Nearly one in five older emergency general surgery patients were readmitted to a hospital other than the one where their original procedure was performed, according to a study published in JAMA Surgery.
Researchers performed a retrospective analysis of the Medicare inpatient claims file, from January 2008 to November 2011, and matched patient details to hospital information in the 2011 American Hospital Association Annual Survey database.
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In all, researchers identified 109,443 emergency general surgery patients readmitted within 30 days of discharge, of which 20,396 were readmitted to nonindex hospitals, or a hospital where their initial surgery was not performed.
Here are five insights:
1. Of the readmitted patients, 56 percent were female.
2. Care discontinuity, defined as readmission within 30 days to nonindex hospitals, was higher among patients who:
• Were male
• Were younger than 85 years old
• Lived 12.8 km or more away from the index hospitals, or hospital where their original procedure was performed
3. Hospital factors associated with care discontinuity included:
• Bed size of 200 or more
• Safety-net status
• Teaching status
4. Care discontinuity was independently associated with mortality.
5. Care discontinuity was significantly lower among designated trauma centers and highest among hospitals in the Midwest.