Jacqueline Tucker1, Christopher S Hollenbeak2, Neerav Goyal1,3. 1. College of Medicine The Pennsylvania State University Hershey Pennsylvania USA. 2. Department of Health Policy and Administration, College of Health and Human Development The Pennsylvania State University University Park Pennsylvania USA. 3. Department of Otolaryngology-Head and Neck Surgery Penn State College of Medicine Hershey Pennsylvania USA.
Abstract
Objective: Lowering hospital readmission rates is a national goal, and presents an opportunity to lower health care costs, improve quality, and increase patient satisfaction. We aim to assess whether discharge disposition is associated with readmission. Methods: A retrospective cohort study using logistic regression to quantify risk factors of hospital readmission in patients with confirmed head and neck cancer (HNC) who underwent surgery from 2010 to 2018 contained in the Pennsylvania Health Care Cost Containment Council database, which includes patients treated in Pennsylvania hospitals. Results: The readmission rate in this study was 18.1%. Cancers of the hypopharynx had the highest rates of readmission (29.2%). Male sex (odds ratio [OR]: 0.87, 95% CI: 0.75-1.00), emergent admission (vs. elective admission: OR = 1.33, 95% CI: 1.02-1.74), discharge to home health (vs. home: OR = 1.85, 95% CI: 1.59-2.16), discharge to skilled nursing facility (SNF) (vs. home: OR = 2.21, 95% CI: 1.80-2.72), and having 4+ comorbidities (vs. 0-1: OR = 1.39, 95% CI: 1.09-1.76) were significant risk factors for hospital readmission. Conclusion: It is necessary to consider the readmission risk associated with HNC patients. Reasons for readmission are multifactorial and can be related to demographics, hospital course, comorbidities, or discharge disposition-this requires further assessment. There is importance in increasing HNC awareness and staff education about the unique needs of this population. Level of Evidence: 4.
Objective: Lowering hospital readmission rates is a national goal, and presents an opportunity to lower health care costs, improve quality, and increase patient satisfaction. We aim to assess whether discharge disposition is associated with readmission. Methods: A retrospective cohort study using logistic regression to quantify risk factors of hospital readmission in patients with confirmed head and neck cancer (HNC) who underwent surgery from 2010 to 2018 contained in the Pennsylvania Health Care Cost Containment Council database, which includes patients treated in Pennsylvania hospitals. Results: The readmission rate in this study was 18.1%. Cancers of the hypopharynx had the highest rates of readmission (29.2%). Male sex (odds ratio [OR]: 0.87, 95% CI: 0.75-1.00), emergent admission (vs. elective admission: OR = 1.33, 95% CI: 1.02-1.74), discharge to home health (vs. home: OR = 1.85, 95% CI: 1.59-2.16), discharge to skilled nursing facility (SNF) (vs. home: OR = 2.21, 95% CI: 1.80-2.72), and having 4+ comorbidities (vs. 0-1: OR = 1.39, 95% CI: 1.09-1.76) were significant risk factors for hospital readmission. Conclusion: It is necessary to consider the readmission risk associated with HNC patients. Reasons for readmission are multifactorial and can be related to demographics, hospital course, comorbidities, or discharge disposition-this requires further assessment. There is importance in increasing HNC awareness and staff education about the unique needs of this population. Level of Evidence: 4.
Authors: Peter T Dziegielewski; Brian Boyce; Amy Manning; Amit Agrawal; Matthew Old; Enver Ozer; Theodoros N Teknos Journal: Head Neck Date: 2015-08-25 Impact factor: 3.147
Authors: Andrés M Bur; Jason A Brant; Carolyn L Mulvey; Elizabeth A Nicolli; Robert M Brody; John P Fischer; Steven B Cannady; Jason G Newman Journal: JAMA Otolaryngol Head Neck Surg Date: 2016-12-01 Impact factor: 6.223
Authors: Evan M Graboyes; Dorina Kallogjeri; Jan Zerega; Sara Kukuljan; Linda Neal; Kelsey M Rosenquist; Brian Nussenbaum Journal: JAMA Otolaryngol Head Neck Surg Date: 2017-12-01 Impact factor: 6.223
Authors: Michelle M Chen; Ryan K Orosco; Jeremy P Harris; Julie B Porter; Eben L Rosenthal; Wendy Hara; Vasu Divi Journal: Oral Oncol Date: 2017-08 Impact factor: 5.337