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BMC Med Inform Decis Mak. 2014 Apr 5;14:28. doi: 10.1186/1472-6947-14-28.

Manual and automated methods for identifying potentially preventable readmissions: a comparison in a large healthcare system.

Author information

1
Care Management Institute, Kaiser Permanente, Oakland, California, USA. ana.h.jackson@kp.org.

Abstract

BACKGROUND:

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.

PMID:
24708889
PMCID:
PMC3984394
DOI:
10.1186/1472-6947-14-28
[Indexed for MEDLINE]
Free PMC Article

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