Role of Post–Acute Care on Hospital Readmission After High-Risk Surgery

Payment models, including the Hospital Readmissions Reduction Program and bundled payments, place pressures on hospitals to limit readmissions. Against this backdrop, we sought to investigate the association of post–acute care after major surgery and readmission rates. We identified patients undergoing high-risk surgery (abdominal aortic aneurysm repair, coronary bypass grafting, aortic valve replacement, carotid endarterectomy, esophagectomy, pancreatectomy, lung resection, and cystectomy) from 2005 to 2010 using the Healthcare Cost and Utilization Project's State Inpatient Database. The primary outcome was readmission rates after major surgery. Secondary outcome was readmission length of stay. We identified 135,523 patients of whom 56,720 (42%) received post–acute care. Patients receiving post–acute care had higher readmission rates than those who were discharged home (16% versus 10%, respectively; P