These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Descriptive analysis of 30-day readmission after inpatient surgery discharge in the Veterans Health Administration.
    Author: Han S, Smith TS, Gunnar W.
    Journal: JAMA Surg; 2014 Nov; 149(11):1162-8. PubMed ID: 25229894.
    Abstract:
    IMPORTANCE: For the first time to our knowledge, this study analyzes and reports the 30-day all-cause readmission rates for surgical procedures performed in the Veterans Health Administration (VHA). OBJECTIVE: To analyze and report 30-day all-cause readmission rates following discharge from 9 surgical specialties in the VHA for a 10-year period. DESIGN, SETTING, AND PARTICIPANTS: In a retrospective observational study, Veterans Affairs Surgical Quality Improvement Program data for surgery records and VHA administrative discharge data were linked to evaluate all-cause readmission within 30 days of discharge from the surgical inpatient stay. The study population represents 9 surgical specialty groups: general, urology, neurosurgery, orthopedic, otolaryngology, plastic, thoracic, peripheral vascular, and cardiac. Trends of postoperative hospital admission rates for each surgery were investigated using 10 years (fiscal years 2001-2010; N = 894,943) of linked data. MAIN OUTCOMES AND MEASURES: All-cause 30-day readmission after surgery for each specialty. RESULTS: During the 10-year period, the overall 30-day all-cause readmission rate following inpatient surgery discharge significantly decreased from 12.9% to 12.2% (P < .001). Unadjusted readmission rates varied by surgical specialty: general, 12.5%; urology, 9.0%; neurosurgery, 10.5%; orthopedic, 9.6%; otolaryngology, 9.5%; plastic, 12.2%; thoracic, 14.4%; peripheral vascular, 16.0%; and cardiac, 16.6%. The following specialties were found to have a significant decline in readmission rates: orthopedic (P = .004), otolaryngology (P = .005), plastic (P = .02), thoracic (P = .04), peripheral vascular (P < .001), and cardiac (P = .003). Postoperative hospital length of stay in individual specialties decreased during this period (each P < .05) except for thoracic and cardiac surgery, which remained unchanged. Readmission diagnoses varied by specialty; postoperative infection was the most common readmission diagnosis in 7 specialties and the second most common in the other 2 specialties (urology and thoracic). Urinary tract infection and digestive system complications were also common readmission diagnoses. CONCLUSIONS AND RELEVANCE: This retrospective observational study showed decreasing 30-day readmission rates associated with a decline in postoperative hospital length of stay for 9 surgical specialties in the VHA during a 10-year period. Further study will be required to capture data from patients who had surgery at a VHA facility but were readmitted in the private sector.
    [Abstract] [Full Text] [Related] [New Search]