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 undergo...
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| Veröffentlicht in: | The Journal of surgical research 2019-02, Vol.234, p.116-122 |
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| container_title | The Journal of surgical research |
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| creator | Lee, Austin J. Liu, Xiang Borza, Tudor Qin, Yongmei Li, Benjamin Y. Urish, Kenneth L. Kirk, Peter S. Gilbert, Scott Hollenbeck, Brent K. Helm, Jonathan E. Lavieri, Mariel S. Skolarus, Ted A. Jacobs, Bruce L. |
| description | 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 |
| doi_str_mv | 10.1016/j.jss.2018.08.053 |
| format | Article |
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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 < 0.001). The risk-adjusted readmission length of stay was greatest for patients who received care from a skilled nursing facility, followed by those who received home care, and lowest for those who did not receive post–acute care (7.1 versus 5.4 versus 4.8 d, respectively; P < 0.001).
The use of post–acute care was associated with higher readmission rates and higher readmission lengths of stay. Improving the support of patients in post–acute care settings may help reduce readmissions and readmission intensity.</description><identifier>ISSN: 0022-4804</identifier><identifier>EISSN: 1095-8673</identifier><identifier>DOI: 10.1016/j.jss.2018.08.053</identifier><identifier>PMID: 30527462</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Female ; Home care ; Humans ; Male ; Middle Aged ; Patient Readmission - statistics & numerical data ; Postoperative Complications ; Post–acute care ; Readmission ; Retrospective Studies ; Skilled nursing facility ; Subacute Care ; Surgery</subject><ispartof>The Journal of surgical research, 2019-02, Vol.234, p.116-122</ispartof><rights>2018 Elsevier Inc.</rights><rights>Copyright © 2018 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c451t-46074f319666a06238c3c577569a3c1925103993b779ec40b3da1e42b42326343</citedby><cites>FETCH-LOGICAL-c451t-46074f319666a06238c3c577569a3c1925103993b779ec40b3da1e42b42326343</cites><orcidid>0000-0003-2878-2297</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jss.2018.08.053$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,778,782,883,3539,27907,27908,45978</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30527462$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Austin J.</creatorcontrib><creatorcontrib>Liu, Xiang</creatorcontrib><creatorcontrib>Borza, Tudor</creatorcontrib><creatorcontrib>Qin, Yongmei</creatorcontrib><creatorcontrib>Li, Benjamin Y.</creatorcontrib><creatorcontrib>Urish, Kenneth L.</creatorcontrib><creatorcontrib>Kirk, Peter S.</creatorcontrib><creatorcontrib>Gilbert, Scott</creatorcontrib><creatorcontrib>Hollenbeck, Brent K.</creatorcontrib><creatorcontrib>Helm, Jonathan E.</creatorcontrib><creatorcontrib>Lavieri, Mariel S.</creatorcontrib><creatorcontrib>Skolarus, Ted A.</creatorcontrib><creatorcontrib>Jacobs, Bruce L.</creatorcontrib><title>Role of Post–Acute Care on Hospital Readmission After High-Risk Surgery</title><title>The Journal of surgical research</title><addtitle>J Surg Res</addtitle><description>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 < 0.001). The risk-adjusted readmission length of stay was greatest for patients who received care from a skilled nursing facility, followed by those who received home care, and lowest for those who did not receive post–acute care (7.1 versus 5.4 versus 4.8 d, respectively; P < 0.001).
