Readmission Rate 13 Percent After Major Surgery

About one patient in seven can expect to be readmitted within 30 days of discharge following major surgery, researchers reported.

But rates of 30-day readmission were better in hospitals with a high surgical volume or with lower surgical mortality rates, according to Ashish Jha, MD, and colleagues at the Harvard School of Public Health.

Good adherence to surgical process measures, on the other hand, had very little effect, Jha and colleagues reported in the Sept. 19 issue of the New England Journal of Medicine.

The findings were a “surprise,” commented co-author Thomas Tsai, MD, because they differ sharply from the pattern seen when readmission rates for medical care have been analyzed.

“The evidence from the medical side is that there isn’t a clear relationship” between hospital quality and readmission rates, he told MedPage Today, but this study does find such a relationship.

Nonetheless, the findings are “very informative research” that starts to tease out readmission rates for areas other than the medical services, according to Brian Jack, MD, of Boston University.

Although not as high as on the medical services, he told MedPage Today, “the data are becoming more clear that readmission rates are also high on the surgical services.”

He added that the findings have important clinical and policy implications for saving healthcare dollars and improving care. “There aren’t too many new advances that would reduce costs and improve care,” he said. “but cutting readmission rates is one of them.”

The issue is also important because the Centers for Medicare and Medicaid Services is planning to expand its readmissions penalty program to include surgical procedures, Jha and colleagues noted, but there is little data on rates of readmission after major surgery and their relationship to other markers of the quality of surgical care.

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