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Predictors of readmission to non-index hospitals after colorectal surgery.
Am J Surg 2017; 213(1):18-23AJ

Abstract

BACKGROUND

Although a significant proportion of patients are readmitted to non-index hospitals after surgery, risk factors for non-index hospital readmission are not well defined.

METHODS

Using the California Office of State Health Planning and Development database from 2008 to 2012, patients readmitted to index versus non-index hospitals after colorectal surgery were directly compared. Risk factors for non-index hospital readmission were assessed through logistic regression.

RESULTS

Among the 14,401 patients requiring readmission, 10,890 (75.6%) were readmitted to index hospitals, whereas 3,511 (24.4%) were readmitted to non-index hospitals. Patients readmitted to non-index hospitals were more likely to be men and have a greater Charlson comorbidity index, non-private insurance, longer initial length of stay, longer travel distance, and non-home discharge disposition. On multivariable logistic regression analysis, living ≥10 miles from the index hospital was strongly predictive of non-index hospital readmission (odds ratio, 1.8; 95% confidence interval, 1.63 to 2.00).

CONCLUSIONS

Approximately 25% of readmissions after colorectal surgery will be to non-index hospitals. Risks factors include greater comorbidities, non-private health insurance, occurrence of an inpatient complication, longer length of stay, greater travel distance, and non-home discharge disposition.

Authors+Show Affiliations

Department of Surgery, Stanford University, Stanford, CA, USA. Electronic address: jmcloyd@mdanderson.org.Department of Surgery, Stanford University, Stanford, CA, USA.Department of Surgery, Stanford University, Stanford, CA, USA.Department of Surgery, Stanford University, Stanford, CA, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27401838

Citation

Cloyd, Jordan M., et al. "Predictors of Readmission to Non-index Hospitals After Colorectal Surgery." American Journal of Surgery, vol. 213, no. 1, 2017, pp. 18-23.
Cloyd JM, Huang L, Ma Y, et al. Predictors of readmission to non-index hospitals after colorectal surgery. Am J Surg. 2017;213(1):18-23.
Cloyd, J. M., Huang, L., Ma, Y., & Rhoads, K. F. (2017). Predictors of readmission to non-index hospitals after colorectal surgery. American Journal of Surgery, 213(1), pp. 18-23. doi:10.1016/j.amjsurg.2016.04.006.
Cloyd JM, et al. Predictors of Readmission to Non-index Hospitals After Colorectal Surgery. Am J Surg. 2017;213(1):18-23. PubMed PMID: 27401838.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictors of readmission to non-index hospitals after colorectal surgery. AU - Cloyd,Jordan M, AU - Huang,Lyen, AU - Ma,Yifei, AU - Rhoads,Kim F, Y1 - 2016/06/11/ PY - 2016/03/27/received PY - 2016/04/19/revised PY - 2016/04/19/accepted PY - 2016/7/13/pubmed PY - 2017/3/30/medline PY - 2016/7/13/entrez KW - Colectomy KW - Discharge KW - Geocoding KW - Hospital readmission KW - Outcomes KW - Travel distance SP - 18 EP - 23 JF - American journal of surgery JO - Am. J. Surg. VL - 213 IS - 1 N2 - BACKGROUND: Although a significant proportion of patients are readmitted to non-index hospitals after surgery, risk factors for non-index hospital readmission are not well defined. METHODS: Using the California Office of State Health Planning and Development database from 2008 to 2012, patients readmitted to index versus non-index hospitals after colorectal surgery were directly compared. Risk factors for non-index hospital readmission were assessed through logistic regression. RESULTS: Among the 14,401 patients requiring readmission, 10,890 (75.6%) were readmitted to index hospitals, whereas 3,511 (24.4%) were readmitted to non-index hospitals. Patients readmitted to non-index hospitals were more likely to be men and have a greater Charlson comorbidity index, non-private insurance, longer initial length of stay, longer travel distance, and non-home discharge disposition. On multivariable logistic regression analysis, living ≥10 miles from the index hospital was strongly predictive of non-index hospital readmission (odds ratio, 1.8; 95% confidence interval, 1.63 to 2.00). CONCLUSIONS: Approximately 25% of readmissions after colorectal surgery will be to non-index hospitals. Risks factors include greater comorbidities, non-private health insurance, occurrence of an inpatient complication, longer length of stay, greater travel distance, and non-home discharge disposition. SN - 1879-1883 UR - https://www.unboundmedicine.com/medline/citation/27401838/Predictors_of_readmission_to_non_index_hospitals_after_colorectal_surgery_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9610(16)30276-8 DB - PRIME DP - Unbound Medicine ER -