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21.01.2019:  REDUCING READMISSION IN CANCER

Hospitalizations and readmissions increase the cost to healthcare significantly. It is estimated, that the annual cost of 30 day hospital readmissions in the United States is 16 billion dollars.
Based on some reports (K.K. Ward) Cancer site, Medicare severity diagnosis-related group (MS-DRG), admission status, length of stay and payer’s status are risk factors and significantly associated with readmission in patients with gynecological cancer.
The overall readmission rate for gynecologic cancer patients was 4.5% with vulvar cancer the commonest. The higher the risk factor the commonest risk of readmissions.
Regarding gastrointestinal cancer, most of readmissions are preventable, based on one study (J.G.M. Manzano). From 30.199 patients with G.I. cancers aged >66years, the unplanned hospitalization was 58%. Among them 77% occurred within the first year of the cancer diagnosis.
The most common causes of readmissions are volume depletion, congestive heart failure, pneumonia, urinary tract infection and septicemia. The overall survival of these patients was poorer. 
The commonest sites of G.I. cancers for readmission were esophageal cancer, gastric cancer, pancreatic cancer and rectal cancer.
Readmissions were more common in non-teaching hospitals than in teaching hospitals (11.2% vs 8.6%).
Digital medical support to cancer patients following discharge from the hospital may offer help and optimism about elimination of some unnecessary readmissions.
According to another study (Dr Montero) suggested interventions to decrease readmission of cancer patients included: a)education of healthcare providers, b)nurses to educate patients by calling them within 48hours of discharge, c)scheduling a follow-up appointment with patients within 5days of discharge.