are created to manage approximately 75% of the workload.
Lag days between admissions. Number of days between a given admission and the previous admission ("preadmission lag days") and the next admission ("readmission") is computed for each patient enterprise index identification number. To avoid exposure of protected health information, these are reported in groups of 0 to 30, 31 to 60, 61 to 90, and 91 to 120 days.
Other variables of interest. Distance between patient home and admission hospital, chronic disease indicator, and death master data sources are applied to the database to enhance analysis.
Section Description
We are pleased to share the paper presentation abstracts from the Summer Institute in Nursing Informatics, Informatics at the Point of Care: A Barrier or a Bridge?, held at the University of Maryland School of Nursing, July 22 to 25, 2009. The program, chaired by Dr Judy Ozbolt, was a great success. Each of the following abstracts was selected for presentation by a peer-review committee.