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Hospital readmissions and emergency department visits following laparoscopic and open colon resection for cancer.
Dis Colon Rectum 2013; 56(9):1053-61DC

Abstract

BACKGROUND

Laparoscopic colectomy for the treatment of colon cancer has been widely adopted in community practice, in part, because of shorter hospitalizations. The benefits of a shorter hospital stay are only realized if readmissions and emergency department visits, collectively termed revisits, do not increase after discharge. We conducted a population-based analysis to determine whether hospitals with higher laparoscopic colectomy rates have higher revisit rates.

OBJECTIVE

The aim of this study was to determine whether hospital utilization after discharge is increased for patients undergoing laparoscopic colectomy for cancer.

DESIGN

This is a retrospective cohort study.

SETTINGS

Data were gathered from the Healthcare Cost and Utilization Project's inpatient and emergency department databases for California. These databases include data from all nonfederal hospitals in the State of California.

PATIENTS

Patients who underwent elective colectomy for cancer from 2008 to 2009 were included.

INTERVENTIONS

The primary intervention was elective colectomy with the use of the open or laparoscopic approach.

MAIN OUTCOME MEASURES

The correlation between hospital laparoscopy rates and hospital readmission rates, emergency department visit rates, and revisit rates was calculated.

RESULTS

Overall, 6760 patients were treated at 176 hospitals. For every 100 patients discharged, there were 14.0 readmissions and 9.2 emergency department encounters. At the hospital level, laparoscopy rates varied considerably (median = 45.7%, range = 2.2%-88.9%), as did the risk-standardized readmission (12.1%, 8.6%-16.5%), emergency department encounter (7.8%, 4.1%-18.0%), and revisit rates (17.9%, 13.0%-26.4%). A hospital's laparoscopy rate was not significantly correlated with its risk-standardized readmission (weighted correlation coefficient = 0.05, p = 0.50), emergency department encounter (-0.11, p = 0.16), or revisit (-0.03, p = 0.70) rates.

LIMITATIONS

There are inherent limitations when using administrative data.

CONCLUSIONS

Hospitals where a greater proportion of colon resections for cancer are approached laparoscopically do not have higher 30-day, risk-standardized readmission, emergency department encounter, or revisit rates.

Authors+Show Affiliations

Department of Surgery, Wright Patterson Air Force Base, Dayton, OH, USA. dallas.hansen@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23929014

Citation

Hansen, Dallas G., et al. "Hospital Readmissions and Emergency Department Visits Following Laparoscopic and Open Colon Resection for Cancer." Diseases of the Colon and Rectum, vol. 56, no. 9, 2013, pp. 1053-61.
Hansen DG, Fox JP, Gross CP, et al. Hospital readmissions and emergency department visits following laparoscopic and open colon resection for cancer. Dis Colon Rectum. 2013;56(9):1053-61.
Hansen, D. G., Fox, J. P., Gross, C. P., & Bruun, J. S. (2013). Hospital readmissions and emergency department visits following laparoscopic and open colon resection for cancer. Diseases of the Colon and Rectum, 56(9), pp. 1053-61. doi:10.1097/DCR.0b013e318293eabc.
Hansen DG, et al. Hospital Readmissions and Emergency Department Visits Following Laparoscopic and Open Colon Resection for Cancer. Dis Colon Rectum. 2013;56(9):1053-61. PubMed PMID: 23929014.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hospital readmissions and emergency department visits following laparoscopic and open colon resection for cancer. AU - Hansen,Dallas G, AU - Fox,Justin P, AU - Gross,Cary P, AU - Bruun,John S, PY - 2013/8/10/entrez PY - 2013/8/10/pubmed PY - 2013/10/22/medline SP - 1053 EP - 61 JF - Diseases of the colon and rectum JO - Dis. Colon Rectum VL - 56 IS - 9 N2 - BACKGROUND: Laparoscopic colectomy for the treatment of colon cancer has been widely adopted in community practice, in part, because of shorter hospitalizations. The benefits of a shorter hospital stay are only realized if readmissions and emergency department visits, collectively termed revisits, do not increase after discharge. We conducted a population-based analysis to determine whether hospitals with higher laparoscopic colectomy rates have higher revisit rates. OBJECTIVE: The aim of this study was to determine whether hospital utilization after discharge is increased for patients undergoing laparoscopic colectomy for cancer. DESIGN: This is a retrospective cohort study. SETTINGS: Data were gathered from the Healthcare Cost and Utilization Project's inpatient and emergency department databases for California. These databases include data from all nonfederal hospitals in the State of California. PATIENTS: Patients who underwent elective colectomy for cancer from 2008 to 2009 were included. INTERVENTIONS: The primary intervention was elective colectomy with the use of the open or laparoscopic approach. MAIN OUTCOME MEASURES: The correlation between hospital laparoscopy rates and hospital readmission rates, emergency department visit rates, and revisit rates was calculated. RESULTS: Overall, 6760 patients were treated at 176 hospitals. For every 100 patients discharged, there were 14.0 readmissions and 9.2 emergency department encounters. At the hospital level, laparoscopy rates varied considerably (median = 45.7%, range = 2.2%-88.9%), as did the risk-standardized readmission (12.1%, 8.6%-16.5%), emergency department encounter (7.8%, 4.1%-18.0%), and revisit rates (17.9%, 13.0%-26.4%). A hospital's laparoscopy rate was not significantly correlated with its risk-standardized readmission (weighted correlation coefficient = 0.05, p = 0.50), emergency department encounter (-0.11, p = 0.16), or revisit (-0.03, p = 0.70) rates. LIMITATIONS: There are inherent limitations when using administrative data. CONCLUSIONS: Hospitals where a greater proportion of colon resections for cancer are approached laparoscopically do not have higher 30-day, risk-standardized readmission, emergency department encounter, or revisit rates. SN - 1530-0358 UR - https://www.unboundmedicine.com/medline/citation/23929014/Hospital_readmissions_and_emergency_department_visits_following_laparoscopic_and_open_colon_resection_for_cancer_ L2 - http://dx.doi.org/10.1097/DCR.0b013e318293eabc DB - PRIME DP - Unbound Medicine ER -