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National trends in readmission following inpatient surgery in the hospital readmissions reduction program era

Mehtsun, Winta T., Papanicolas, Irene ORCID: 0000-0002-8000-3185, Zheng, Jie, Orav, E. John, Lillemoe, Keith D. and Jha, Ashish K. (2017) National trends in readmission following inpatient surgery in the hospital readmissions reduction program era. Annals of Surgery. ISSN 0003-4932

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Identification Number: 10.1097/SLA.0000000000002350

Abstract

Objective: The aim of this study was to investigate whether the Hospital Readmissions Reduction Program, a national program that introduced financial penalties for high readmission rates for certain medical conditions, had a “spillover” effect on surgical conditions. Summary Background Data: During the past decade, there have been multiple national efforts to improve surgical care. Readmission rates are a key metric for assessing surgical quality. Whether surgical readmission rates have declined, and whether the Hospital Readmissions Reduction Program has had an influence is unclear. Methods: Using national Medicare data, we identified patients undergoing a range of procedures during the past decade. We examined whether certain procedures that would be targeted by the HRRP had a differential change in readmissions compared to other procedures. We used an interrupted time-series model to examine readmission trends in three time periods: pre-ACA, HRRP implementation, and HRRP penalty. Results: Between 2005 and 2014, 17,423,106 patients underwent the procedures of interest; risk-adjusted rates of readmission across the 8 procedures declined from 12.2% to 8.6%. Pre-ACA rates of readmission were decreasing [−0.060% per quarter (−0.072%, −0.048%), P < 0.001]. During the HRRP implementation period, the rate of decline of readmissions increased [−0.129% (−0.142%, −0.116%), P < 0.001] and continued declining at a similar rate during the penalty period [−0.118% (−0.131%, −0.105%), P < 0.001]. Largest declines in surgical readmissions were seen among the nontargeted procedures. The hospitals with the greatest reductions in medical readmissions also had the greatest drop in surgical readmissions. Conclusions: Surgical readmission rates have fallen during the past decade and rates of decline have increased during the HRRP period.

Item Type: Article
Official URL: http://journals.lww.com/annalsofsurgery/pages/defa...
Additional Information: © 2017 Wolters Kluwer Health, Inc.
Divisions: LSE Health
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RD Surgery
Sets: Research centres and groups > LSE Health
Date Deposited: 24 Aug 2017 10:30
Last Modified: 20 Oct 2020 05:21
Projects: R25CA92203
Funders: National Cancer Institute
URI: http://eprints.lse.ac.uk/id/eprint/84101

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