title: Perceptions of readmitted patients on the transition from hospital to home.
abstract: BACKGROUND
  Hospital leaders have had mixed success reducing readmissions Little is known about the readmitted patient's perspective.
  
  
  METHODS
  A cross-sectional 36-item survey was administered to 1084 readmitted inpatients of The Hospital of the University of Pennsylvania (an urban academic medical center) and Penn Presbyterian Medical Center (an urban community hospital) between November 10, 2010 and July 5, 2011. The survey response rate was 32.9%.
  
  
  RESULTS
  The most commonly reported issues contributing to readmission were: 1) feeling unprepared for discharge (11.8%); 2) difficulty performing activities of daily living (ADLs) (10.6%); 3) trouble adhering to discharge medications (5.7%); 4) difficulty accessing discharge medications (5.0%); and 5) lack of social support (4.7%). Low-socioeconomic status (SES) (defined as uninsured or Medicaid) patients were more likely than high-SES patients to report difficulty understanding (odds ratio [OR] 2.7; 95% confidence interval [CI] 1.1, 6.6) and executing (OR 2.2; 95% CI 1.1, 4.4) discharge instructions, difficulty adhering to medications (OR 1.8; 95% CI 1.2, 3.0), lack of social support (OR 2.0; 95% CI 1.2, 3.6), lack of basic resources (OR 2.6; 95% CI 1.1, 6.1), and substance abuse (OR 6.7; 95% CI 2.3, 19.2).
  
  
  CONCLUSIONS
  Patients reported transition challenges which they believe contribute to illness relapse and readmission. Interventions designed to address these challenges, and tailored for patient characteristics such as SES, may better address the root causes of readmission.
authors.affiliation: Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA. kangovi@mail.med.upenn.edu
authors.forename: Shreya
authors.initials: S
authors.lastname: Kangovi
authors.forename: David
authors.initials: D
authors.lastname: Grande
authors.forename: Patricia
authors.initials: P
authors.lastname: Meehan
authors.forename: Nandita
authors.initials: N
authors.lastname: Mitra
authors.forename: Richard
authors.initials: R
authors.lastname: Shannon
authors.forename: Judith A
authors.initials: JA
authors.lastname: Long
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data; D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D003266:Continuity of Patient Care / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010351:Patient Discharge; D010359:Patient Readmission / Q000706:statistics & numerical data*; D010414:Pennsylvania; D010465:Perception; D012307:Risk Factors; D012944:Social Support; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires