الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
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Abstract
Hospital readmissions have long been a concern for policymakers, providers, payers, patients, and their families due to increasing costs and an indication of poor quality and inefficiency in providing care. So healthcare leaders see the future of their dynamic industry through the eyes of patients, families, providers, clinicians, employers, health insurers, and policymakers. As healthcare organizations face growing economic challenges and the nation engages in comprehensive healthcare reform, reducing preventable readmissions is considered part of the solution to achieving new system-wide efficiencies. (Stephen et al 2009).
The present study aimed to identfy the factors contributing to hospital readmission and classify patients groups at high risk of readmission in CCU at Assuit University Hospital , the study was include 76 patients who were readmitted during 6 months duration from February to July 2009.
Tools of the study;
Data were collected using structured questionnaire consists of 2 parts; part(1) ; closed chart audit; related to the personal characteristics of patient’s include patient’s age, sex, marital status, educational level, occupation and social & financial status.
Part (2); Factors contributing to hospital readmission; it includes three factors related to; Hospital, Disease, and Patients (post care interview).
A- Aspect related to hospital; consisted of the following 3 items;
Types of hospital (university hospital (teaching hospital), privet hospital or all of them), when patients prepared to discharge (during hospitalization, at the moment of discharge or both), and Presence of rehabilitation program (yes or no).
B- Aspect related to disease; consisted of 2 parts;
Part (1); presence of chronic disease, patient careful to make follow-up for chronic disease, compliance with medication of chronic disease, and presence of unresolved medical problem before discharge. Part (2) includes patient’s diagnosis (system’s disorders) (Central nervous system disorder, Circulatory system disorder, Respiratory system disorder and Digestive system disorder).
C- Aspect related to patients; consisted of;
Presence of care provider after discharge, Patient’s compliance for medication, and Social & financial support for patient after discharge
After an official approval to carry out the study was obtained from administrative persons, the investigator collected data by herself; the duration was about 6 months (February to July 2009).
Results of the present study revealed that; the majority of readmitted patients were males, married, aged ranged from 50 to 64 years old. Most of them were read and write, employee at governmental agencies, had health insurance, and they had care providers after discharge, they had chronic diseases and not complied with treatment or follow-up appointment, beside that readmitted in university hospital.
In the light of the results of this study, the following recommendations are suggested to help in reducing the readmission rates in CCU at A.U.H;
• As continue with use of Disease Management Program (DMP) to use geriatric case manger.
• Successfully transitioning patients from one care setting to another.
• Structure coordinated, patient-centered discharge planning to reduce readmission rates.
• Encourage continuity of care with patients at their homes through community home visit nurse.
• Facilitate follow-up at out-patient clinic with easy available of free samples of expensive medications.
• Facilitate telephone communication with patients and their families at all the time