Readmission after emergency general surgery
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...
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Veröffentlicht in: | The American journal of surgery 2020-09, Vol.220 (3), p.731-735 |
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creator | Kelley, Katherine M. Collins, Jay Britt, L.D. Taylor, DaShaunda D.H. Britt, Rebecca |
description | 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.
•30-day readmit factors: LOS, discharge location, comorbidities.•90-day readmission: insurance, LOS, discharge location, and more comorbidities.•Discharge to rehab, SNF or with home health had very high rates of 90 day readmission.
This is a database study of patients undergoing emergency surgery procedures in the state of Virginia identifying factors associated with 30 and 90 day readmission. Type of insurance, length of stay, discharge to other than home, and several comorbidities were significant factors for readmission. |
doi_str_mv | 10.1016/j.amjsurg.2020.01.010 |
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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.
•30-day readmit factors: LOS, discharge location, comorbidities.•90-day readmission: insurance, LOS, discharge location, and more comorbidities.•Discharge to rehab, SNF or with home health had very high rates of 90 day readmission.
This is a database study of patients undergoing emergency surgery procedures in the state of Virginia identifying factors associated with 30 and 90 day readmission. Type of insurance, length of stay, discharge to other than home, and several comorbidities were significant factors for readmission.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2020.01.010</identifier><identifier>PMID: 31983408</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Age ; Comorbidity ; Diabetes ; Emergency general surgery ; Emergency medical services ; Emergency procedures ; Government programs ; Heart failure ; Hospitals ; Identification methods ; Liver diseases ; Medicaid ; Medicare ; Metastasis ; Multivariate analysis ; Patient Protection & Affordable Care Act 2010-US ; Patient satisfaction ; Population ; Readmission ; Rehabilitation ; Rheumatoid arthritis ; Surgery ; Ulcers</subject><ispartof>The American journal of surgery, 2020-09, Vol.220 (3), p.731-735</ispartof><rights>2020 Elsevier Inc.</rights><rights>Copyright © 2020 Elsevier Inc. All rights reserved.</rights><rights>2020. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c393t-6903ecb2532ddc09b8e6ad0b18e6c48a174ccebe9ba27f2e37db8855517057e53</citedby><cites>FETCH-LOGICAL-c393t-6903ecb2532ddc09b8e6ad0b18e6c48a174ccebe9ba27f2e37db8855517057e53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2439970850?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994,64384,64386,64388,72240</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31983408$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kelley, Katherine M.</creatorcontrib><creatorcontrib>Collins, Jay</creatorcontrib><creatorcontrib>Britt, L.D.</creatorcontrib><creatorcontrib>Taylor, DaShaunda D.H.</creatorcontrib><creatorcontrib>Britt, Rebecca</creatorcontrib><title>Readmission after emergency general surgery</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>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.
•30-day readmit factors: LOS, discharge location, comorbidities.•90-day readmission: insurance, LOS, discharge location, and more comorbidities.•Discharge to rehab, SNF or with home health had very high rates of 90 day readmission.
