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논문 기본 정보

자료유형
학술저널
저자정보
Mahender Avinash (Ganga Medical Centre & Hospital Pvt. Ltd) Karukayil Ramakrishnan Renjith (Ganga Medical Centre & Hospital Pvt. Ltd) Ajoy Prasad Shetty (Ganga Medical Centre & Hospital Pvt. Ltd) Vyom Sharma (Ganga Medical Centre & Hospital Pvt. Ltd) Rishi Mugesh Kanna (Ganga Medical Centre & Hospital Pvt. Ltd) Shanmuganathan Rajasekaran (Ganga Medical Centre & Hospital Pvt. Ltd)
저널정보
대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.14 No.1
발행연도
2020.1
수록면
43 - 50 (8page)

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Study Design: Prospective study. Purpose: During the last decades, an emergence of unplanned readmissions has been shown to be a useful tool to gage the healthcare quality and hospital performance. Previous studies were limited by their retrospective designs based on database information and short-term 30-day follow-up intervals. We analyzed the incidence and causes for unplanned readmissions following spine surgery at a 90-day interval and the difference at 30-, 31–60-, and 61–90-day intervals after discharge. Additionally, we assessed total bed-days lost and the economic impact of readmissions and probable risk factors. Overview of Literature: Recent reports on readmission rates suggested the contribution of this parameter for the assessment of healthcare quality. Methods: A prospective analysis of 2,860 admissions was performed over 1 year in a tertiary care orthopedic hospital. All unscheduled readmissions following spine surgery within 90 days of discharge were included, irrespective of type or location of surgery. Polytrauma, primary osseous infections, and planned readmissions were excluded. Results: Our readmission rate was 3.32% (95/2,860). Leading readmission causes were surgical site infections (SSIs) accounting for 44.21% (n=42; superficial, 23; deep, 11; organ and space, 8), followed by aseptic pain 31.58% (n=30) and medical causes 13.68% (n=13). Though 86.95% of superficial SSIs occurred within 30 days, 21.1% of deep SSIs occurred beyond 30 days. During the 30–90-day interval, 33.68% of readmissions occurred. The financial burden amounted to 41,93,660 Indian Rupees, and the mean bed-days lost was 7.33 per readmission. Hospital stay ≥10 days, health insurance, and comorbid illnesses (diabetes, hypertension, and liver disease) were associated with readmissions (p<0.05). Conclusions: Our study showed that SSIs and aseptic pain were the leading causes of readmissions at 90 days after spine surgery. Limiting the analysis to 30-day readmissions as in previous studies would lead to failure in the identification of more severe complications like deep SSIs. Continued vigilance, particularly for patients with predisposing factors, could help alleviate the financial burden.
#Readmissions #Quality of health care #Surgical-site infections #Spine

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참고문헌 (22)

참고문헌 신청
Jencks SF / 2009 / Rehospitalizations among patients in the Medicare fee-for-service program / N Engl J Med 360:1418~1428 google schola Stefan MS / 2013 / Hospital performance measures and 30-day readmission rates / J Gen Intern Med 28:377~385 google schola Medicare Payment Advisory Commission / 2007 / Report to the congress: promoting greater efficiency in Medicare google schola Boozary AS / 2015 / The Medicare Hospital Readmissions Reduction Program : time for reform / JAMA 314:347~348 google schola Issa K / 2015 / Readmission rates for cruciate-retaining total knee arthroplasty / J Knee Surg 28:239~242 google schola

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