Unplanned early hospital readmission among critical care survivors: a mixed methods study of patients and carers.

摘要: Background Many intensive care (ICU) survivors experience early unplanned hospital readmission, but the reasons and potential prevention strategies are poorly understood. We aimed to understand contributors readmissions from patient/carer perspective. Methods This is a mixed methods study with qualitative data taking precedence. Fifty-eight ICU carers who experienced rehospitalisation were interviewed. Thematic analysis was used identify factors contributing readmissions, supplemented questionnaire measuring patient comorbidity carer strain, importance rating scales for that contribute in other groups. Data integrated iteratively patterns, which discussed five focus groups different patients/carers also readmissions. Major patterns contexts occurred described. Results Interviews suggested 10 themes comprising patient-level system-level issues. Integration data, pattern exploration discussion at two major readmission contexts. A ‘complex health psychosocial needs’ context patients multimorbidity polypharmacy, frequently had significant psychological problems, mobility issues, problems specialist aids/equipment fragile social support. These typically described inadequate preparation discharge, poor communication between secondary/primary care, support medications goal setting. complex multidimensional situation contrasted markedly alternative ‘medically unavoidable’ context. In these medical issues/complications primarily resulted issues absent or not considered important. Conclusions Although some medically unavoidable, many concurrently rehospitalisation. Care pathways anticipate institute anticipatory multifaceted merit further development evaluation.