Differences in 30-day preventable readmission rates after index cancer surgery in New York State hospitals.

6640 Background: 30-day readmission rates are currently being used as a measure of performance quality. Among surgical patients, readmissions may be reducible for certain complications such as deep venous thrombosis or wound infection. We report 30-day readmission rates for potentially preventable readmissions following surgical treatment of the most common malignancies in the US. Methods: The most common cancer hospitalizations were identified from the Healthcare Cost and Utilization Project. Previously reported ICD-9 codes of preventable readmissions from cancer surgery were used to assess 30-day readmissions in New York State in 2009. We measured comorbidity using CMS hierarchical condition categories. Hospital teaching status was based on the American Hospital Association designation. Random effect hierarchical logistic regression models were run to account for clustering within hospitals. Results: 21,945 index admissions for cancer surgery occurred in 2009 at 169 teaching and 73 non-teaching hospitals. The most common operations were for prostate, breast, colon, lung, and renal cancer. 51% of patients were male and 12% were black. The overall readmission rate was 9.3% with readmissions being higher in non-teaching hospitals (11.2%) vs. teaching hospitals (8.6%) (p<0.0001). There was a significant interaction between hospital teaching status and patient race. In teaching hospitals, there was no racial difference in readmission. However, in non-teaching hospitals, black patients were more likely to be readmitted (15.1% vs 10.9%; p=0.02). Multivariate models found that being male (OR=1.17; 95% CI: 1.04; 1.31; p=0.007), undergoing surgery at a non-teaching hospital (OR=1.16; 95% CI: 1.00; 1.35; p=0.048), black race (OR=1.47; 95% CI: 1.04; 2.08; p=0.029), and certain comorbidities increased a patient’s risk of 30-day readmission for a preventable cause. Conclusions: The 30-day preventable readmission rate after index hospitalizations for cancer surgery is higher in non-teaching hospitals, and this difference is more pronounced for black patients. Clinical protocols in teaching hospitals may play a role in this phenomenon. Efforts to address remediable causes of this disparity are warranted.

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Thirty-Day Readmissions in Patients With Metastatic Cancer: Room for Improvement?

Journal of Oncology Practice ◽

10.1200/jop.18.00500 ◽

2019 ◽

Vol 15 (5) ◽

pp. e410-e419 ◽

Cited By ~ 2

Author(s):

Rachel Solomon ◽

Natalia Egorova ◽

Kerin Adelson ◽

Cardinale B. Smith ◽

Rebeca Franco ◽

...

Keyword(s):

New York ◽

Metastatic Cancer ◽

Private Insurance ◽

New York State ◽

Skilled Nursing Facility ◽

Teaching Hospitals ◽

Readmission Rates ◽

Data Set ◽

Discharge Disposition ◽

Discharge Home

Purpose: Cancer, with readmission rates as high as 27%, has thus far been excluded from most readmission reduction efforts. However, some readmissions for patients with advanced disease may be avoidable. We assessed the prevalence of potentially preventable readmissions and associated factors in patients with metastatic cancer. Patients and Methods: Using a merged longitudinal data set of New York State hospital discharges and vital records, we measured 30-day readmissions for anemia, dehydration, diarrhea, emesis, fever, nausea, neutropenia, pain, pneumonia, and sepsis among patients with metastatic cancer between 2012 and 2014. We used competing-risk models to assess the effects of demographics, comorbidities, hospital type, payer, and discharge disposition. Results: A total of 11,275 patients had 19,307 hospitalizations. The 30-day readmission rate was 24.5%; 11.9% (n = 565) of readmissions were potentially preventable. Higher readmission rates occurred in black (hazard rate [HR], 1.26; 95% CI, 1.17 to 1.35), Hispanic (HR, 1.19; 95% CI, 1.09 to 1.31), and younger patients (HR per 10 years, 0.94; 95% CI, 0.90 to 0.97). Lower rates were associated with female sex (HR, 0.95; 95% CI, 0.91 to 0.99), private insurance (HR, 0.87; 95% CI, 0.87 to 0.81), teaching hospitals, and hospice discharge (HR, 0.62; 95% CI, 0.42 to 0.91). Discharge home with services (HR, 1.21; 95% CI, 1.14 to 1.27) or to a skilled nursing facility (HR, 1.11; 95% CI, 1.01 to 1.23) increased readmission likelihood. Potentially preventable readmissions were associated with younger age (HR per 10 years, 0.98; 95% CI, 0.98 to 0.99) and discharge home with services (HR, 1.25; 95% CI, 1.04 to 1.50). Likelihood decreased if care was received at a teaching hospital (HR, 0.76; 95% CI, 0.59 to 0.99). Payer, sex, race, and comorbidities did not contribute. Conclusion: Although the overall rate of potentially preventable readmissions among patients with metastatic cancer is low, higher readmission rates among those discharged home with help suggest that services supplied may not be sufficient to address health needs.

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Postoperative complications and survivorship trends following ovarian cancer surgery in New York state

Gynecologic Oncology ◽

10.1016/j.ygyno.2017.03.384 ◽

2017 ◽

Vol 145 ◽

pp. 168

Author(s):

Z. Xu ◽

A.Z. Becerra ◽

F.J. Fleming ◽

F.P. Boscoe ◽

M.J. Schymura ◽

...

