NDLI: Descriptive Analysis of 30-Day Readmission After Inpatient Surgery Discharge in the Veterans Health Administration

Content Provider	JAMA Network
Author	Han, Soonhee Smith, Tracy S. Gunnar, William
Copyright Year	2014
Abstract	Importance: For the first time to our knowledge, this study analyzes and reports the 30-day all-cause readmission rates for surgical procedures performed in the Veterans Health Administration ( VHA). Objective: To analyze and report 30-day all-cause readmission rates following discharge from 9 surgical specialties in the VHA for a 10-year period. Design, Setting, and Participants: In a retrospective observational study, Veterans Affairs Surgical Quality Improvement Program data for surgery records and VHA administrative discharge data were linked to evaluate all-cause readmission within 30 days of discharge from the surgical inpatient stay. The study population represents 9 surgical specialty groups: general, urology, neurosurgery, orthopedic, otolaryngology, plastic, thoracic, peripheral vascular, and cardiac. Trends of postoperative hospital admission rates for each surgery were investigated using 10 years (fiscal years 2001-2010; N = 894 943) of linked data. Main Outcomes and Measures: All-cause 30-day readmission after surgery for each specialty. Results: During the 10-year period, the overall 30-day all-cause readmission rate following inpatient surgery discharge significantly decreased from 12.9% to 12.2% ( P < .001). Unadjusted readmission rates varied by surgical specialty: general, 12.5%; urology, 9.0%; neurosurgery, 10.5%; orthopedic, 9.6%; otolaryngology, 9.5%; plastic, 12.2%; thoracic, 14.4%; peripheral vascular, 16.0%; and cardiac, 16.6%. The following specialties were found to have a significant decline in readmission rates: orthopedic ( P = .004), otolaryngology ( P = .005), plastic ( P = .02), thoracic ( P = .04), peripheral vascular ( P < .001), and cardiac ( P = .003). Postoperative hospital length of stay in individual specialties decreased during this period (each: P < .05) except for thoracic and cardiac surgery, which remained unchanged. Readmission diagnoses varied by specialty; postoperative infection was the most common readmission diagnosis in 7 specialties and the second most common in the other 2 specialties (urology and thoracic). Urinary tract infection and digestive system complications were also common readmission diagnoses. Conclusions and Relevance: This retrospective observational study showed decreasing 30-day readmission rates associated with a decline in postoperative hospital length of stay for 9 surgical specialties in the VHA during a 10-year period. Further study will be required to capture data from patients who had surgery at a VHA facility but were readmitted in the private sector.
Ending Page	1168
Starting Page	1162
Page Count	7
File Format	PDF HTM / HTML
ISSN	21686254
DOI	10.1001/jamasurg.2014.1706
Issue Number	11
Journal	JAMA Surgery
Volume Number	149
Language	English
Publisher	American Medical Association
Publisher Date	2014-11-01
Access Restriction	Open
Subject Keyword	urinary tract infection postoperative complications length of stay patient readmission pneumonia surgical wound infection veterans postoperative infections operative surgical procedures
Content Type	Text
Resource Type	Article
Subject	Surgery

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

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