TY - JOUR
T1 - Patient and Provider Perspectives on 30-Day Readmissions, Preventability, and Strategies for Improving Transitions of Care for Patients with HIV at a Safety Net Hospital
AU - Nijhawan, Ank E.
AU - Higashi, Robin T.
AU - Marks, Emily G.
AU - Tiruneh, Yordanos M.
AU - Lee, Simon Craddock
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by National Institutes of Health (NIH) (1K23AI112477; Nijha-wan); Agency for Healthcare Research and Quality (AHRQ) (R24 HS022418 to the UT Southwestern Medical Center, Center for Patient-Centered Outcomes Research); NIH/NIDA (T32DA013911; Tiruneh); NIH (P30AI042853 to the Providence/Boston Center for AIDS Research; Tiruneh); and NIH/NIMH (R25MH083620; Tiruneh).
Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by National Institutes of Health (NIH) (1K23AI112477; Nijhawan); Agency for Healthcare Research and Quality (AHRQ) (R24 HS022418 to the UT Southwestern Medical Center, Center for Patient-Centered Outcomes Research); NIH/NIDA (T32DA013911; Tiruneh); NIH (P30AI042853 to the Providence/Boston Center for AIDS Research; Tiruneh); and NIH/NIMH (R25MH083620; Tiruneh).
Publisher Copyright:
© The Author(s) 2019.
PY - 2019/2/13
Y1 - 2019/2/13
N2 - Thirty-day hospital readmissions, a key quality metric, are common among people living with HIV. We assessed perceived causes of 30-day readmissions, factors associated with preventability, and strategies to reduce preventable readmissions and improve continuity of care for HIV-positive individuals. Patient, provider, and staff perspectives toward 30-day readmissions were evaluated in semistructured interviews (n = 86) conducted in triads (HIV-positive patient, medical provider, and case manager) recruited from an inpatient safety net hospital. Iterative analysis included both deductive and inductive themes. Key findings include the following: (1) The 30-day metric should be adjusted for safety net institutions and patients with AIDS; (2) Participants disagreed about preventability, especially regarding patient-level factors; (3) Various stakeholders proposed readmission reduction strategies that spanned the inpatient to outpatient care continuum. Based on these diverse perspectives, we outline multiple interventions, from teach-back patient education to postdischarge home visits, which could substantially decrease hospital readmissions in this underserved population.
AB - Thirty-day hospital readmissions, a key quality metric, are common among people living with HIV. We assessed perceived causes of 30-day readmissions, factors associated with preventability, and strategies to reduce preventable readmissions and improve continuity of care for HIV-positive individuals. Patient, provider, and staff perspectives toward 30-day readmissions were evaluated in semistructured interviews (n = 86) conducted in triads (HIV-positive patient, medical provider, and case manager) recruited from an inpatient safety net hospital. Iterative analysis included both deductive and inductive themes. Key findings include the following: (1) The 30-day metric should be adjusted for safety net institutions and patients with AIDS; (2) Participants disagreed about preventability, especially regarding patient-level factors; (3) Various stakeholders proposed readmission reduction strategies that spanned the inpatient to outpatient care continuum. Based on these diverse perspectives, we outline multiple interventions, from teach-back patient education to postdischarge home visits, which could substantially decrease hospital readmissions in this underserved population.
KW - 30-day hospital readmission
KW - HIV/AIDS
KW - qualitative methods
KW - safety net
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U2 - 10.1177/2325958219827615
DO - 10.1177/2325958219827615
M3 - Article
C2 - 30760091
AN - SCOPUS:85061595313
SN - 2325-9574
VL - 18
JO - Journal of the International Association of Providers of AIDS Care
JF - Journal of the International Association of Providers of AIDS Care
ER -