Suzann Pershing1, Douglas E Morrison2, Tina Hernandez-Boussard3. 1. Veterans Affairs Palo Alto Health Care System, Byers Eye Institute at Stanford University, Palo Alto, California. 2. Department of Surgery, Stanford University, Palo Alto, California. 3. Stanford School of Medicine, Stanford, California. Electronic address: boussard@stanford.edu.
Abstract
PURPOSE: To characterize population-based 30-day procedure-related readmissions (revisits) following cataract surgery. SETTING: Ambulatory cataract surgery performed in California, Florida, or New York. DESIGN: Retrospective cohort study. METHODS: This study used all-capture state administrative datasets. Cataract procedures from California, Florida, and New York state ambulatory surgery settings were identified using ICD-9-CM and CPT codes. Thirty-day readmissions (revisits) were identified in inpatient, ambulatory, and emergency department settings across each state. RESULTS: Across the 3 states, the all-cause 30-day readmission rate was 6.0% and the procedure-related readmission (revisit) rate was 1.0%. Procedure-related revisits were highest for patients aged 20-29 (2.9%) and 30-39 (2.3%) and lowest for patients aged 70-79 (0.9%). Multivariate associations between clinical characteristics and 30-day procedure-related revisits included age 20-29 (odds ratio [OR]: 3.13; 95% confidence intervals [CI]: 2.33-4.20) and age 30-39 (OR: 2.35; CI: 1.91-2.89) compared with age 70-79, male sex (OR: 1.29; CI: 1.24-1.34), races black (OR: 1.37; CI: 1.27-1.48) and Hispanic (OR: 1.16; CI: 1.08-1.24) compared with white, and Medicaid insurance (OR: 1.18, CI: 1.07-1.30) compared with Medicare. Diabetes was also associated with increased 30-day procedure-related revisits (OR: 1.093, CI: 1.024-1.168). CONCLUSIONS: Cataract surgery is a common and, in aggregate, expensive procedure. Complication-related revisits follow a similar trend as surgical complications in large-scale population data, and may be useful as a preliminary, screening outcome measure. Our results highlight the importance of age as a risk factor for cataract surgery readmissions, and suggest a relationship between black or Hispanic race, Medicaid insurance, and diabetes associated with higher risk for cataract surgery complications.
PURPOSE: To characterize population-based 30-day procedure-related readmissions (revisits) following cataract surgery. SETTING: Ambulatory cataract surgery performed in California, Florida, or New York. DESIGN: Retrospective cohort study. METHODS: This study used all-capture state administrative datasets. Cataract procedures from California, Florida, and New York state ambulatory surgery settings were identified using ICD-9-CM and CPT codes. Thirty-day readmissions (revisits) were identified in inpatient, ambulatory, and emergency department settings across each state. RESULTS: Across the 3 states, the all-cause 30-day readmission rate was 6.0% and the procedure-related readmission (revisit) rate was 1.0%. Procedure-related revisits were highest for patients aged 20-29 (2.9%) and 30-39 (2.3%) and lowest for patients aged 70-79 (0.9%). Multivariate associations between clinical characteristics and 30-day procedure-related revisits included age 20-29 (odds ratio [OR]: 3.13; 95% confidence intervals [CI]: 2.33-4.20) and age 30-39 (OR: 2.35; CI: 1.91-2.89) compared with age 70-79, male sex (OR: 1.29; CI: 1.24-1.34), races black (OR: 1.37; CI: 1.27-1.48) and Hispanic (OR: 1.16; CI: 1.08-1.24) compared with white, and Medicaid insurance (OR: 1.18, CI: 1.07-1.30) compared with Medicare. Diabetes was also associated with increased 30-day procedure-related revisits (OR: 1.093, CI: 1.024-1.168). CONCLUSIONS:Cataract surgery is a common and, in aggregate, expensive procedure. Complication-related revisits follow a similar trend as surgical complications in large-scale population data, and may be useful as a preliminary, screening outcome measure. Our results highlight the importance of age as a risk factor for cataract surgery readmissions, and suggest a relationship between black or Hispanic race, Medicaid insurance, and diabetes associated with higher risk for cataract surgery complications.
Authors: Amy K Rosen; Megan E Vanneman; William J O'Brien; Suzann Pershing; Todd H Wagner; Erin Beilstein-Wedel; Jeanie Lo; Qi Chen; Glenn C Cockerham; Michael Shwartz Journal: Health Serv Res Date: 2020-07-27 Impact factor: 3.402
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