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. 2020 Jul 23;37(3):390-394.
doi: 10.1093/fampra/cmz086.

Validity of a tool designed to assess the preventability of potentially preventable hospitalizations for chronic conditions

Jennifer J Johnston  1 , Jo M Longman  1 , Dan P Ewald  1   2 , Margaret I Rolfe  1 , Sergio Diez Alvarez  3 , Adrian H B Gilliland  4 , Steven C Chung  5 , Sumon K Das  1   6 , Jonathan M King  1   7 , Megan E Passey  1
Affiliations

Validity of a tool designed to assess the preventability of potentially preventable hospitalizations for chronic conditions

Jennifer J Johnston et al. Fam Pract. .

Abstract

Background: Potentially preventable hospitalizations (PPH) are defined as unplanned hospital admissions which could potentially have been prevented with the provision of effective, timely outpatient care. To better understand and ultimately reduce rates of PPH, a means of identifying those which are actually preventable is required. The Preventability Assessment Tool (PAT) was designed for use by hospital clinicians to assess the preventability of unplanned admissions for chronic conditions.

Objective: The present study examined the ability of the PAT to distinguish between those unplanned admissions which are preventable and those which are not, compared to the assessments of an Expert Panel.

Methods: Data were collected between November 2014 and June 2017 at three hospitals in NSW, Australia. Participants were community-dwelling patients with unplanned hospital admissions for congestive heart failure, chronic obstructive pulmonary disease, diabetes complications or angina pectoris. A nurse and a doctor caring for the patient made assessments of the preventability of the admission using the PAT. Expert Panels made assessments of the preventability of each admission based on a comprehensive case report and consensus process.

Results: There was little concordance between the hospital doctors and nurses regarding the preventability of admissions, nor between the assessments of the Expert Panel and the hospital nurse or the Expert Panel and the hospital doctor.

Conclusions: The PAT demonstrated poor concurrent validity and is not a valid tool for assessing the preventability of unplanned hospital admissions. The use of Expert Panels provides a more rigorous approach to assessing the preventability of such admissions.

Keywords: ambulatory care; chronic disease; consensus; data collection; health personnel; hospitalization.

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References

    1. Kocher KE, Dimick JB, Nallamothu BK. Changes in the source of unscheduled hospitalizations in the United States. Med Care 2013; 51: 689–98. - PubMed
    1. National Audit Office. Emergency Admission to Hospital: Managing the Demand 2013 https://www.nao.org.uk/wp-content/uploads/2013/10/10288-001-Emergency-ad... (accessed 24 January 2017).
    1. Busby J, Purdy S, Hollingworth W. A systematic review of the magnitude and cause of geographic variation in unplanned hospital admission rates and length of stay for ambulatory care sensitive conditions. BMC Health Serv Res 2015; 15: 324. - PMC - PubMed
    1. Billings J, Zeitel L, Lukomnik J, Carey TS, Blank AE, Newman L. Impact of socioeconomic status on hospital use in New York City. Health Aff (Millwood) 1993; 12: 162–73. - PubMed
    1. Muenchberger H, Kendall E. Predictors of preventable hospitalization in chronic disease: priorities for change. J Public Health Policy 2010; 31: 150–63. - PubMed

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