Association between occurrence of a postoperative complication and readmission: implications for quality improvement and cost savings.

摘要: OBJECTIVE To estimate the effect of preventing postoperative complications on readmission rates and costs. BACKGROUND Policymakers are targeting for quality improvement cost savings. Little is known regarding mutable factors associated with readmissions. METHODS Patient records (2005-2008) from American College Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) were linked to Medicare inpatient claims. Risk factors, procedure, 30-day determined ACS-NSQIP. The costs Medicare. Occurrence a complication included surgical site infections cardiac, pulmonary, neurologic, renal complications. Multivariate regression models predicted reducing risk-adjusted by procedure. RESULTS rate was 12.8%. Complication readmitted nonreadmitted patients 53% 16% (P < 0.001). Patients had higher probability than without complication. For 20 procedures accounting greatest number readmissions, ACS-NSQIP relative 5% could result in prevention 2092 readmissions per year savings $31.0 million year. Preventing all these 41,846 $620.3 CONCLUSIONS This study provides substantial evidence that efforts reduce should begin focusing can be reliably validly measured. Such an approach will not eliminate but likely have major rates.