Readmission after emergency general surgery.


Journal

American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473

Informations de publication

Date de publication:
09 2020
Historique:
received: 05 09 2019
revised: 03 01 2020
accepted: 07 01 2020
pubmed: 28 1 2020
medline: 26 11 2020
entrez: 28 1 2020
Statut: ppublish

Résumé

Readmission rates are an important metric because they enable an evaluation of care and affect Medicare funding. This study evaluates factors contributing to readmission after emergency general surgery. The Virginia Health Information database was used to identify patients who had undergone the most common emergency general surgery procedures from 1/2011-6/2016. Analyses were performed for 30 and 90-day readmission. 121,223 records met initial inclusion criteria and 54,372 remained after exclusions. In 30 days there were 5050 readmissions and 7896 readmissions in 90 days. Factors significant in contributing to 30-day readmission were length of stay, discharge location, and several comorbidities. For 90-day readmission the same factors were significant with the addition of urgent vs emergency admission and insurance status as well as additional comorbidities. Discharge to rehab, SNF, or with home healthcare had particularly high rates of 90 day readmission. We identified factors that contribute to readmission after emergency general surgery providing targets for future interventions. Improved follow up for patients discharged with rehab or home health needs is our next step.

Sections du résumé

BACKGROUND
Readmission rates are an important metric because they enable an evaluation of care and affect Medicare funding. This study evaluates factors contributing to readmission after emergency general surgery.
METHODS
The Virginia Health Information database was used to identify patients who had undergone the most common emergency general surgery procedures from 1/2011-6/2016. Analyses were performed for 30 and 90-day readmission.
RESULTS
121,223 records met initial inclusion criteria and 54,372 remained after exclusions. In 30 days there were 5050 readmissions and 7896 readmissions in 90 days. Factors significant in contributing to 30-day readmission were length of stay, discharge location, and several comorbidities. For 90-day readmission the same factors were significant with the addition of urgent vs emergency admission and insurance status as well as additional comorbidities. Discharge to rehab, SNF, or with home healthcare had particularly high rates of 90 day readmission.
CONCLUSIONS
We identified factors that contribute to readmission after emergency general surgery providing targets for future interventions. Improved follow up for patients discharged with rehab or home health needs is our next step.

Identifiants

pubmed: 31983408
pii: S0002-9610(20)30011-8
doi: 10.1016/j.amjsurg.2020.01.010
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

731-735

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest There are no conflicts of interest for any authors for this study. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Auteurs

Katherine M Kelley (KM)

Eastern Virginia Medical School, Department of Surgery, 825 Fairfax Ave, 6th Floor, Norfolk, VA, 23507, USA. Electronic address: katherine.kelley@umm.edu.

Jay Collins (J)

Eastern Virginia Medical School, Department of Surgery, 825 Fairfax Ave, 6th Floor, Norfolk, VA, 23507, USA. Electronic address: collinjn@evms.edu.

L D Britt (LD)

Eastern Virginia Medical School, Department of Surgery, 825 Fairfax Ave, 6th Floor, Norfolk, VA, 23507, USA. Electronic address: Brittld@evms.edu.

DaShaunda D H Taylor (DDH)

Eastern Virginia Medical School, EVMS-Sentara Healthcare Analytics and Delivery Science Institute, P. O. Box 1980, Norfolk, VA, 23501, USA. Electronic address: Ddhilliard20@gmail.com.

Rebecca Britt (R)

Eastern Virginia Medical School, Department of Surgery, 825 Fairfax Ave, 6th Floor, Norfolk, VA, 23507, USA. Electronic address: brittrc@evms.edu.

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Classifications MeSH