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Predictors and costs of readmissions at an academic head and neck surgery service
Peter T Dziegielewski1,2,3, Brian Boyce1,2, Amy Manning1,2
1Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
Background:
Health care metrics, such as readmission rates, are being scrutinized to improve quality and decrease cost of care. The purpose of this study was to determine the rate, predictors, and costs of 30-day unplanned readmissions (30dURs) in patients who undergo head and neck surgery.
Methods:
All patients undergoing head and neck surgery at the Ohio State University from July 1, 2011, to June 30, 2012, were retrospectively reviewed. Univariate and multivariate logistic regression analyses were performed to identify risk factors for 30dURs.
Results:
\Six hundred seven patients underwent 660 operations. Forty-eight cases (7.3%) had a 30dUR. Significant independent risk factors for readmissions included: coronary artery disease (odds ratio [OR] = 2.80; confidence interval [CI] = 1.3-5.9), chronic renal failure (OR = 3.56; CI = 1.5-8.5), not attending the preoperative clinic (OR = 2.74; CI = 1.2-6.3), length of stay (LOS) >5 days (OR = 3.19; CI = 1.6-6.5), and presence of a gastrostomy tube (OR = 2.75; CI = 1.3-5.8).The total cost of 30dURs was $1.68 million.
Conclusion:
The 30dURs in patients who undergo head and neck surgery can be low, but costly. Identifying patients at risk for 30dUR will help develop preventative strategies. © 2015 Wiley Periodicals, Inc. Head Neck 38: E502-E510, 2016.