This is a database study of patients undergoing emergency surgery procedures in the state of Virginia identifying factors associated with 30 and 90 day readmission. Type of insurance, length of stay, discharge to other than home, and several comorbidities were significant factors for readmission.</description><subject>Age</subject><subject>Comorbidity</subject><subject>Diabetes</subject><subject>Emergency general surgery</subject><subject>Emergency medical services</subject><subject>Emergency procedures</subject><subject>Government programs</subject><subject>Heart failure</subject><subject>Hospitals</subject><subject>Identification methods</subject><subject>Liver diseases</subject><subject>Medicaid</subject><subject>Medicare</subject><subject>Metastasis</subject><subject>Multivariate analysis</subject><subject>Patient Protection & Affordable Care Act 2010-US</subject><subject>Patient satisfaction</subject><subject>Population</subject><subject>Readmission</subject><subject>Rehabilitation</subject><subject>Rheumatoid arthritis</subject><subject>Surgery</subject><subject>Ulcers</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkEtLxDAQgIMo7rr6E5SCF0FaJ0nTJieRxRcsCKLnkKbTpaUPTbbC_ntTdvXgRRhmGPjmwUfIOYWEAs1umsR0jR_dOmHAIAEaAg7InMpcxVRKfkjmAMBilVGYkRPvm9BSmvJjMuNUSZ6CnJPrVzRlV3tfD31kqg26CDt0a-ztNgoZnWmj6Qy67Sk5qkzr8WxfF-T94f5t-RSvXh6fl3er2HLFN3GmgKMtmOCsLC2oQmJmSihoqDaVhuaptVigKgzLK4Y8LwsphRA0B5Gj4Atytdv74YbPEf1Ghwcttq3pcRi9ZjzNmMwzxgN6-QdthtH14TvNUq5UDlJAoMSOsm7w3mGlP1zdGbfVFPRkUzd6b1NPNjXQENPcxX77WHRY_k796AvA7Q7AoOOrRqe9rYM6LGuHdqPLof7nxDcW64cy</recordid><startdate>20200901</startdate><enddate>20200901</enddate><creator>Kelley, Katherine M.</creator><creator>Collins, Jay</creator><creator>Britt, L.D.</creator><creator>Taylor, DaShaunda D.H.</creator><creator>Britt, Rebecca</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20200901</creationdate><title>Readmission after emergency general surgery</title><author>Kelley, Katherine M. ; Collins, Jay ; Britt, L.D. ; Taylor, DaShaunda D.H. ; Britt, Rebecca</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c393t-6903ecb2532ddc09b8e6ad0b18e6c48a174ccebe9ba27f2e37db8855517057e53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Age</topic><topic>Comorbidity</topic><topic>Diabetes</topic><topic>Emergency general surgery</topic><topic>Emergency medical services</topic><topic>Emergency procedures</topic><topic>Government programs</topic><topic>Heart failure</topic><topic>Hospitals</topic><topic>Identification methods</topic><topic>Liver diseases</topic><topic>Medicaid</topic><topic>Medicare</topic><topic>Metastasis</topic><topic>Multivariate analysis</topic><topic>Patient Protection & Affordable Care Act 2010-US</topic><topic>Patient satisfaction</topic><topic>Population</topic><topic>Readmission</topic><topic>Rehabilitation</topic><topic>Rheumatoid arthritis</topic><topic>Surgery</topic><topic>Ulcers</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kelley, Katherine M.</creatorcontrib><creatorcontrib>Collins, Jay</creatorcontrib><creatorcontrib>Britt, L.D.</creatorcontrib><creatorcontrib>Taylor, DaShaunda D.H.</creatorcontrib><creatorcontrib>Britt, Rebecca</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kelley, Katherine M.</au><au>Collins, Jay</au><au>Britt, L.D.</au><au>Taylor, DaShaunda D.H.</au><au>Britt, Rebecca</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Readmission after emergency general surgery</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2020-09-01</date><risdate>2020</risdate><volume>220</volume><issue>3</issue><spage>731</spage><epage>735</epage><pages>731-735</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><abstract>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.
•30-day readmit factors: LOS, discharge location, comorbidities.•90-day readmission: insurance, LOS, discharge location, and more comorbidities.•Discharge to rehab, SNF or with home health had very high rates of 90 day readmission.
This is a database study of patients undergoing emergency surgery procedures in the state of Virginia identifying factors associated with 30 and 90 day readmission. Type of insurance, length of stay, discharge to other than home, and several comorbidities were significant factors for readmission.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>31983408</pmid><doi>10.1016/j.amjsurg.2020.01.010</doi><tpages>5</tpages></addata></record> |
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source | ScienceDirect Journals (5 years ago - present); ProQuest Central UK/Ireland |
subjects | Age Comorbidity Diabetes Emergency general surgery Emergency medical services Emergency procedures Government programs Heart failure Hospitals Identification methods Liver diseases Medicaid Medicare Metastasis Multivariate analysis Patient Protection & Affordable Care Act 2010-US Patient satisfaction Population Readmission Rehabilitation Rheumatoid arthritis Surgery Ulcers |
title | Readmission after emergency general surgery |
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