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Am J Surg. 2016 Jul;212(1):24-33. doi: 10.1016/j.amjsurg.2015.08.020. Epub 2015 Oct 1.

Measuring readmissions after surgery: do different methods tell the same story?

Author information

1
Center for Healthcare Organizational and Implementation Research, VA Boston Healthcare System, 150 South Huntington Avenue (152M), Boston, MA, 02130, USA. Electronic address: qi.chen2@va.gov.
2
Center for Healthcare Organizational and Implementation Research, VA Boston Healthcare System, 150 South Huntington Avenue (152M), Boston, MA, 02130, USA; Department of Surgery, Boston University School of Medicine, Boston, MA, USA.
3
Center for Healthcare Organizational and Implementation Research, Bedford VAMC, Bedford, MA, USA; Department of Health Policy and Management, Boston University School of Public Health, Boston, MA, USA; Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
4
Center for Healthcare Organizational and Implementation Research, VA Boston Healthcare System, 150 South Huntington Avenue (152M), Boston, MA, 02130, USA.
5
Department of Surgery, Boston University School of Medicine, Boston, MA, USA; Department of Surgery, VA Boston Healthcare System, Boston, MA, USA; Department of Surgery, Harvard Medical School, Boston, MA, USA.

Abstract

BACKGROUND:

Readmission is widely used as a quality metric to assess hospital performance. However, different methods to calculate readmissions may produce various results, leading to differences in classification with respect to hospital performance. This study compared 2 commonly used approaches to measure surgical readmissions: the 30-day all-cause hospital-wide readmissions (HWRs) and the potentially preventable readmissions (PPRs).

METHODS:

We examined the correlation between hospitals' risk-adjusted HWR and PPR rates and whether there was agreement in categorizing hospital performance between these measures among 111 hospitals with inpatient surgical programs in the Veterans Health Administration.

RESULTS:

We found that hospitals' HWR and PPR rates were highly correlated (r = .85, P < .0001). The overall agreement between these 2 methods in categorizing hospital performance was 82% for all surgeries, 82% for colectomy, 84% for coronary bypass, and 87% for hip/knee replacement, respectively.

CONCLUSIONS:

Despite differences in methodologies, the HWR and the PPR measures provided relatively consistent perceptions of hospitals' performance on surgical readmissions.

KEYWORDS:

30-Day all-cause hospital-wide readmissions; Administrative data; Potentially preventable readmissions; Surgical readmissions; Veterans Health Administration

PMID:
26506557
DOI:
10.1016/j.amjsurg.2015.08.020
[Indexed for MEDLINE]

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