After Colorectal Cancer Surgery, Risk-Adjusted Readmission Rates Similar

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Little variation in hospital readmission rates after adjustment for patient characteristics, comorbidities.
Little variation in hospital readmission rates after adjustment for patient characteristics, comorbidities.

There is little variation in risk-adjusted hospital readmission rates after colorectal surgery, according to a study published in JAMA Surgery.

Donald J. Lucas, M.D., M.P.H., from the Walter Reed National Military Medical Center in Bethesda, Md., and colleagues examined the variability in risk-adjusted readmission rates after colorectal surgery. Observational data were collected from the Surveillance, Epidemiology, and End Results-Medicare linked database for 44,822 patients who underwent colorectal resection for cancer at 1,401 U.S. hospitals.

The researchers found that the 30-day readmission rate was 12.3 percent overall. There was marked variation in raw readmission rates among hospitals that performed at least five operations annually, with a range of 0 to 41.2 percent.

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No significant variability was found in readmission rates among hospitals after adjustment for patient characteristics, comorbidities, and operation types, with a range of 11.3 to 13.2 percent. At every hospital, the 95 percent confidence interval for hospital-specific readmission overlapped the overall mean.

"The use of readmission rates as a high-stakes quality measure for payment adjustment or public reporting across surgical specialties should proceed cautiously and must include appropriate risk adjustment," the authors write.

Reference

  1. Lucas, Donald J., MD, MPHD, et al. "Variation in Readmission by Hospital After Colorectal Cancer Surgery." JAMA Surgery. doi:10.1001/jamasurg.2014.988. October 22, 2014.

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