scholarly journals Association of insomnia with postpartum readmission rates

2022 ◽  
Vol 226 (1) ◽  
pp. S395
Author(s):  
Justin Swanson ◽  
Anthony Kendle ◽  
Jason L. Salemi ◽  
Judette Louis
Keyword(s):  
Readmission Rates

Upper Extremity Free Flap Transfers: An Analysis of the National Surgical Quality Improvement Program Database

2020 ◽  
Author(s):  
George A. Beyer ◽  
Karan Dua ◽  
Neil V. Shah ◽  
Joseph P. Scollan ◽  
Jared M. Newman ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Upper Extremity ◽  
Free Flap ◽  
Quality Improvement Program ◽  
Readmission Rates ◽  
Improvement Program ◽  
Surgical Quality ◽  
Flap Transfer ◽  
Free Flap Transfer ◽  
Reoperation Rates

Abstract Introduction We evaluated the demographics, flap types, and 30-day complication, readmission, and reoperation rates for upper extremity free flap transfers within the National Surgical Quality Improvement Program (NSQIP) database. Materials and Methods Upper extremity free flap transfer patients in the NSQIP from 2008 to 2016 were identified. Complications, reoperations, and readmissions were queried. Chi-squared tests evaluated differences in sex, race, and insurance. The types of procedures performed, complication frequencies, reoperation rates, and readmission rates were analyzed. Results One-hundred-eleven patients were selected (mean: 36.8 years). Most common upper extremity free flaps were muscle/myocutaneous (45.9%) and other vascularized bone grafts with microanastomosis (27.9%). Thirty-day complications among all patients included superficial site infections (2.7%), intraoperative transfusions (7.2%), pneumonia (0.9%), and deep venous thrombosis (0.9%). Thirty-day reoperation and readmission rates were 4.5% and 3.6%, respectively. The mean time from discharge to readmission was 12.5 days. Conclusion Upper extremity free flap transfers could be performed with a low rate of 30-day complications, reoperations, and readmissions.

Thirty-Day Readmission Rates Comparing Specific Cruciate Retaining and Posterior Stabilizing Knee Arthroplasties to the National Readmission Rates

2015 ◽  
Vol 25 (4) ◽  
pp. 307-311 ◽  
Author(s):  
Julio J. Jauregui ◽  
Jeffery J. Cherian ◽  
Todd P. Pierce ◽  
Randa K Elmallah ◽  
Michael A. Mont
Keyword(s):  
Readmission Rates ◽  
Cruciate Retaining

Impact of Michigan’s new opioid prescribing laws on spine surgery patients: analysis of the Michigan Spine Surgery Improvement Collaborative

2020 ◽  
pp. 1-6
Author(s):  
Paul Park ◽  
Victor Chang ◽  
Hsueh-Han Yeh ◽  
Jason M. Schwalb ◽  
David R. Nerenz ◽  
...  
Keyword(s):  
Spine Surgery ◽  
Spinal Surgery ◽  
Readmission Rate ◽  
Rating Scale ◽  
Short Term ◽  
Readmission Rates ◽  
Opioid Prescribing ◽  
Number Of Patients ◽  
Before And After ◽  
The Impact

OBJECTIVEIn 2017, Michigan passed new legislation designed to reduce opioid abuse. This study evaluated the impact of these new restrictive laws on preoperative narcotic use, short-term outcomes, and readmission rates after spinal surgery.METHODSPatient data from 1 year before and 1 year after initiation of the new opioid laws (beginning July 1, 2018) were queried from the Michigan Spine Surgery Improvement Collaborative database. Before and after implementation of the major elements of the new laws, 12,325 and 11,988 patients, respectively, were treated.RESULTSPatients before and after passage of the opioid laws had generally similar demographic and surgical characteristics. Notably, after passage of the opioid laws, the number of patients taking daily narcotics preoperatively decreased from 3783 (48.7%) to 2698 (39.7%; p < 0.0001). Three months postoperatively, there were no differences in minimum clinically important difference (56.0% vs 58.0%, p = 0.1068), numeric rating scale (NRS) score of back pain (3.5 vs 3.4, p = 0.1156), NRS score of leg pain (2.7 vs 2.7, p = 0.3595), satisfaction (84.4% vs 84.7%, p = 0.6852), or 90-day readmission rate (5.8% vs 6.2%, p = 0.3202) between groups. Although there was no difference in readmission rates, pain as a reason for readmission was marginally more common (0.86% vs 1.22%, p = 0.0323).CONCLUSIONSThere was a meaningful decrease in preoperative narcotic use, but notably there was no apparent negative impact on postoperative recovery, patient satisfaction, or short-term outcomes after spinal surgery despite more restrictive opioid prescribing. Although the readmission rate did not significantly increase, pain as a reason for readmission was marginally more frequently observed.

scholarly journals Outpatient Total Hip Arthroplasty: A Meta-Analysis

2021 ◽  
Vol 11 (15) ◽  
pp. 6853
Author(s):  
Filippo Migliorini ◽  
Lucio Cipollaro ◽  
Francesco Cuozzo ◽  
Francesco Oliva ◽  
Andrea Valerio Marino ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Meta Analysis ◽  
Readmission Rates ◽  
Total Hip ◽  
Vein Thrombosis ◽  
Outpatient Group ◽  
Operative Planning ◽  
The Mean ◽  
And Gender

