Home parenteral nutrition and 30-day hospital readmission: A descriptive study.

PURPOSE: Hospital readmissions are a measure of the quality of postdischarge outpatient care. A review of the research literature revealed a lack of published multicenter studies evaluating hospital readmission rates and the timing of readmission events within the first 30 days after discharge among patients receiving home parenteral nutrition (HPN). Thus, the objective of this research was to evaluate hospital readmissions in patients newly discharged on HPN and to determine the 30-day hospital readmission rate, the mean number of days to hospital readmission, the day of the week of hospital discharge on HPN for readmissions, and the cause of readmission.

METHODS: This descriptive and retrospective multicenter study used 30-day hospital readmission data that were submitted to the National Home Infusion Foundation's benchmarking program by home infusion providers.

RESULTS: Data were collected on 1,692 patients on HPN from 21 home infusion provider locations. The 30-day readmission rate was 36.8% (n = 623). When the days to hospital readmission were categorized into 2 groups, 0-14 and 15-30 days, 66.7% of readmitted patients were in the first of these categories. Reasons for readmission included vascular access device infection (57.8%), insufficient response to HPN (28.4%), and vascular access device-related events other than infection (9.5%).

CONCLUSION: This study demonstrated that HPN-related hospital readmissions are more likely to occur in the first 14 days at home. Earlier readmissions highlight the importance of the transition care process, specifically addressing readiness for discharge home, and closer monitoring and follow-up by the home infusion team. Understanding the risk timeframe for readmission will help providers assess their current follow-up practices.