If Not Preventable Deaths, Then What About Preventable Admissions?

This is the same problem re-written. Since the great majority of readmissions are non-preventable we are stuck with signal to noise problems in database studies. And case note review is equally unreliable, with preventability rates varying from 5% to 79%.[1] But deaths have one big advantage as an outcome measure – they are a very bad thing from the perspective of the patient. A recent article on readmissions [2] finds that they do not even satisfy this criterion; patients are not greatly concerned by readmission. Let us forget readmissions as a useful measure of quality, and concentrate instead on adverse events (as a whole) and process measures.[3]

— Richard Lilford, CLAHRC WM Director


  1. van Walraven C, Bennett C, Jennings A, et al. Proportion of hospital readmissions deemed avoidable: a systematic review. CMAJ. 2011; 183: E391–402.
  2. Soong C, & Bell C. Identifying preventable readmissions: an achievable goal or waiting for Godot? BMJ Qual Saf. 2015; 24(12): 741-3.
  3. Yao G, et al. Evaluation of a predevelopment service delivery intervention: an application to improve clinical handovers. BMJ Qual Saf. 2012;21(s1):i29-i38.

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