The use of post–acute care was associated with higher readmission rates and higher readmission lengths of stay. Improving the support of patients in post–acute care settings may help reduce readmissions and readmission intensity.</description><subject>Adult</subject><subject>Aged</subject><subject>Female</subject><subject>Home care</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Patient Readmission - statistics & numerical data</subject><subject>Postoperative Complications</subject><subject>Post–acute care</subject><subject>Readmission</subject><subject>Retrospective Studies</subject><subject>Skilled nursing facility</subject><subject>Subacute Care</subject><subject>Surgery</subject><issn>0022-4804</issn><issn>1095-8673</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9Uc1qGzEQFqGhcdM-QC5lj72sq9HfrggEjEnqQCDBSc9C1s46ctcrV9oN5JZ36Bv2SargNLSXwMAwM9988_MRcgJ0ChTU1810k9KUUainNJvkB2QCVMuyVhV_RyaUMlaKmooj8iGlDc2xrvh7csSpZJVQbEIul6HDIrTFTUjD76dfMzcOWMxtzMm-WIS084PtiiXaZutT8jk5aweMxcKv78ulTz-K2zGuMT5-JIet7RJ-evHH5PvF-d18UV5df7ucz65KJyQMpVC0Ei0HrZSyVDFeO-5kVUmlLXegmQTKtearqtLoBF3xxgIKthKMM8UFPyZne97duNpi47Afou3MLvqtjY8mWG_-r_T-3qzDg1FMQy0gE3x5IYjh54hpMPkyh11newxjMgykBKmA6wyFPdTFkFLE9nUMUPMsgdmYLIF5lsDQbJLnns__7vfa8ffnGXC6B2D-0oPHaJLz2DtsfEQ3mCb4N-j_AGA8lmY</recordid><startdate>20190201</startdate><enddate>20190201</enddate><creator>Lee, Austin J.</creator><creator>Liu, Xiang</creator><creator>Borza, Tudor</creator><creator>Qin, Yongmei</creator><creator>Li, Benjamin Y.</creator><creator>Urish, Kenneth L.</creator><creator>Kirk, Peter S.</creator><creator>Gilbert, Scott</creator><creator>Hollenbeck, Brent K.</creator><creator>Helm, Jonathan E.</creator><creator>Lavieri, Mariel S.</creator><creator>Skolarus, Ted A.</creator><creator>Jacobs, Bruce L.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-2878-2297</orcidid></search><sort><creationdate>20190201</creationdate><title>Role of Post–Acute Care on Hospital Readmission After High-Risk Surgery</title><author>Lee, Austin J. ; Liu, Xiang ; Borza, Tudor ; Qin, Yongmei ; Li, Benjamin Y. ; Urish, Kenneth L. ; Kirk, Peter S. ; Gilbert, Scott ; Hollenbeck, Brent K. ; Helm, Jonathan E. ; Lavieri, Mariel S. ; Skolarus, Ted A. ; Jacobs, Bruce L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c451t-46074f319666a06238c3c577569a3c1925103993b779ec40b3da1e42b42326343</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Female</topic><topic>Home care</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Patient Readmission - statistics & numerical data</topic><topic>Postoperative Complications</topic><topic>Post–acute care</topic><topic>Readmission</topic><topic>Retrospective Studies</topic><topic>Skilled nursing facility</topic><topic>Subacute Care</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Austin J.</creatorcontrib><creatorcontrib>Liu, Xiang</creatorcontrib><creatorcontrib>Borza, Tudor</creatorcontrib><creatorcontrib>Qin, Yongmei</creatorcontrib><creatorcontrib>Li, Benjamin Y.</creatorcontrib><creatorcontrib>Urish, Kenneth L.</creatorcontrib><creatorcontrib>Kirk, Peter S.</creatorcontrib><creatorcontrib>Gilbert, Scott</creatorcontrib><creatorcontrib>Hollenbeck, Brent K.</creatorcontrib><creatorcontrib>Helm, Jonathan E.</creatorcontrib><creatorcontrib>Lavieri, Mariel S.</creatorcontrib><creatorcontrib>Skolarus, Ted A.</creatorcontrib><creatorcontrib>Jacobs, Bruce L.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The Journal of surgical research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Austin J.</au><au>Liu, Xiang</au><au>Borza, Tudor</au><au>Qin, Yongmei</au><au>Li, Benjamin Y.</au><au>Urish, Kenneth L.</au><au>Kirk, Peter S.</au><au>Gilbert, Scott</au><au>Hollenbeck, Brent K.</au><au>Helm, Jonathan E.</au><au>Lavieri, Mariel S.</au><au>Skolarus, Ted A.</au><au>Jacobs, Bruce L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Role of Post–Acute Care on Hospital Readmission After High-Risk Surgery</atitle><jtitle>The Journal of surgical research</jtitle><addtitle>J Surg Res</addtitle><date>2019-02-01</date><risdate>2019</risdate><volume>234</volume><spage>116</spage><epage>122</epage><pages>116-122</pages><issn>0022-4804</issn><eissn>1095-8673</eissn><abstract>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 < 0.001). The risk-adjusted readmission length of stay was greatest for patients who received care from a skilled nursing facility, followed by those who received home care, and lowest for those who did not receive post–acute care (7.1 versus 5.4 versus 4.8 d, respectively; P < 0.001).
The use of post–acute care was associated with higher readmission rates and higher readmission lengths of stay. Improving the support of patients in post–acute care settings may help reduce readmissions and readmission intensity.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>30527462</pmid><doi>10.1016/j.jss.2018.08.053</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-2878-2297</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adult Aged Female Home care Humans Male Middle Aged Patient Readmission - statistics & numerical data Postoperative Complications Post–acute care Readmission Retrospective Studies Skilled nursing facility Subacute Care Surgery |
| title | Role of Post–Acute Care on Hospital Readmission After High-Risk Surgery |
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