Readmission of Palliative Patients at Karunruk Palliative Care Center, Srinagarind Hospital

Abstract

Background and objective: Unplanned hospital readmissions provide a huge impact on palliative care patients and their families. Causes and problematics analysis were not performed before, thus the authors are interested to study in these aspects and use the results from this research to improve quality of care in palliative population.

Methods: A retrospective study of unplanned readmission of palliative patients was performed at Srinagarind hospital, Thailand. The data of 39 patients were collected from 1 October 2017 to 31 September 2018.

Results: This study includes 63 readmissions from 39 patients.  Causes of readmission were divided into 3 groups. The first group was patient physical problems, that include recurrent pain problem 45.23%, new aspiration pneumonia 13.80% and emergency condition such as spinal cord completion and superior vena cava obstruction 3.45%. The second group was family problems, that include over expectation from treatment 10.26% and caregiver burdens 5.23%. The third group was at advance care planning (ACP) problems, that include full treatment ACP 43.59% and undecided ACP 7.69%.

Conclusion: Causes of readmission are patients’ physical, family and ACP problems. Some problems are appropriate to readmission for treatment. On the other hand, a large number of readmission can be reduced by good palliative home care service and a better communication.