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Preventing Readmissions after Surgery

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28 papers 500 to 1000 followers Causes, predictors and interventions related to preventing readmissions after surgery
By Joshua Liu MD & CEO of Seamless Mobile Health. We enable surgeons to deliver automated, electronic care plans with real time feedback to improve surgical outcomes.
Laurent G Glance, Arthur L Kellermann, Turner M Osler, Yue Li, Dana B Mukamel, Stewart J Lustik, Michael P Eaton, Andrew W Dick
IMPORTANCE: Hospital readmissions are believed to be an indicator of suboptimal care and are the focus of efforts by the Centers for Medicare and Medicaid Services to reduce health care cost and improve quality. Strategies to reduce surgical readmissions may be most effective if applied prospectively to patients who are at increased risk for readmission. Hospitals do not currently have the means to identify surgical patients who are at high risk for unplanned rehospitalizations. OBJECTIVE: To examine whether the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) predicted risk of major complications can be used to identify surgical patients at risk for rehospitalization...
May 2014: JAMA Surgery
Elizabeth M Hechenbleikner, Elizabeth C Wick
No abstract text is available yet for this article.
April 2014: JAMA Surgery
Micah E Girotti, Terry Shih, Justin B Dimick
No abstract text is available yet for this article.
August 2014: JAMA Surgery
Thomas C Tsai, E John Orav, Karen E Joynt
OBJECTIVE: To determine whether black patients have higher odds of readmission than white patients after major surgery, and to ascertain whether these disparities are related to where black patients receive care. BACKGROUND: Racial disparities are known to exist for many aspects of surgical care. However, it is unknown if disparities exist in readmissions after a surgical procedure, an area which is becoming a prime focus for clinical leaders and policymakers. METHODS: Using national Medicare data from 2007 to 2010, we examined 30-day readmissions for patients undergoing coronary artery bypass grafting, pulmonary lobectomy, endovascular abdominal aortic aneurysm repair, open abdominal aortic aneurysm repair, colectomy, and hip replacement...
June 2014: Annals of Surgery
Elise H Lawson, Bruce Lee Hall, Rachel Louie, Susan L Ettner, David S Zingmond, Lein Han, Michael Rapp, Clifford Y Ko
OBJECTIVE: To estimate the effect of preventing postoperative complications on readmission rates and costs. BACKGROUND: Policymakers are targeting readmission for quality improvement and cost savings. Little is known regarding mutable factors associated with postoperative readmissions. METHODS: Patient records (2005-2008) from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) were linked to Medicare inpatient claims...
July 2013: Annals of Surgery
Greg D Sacks, Aaron J Dawes, Marcia M Russell, Anne Y Lin, Melinda Maggard-Gibbons, Deborah Winograd, Hallie R Chung, James Tomlinson, Areti Tillou, Stephen B Shew, Darryl T Hiyama, H Gill Cryer, F Charles Brunicardi, Jonathan R Hiatt, Clifford Ko
IMPORTANCE: The Centers for Medicare & Medicaid Services has developed an all-cause readmission measure that uses administrative data to measure readmission rates and financially penalize hospitals with higher-than-expected readmission rates. OBJECTIVES: To examine the accuracy of administrative codes in determining the cause of readmission as determined by medical record review, to evaluate the readmission measure's ability to accurately identify a readmission as planned, and to document the frequency of readmissions for reasons clinically unrelated to the original hospital stay...
August 2014: JAMA Surgery
Aaron J Dawes, Greg D Sacks, Marcia M Russell, Anne Y Lin, Melinda Maggard-Gibbons, Deborah Winograd, Hallie R Chung, Areti Tillou, Jonathan R Hiatt, Clifford Ko
BACKGROUND: Hospital readmissions are under intense scrutiny as a measure of health care quality. The Center for Medicare and Medicaid Services (CMS) has proposed using readmission rates as a benchmark for improving care, including targeting them as nonreimbursable events. Our study aim was to describe potentially preventable readmissions after surgery and to identify targets for improvement. STUDY DESIGN: Patients discharged from a general surgery service over 8 consecutive quarters (Q4 2009 to Q3 2011) were selected...
