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Examination of a Proposed 30-day Readmission Risk Score on Discharge Location and Cost
Scott D Barnett1, Eric Sarin1, Andy C Kiser2
1Department of Cardiac Surgery Research, Inova Heart and Vascular Institute, Falls Church, Virginia.
The Annals of Thoracic Surgery
|November 11, 2019
Summary
A new risk model accurately predicts 30-day readmissions after cardiac surgery, validating its use as a quality improvement tool. Including discharge location refines predictions for high-risk patients, aiding in cost reduction and care planning.
Area of Science:
- Cardiovascular Surgery
- Health Services Research
- Predictive Analytics
Background:
- Annual US readmissions cost $41 billion.
- A novel risk model for 30-day cardiac surgery readmissions was developed.
- This study aimed to validate and refine the model statewide.
Purpose of the Study:
- To validate a new risk model for 30-day readmissions after adult cardiac surgery.
- To refine the model using a statewide database.
- To assess the impact of discharge location on readmission risk.
Main Methods:
- A statewide Society of Thoracic Surgeons database (2014-2017) of 19,964 patients was analyzed.
- A multivariate model (race, length of stay, lung disease, operation type, renal failure) was replicated.
- A second model incorporated discharge location.
Main Results:
- The overall 30-day readmission rate was 11.1%.
- Both models accurately predicted readmissions (OR 1.09-1.10).
- Discharge location significantly impacted risk categories and total cost, with hospice discharges showing the highest cost increase.
Conclusions:
- The risk models are valid and generalizable quality improvement tools for predicting 30-day readmissions.
- Incorporating discharge location and cost provides valuable insights for identifying high-risk patients.
- These findings support efforts to reduce readmissions and associated healthcare costs.
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