NCT02833259

Brief Summary

From 10% to 30% of patients hospitalized with community-acquired pneumonia (CAP) are readmitted within 30 days of discharge. These readmissions have negative consequences for the patients and the hospitals where they are treated, including impaired quality of life, exposure to hospital-related adverse events, and increased resource utilization. Risk-adjusted readmission rates can be easily computed and tracked from computerized hospital discharge data, using validated models. As part of the Hospital Readmission Reduction Program (HRRP) effective in fiscal year 2013, United States hospitals with higher than expected 30-day readmission rates after pneumonia hospitalization have been subject to financial penalties from the Center for Medicare and Medicaid Services (CMS). The underlying logic of the HRRP is based upon the notion that short-term readmission is often a preventable adverse outcome, reflecting suboptimal quality of care during index hospitalization. Yet, published evidence suggests that less than one in four all-cause readmissions are deemed avoidable. Because only avoidable readmissions can be influenced by interventions designed to decrease readmission rates, avoidable readmission is a more relevant metric than all-cause readmission for tracking quality of hospital care for pneumonia. The purpose of this study is to develop an administrative data-based risk prediction model for identifying potentially avoidable readmissions within 30 days of discharge for patients hospitalized with CAP. R3P is a retrospective observational cohort study of consecutive adult patients discharged from two hospitals with a diagnosis code of CAP. Data sources include routinely collected hospital discharge data and retrospective chart reviews.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
1,150

participants targeted

Target at P75+ for all trials

Timeline
Completed

Started May 2017

Longer than P75 for all trials

Geographic Reach
1 country

2 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

July 11, 2016

Completed
3 days until next milestone

First Posted

Study publicly available on registry

July 14, 2016

Completed
10 months until next milestone

Study Start

First participant enrolled

May 10, 2017

Completed
4.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 1, 2021

Completed
4 months until next milestone

Study Completion

Last participant's last visit for all outcomes

January 1, 2022

Completed
Last Updated

June 1, 2022

Status Verified

May 1, 2022

Enrollment Period

4.3 years

First QC Date

July 11, 2016

Last Update Submit

May 31, 2022

Conditions

Community-acquired Pneumonia

Keywords

PneumoniaPatient readmissionCommunity-acquired infectionsObservational studyQuality of health careModels, Statistical

Outcome Measures

Primary Outcomes (1)

  • Potentially avoidable readmission

    30 days

Secondary Outcomes (5)

  • All-cause readmission

    30 days

  • All-cause readmission

    1 year

  • All-cause mortality

    1 year

  • Composite of all-cause mortality and readmission

    30 days

  • Intensive care unit admission

    30 days

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodProbability Sample
Study Population

The study population comprises consecutive adult patient hospital discharges from two hospitals with an ICD-10 diagnosis code of pneumonia. If a patient is admitted more than once during the study period, only the first hospitalization will be included as the index admission.

You may qualify if:

  • Adult patient hospital discharges with:
  • a primary ICD-10 diagnosis code of pneumonia
  • or a secondary diagnosis code of pneumonia with a primary diagnosis code of respiratory failure or sepsis.

You may not qualify if:

  • Patient admitted from another acute care facility
  • Patient transferred to another acute care facility
  • Patient admitted in day care unit

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

Grenoble University Hospital CS10217 Grenoble Cedex 9

Grenoble, 38043, France

Location

Centre Hospitalier Annecy Genevois,1 avenue de l'hôpital, Epagny Metz-Tessy,BP 90074

Pringy, 74374, France

Location

Related Publications (7)

  • Halfon P, Eggli Y, van Melle G, Chevalier J, Wasserfallen JB, Burnand B. Measuring potentially avoidable hospital readmissions. J Clin Epidemiol. 2002 Jun;55(6):573-87. doi: 10.1016/s0895-4356(01)00521-2.

    PMID: 12063099BACKGROUND

  • Jasti H, Mortensen EM, Obrosky DS, Kapoor WN, Fine MJ. Causes and risk factors for rehospitalization of patients hospitalized with community-acquired pneumonia. Clin Infect Dis. 2008 Feb 15;46(4):550-6. doi: 10.1086/526526.

    PMID: 18194099BACKGROUND

  • Skull SA, Andrews RM, Byrnes GB, Campbell DA, Nolan TM, Brown GV, Kelly HA. ICD-10 codes are a valid tool for identification of pneumonia in hospitalized patients aged > or = 65 years. Epidemiol Infect. 2008 Feb;136(2):232-40. doi: 10.1017/S0950268807008564. Epub 2007 Apr 20.

    PMID: 17445319BACKGROUND

  • van Walraven C, Bennett C, Jennings A, Austin PC, Forster AJ. Proportion of hospital readmissions deemed avoidable: a systematic review. CMAJ. 2011 Apr 19;183(7):E391-402. doi: 10.1503/cmaj.101860. Epub 2011 Mar 28.

    PMID: 21444623BACKGROUND

  • van Walraven C, Jennings A, Taljaard M, Dhalla I, English S, Mulpuru S, Blecker S, Forster AJ. Incidence of potentially avoidable urgent readmissions and their relation to all-cause urgent readmissions. CMAJ. 2011 Oct 4;183(14):E1067-72. doi: 10.1503/cmaj.110400. Epub 2011 Aug 22.

    PMID: 21859870BACKGROUND

  • Lindenauer PK, Normand SL, Drye EE, Lin Z, Goodrich K, Desai MM, Bratzler DW, O'Donnell WJ, Metersky ML, Krumholz HM. Development, validation, and results of a measure of 30-day readmission following hospitalization for pneumonia. J Hosp Med. 2011 Mar;6(3):142-50. doi: 10.1002/jhm.890. Epub 2011 Jan 5.

    PMID: 21387551BACKGROUND

  • Mounayar AL, Francois P, Pavese P, Sellier E, Gaillat J, Camara B, Degano B, Maillet M, Bouisse M, Courtois X, Labarere J, Seigneurin A. Development of a risk prediction model of potentially avoidable readmission for patients hospitalised with community-acquired pneumonia: study protocol and population. BMJ Open. 2020 Nov 11;10(11):e040573. doi: 10.1136/bmjopen-2020-040573.

    PMID: 33177142DERIVED

MeSH Terms

Conditions

Community-Acquired PneumoniaPneumoniaCommunity-Acquired Infections

Condition Hierarchy (Ancestors)

InfectionsRespiratory Tract InfectionsRespiratory Tract DiseasesLung Diseases

Study Officials

  • Patrice François, MD, PhD

    University Hospital, Grenoble

    PRINCIPAL INVESTIGATOR

  • José Labarère, MD, PhD

    University Hospital, Grenoble

    STUDY CHAIR

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
RETROSPECTIVE
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

July 11, 2016

First Posted

July 14, 2016

Study Start

May 10, 2017

Primary Completion

September 1, 2021

Study Completion

January 1, 2022

Last Updated

June 1, 2022

Record last verified: 2022-05

Locations

FR(2)