title: [Preventable readmissions of "community-acquired pneumonia": Usefulness and reliability of an indicator of the quality of care of patients' care pathways].
abstract: Unlike Anglo-Saxon countries, the rate of preventable readmissions is not a national quality indicator in France. In the context of the European research project Performance Assessment Tool for quality improvement in Hospitals (PATH), this pilot study provides a tool for health professionals to more easily identify preventable readmissions in order to analyze their causes. The objective of this work was to show the reliability of this tool.
  
  
  METHODS
  We compared the rate of preventable readmissions occurring within 30 days, for a given disease, collected by analyzing medical reports (the gold standard rate of this study) to the rates of preventable readmissions occurring within 30 days, measured from algorithms using data from the French Programme of Medicalization of Information Systems (PMSI). The data were derived from PMSI data of the Lariboisiere-Fernand-Widal Hospital, a university hospital in Paris.
  
  
  RESULTS
  The community-acquired pneumonia gold standard rate of preventable readmissions occurring within 30 days was 6.3 %. Five algorithmic tools were used and measured rates between 2.9 % and 7.9 %. The positive likelihood ratios of these tools range from 8 to 308.
  
  
  CONCLUSIONS
  This work presents a tool aimed at the health professionals that takes into account the diversity and complexity of the causes of avoidable readmissions, resulting from the quality of medical practice, the variability of the organization of hospital pathways and the links with ambulatory care.
authors.affiliation: CHU de Nantes, hôpital Saint-Jacques, pôle d'information médicale, d'évaluation et de santé publique, Nantes, France. c.dely@ch-bretagne-sud.fr
authors.forename: Claire
authors.initials: C
authors.lastname: Dely
authors.forename: Pierre
authors.initials: P
authors.lastname: Sellier
authors.forename: Adrien
authors.initials: A
authors.lastname: Dozol
authors.forename: Christophe
authors.initials: C
authors.lastname: Segouin
authors.forename: Leila
authors.initials: L
authors.lastname: Moret
authors.forename: Pierre
authors.initials: P
authors.lastname: Lombrail
mesh_terms: D000368:Aged; D000465:Algorithms; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000628:therapy / Q000635:transmission; D003266:Continuity of Patient Care / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D005544:Forecasting; D005602:France; D006785:Hospitals, University; D006801:Humans; D008297:Male; D010297:Paris; D010359:Patient Readmission / Q000706:statistics & numerical data*; D010865:Pilot Projects; D011014:Pneumonia / Q000453:epidemiology / Q000517:prevention & control* / Q000628:therapy; D011237:Predictive Value of Tests; D019984:Quality Indicators, Health Care / Q000592:standards / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000706:statistics & numerical data; D015203:Reproducibility of Results