Are you evaluating a patient who has been readmitted to the hospital?

Gender of the patient

Number of days since the previous admission

Is the admission part of a program of phased care?

Is the admission for a new health problem?

Is the admission due to?

• a complication of a surgical or obstetrical procedure?

• a complication of a surgical procedure?

• a complication of nonsurgical care?

• an adverse effect of drug or radiation therapy?

• premature discharge?

• a failure to identify or treat an existing condition that should have been handled during the admission?

• an incorrect diagnosis or therapy?

• inadequate discharge planning?

• failure in followup care after discharge?

• inadequate patient behavior?

• relapse or aggravation of a previously known disorder?

• a social cause?

• nosocomial infection?

• deep vein thrombosis, pulmonary embolism, decubitus ulcer, or other complication?


Please fill out required fields.