Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jun 14;32(7):433.
doi: 10.1007/s00520-024-08644-7.

Is it legitimate to use unplanned hospitalizations as a quality indicator for cancer patients? A retrospective French cohort study with special attention to the influence of social deprivation

Thomas Vermeulin  1   2   3 , Loetizia Froment  4 , Véronique Merle  4   5 , Brigitte Dormont  6
Affiliations

Is it legitimate to use unplanned hospitalizations as a quality indicator for cancer patients? A retrospective French cohort study with special attention to the influence of social deprivation

Thomas Vermeulin et al. Support Care Cancer. .

Abstract

Purpose: Readmission indicators are used around the world to assess the quality of hospital care. We aimed to assess the relevance of this type of indicator in oncology, especially for socially deprived patients. Our objectives were (1) to assess the proportion of unplanned hospitalizations (UHs) in cancer patients, (2) to assess the proportion of UHs that were avoidable, i.e., related to poor care quality, and (3) to analyze cancer patients the effect of patients' deprivation level on the type of UH (avoidable UHs vs. unavoidable UHs).

Methods: In a French university hospital, we selected all hospitalizations over a year for a random sample of cancer patients. Based on medical records, we identified those among UHs due to avoidable health problems. We assessed the association between social deprivation, home-to-hospital distance, or home-to-general practitioner with the type of UH (avoidable vs. unavoidable) via a multivariate binary logit estimation.

Results: Among 2349 hospitalizations (355 patients), there were 383 UHs (16 %), among which 38% were avoidable. Among UHs, the European Deprivation Index was significantly associated with the risk of avoidable UHs, with a lower risk of avoidable UH for patients with medium or high social deprivation.

Conclusion: Our results suggest that the use of UHs rate as a quality indicator is questionable in oncology. Indeed, the majority of UHs were not avoidable. Furthermore, within UHs, those involving patients with medium or high social deprivation are more often unavoidable in comparison with other patients.

Keywords: Health economics; Neoplasms; Patient readmission; Public Health; Social environment.

PubMed Disclaimer

Similar articles

See all similar articles

References

    1. Aubert CE, Schnipper JL, Williams MV et al (2017) Simplification of the Hospital score for predicting 30-day readmissions. BMJ Qual Saf 26:799–805. https://doi.org/10.1136/bmjqs-2016-006239 - DOI - PubMed
    1. Donzé JD, Williams MV, Robinson EJ et al (2016) International validity of the HOSPITAL score to predict 30-day potentially avoidable hospital readmissions. JAMA Intern Med 176:496–502. https://doi.org/10.1001/jamainternmed.2015.8462 - DOI - PubMed - PMC
    1. Donzé J, Lipsitz S, Bates DW, Schnipper JL (2013) Causes and patterns of readmissions in patients with common comorbidities: retrospective cohort study. BMJ 347:f7171. https://doi.org/10.1136/bmj.f7171 - DOI - PubMed - PMC
    1. van Walraven C, Bennett C, Jennings A et al (2011) Proportion of hospital readmissions deemed avoidable: a systematic review. CMAJ Can Med Assoc J J Assoc Medicale Can 183:E391–E402. https://doi.org/10.1503/cmaj.101860 - DOI
    1. WHO regional office for Europe, Copenhagen (2011) Diagnosis-related groups in Europe: moving towards transparency, efficiency and quality in hospitals

LinkOut - more resources