Hospital Readmission by Method of Data Collection

Published

April 11, 2013

Author(s)

Elizabeth M. Hechenbleikner, Martin A. Makary, Daniel Samarov, Jennifer L. Bennett, Susan L. Gearhart, Jonathan E. Efron, Elizabeth C. Wick

Abstract

Hospital readmissions are increasingly used as a metric of quality with non-payment planned for excess preventable rehospitalizations. Currently, data for pay-for-performance incentives are obtained from administrative sources however this information may not be accurate. We hypothesized that determining readmission rates and establishing preventability vary by data collection method for surgical patients. Study Design: Using three different methods, we compared 30-day unplanned readmission rates and potentially preventable readmissions for colorectal surgery patients at a single institution between July 2009 and November 2011: National Surgical Quality Improvement Program/NSQIP (nurse clinical reviewer), University HealthSystem Consortium/UHC (administrative billing data), and physician medical record review. Results: We identified 735 patients in NSQIP and UHC; unplanned readmissions occurred in 14.7%(108 patients) and 17.6%(129 patients), respectively. NSQIP identified 10 readmissions not found in billing records because the readmission occurred at another hospital(n=7), discrepancy in definition(n=2), or oversight(n=1). UHC identified 31 readmissions not found in NSQIP because of discrepancy in 30-day readmission definition(n=20) or oversight(n=11). UHC identified 66(51%) readmissions as related to index admission, which were identified as potentially preventable, compared to physician chart review at 111 readmissions(86%) but objective clinical criteria revealed that only 17(13%) readmissions were avoidable. The majority of readmissions were due to complications like surgical site infection(SSI) and dehydration.

Citation

Journal of the American College of Surgeons

Pub Type

Journals

Keywords

Hospital readmissions, surgical readmissions, readmission preventability.

Citation

Hechenbleikner, E. , Makary, M. , Samarov, D. , Bennett, J. , Gearhart, S. , Efron, J. and Wick, E. (2013), Hospital Readmission by Method of Data Collection, Journal of the American College of Surgeons (Accessed April 19, 2024)