Healthcare News & Insights

Hospital readmissions: Study identifies responsible post-op complications

Here’s a quiz for you: Out of 10 general surgery patients, how many return due to post-op complications?
a.) one b.) two c.) three d.) five

According to a recent study published in the Journal of the American College of Surgeons, the answer is one.

But for hospital executives, that’s too many when you consider that starting next month, hospitals will be penalized from .42% to 1% for high readmission rates.  And according to Kaiser Health News report, that can add up to the high six figures or low seven figures for a single, large facility.

That’s a lot of money to lose considering most hospitals have been doing more with less for some time now — trying to provide improved patient care for fewer healthcare dollars.

Risk factors

In the study, the American College of Surgeons looked at facilities enrolled in the National Surgical Quality Improvement Program. Out of 1,500 general surgery patients, 11.3% were readmitted to the hospital within 30 days.

So if hospital administrators want to avoid readmission penalties, then they have to know what procedures and complications are responsible for the most readmissions and take steps to reduce them.

Obviously this is easier said than done, since multiple risk factors are often responsible for readmissions.

In this study, however, the driving risk factor was postoperative complications. Of the possible postoperative complications, here are the top three:

  • gastrointestinal problems/complications (27.6%)
  • surgical infections (22.1%), and
  • failure to thrive/malnutrition (10.4%).

As for the procedures that had the highest rates of readmission, they included pancreatectomy, colectomy and liver resection.

Other factors the study found that lead to an increased risk of readmission were blood transfusion, postoperative pulmonary complication, wound complication, sepsis/shock, urinary tract infection and vascular complications.

Of course, it goes to reason that the more postoperative complications a patient has, the higher his or her likelihood of being readmitted.

And if any of the complications happen when a patient is at home, he or she has a higher probability of being re-hospitalized.

What to do

The study concluded that taking the appropriate steps to minimize postoperative complications will decrease postoperative readmissions — if only it were that simple.

Your best bet: Run an analysis of your facility’s hospital readmissions and their causes.

Assign teams to study what processes can be changed to lower the risk of complications and how they can be implemented.

Yes this takes time and effort, and the penalty deadline is right around the corner, but if you haven’t already started doing this, there’s no time like the present.

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