Editor - We read with interest the study by Glynn et al (Clin Med April 2011 pp 114–8) describing long-term trends in emergency medical readmissions and the impact on mortality. There is much interest in emergency readmissions at present and a view that many readmissions are preventable.
In 2002–03, we undertook an audit of 28-day emergency readmissions from 14 general medical (including care of the elderly) wards in our 800-bedded acute trust serving a predominantly deprived population. As part of that audit, we solicited patients' views on their emergency readmission. There were 642 emergency readmissions in 4,801 medical discharges (13%) over a seven-month period, of 606 for whom notes were available, 202 (33%) had died by the time we undertook the survey and 15 had moved district. We wrote to the remaining 389, and 119 (31%) responded.
Interestingly, 85% of patients said that their readmission was for the same problem as the index admission (25% heart, 24% chest, 33% unsure of condition, other conditions all <5%). With hindsight, 40% of patients felt that they were not ready for discharge after their index admission, 45% felt that the readmission might have been prevented with better care or a longer index admission, 40% of patients felt an early follow-up outpatient appointment would have prevented readmission, 28% felt readmission could have been prevented by better post-discharge support from the primary care team and 20% felt social service input after discharge could have prevented readmission.
Listening to our patients may also help prevent emergency readmissions.