Hospital readmission (HP) prevention is an increasingly promising subject of discussion that aims at reducing morbidity and costs in the American healthcare system. The National Quality Forum (NQF) and the Agency for Healthcare Research and Quality (AHRQ) have decided to focus on the connection between HP and the safety of patients. According to NQF and AHRQ, HP is a function of patient morbidity as well as of hospitals’ ability to safely transition from the inpatient to the post-acute care settings and vice versa. Guided by this hypothesis, Hansen et al. (2011) devoted their research to defining the relationship between the safety of patients in a hospital climate and rehospitalization rates of hospitals within 30 days after discharge.
Hansen et al. (2011) conducted a cross-sectional study of 67 hospitals and tested their hypotheses using multiple regressions. When it comes to variables, the dependent ones in selected models for specific diseases were the standardized 30-day readmission rates, and the independent ones were the safety climate measures. Multiple regression analysis is resorted to when there is a need to simulate the relationship between a response variable and multiple regressor variables. Since this is the case with this study, the selected instrument is valid and reliable.
The decision to include covariates in multivariate models was made on the basis of an assumed link to readmission or safety climate. Since the sample size was small, Hansen et al. (2011) needed to conduct a process to determine the minimum amount of appropriate controls. The process included two steps: first, all the control variables suspected to be linked were identified. Then, all these models were run individually, and the control variables relevant to each model were determined. For the three studied groupings – frontline vs. senior management, doctor vs. nurse, whole population – only the variables relevant for more than a third of the analyzed models were retained to rule out special cases.
Reference
Hansen, L. O., Williams, M. V., & Singer, S. J. (2011). Perceptions of hospital safety climate and incidence of readmission. Health Services Research, 46(2), 596-616. Web.