Patient, provider and system factors influencing rehospitalisation in adults with heart failure.

OBJECTIVES To identify patient, provider and system factors predicting rehospitalisation in adults with heart failure (HF). METHOD The electronic data bases MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase and PsychInfo were searched from 1996-2008 to identify studies identifying predictors of rehospitalisation from which the factors of patient, provider and systems were extracted. RESULTS A total of 62 elements were identified. These elements were then sorted into patient, provider and system categories. Risk factors identified for rehospitalisation were predominantly related to clinical factors. There were less factors identifying risk from the perspective of provider and health care systems. CONCLUSIONS In people with HF it is likely that non-clinical factors including provider and system play an important role in rehospitalisation. There is a need to identify individuals at risk of rehospitalisation and tailor disease management programmes accordingly. (NHMRC Grant 418967)