Original articleGeneral thoracicA Comparison of Length of Stay, Readmission Rate, and Facility Reimbursement After Lobectomy of the Lung
Section snippets
Patients and Methods
Institutional Review Board approval was obtained at the authors' institution, and individual patient consent was not required with the condition of patient anonymity outside the initial data-gathering phase of the study. Using the Premier inpatient database (Premier Inc, Charlotte, NC), hospitals performing at least 50 lobectomies, cumulative (Current Procedural Terminology [CPT] code 32480) for NSCLC (diagnosis codes 162.2, 162.3, 162.4, 162.5, 162; International Classification of Diseases,
Results
Over the 5-year study period, 4,411 lobectomies were performed by 69 cardiothoracic surgeons at 61 hospitals in 31 states that met the entrance criteria for this investigation. Operative mortality occurred in 114 of patients (2.6%) who subsequently had no risk of readmission. Therefore, 4,296 patients undergoing lobectomy were available for analysis.
Readmission to a hospital within 90 of discharge could be documented to have occurred in 367 of these patients. Review of each readmission resulted
Comment
An unplanned or potentially preventable readmission to the hospital within 30 days of discharge has been recognized to occur in as many as one in five Medicare beneficiaries. This is estimated to result in a cost of more than 15 billion dollars per year for CMS. Appropriately, such a figure has drawn attention from CMS and private health care insurers as an area of potential cost saving. Under Medicare's Inpatient Prospective Payment System as included in the Affordable Care Act, excessive
References (22)
- et al.
A comparison of quality and cost indicators by surgical specialty for lobectomy of the lung
J Thorac Cardiovasc Surg
(2013) - et al.
Morbidity and mortality of major pulmonary resections in patients with early stage lung cancer: initial results of the randomized, prospective ASOSOG Z0030 trial
Ann Thorac Surg
(2006) - et al.
Risk factors for 30-day hospital readmission among general surgery patients
J Am Coll Surg
(2012) - et al.
Predictors of prolonged length of stay after lobectomy for lung cancer: a Society of Thoracic Surgeons general thoracic surgery database risk-adjustment model
Ann Thorac Surg
(2008) - Patient Protection and Affordable Care Act, Pub. L. No. 111-148, §2702, 124 Stat....
- et al.
Hospital readmission after pulmonary resection: prevalence, patterns, and predisposing characteristics
Ann Thorac Surg
(2001) - et al.
Toxicity and response criteria of the Eastern Cooperative Oncology Group
Am J Clin Oncol
(1982) Risk adjustment for measuring health care outcomes
(2003)- et al.
Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data
Med Care
(2005) - National average DRG rates. United States Federal Register...