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dc.contributor.advisorKarim Alavi, MD/Surgery
dc.contributor.authorDamle, Rachelle N.
dc.contributor.authorCherng, Nicole B.
dc.contributor.authorFlahive, Julie
dc.contributor.authorDavids, Jennifer S.
dc.contributor.authorMaykel, Justin A.
dc.contributor.authorSturrock, Paul R.
dc.contributor.authorSweeney, W. Brian
dc.contributor.authorAlavi, Karim
dc.date2022-08-11T08:10:55.000
dc.date.accessioned2022-08-23T17:24:52Z
dc.date.available2022-08-23T17:24:52Z
dc.date.issued2014-12-01
dc.date.submitted2016-04-20
dc.identifier.citationDis Colon Rectum. 2014 Dec;57(12):1421-9. doi: 10.1097/DCR.0000000000000251. <a href="http://dx.doi.org/10.1097/DCR.0000000000000251">Link to article on publisher's site</a>
dc.identifier.issn0012-3706 (Linking)
dc.identifier.doi10.1097/DCR.0000000000000251
dc.identifier.pmid25380009
dc.identifier.urihttp://hdl.handle.net/20.500.14038/49282
dc.description<p>Nichole Cherng participated in this study as a medical student as part of the Senior Scholars research program at the University of Massachusetts Medical School.</p>
dc.description.abstractBACKGROUND: After passage of the Affordable Care Act, 30 -day hospital readmissions have come under greater scrutiny. Excess readmissions for certain medical conditions and procedures now result in penalizations on all Medicare reimbursements. OBJECTIVE: The purpose of this work was to define the risk factors, outcomes, and costs of 30-day readmissions after colorectal surgery. DESIGN: Adults undergoing colorectal surgery were studied using data from the University HealthSystem Consortium. Univariate and multivariable analyses were used to identify patient-related risk factors for, and 30-day outcomes of, readmission after colorectal surgery. SETTINGS: This study was conducted at an academic hospital and its affiliates. PATIENTS: Adults > /=18 years of age who underwent colorectal surgery for cancer, diverticular disease, IBD, or benign tumors between 2008 and 2011 were included in this study. MAIN OUTCOME MEASURES: Readmission within 30 days of index discharge was the main outcome measured. RESULTS: A total of 70,484 patients survived the index hospitalization after colorectal surgery; 9632 (13.7%) were readmitted within 30 days of discharge. The strongest independent predictors of readmission were length of stay > /=4 days (OR 1.44; 95% CI 1.32-1.57), stoma (OR 1.54; 95% CI 1.46-1.51), and discharge to skilled nursing (OR 1.62; 95% CI 1.49-1.76) or rehabilitation facility (OR 2.93; 95% CI 2.53-3.40). Of those readmitted, half of the readmissions occurred within 7 days, 13% required the intensive care unit, 6% had a reoperation, and 2% died during the readmission stay. The median combined total direct hospital cost was more than 2 times higher ($26,917 vs $13,817; p < 0.001) for readmitted than for nonreadmitted patients. LIMITATIONS: Follow-up was limited to 30 days after initial discharge. CONCLUSIONS: Readmissions after colorectal resection occur frequently and incur a significant financial burden on the health-care system. Future studies aimed at targeted interventions for high-risk patients may reduce readmissions and curb escalating health-care costs.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=25380009&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1097/DCR.0000000000000251
dc.subjectCohort Studies
dc.subject*Colectomy
dc.subjectComorbidity
dc.subjectCost of Illness
dc.subjectFemale
dc.subjectHospital Costs
dc.subjectHumans
dc.subject*Intestinal Diseases
dc.subjectLength of Stay
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectOutcome Assessment (Health Care)
dc.subjectPatient Discharge
dc.subject*Patient Readmission
dc.subject*Postoperative Complications
dc.subjectReoperation
dc.subjectRisk Factors
dc.subjectSeverity of Illness Index
dc.subjectTime Factors
dc.subjectUnited States
dc.subjectClinical Epidemiology
dc.subjectHealth Services Research
dc.subjectSurgery
dc.titleClinical and financial impact of hospital readmissions after colorectal resection: predictors, outcomes, and costs
dc.typeJournal Article
dc.source.journaltitleDiseases of the colon and rectum
dc.source.volume57
dc.source.issue12
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/ssp/225
dc.identifier.contextkey8497977
html.description.abstract<p>BACKGROUND: After passage of the Affordable Care Act, 30 -day hospital readmissions have come under greater scrutiny. Excess readmissions for certain medical conditions and procedures now result in penalizations on all Medicare reimbursements.</p> <p>OBJECTIVE: The purpose of this work was to define the risk factors, outcomes, and costs of 30-day readmissions after colorectal surgery.</p> <p>DESIGN: Adults undergoing colorectal surgery were studied using data from the University HealthSystem Consortium. Univariate and multivariable analyses were used to identify patient-related risk factors for, and 30-day outcomes of, readmission after colorectal surgery.</p> <p>SETTINGS: This study was conducted at an academic hospital and its affiliates.</p> <p>PATIENTS: Adults > /=18 years of age who underwent colorectal surgery for cancer, diverticular disease, IBD, or benign tumors between 2008 and 2011 were included in this study.</p> <p>MAIN OUTCOME MEASURES: Readmission within 30 days of index discharge was the main outcome measured.</p> <p>RESULTS: A total of 70,484 patients survived the index hospitalization after colorectal surgery; 9632 (13.7%) were readmitted within 30 days of discharge. The strongest independent predictors of readmission were length of stay > /=4 days (OR 1.44; 95% CI 1.32-1.57), stoma (OR 1.54; 95% CI 1.46-1.51), and discharge to skilled nursing (OR 1.62; 95% CI 1.49-1.76) or rehabilitation facility (OR 2.93; 95% CI 2.53-3.40). Of those readmitted, half of the readmissions occurred within 7 days, 13% required the intensive care unit, 6% had a reoperation, and 2% died during the readmission stay. The median combined total direct hospital cost was more than 2 times higher ($26,917 vs $13,817; p < 0.001) for readmitted than for nonreadmitted patients.</p> <p>LIMITATIONS: Follow-up was limited to 30 days after initial discharge.</p> <p>CONCLUSIONS: Readmissions after colorectal resection occur frequently and incur a significant financial burden on the health-care system. Future studies aimed at targeted interventions for high-risk patients may reduce readmissions and curb escalating health-care costs.</p>
dc.identifier.submissionpathssp/225
dc.contributor.departmentDepartment of Surgery
dc.contributor.departmentSchool of Medicine
dc.contributor.departmentSenior Scholars Program
dc.source.pages1421-9
dc.contributor.studentNicole Cherng


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