Hospital readmission rates linked with quality of surgical care

September 18, 2013

Reducing hospital readmission rates is an important clinical and policy priority but whether those rates really measure the quality of hospital care isn't clear. In a new study, researchers from Harvard School of Public Health (HSPH) found strong evidence of a relationship between surgical readmission rates and quality of surgical care. The finding provides an opportunity for policymakers to improve surgical quality and decrease readmission costs and supports plans by the Centers for Medicare and Medicaid Services to expand its readmission penalty program to include surgical procedures.

"Our findings suggest that focusing on surgical readmissions may be a smart policy approach to both improving care and reducing unnecessary spending," said Ashish Jha, professor of health policy at HSPH and the study's senior author.

The study appears in the Sept. 19, 2013 issue of the New England Journal of Medicine.

Much of the policy focus to date has been on reducing readmissions after hospitalization for medical conditions, such as and pneumonia, but this approach has been controversial. Readmissions for medical conditions are primarily driven by how sick the patients are and whether they live in poor or better-off communities; the link between hospital quality and readmissions is less clear. The authors postulated that surgical care may be different—and sought to find out if there was a relationship between readmission rates after surgery and the quality of surgical care in that hospital.

The researchers calculated 30-day readmission rates using Medicare data for six major surgical procedures: coronary-artery bypass grafting, pulmonary , endovascular repair of abdominal aortic aneurysm, open repair of abdominal aortic aneurysm, , and . The study cohort was composted of 479,471 discharged patients from 3,004 hospitals in the U.S. who underwent one of the six procedures.

The results showed that approximately one in seven patients discharged was readmitted within 30 days. Hospitals with the best performance on two well-established measures of hospital surgical quality, surgical volume and 30-day mortality rates, had much lower readmission rates than other hospitals. For example, hospitals in the highest quartile for surgical volume had a significantly lower readmission rate than hospitals in the lowest quartile (12.7% vs. 16.8%). Hospitals with the lowest surgical mortality rates had a significantly lower readmission rate than hospitals with the highest mortality rates (13.3% vs. 14.2%).

The findings provide evidence of a strong relationship between and readmissions and could encourage hospitals to focus on making surgical care better. "The findings are good news for policy makers and the public health community as a way to reduce health care spending and improve outcomes for surgical patients," said Thomas Tsai, the lead author of the study. Tsai is a post-doctoral fellow at HSPH and a surgical resident at Brigham and Women's Hospital.

Explore further: Hospital readmission rates not accurate measure of care quality

More information: "Variation in Surgical-Readmission Rates and Quality of Hospital Care," Thomas C. Tsai, Karen E. Joynt, E. John Orav, Atul A. Gawande, Ashish K. Jha, NEJM, 369:1134-1142, September 19, 2013

Related Stories

Unplanned readmission common after spine fusion

September 11, 2013

(HealthDay)—For patients undergoing spine fusion for adult spinal deformity, unplanned hospital readmissions are relatively common and are often related to surgical site infections, according to a study published in the ...

Recommended for you

Clock controls junk food appeal

July 22, 2016

When it comes to extra kilojoules, a little more self-restraint won't go astray as the day progresses. New research from Flinders University and Liverpool University has studied the urge to snack more later in the day, even ...

Diagnoses: When are several opinions better than one?

July 22, 2016

Methods of collective intelligence can result in considerably more accurate medical diagnoses, but only under certain conditions. A study headed by researchers at the Max Planck Institute for Human Development has shed new ...

How to increase the fat burned during exercise

July 19, 2016

During exercise, oxidation of fat and carbohydrates depends on the intensity and duration of the activity. A new study analyses the effect of consuming an alkaloid, p-synephrine, on the burning of lipids and refutes the value ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.