September 2014: Journal of the American College of Surgeons
Jing Li, Robert Young, Mark V Williams
Transitions of care-when patients move from one health care facility to another or back home-that are poorly executed result in adverse effects for patients. Fortunately, programs can be implemented that enhance collaboration across care settings and improve outcomes including reducing hospital readmission rates.
May 2014: Cleveland Clinic Journal of Medicine
Francis Lovecchio, Rebecca Farmer, Jason Souza, Nima Khavanin, Gregory A Dumanian, John Y S Kim
BACKGROUND: Ventral hernia repair (VHR), an increasingly common procedure, may have a greater impact on health care costs than is currently appreciated. Readmissions have the potential to further increase these costs and negatively impact patient outcomes. New national registry data allows for an in-depth look at the predictors and rates of readmission after VHR. METHODS: The American College of Surgeon's National Surgical Quality Improvement Program database was queried for all patients who underwent only an incisional or VHR in 2011...
April 2014: Surgery
Jennifer Q Zhang, Thomas Curran, John C McCallum, Li Wang, Mark C Wyers, Allen D Hamdan, Raul J Guzman, Marc L Schermerhorn
OBJECTIVE: Readmission is associated with high mortality, morbidity, and cost. We used the American College of Surgeons National Surgery Quality Improvement Program (ACS-NSQIP) to determine risk factors for readmission after lower extremity bypass (LEB). METHODS: We identified all patients who received LEB in the 2011 ACS-NSQIP database. Multivariable logistic regression was used to assess independent predictors of 30-day readmission. We also identified our institutional contribution of LEB patients to the ACS-NSQIP from 2005 to 2011 to determine our institution's rate of readmission and readmission indications...
May 2014: Journal of Vascular Surgery
Thomas C Tsai, Karen E Joynt, E John Orav, Atul A Gawande, Ashish K Jha
BACKGROUND: Reducing hospital-readmission rates is a clinical and policy priority, but little is known about variation in rates of readmission after major surgery and whether these rates at a given hospital are related to other markers of the quality of surgical care. METHODS: Using national Medicare data, we calculated 30-day readmission rates after hospitalization for coronary-artery bypass grafting, pulmonary lobectomy, endovascular repair of abdominal aortic aneurysm, open repair of abdominal aortic aneurysm, colectomy, and hip replacement...
September 19, 2013: New England Journal of Medicine
Edward L Hannan, Ye Zhong, Stephen J Lahey, Alfred T Culliford, Jeffrey P Gold, Craig R Smith, Robert S D Higgins, Desmond Jordan, Andrew Wechsler
OBJECTIVES: The aim of this study was to identify reasons for and predictors of readmission. BACKGROUND: Short-term readmissions have been identified as an important cause of escalating health care costs, and coronary artery bypass graft (CABG) surgery is 1 of the most expensive procedures. METHODS: We retrospectively analyzed 30-day readmissions for 33,936 New York State patients who underwent CABG surgery between January 1, 2005, and November 30, 2007...
May 2011: JACC. Cardiovascular Interventions
Eric B Schneider, Omar Hyder, Benjamin S Brooke, Jonathan Efron, John L Cameron, Barish H Edil, Richard D Schulick, Michael A Choti, Christopher L Wolfgang, Timothy M Pawlik
BACKGROUND: Data on readmission as well as the potential impact of length of stay (LOS) after colectomy for colon cancer remain poorly defined. The objective of the current study was to evaluate risk factors associated with readmission among a nationwide cohort of patients after colorectal surgery. STUDY DESIGN: We identified 149,622 unique individuals from the Surveillance, Epidemiology, and End Results-Medicare dataset with a diagnosis of primary colorectal cancer who underwent colectomy between 1986 and 2005...
April 2012: Journal of the American College of Surgeons
Michael T Kassin, Rachel M Owen, Sebastian D Perez, Ira Leeds, James C Cox, Kurt Schnier, Vjollca Sadiraj, John F Sweeney
BACKGROUND: Hospital readmission within 30 days of an index hospitalization is receiving increased scrutiny as a marker of poor-quality patient care. This study identifies factors associated with 30-day readmission after general surgery procedures. STUDY DESIGN: Using standard National Surgical Quality Improvement Project protocol, preoperative, intraoperative, and postoperative outcomes were collected on patients undergoing inpatient general surgery procedures at a single academic center between 2009 and 2011...
