Roman Trimba1, Richard T Laughlin2, Anil Krishnamurthy3, Joseph S Ross4, Justin P Fox5. 1. Department of Orthopaedic Surgery, Sports Medicine, and Rehabilitation, Boonshoft School of Medicine, Wright State University, Dayton, Ohio. 2. Department of Orthopaedic Surgery, Sports Medicine, and Rehabilitation, Boonshoft School of Medicine, Wright State University, Dayton, Ohio; Department of Orthopaedic Surgery, Dayton Veteran's Association Medical Center, Dayton, Ohio. 3. Department of Orthopaedic Surgery, Dayton Veteran's Association Medical Center, Dayton, Ohio. 4. Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut; Section of General Internal Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut. 5. Department of Surgery, Boonshoft School of Medicine, Wright State University, Dayton, Ohio.
Abstract
BACKGROUND: Although hospital readmissions are being adopted as a quality measure after total hip or knee arthroplasty, they may fail accurately capture the patient's postdischarge experience. METHODS: We studied 272,853 discharges from 517 hospitals to determine hospital emergency department (ED) visit and readmission rates. RESULTS: The hospital-level, 30-day, risk-standardized ED visit (median = 5.6% [2.4%-13.7%]) and hospital readmission (5.0% [2.6%-9.2%]) rates were similar and varied widely. A hospital's risk-standardized ED visit rate did not correlate with its readmission rate (r = -0.03, P = .50). If ED visits were included in a broader "readmission" measure, 246 (47.6%) hospitals would change perceived performance groups. CONCLUSION: Including ED visits in a broader, hospital-based, acute care measure may be warranted to better describe postdischarge health care utilization.
BACKGROUND: Although hospital readmissions are being adopted as a quality measure after total hip or knee arthroplasty, they may fail accurately capture the patient's postdischarge experience. METHODS: We studied 272,853 discharges from 517 hospitals to determine hospital emergency department (ED) visit and readmission rates. RESULTS: The hospital-level, 30-day, risk-standardized ED visit (median = 5.6% [2.4%-13.7%]) and hospital readmission (5.0% [2.6%-9.2%]) rates were similar and varied widely. A hospital's risk-standardized ED visit rate did not correlate with its readmission rate (r = -0.03, P = .50). If ED visits were included in a broader "readmission" measure, 246 (47.6%) hospitals would change perceived performance groups. CONCLUSION: Including ED visits in a broader, hospital-based, acute care measure may be warranted to better describe postdischarge health care utilization.
Authors: Muhammad Ali Chaudhary; Jeffrey K Lange; Linda M Pak; Justin A Blucher; Lauren B Barton; Daniel J Sturgeon; Tracey Koehlmoos; Adil H Haider; Andrew J Schoenfeld Journal: Clin Orthop Relat Res Date: 2018-08 Impact factor: 4.176
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