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

Ank E. Nijhawan, Robin T. Higashi, Emily G. Marks, Yordanos M. Tiruneh, Simon Craddock Lee

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
JournalJournal of the International Association of Providers of AIDS Care
Volume18
DOIs
StatePublished - Jan 1 2019

Keywords

  • 30-day hospital readmission
  • HIV/AIDS
  • qualitative methods
  • safety net

ASJC Scopus subject areas

  • Immunology
  • Dermatology
  • Infectious Diseases

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