Evaluation of readmissions due to surgical site infections: A potential target for quality improvement
| Autor: | Emily S. Pavey, Anthony D. Yang, Karl Y. Bilimoria, Mila Ju, Romil F. Shah, Allison R. Dahlke, Ravi Rajaram, Ryan P. Merkow, Michael W. Wandling, Mark E. Cohen |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Colectomies Quality management Hospital performance Patient Readmission 03 medical and health sciences 0302 clinical medicine Surgical site medicine Humans Surgical Wound Infection 030212 general & internal medicine Male gender Aged Aged 80 and over business.industry Open surgery General Medicine Middle Aged Risk adjustment Readmission rate Quality Improvement Surgery 030220 oncology & carcinogenesis Emergency medicine Female business |
| Zdroj: | The American Journal of Surgery. 214:773-779 |
| ISSN: | 0002-9610 |
| DOI: | 10.1016/j.amjsurg.2017.04.011 |
| Popis: | Introduction Readmissions have become a focus of pay-for-performance programs. Surgical site infections (SSI) are the reason for most readmissions. Readmissions for SSI could be a unique target for quality improvement. Methods Readmission risk for SSI were evaluated for patients undergoing colectomies from 2013 to 2014. Hazard models were developed to examine factors associated with and hospital-level variation in risk-adjusted rates of readmission for SSI. Results Among 59,088 patients at 525 hospitals, the rate of readmissions for SSI ranged from 1.45% to 6.34%. Characteristics associated with a greater likelihood of SSI readmissions include male gender, smoking, open surgery and hospitals with increased socioeconomically-disadvantaged patients. After risk adjustment, there was little correlation between hospital performance with SSI readmission rate and performance with overall SSI or total readmission rate (r 2 = 0.29, r 2 = 0.14). Conclusions Readmission for SSI represents a unique aspect of quality beyond that offered by measuring only SSI or readmission rates alone, and may provide actionable quality improvement. |
| Databáze: | OpenAIRE |
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