Assessment of Potentially Preventable Hospital Readmissions
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This JAMA Surgery study suggests that improved access to ambulatory care in the postoperative period, particularly for high-risk patients, may be associated with a substantial reduction in postoperative readmissions after major surgery.

The aim of this study was to evaluate the degree to which readmissions after major surgery are potentially preventable.

This retrospective cohort study used a weighted sample of 1?937?354 patients from the 2017 National Readmissions Database to evaluate all adult inpatient hospitalizations for 1 of 7 common major surgical procedures.

-- A total weighted sample of 1?937?354 patients underwent surgical procedures; 164?755 experienced readmissions within 90 days.

--Potentially preventable readmissions accounted for 29?321 of all 90-day readmissions, for an estimated total cost to the US health care system of approximately $296 million.

--The most common reasons for PPRs were congestive heart failure exacerbation, pneumonia, and acute kidney injury.

--In a multivariable model of adults aged 18 to 64 years, patients with public health insurance (Medicare or Medicaid) had more than twice the odds of PPR compared with those with private insurance.

--Among patients aged 65 years or older, patients with private insurance had 18% lower odds of PPR compared with patients with Medicare as the primary payer.

This study suggests that nearly 1 in 5 readmissions after surgery are potentially preventable and account for nearly $300 million in costs. In addition to better inpatient care, improved access to ambulatory care may represent an opportunity to reduce costly readmissions among surgical patients.

Source: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2778521
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