Keyword(s):

Ovarian Cancer ◽

New York ◽

Postoperative Complications ◽

New York State ◽

Cancer Surgery ◽

York State

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Capacity for Development of Primary Care Residency Programs in Non-Teaching Hospitals in New York State (NYS)

American Journal of Health Research ◽

10.11648/j.ajhr.20150301.13 ◽

2015 ◽

Vol 3 (1) ◽

pp. 13

Author(s):

Fabio V. Lima

Keyword(s):

Primary Care ◽

New York ◽

New York State ◽

Teaching Hospitals ◽

Residency Programs ◽

York State ◽

Primary Care Residency

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Are Facebook user ratings associated with hospital cost, quality and patient satisfaction? A cross-sectional analysis of hospitals in New York State

BMJ Quality & Safety ◽

10.1136/bmjqs-2016-006291 ◽

2017 ◽

Vol 27 (2) ◽

pp. 119-129 ◽

Cited By ~ 9

Author(s):

Lauren Campbell ◽

Yue Li

Keyword(s):

New York ◽

Patient Satisfaction ◽

Readmission Rate ◽

New York State ◽

Hospital Inpatient ◽

York State ◽

Star Rating ◽

Satisfaction Measures ◽

User Ratings ◽

Medicare Spending

BackgroundHospital care costs are high while quality varies across hospitals. Patient satisfaction may be associated with better clinical quality, and social media ratings may offer another opportunity to measure patient satisfaction with care.ObjectivesTo test if Facebook user ratings of hospitals are associated with existing measures of patient satisfaction, cost and quality.Research designData were obtained from Centers for Medicare and Medicaid Services Hospital Compare, the Hospital Inpatient Prospective Payment System impact files and the Area Health Resource File for 2015. Information from hospitals’ Facebook pages was collected in July 2016. Multivariate linear regression was used to test if there is an association between Facebook user ratings (star rating and adjusted number of ‘likes’) and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction measures, the 30-day all-cause readmission rate, and the Medicare spending per beneficiary (MSPB) ratio.SubjectsOne hundred and thirty-six acute care hospitals in New York State in 2015.ResultsAn increase in the Facebook star rating is associated with significant increases in 21/23 HCAHPS measures (p≤0.003). An increase in the adjusted number of ‘likes’ is associated with very small increases in 3/23 HCAHPS measures (p<0.05). Facebook user ratings are not associated with the 30-day all-cause readmission rate or the Medicare spending per beneficiary ratio.ConclusionsResults demonstrate an association between HCAHPS patient satisfaction measures and Facebook star ratings. Adjusted number of ‘likes’ may not be a useful measure of patient satisfaction.

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Trends for In- and Outpatient Thyroid Cancer Surgery in Older Adults in New York State, 2007-2017

Journal of Surgical Research ◽

10.1016/j.jss.2021.12.008 ◽

2022 ◽

Vol 273 ◽

pp. 64-70

Author(s):

Maaike van Gerwen ◽

Mathilda Alsen ◽

Naomi Alpert ◽

Catherine Sinclair ◽

Emanuela Taioli

Keyword(s):

Older Adults ◽

New York ◽

Thyroid Cancer ◽

New York State ◽

Cancer Surgery ◽

York State

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Utilisation and outcomes of allogeneic hematopoietic cell transplantation in Ontario, Canada, and New York State, USA: a population-based retrospective cohort study

BMJ Open ◽

10.1136/bmjopen-2020-039293 ◽

2020 ◽

Vol 10 (10) ◽

pp. e039293

Author(s):

Samantha Aliza Hershenfeld ◽

John Matelski ◽

Vicki Ling ◽

Michael Paterson ◽

Matthew Cheung ◽

...

Keyword(s):

New York ◽

Cohort Study ◽

Hospital Mortality ◽

Cell Transplantation ◽

Outcome Measures ◽

Older Patients ◽

New York State ◽

Population Based ◽

Readmission Rates ◽

York State

ObjectiveAllogeneic haematopoietic cell transplantation (HCT) is a potentially curative treatment for haematologic and oncologic diseases. There is a perception that the United States of America (USA) offers greater access to expensive therapies such as HCT. Alternatively, Canada is thought to suffer from protracted wait times, but lower spending. Our objective was to compare HCT utilisation and short-term outcomes in Ontario (ON), Canada, and New York State (NY), USA.Design, setting and participantsWe conducted a population-based cohort study using administrative health data to identify all residents of ON and NY who underwent allogeneic HCT between 2012 and 2015.Primary and secondary outcome measuresThe primary outcome measures were age and sex standardised HCT utilisation rates, in-hospital mortality, hospital length of stay (LOS) and readmission rates in ON and NY. Secondary outcomes included comparing ON and NY HCT recipients with respect to demographic characteristics and patient wealth (using neighbourhood income quintile).ResultsWe identified 547 HCT procedures in ON and 1361 HCT procedures performed in NY. HCT recipients in ON were younger than NY (mean age 49.0 vs 51.6 years; p<0.001) and a lower percentage of ON recipients resided in affluent neighbourhoods compared with NY (47.2% vs 52.6%; p=0.026). Utilisation of HCT was 14.4 per 1 million population per year in ON and 26.7 per 1 million per year in NY (p<0.001). The magnitude of the ON–NY difference in utilisation was larger for older patients. In-hospital mortality, LOS and readmission rates were lower in ON than NY in both unadjusted and adjusted analyses.ConclusionsWe found significantly lower utilisation of HCT in ON compared with NY, particularly among older patients. Higher in-hospital mortality in NY relative to ON requires further study. These differences are thought provoking for patients, healthcare providers and policy-makers in both jurisdictions.

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