Katherine M Kelley1, Jay Collins2, L D Britt3, DaShaunda D H Taylor4, Rebecca Britt5. 1. Eastern Virginia Medical School, Department of Surgery, 825 Fairfax Ave, 6th Floor, Norfolk, VA, 23507, USA. Electronic address: katherine.kelley@umm.edu. 2. Eastern Virginia Medical School, Department of Surgery, 825 Fairfax Ave, 6th Floor, Norfolk, VA, 23507, USA. Electronic address: collinjn@evms.edu. 3. Eastern Virginia Medical School, Department of Surgery, 825 Fairfax Ave, 6th Floor, Norfolk, VA, 23507, USA. Electronic address: Brittld@evms.edu. 4. Eastern Virginia Medical School, EVMS-Sentara Healthcare Analytics and Delivery Science Institute, P. O. Box 1980, Norfolk, VA, 23501, USA. Electronic address: Ddhilliard20@gmail.com. 5. Eastern Virginia Medical School, Department of Surgery, 825 Fairfax Ave, 6th Floor, Norfolk, VA, 23507, USA. Electronic address: brittrc@evms.edu.
Abstract
BACKGROUND: Readmission rates are an important metric because they enable an evaluation of care and affect Medicare funding. This study evaluates factors contributing to readmission after emergency general surgery. METHODS: The Virginia Health Information database was used to identify patients who had undergone the most common emergency general surgery procedures from 1/2011-6/2016. Analyses were performed for 30 and 90-day readmission. RESULTS: 121,223 records met initial inclusion criteria and 54,372 remained after exclusions. In 30 days there were 5050 readmissions and 7896 readmissions in 90 days. Factors significant in contributing to 30-day readmission were length of stay, discharge location, and several comorbidities. For 90-day readmission the same factors were significant with the addition of urgent vs emergency admission and insurance status as well as additional comorbidities. Discharge to rehab, SNF, or with home healthcare had particularly high rates of 90 day readmission. CONCLUSIONS: We identified factors that contribute to readmission after emergency general surgery providing targets for future interventions. Improved follow up for patients discharged with rehab or home health needs is our next step.
BACKGROUND: Readmission rates are an important metric because they enable an evaluation of care and affect Medicare funding. This study evaluates factors contributing to readmission after emergency general surgery. METHODS: The Virginia Health Information database was used to identify patients who had undergone the most common emergency general surgery procedures from 1/2011-6/2016. Analyses were performed for 30 and 90-day readmission. RESULTS: 121,223 records met initial inclusion criteria and 54,372 remained after exclusions. In 30 days there were 5050 readmissions and 7896 readmissions in 90 days. Factors significant in contributing to 30-day readmission were length of stay, discharge location, and several comorbidities. For 90-day readmission the same factors were significant with the addition of urgent vs emergency admission and insurance status as well as additional comorbidities. Discharge to rehab, SNF, or with home healthcare had particularly high rates of 90 day readmission. CONCLUSIONS: We identified factors that contribute to readmission after emergency general surgery providing targets for future interventions. Improved follow up for patients discharged with rehab or home health needs is our next step.