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• W2024263810 abstract "You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Cost Effectiveness IV1 Apr 2015MP32-15 READMISSION INTENSITY AFTER HIGH-RISK SURGERY Bruce Jacobs, Chang He, Benjamin Li, Michael Hu, Alex Helfand, Naveen Krishnan, Brent Hollenbeck, Jonathan Helm, Mariel Lavieri, and Ted Skolarus Bruce JacobsBruce Jacobs More articles by this author , Chang HeChang He More articles by this author , Benjamin LiBenjamin Li More articles by this author , Michael HuMichael Hu More articles by this author , Alex HelfandAlex Helfand More articles by this author , Naveen KrishnanNaveen Krishnan More articles by this author , Brent HollenbeckBrent Hollenbeck More articles by this author , Jonathan HelmJonathan Helm More articles by this author , Mariel LavieriMariel Lavieri More articles by this author , and Ted SkolarusTed Skolarus More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1411AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The Hospital Readmissions Reduction Program currently reduces payments to hospitals with excess readmissions for 3 common medical conditions and plans to extend its readmission program to surgeries, including those that are high risk. However, the characterization of readmissions after high-risk surgery (e.g., radical cystectomy) is still largely unknown. We sought to investigate readmission intensity as defined by resource utilization for high-risk surgeries and examine predictors of higher readmission intensity. METHODS Using the Healthcare Cost and Utilization Project's State Inpatient Database, we identified 69,321 adults in 4 geographically diverse states (Iowa, New York, North Carolina, and Washington) who underwent 1 of 7 high-risk surgeries in 2009 and 2010. These surgeries included abdominal aortic aneurysm repair (open approach), coronary artery bypass grafting, aortic valve replacement, esophagectomy, pancreatectomy, lung resection, and cystectomy. We categorized readmission intensity as higher (≥4 events) or lower (≤3 events) based on the utilization of 5 different resources: a major operating room procedure, blood transfusion, imaging (CT, MRI, or ultrasound), intensive care unit stay, and dialysis. We used a generalized logistic model to estimate the effects of patient and index admission characteristics on readmission intensity. RESULTS Across all 7 surgeries, 30-day readmission rates were high and ranged from 11% (lung resection) to 29% (cystectomy). The relationship between median readmission length of stay and resource utilization is shown in the Figure. Compared with patients who had lower readmission intensity, those with higher readmission intensity were more likely to be discharged home after the index admission (adjusted odds ratio [aOR] 1.79; 95% confidence interval [CI] 1.34-2.40), undergo imaging (aOR 1.26; 1.00-1.59), intensive care unit stay (aOR 1.83; 1.41-2.36), or dialysis (aOR 4.11; 3.05-5.54) on index admission, and be readmitted from another hospital (aOR 2.62; 1.35-5.10). CONCLUSIONS Certain characteristics of the index admission are predictors of higher intensity readmissions. Better identifying patients susceptible to higher intensity readmissions may inform future interventions to either reduce the intensity of these readmissions or eliminate them altogether. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e370 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Bruce Jacobs More articles by this author Chang He More articles by this author Benjamin Li More articles by this author Michael Hu More articles by this author Alex Helfand More articles by this author Naveen Krishnan More articles by this author Brent Hollenbeck More articles by this author Jonathan Helm More articles by this author Mariel Lavieri More articles by this author Ted Skolarus More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2024263810 title "MP32-15 READMISSION INTENSITY AFTER HIGH-RISK SURGERY" @default.
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