Targeting zero preventable trauma readmissions.

Area of Science:

• Trauma care outcomes
• Health economics
• Healthcare quality improvement

Background:

• Nearly 10% of US trauma patients face 30-day readmission, incurring significant costs.
• National initiatives aim to reduce trauma readmissions, but identifying preventable cases is crucial.
• Understanding potentially preventable readmissions (PPRs) is key to reducing overall readmission rates.

Purpose of the Study:

• To quantify potentially preventable readmissions (PPRs) in trauma care.
• To establish a baseline for efforts aimed at reducing hospital readmissions.
• To inform strategies for minimizing preventable readmissions in trauma patients.

Main Methods:

• Analysis of the 2017 National Readmissions Database (NRD) for trauma admissions and 90-day readmissions.
• Definition of PPRs based on Agency for Healthcare Research and Quality criteria, plus specific conditions like SSI, AKI, and aspiration pneumonitis.
• Multivariable logistic regression to identify patient characteristics associated with PPRs.

Main Results:

• 10.4% of 1.32 million trauma admissions resulted in readmission within 90 days.
• 22.7% of these readmissions were classified as potentially preventable (PPRs), costing over $313 million.
• Increased odds of PPRs were observed in patients with specific comorbidities (CHF, COPD, diabetes, CKD) and those with Medicaid/Medicare insurance.

Conclusions:

• Approximately 1-in-5 trauma readmissions are preventable, representing a substantial financial burden.
• Enhanced post-discharge ambulatory care access is vital for reducing PPRs, particularly for high-risk patients.
• Targeted interventions for patients with comorbidities can mitigate preventable readmissions in trauma care.