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

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

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.

Publication types

  • Comparative Study

MeSH terms

  • Cross-Sectional Studies
  • Female
  • Hospital Mortality
  • Humans
  • Length of Stay*
  • Male
  • Medicaid / economics
  • Medicaid / statistics & numerical data
  • Medicare / economics
  • Medicare / statistics & numerical data
  • Outcome Assessment, Health Care
  • Patient Readmission / statistics & numerical data*
  • Postoperative Complications / physiopathology
  • Postoperative Complications / therapy
  • Quality Indicators, Health Care*
  • Retrospective Studies
  • Risk Adjustment
  • Surgical Procedures, Operative / adverse effects*
  • Surgical Procedures, Operative / methods
  • Surgical Procedures, Operative / mortality
  • United States
  • United States Department of Veterans Affairs