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Identification of Risk Factors for Chemotherapy-Related 30-Day Readmissions

Jeremy Lund, Angela Pearson, and Georgia Keriazes

Purpose: The goal of this study was to develop a method for practitioners to evaluate both quality of care delivered to patients receiving chemotherapy and illicit risk factors for 30-day chemotherapy-related readmissions (CRR). Methods: Midas+ DataVision Readmission Tool Pack (Version 2.x) was used to retrospectively identify patients who received inpatient chemotherapy from April 2010 through May 2013. The population was screened for unscheduled admissions within 30 days after discharge. A multidisciplinary team was used to attribute readmissions to chemotherapy administration. Demographic information and oncology-specific characteristics were collected. The CRR rate and relative risk for readmission were calculated for each characteristic. Results: A baseline CRR rate of 11.1% was established. Risk factors associated with an increased risk for experiencing a CRR included age of 65 years or older, hematologic cancer diagnosis, first cycle chemotherapy, Medicare coverage, discharge to a skilled nursing facility, and anthracycline administration. Conclusions: A baseline CRR rate was established. Institution-specific 30-day CRR risk factors were elucidated. Modifiable risk factors included discharge to a skilled nursing facility and administration of an anthracycline. Further investigation for opportunities for quality improvement in these 2 risk factors is a topic for future research. Expanded research into chemotherapy-related toxicities requiring inpatient admission/readmission outside of clinical trials is warranted.