September 2012: Journal of the American College of Surgeons
Donald J Lucas, Adil Haider, Elliot Haut, Rebecca Dodson, Christopher L Wolfgang, Nita Ahuja, John Sweeney, Timothy M Pawlik
OBJECTIVE: In 2012, Medicare began cutting reimbursement for hospitals with high readmission rates. We sought to define the incidence and risk factors associated with readmission after surgery. METHODS: A total of 230,864 patients discharged after general, upper gastrointestinal (GI), small and large intestine, hepatopancreatobiliary (HPB), vascular, and thoracic surgery were identified using the 2011 American College of Surgeons National Surgical Quality Improvement Program...
September 2013: Annals of Surgery
Hadiza S Kazaure, Sanziana A Roman, Julie A Sosa
OBJECTIVES: To describe procedure-specific types, rates, and risk factors for postdischarge (PD) complications occurring within 30 days after 21 groups of inpatient general surgery procedures. DESIGN: Retrospective cohort study. SETTING: American College of Surgeons National Surgical Quality Improvement Program 2005 through 2010 Participant Use Data Files. PATIENTS: A total of 551,510 adult patients who underwent one of 21 groups of general surgery procedures in the inpatient setting...
November 2012: Archives of Surgery
Elizabeth C Wick, Andrew D Shore, Kenzo Hirose, Andrew M Ibrahim, Susan L Gearhart, Jonathan Efron, Jonathan P Weiner, Martin A Makary
BACKGROUND: Hospital readmission is emerging as a quality indicator by the state, federal, and private payors with the goal of denying payment for select readmissions. OBJECTIVE: We designed a study to measure the rate, cost, and risk factors for hospital readmission after colorectal surgery. STUDY DESIGN/SETTING: We reviewed commercial health insurance records of 10,882 patients who underwent colorectal surgery over a 7-year period (2002-2008)...
December 2011: Diseases of the Colon and Rectum
Linda T Li, Whitney L Mills, Donna L White, Alexa Li, Amanda M Gutierrez, David H Berger, Aanand D Naik
A systematic review and meta-analysis of the current literature was conducted to compare the overall and cause-specific readmission rates after colorectal surgery of older adults with those of younger individuals. Potential predictors of unplanned readmission were also identified. Estimated pooled readmission rates were calculated and reported as pooled proportions with associated 95% confidence intervals (CI) in 60,131 total readmissions; 11.0% (95% CI = 10.0-12.0) of all admissions after colorectal surgery resulted in unplanned readmission at 30 days...
July 2013: Journal of the American Geriatrics Society
Rutledge Carter Clement, Peter B Derman, Danielle S Graham, Rebecca M Speck, David N Flynn, Lawrence Scott Levin, Lee A Fleisher
In order to identify risk factors for readmissions following total hip arthroplasty (THA) and the causes and financial implications of such readmissions, we analyzed clinical and administrative data on 1583 consecutive primary THAs performed at a single institution. The 30-day readmission rate was 6.51%. Increased age, length of stay, and body mass index were associated with significantly higher readmission rates. The most common re-admitting diagnoses were deep infection, pain, and hematoma. Average profit was lower for episodes of care with readmissions ($1548 vs...
September 2013: Journal of Arthroplasty
James T McPhee, Neal R Barshes, Karen J Ho, Arin Madenci, C Keith Ozaki, Louis L Nguyen, Michael Belkin
BACKGROUND: Thirty-day unplanned readmission after lower extremity bypass represents a large cost burden and is a logical target for cost-containment strategies. We undertook this study to evaluate factors associated with unplanned readmission after lower extremity bypass. METHODS: This is a retrospective analysis from a prospective institutional registry. All lower extremity bypasses for occlusive disease from January 1995 to July 2011 were included. The primary end point was 30-day unplanned readmission...
April 2013: Journal of Vascular Surgery
2014-01-03 21:32:16
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