PMID- 31126362
OWN - NLM
STAT- MEDLINE
DCOM- 20190603
LR  - 20190603
IS  - 1555-9823 (Electronic)
IS  - 0003-1348 (Linking)
VI  - 85
IP  - 5
DP  - 2019 May 1
TI  - Variations in Nationwide Readmission Patterns after Umbilical Hernia Repair.
PG  - 494-500
AB  - Up to one in three readmissions occur at a different hospital and are thus missed 
      by current quality metrics. There are no national studies examining 30-day 
      readmission, including to different hospitals, after umbilical hernia repair 
      (UHR). We tested the hypothesis that a large proportion were readmitted to a 
      different hospital, that risk factors for readmission to a different hospital are 
      unique, and that readmission costs differed between the index and different 
      hospitals. The 2013 to 2014 Nationwide Readmissions Database was queried for 
      patients admitted for UHR, and cost was calculated. Multivariate logistic 
      regression identified risk factors for 30-day readmission at index and different 
      hospitals. There were 102,650 admissions for UHR and 8.9 per cent readmissions, 
      of which 15.8 per cent readmissions were to a different hospital. The most common 
      reason for readmission was infection (25.8%). Risk factors for 30-day readmission 
      to any hospital include bowel resection, index admission at a for-profit 
      hospital, Medicare, Medicaid, and Charlson Comorbidity Index >/= 2. Risk factors 
      for 30-day readmission to a different hospital include elective operation, drug 
      abuse, discharge to a skilled nursing facility, and leaving against medical 
      advice. The median cost of initial admission was higher in those who were 
      readmitted ($16,560 [$10,805-$29,014] vs $11,752 [$8151-$17,724], P < 0.01). The 
      median cost of readmission was also higher among those readmitted to a different 
      hospital ($9826 [$5497-$19,139] vs $9227 [$5211-$16,817], P = 0.02). After UHR, 
      one in six readmissions occur at a different hospital, have unique risk factors, 
      and are costlier. Current hospital benchmarks fail to capture this subpopulation 
      and, therefore, likely underestimate UHR readmissions.
FAU - Eidelson, Sarah A
AU  - Eidelson SA
FAU - Parreco, Joshua
AU  - Parreco J
FAU - Mulder, Michelle B
AU  - Mulder MB
FAU - Dharmaraja, Arjuna
AU  - Dharmaraja A
FAU - Hilton, L Renee
AU  - Hilton LR
FAU - Rattan, Rishi
AU  - Rattan R
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am Surg
JT  - The American surgeon
JID - 0370522
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Female
MH  - Hernia, Umbilical/economics/*surgery
MH  - Herniorrhaphy/adverse effects/economics/*statistics & numerical data
MH  - Hospital Costs
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Patient Readmission/economics/*statistics & numerical data
MH  - Risk Factors
MH  - Time Factors
MH  - United States
MH  - Young Adult
EDAT- 2019/05/28 06:00
MHDA- 2019/06/04 06:00
CRDT- 2019/05/26 06:00
PHST- 2019/05/26 06:00 [entrez]
PHST- 2019/05/28 06:00 [pubmed]
PHST- 2019/06/04 06:00 [medline]
PST - ppublish
SO  - Am Surg. 2019 May 1;85(5):494-500.