Identifying adverse events after discharge from a community hospital

Background: Adverse events that occur after discharge from the hospital have recently become a major public health concern. The only two existing studies that identified postdischarge adverse events have been limited to urban populations with no research efforts in rural populations. We present preliminary results, from a recently funded R01 AHRQ grant, on the frequency of potential postdischarge adverse events in rural patients and compare results with urban patients.

Methods: Adverse events (medications, diagnostic errors, nosocomial infections) are defined as injuries occurring as a result of medical management. Patients were recruited prospectively from a hospitalist service prior to discharge from a community hospital. Potential postdischarge adverse events were determined by performing a medical record review and a structured telephone interview approximately 3-weeks postdischarge. We provide frequencies and odds ratio with 95% confidence intervals to estimate the likelihood of rural patients experiencing a potential postdischarge adverse event when compared to urban patients.

Results: Reviews were completed for 68 patients, 35 (51.4%) rural and 33 (48.6%) urban. Forty-seven (69.1%) of 68 patients were flagged for a potential postdischarge adverse event, 26 (55.3%) rural and 21 (44.7%) urban. The odds ratio was 1.65 (95% confidence interval CI: 0.52-5.35) for rural patients experiencing a potential postdischarge adverse event when compared to urban patients.

Conclusion: Preliminary results indicate no difference in the frequency of potential postdischarge adverse events when comparing 68 rural and urban patients. However, we expect to reach a sample goal of 590 (295 rural and 295 urban) patients by June 2012.