Transforming Surgical and Interventional Care: Insights from the Robert Wood Johnson Foundation Clinical Scholars ProgramIdentification of modifiable factors for reducing readmission after colectomy: A national analysis
Section snippets
Data sources and study sample
The study design and procedures were approved by the RAND Health Institutional Review Board. The primary data sources for this study were Medicare inpatient claims and ACS-NSQIP, as previously described.8, 9 Briefly, the 100% Medicare provider analysis and review file (MedPAR) contains inpatient hospital final stay records for Medicare beneficiaries assembled from claims submitted by hospitals for reimbursement. Each Medicare beneficiary has a unique identification number allowing for linkage
Results
Among 12,981 patients undergoing colectomy with an initial length of stay <21 days, 1,752 were readmitted within 30 days of surgery (13.5%). For the readmitted patient population, 82% were readmitted to the same hospital as the index hospitalization, and 18% were readmitted to a different hospital. The median hospital-level, 30-day postoperative readmission rate was 13.0% (interquartile range, 9.1–16.2%; mean, 13.2%; standard deviation [SD], 8.2%). There was no difference in the yearly
Discussion
Hospital readmission has become a topic of increased interest among policymakers interested in improving the quality of health care delivery in the United States while reducing costs. To aid surgeons and hospitals in the development of effective strategies for reducing postoperative readmissions, we sought to characterize readmissions among patients undergoing colectomy procedures and to identify targets for the development of interventions and best practices. In previous work, we demonstrated
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