A method for determining an emergency readmission time window for better patient management

Abstract

This paper introduces a modelling approach to determining the appropriate width of a time window within which an admission is classified as a readmission. The approach is based on an intuitive idea that patients, who are discharged from hospital, can be broadly considered as consisting of two groups - a group that is at high risk of readmission and a group that is at low risk. Using national data from the London area (UK), we demonstrate its usefulness in the case of chronic obstructive pulmonary diseases (COPD), one of the leading causes of early readmission. Although marked regional differences exist for the optimal width of the time window for COPD patients, our findings are largely inline with figures used by the government, hence provide some support for the use of 28 days as the time window for defining COPD readmissions. The novelty of this modelling approach lies in its ability to estimate an appropriate time window based on evidence objectively derived from operational data. Therefore, it can provide a means of monitoring performance for hospitals, and can potentially contribute to the better management of patient care