Evidence map›Paper›PMID 29710243›Full record

ArticleAnnals of internal medicine2018

Preventability of Early Versus Late Hospital Readmissions in a National Cohort of General Medicine Patients.

Kelly L Graham, Andrew D Auerbach, Jeffrey L Schnipper, Scott A Flanders, Christopher S Kim, Edmondo J Robinson, Gregory W Ruhnke, Larissa R Thomas, Sunil Kripalani, Eduard E Vasilevskis and 9 more

Erratum issuedOpen access · greenAbstract readMulticenter Study
In one paragraph

Article in Annals of internal medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 64 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
64citing papers in PubMed, 2 pooled it
12.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

64 citing papers in PubMed, 2 syntheses or guidelines pooled it, 132 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
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  4. PMEnvironmental health perspectives · 2026
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4 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors at 14 institutions in 1 country.

Kelly L GrahamBeth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts (K.L.G., R.B.D., J.Y., E.R.M., S.J.H.).
Andrew D AuerbachUniversity of California, San Francisco, San Francisco, California (A.D.A.).
Jeffrey L SchnipperHarvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts (J.L.S.).
Scott A FlandersUniversity of Michigan Medical School, Ann Arbor, Michigan (S.A.F.).
Christopher S KimUniversity of Washington, Seattle, Washington (C.S.K.).
Edmondo J RobinsonValue Institute, Christiana Care Health System, Wilmington, Delaware (E.J.R.).
Gregory W RuhnkeUniversity of Chicago, Chicago, Illinois (G.W.R.).
Larissa R ThomasUniversity of California, San Francisco, at Zuckerberg San Francisco General Hospital, San Francisco, California (L.R.T.).
Sunil KripalaniCenter for Clinical Quality and Implementation Research, Vanderbilt University Medical Center, Nashville, Tennessee (S.K.).
Eduard E VasilevskisCenter for Quality Aging at Vanderbilt University Medical Center and VA Tennessee Valley Healthcare System Geriatric Research Education and Clinical Center, Nashville, Tennessee (E.E.V.).
Grant S FletcherHarborview Medical Center, University of Washington, Seattle, Washington (G.S.F.).
Neil J SehgalUniversity of Maryland School of Public Health, College Park, Maryland (N.J.S.).
Peter K LindenauerInstitute for Healthcare Delivery and Population Science, University of Massachusetts Medical School-Baystate, Springfield, Massachusetts (P.K.L.).
Mark V WilliamsCenter for Health Services Research, University of Kentucky, Lexington, Kentucky (M.V.W.).
Joshua P MetlayMassachusetts General Hospital, Boston, Massachusetts (J.P.M.).
Roger B DavisBeth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts (K.L.G., R.B.D., J.Y., E.R.M., S.J.H.).
Julius YangBeth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts (K.L.G., R.B.D., J.Y., E.R.M., S.J.H.).
Edward R MarcantonioBeth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts (K.L.G., R.B.D., J.Y., E.R.M., S.J.H.).
Shoshana J HerzigBeth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts (K.L.G., R.B.D., J.Y., E.R.M., S.J.H.).
Beth Israel Deaconess Medical Center · USHarvard University · USUniversity of California, San Francisco · USBaystate Health · USChristiana Care Health System · USGeriatric Research Education and Clinical Center · USHarborview Medical Center · USMassachusetts General Hospital · USUniversity of Chicago · USUniversity of Kentucky · USUniversity of Maryland, College Park · USUniversity of Michigan–Ann Arbor · USUniversity of Washington · USVanderbilt University Medical Center · US

Funding

Harvard Clinical and Translational Science CenterUL1TR001102 · NCATS · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2013 to 2017
$106.2M
The Vanderbilt Institute for Clinical and Translational Research (VICTR)UL1TR000445 · NCATS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI BERNARD, GORDON RAPHAEL · 2012 to 2016
$41.4M
READI-SET-GO: Researching Efficient Approaches to Delirium Identification - Sustaining Effective Translation to create Gero-friendly OrganizationsR01AG030618 · NIA · PENNSYLVANIA STATE UNIVERSITY, THE · PI DONNA Marie FICK, EDWARD R MARCANTONIO · 2008 to 2026
$7.9M
UC Berkeley-UCSF Health Services Research Training ProgramT32HS022241 · AHRQ · UNIVERSITY OF CALIFORNIA BERKELEY · PI RODRIGUEZ, HECTOR P. · 2013 to 2024
$3.2M
Mid-Career Mentoring Award for Patient-Oriented Research in AgingK24AG035075 · NIA · BETH ISRAEL DEACONESS MEDICAL CENTER · PI MARCANTONIO, EDWARD R · 2010 to 2021
$1.9M
Improving Use of Sedating Medications in Hospitalized Older AdultsK23AG042459 · NIA · BETH ISRAEL DEACONESS MEDICAL CENTER · PI HERZIG, SHOSHANA J · 2013 to 2017
$783k
Predicting Acute Brain Dysfunction in Older Patients: A Quality Improvement ToolK23AG040157 · NIA · VANDERBILT UNIVERSITY MEDICAL CENTER · PI VASILEVSKIS, EDUARD E · 2011 to 2015
$609k
AHRQ HHS T32 HS022241NCATS NIH HHS UL1 TR000445NCATS NIH HHS UL1 TR001102NIA NIH HHS K23 AG040157NIA NIH HHS K23 AG042459NIA NIH HHS K24 AG035075NIA NIH HHS R01 AG030618
6 · The paper itself

Abstract

Background: Many experts believe that hospitals with more frequent readmissions provide lower-quality care, but little is known about how the preventability of readmissions might change over the postdischarge time frame. Objective: To determine whether readmissions within 7 days of discharge differ from those between 8 and 30 days after discharge with respect to preventability. Design: Prospective cohort study. Setting: 10 academic medical centers in the United States. Patients: 822 adults readmitted to a general medicine service. Measurements: For each readmission, 2 site-specific physician adjudicators used a structured survey instrument to determine whether it was preventable and measured other characteristics. Results: Overall, 36.2% of early readmissions versus 23.0% of late readmissions were preventable (median risk difference, 13.0 percentage points [interquartile range, 5.5 to 26.4 percentage points]). Hospitals were identified as better locations for preventing early readmissions (47.2% vs. 25.5%; median risk difference, 22.8 percentage points [interquartile range, 17.9 to 31.8 percentage points]), whereas outpatient clinics (15.2% vs. 6.6%; median risk difference, 10.0 percentage points [interquartile range, 4.6 to 12.2 percentage points]) and home (19.4% vs. 14.0%; median risk difference, 5.6 percentage points [interquartile range, -6.1 to 17.1 percentage points]) were better for preventing late readmissions. Limitation: Physician adjudicators were not blinded to readmission timing, community hospitals were not included in the study, and readmissions to nonstudy hospitals were not included in the results. Conclusion: Early readmissions were more likely to be preventable and amenable to hospital-based interventions. Late readmissions were less likely to be preventable and were more amenable to ambulatory and home-based interventions. Primary Funding Source: Association of American Medical Colleges.

Indexed as

Academic Medical CentersAdultAgedFemaleHumansMaleMedicareMiddle AgedPatient Protection and Affordable Care ActPatient ReadmissionProspective StudiesQuality Assurance, Health CareRisk FactorsTime FactorsUnited States

Identifiers

PMID29710243
PMCPMC6247894
OpenAlexW2799444738

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.