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Post-Op Weekend Admissions & Discharges

Post-Op Weekend Admissions & Discharges

Hospital readmission is associated with high morbidity, mortality, and healthcare expenditures and is increasingly being recognized as an important outcome for clinicians, patients, policymakers, and healthcare payers. “Furthermore, CMS has begun assigning financial penalties to hospitals with excessive unplanned readmissions,” explains Jordan M. Cloyd, MD. “For these reasons, much attention has been placed on efforts to reduce hospital readmissions. However, we still have an incomplete understanding of when and why hospital readmissions occur following major surgery.”   The Weekend Effect The “weekend effect,” which refers to a phenomenon of worse outcomes seen in patients cared for on weekends, has been extensively described in patients admitted to the hospital on weekend days. Few studies have explored the impact of weekend discharge in patients undergoing surgery. To address this issue, Dr. Cloyd and colleagues had a study published in JAMA Surgery that investigated the association between weekend discharge and 30- and 90-day readmissions in patients undergoing major surgery. “We hypothesized that postoperative patients discharged on a weekend, when certain hospital and ambulatory resources are limited, would be at higher risk of readmission to the hospital,” Dr. Cloyd says. For the investigation, researchers analyzed hospital readmission rates using a large administrative database from California among patients undergoing abdominal aortic aneurysm (AAA) repair, total hip arthroplasty, colectomy, or pancreatectomy. “One of the strengths of our study was that the data source utilized a unique record linkage number to identify hospital readmissions to all non-federal hospitals in the state, not just those where surgery took place,” says Dr. Cloyd. Overall, the 30-day readmission rate was 9.4% after AAA repair, 13.6% after colectomy, 7.5% after...
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