Introduction: Outpatient total hip arthroplasty (THA) is increasingly popular. This meta-analysis investigated the potential advantages of outpatient regimes for THA. Methods: This study followed the PRISMA guidelines. PubMed, Web of Science, Google Scholar, Embase, and Scopus databases were accessed in June 2021. All clinical studies investigating outpatient THA were considered. The outcomes of interest were pain, infection, mortality, revision, dislocation, readmission rates, and deep vein thrombosis (DVT). Results: Data from 102,839 patients were included. A total of 52% (153,168 of 102,839 patients) were women. The mean age of patients was 62.6 ± 4.6 years, the mean BMI was 29.1 ± 1.8 kg/m2. Good comparability was found in age, BMI, and gender (p > 0.1). No difference was found in pain (p = 0.4), infections (p = 0.9), mortality (p = 0.9), rate of revision (p = 0.1), dislocation (p = 0.9), and readmission (p = 0.8). The outpatient group demonstrated a greater rate of DVT (OR 3.57; 95% CI 2.47 to 5.18; p < 0.0001). Conclusions: In selected patients, outpatient THA can be performed safely with optimal outcomes comparable with inpatient THA. Clear and comprehensive pre-operative planning should involve a multi-disciplinary group composed of orthopaedic surgeons, anaesthesia and rehabilitation specialists, and physiotherapists. Each centre performing outpatient THA should implement continuous homecoming welfare activity, to supervise physiotherapy and monitor anticoagulant therapy.

Length of Stay and Readmission Rates in Pediatric Acute Heart Failure

2021 ◽  
Vol 40 (4) ◽  
pp. S122-S123
Author(s):  
D.S. Burstein ◽  
C. Connelly ◽  
C.S. Almond ◽  
R.A. Niebler ◽  
J.A. Godown ◽  
...  
Keyword(s):  
Heart Failure ◽  
Length Of Stay ◽  
Acute Heart Failure ◽  
Readmission Rates

scholarly journals Delivering and Embedding Dementia-Friendly Training in a Healthcare System

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 160-161
Author(s):  
Ellen Schneider ◽  
Maureen Dale ◽  
Krista Wells ◽  
John Gotelli ◽  
Carol Julian ◽  
...  
Keyword(s):  
North Carolina ◽  
Self Efficacy ◽  
Hospital Staff ◽  
Clinical Staff ◽  
Pilot Training ◽  
Readmission Rates ◽  
Dementia Patients ◽  
People With Dementia ◽  
Aging And Health ◽  
The University

Abstract Alzheimer’s disease is the 4th leading cause of death in North Carolina for people 65 and older. People with dementia are hospitalized more often and have prolonged stays, poorer outcomes, higher costs, and increased readmission rates. Hospital employees have expressed the desire to have specialized training to learn how to more effectively communicate with and provide better care to patients with dementia. To address identified patient and hospital employee needs, the University of North Carolina (UNC) Center for Aging and Health is disseminating hospital-specific dementia-friendly training at five hospitals within the UNC Health System. The training is being delivered via online modules and follow-up didactic sessions over a three-year period to clinical and non-clinical staff who interact with patients. To date, 1,948 employees at three of the five hospitals have launched the online training; 1,102 have completed the training. The pilot training took place at the UNC Hospitals--Hillsborough Campus (“Hillsborough Hospital”) in 2019. Hillsborough Hospital staff (n=195) who participated in the dementia friendly training completed a survey to assess their ability to recognize symptoms and provide appropriate care to dementia patients pre- and post-training. Clinical staff answered 23 Likert scale self-efficacy questions; non-clinical staff answered the first 12 of these questions. Positive change in self-efficacy ratings from pre- to post-training was significant for every question (p &lt; .0001). Additional results will be included in the poster. The dementia-friendly hospital initiative is preparing employees to provide better care for people with dementia and is effective in increasing employee self-efficacy.

scholarly journals Potential of community-based risk estimates for improving hospital performance measures and discharge planning

2021 ◽  
Vol 10 (2) ◽  
pp. e001230
Author(s):  
Michael Reid ◽  
George Kephart ◽  
Pantelis Andreou ◽  
Alysia Robinson
Keyword(s):  
Discharge Planning ◽  
Care Transitions ◽  
Hospital Setting ◽  
Hospital Performance ◽  
Case Mix ◽  
Readmission Rates ◽  
Mixed Effect ◽  
Adjusted Risk ◽  
Community Risk ◽  
Effect Regression

BackgroundRisk-adjusted rates of hospital readmission are a common indicator of hospital performance. There are concerns that current risk-adjustment methods do not account for the many factors outside the hospital setting that can affect readmission rates. Not accounting for these external factors could result in hospitals being unfairly penalized when they discharge patients to communities that are less able to support care transitions and disease management. While incorporating adjustments for the myriad of social and economic factors outside of the hospital setting could improve the accuracy of readmission rates as a performance measure, doing so has limited feasibility due to the number of potential variables and the paucity of data to measure them. This paper assesses a practical approach to addressing this problem: using mixed-effect regression models to estimate case-mix adjusted risk of readmission by community of patients’ residence (community risk of readmission) as a complementary performance indicator to hospital readmission rates.MethodsUsing hospital discharge data and mixed-effect regression models with a random intercept for community, we assess if case-mix adjusted community risk of readmission can be useful as a quality indicator for community-based care. Our outcome of interest was an unplanned repeat hospitalisation. Our primary exposure was community of residence.ResultsCommunity of residence is associated with case-mix adjusted risk of unplanned repeat hospitalisation. Community risk of readmission can be estimated and mapped as indicators of the ability of communities to support both care transitions and long-term disease management.ConclusionContextualising readmission rates through a community lens has the potential to help hospitals and policymakers improve discharge planning, reduce penalties to hospitals, and most importantly, provide higher quality care to the people that they serve.

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