SOURCES OF VARIATION IN READMISSION RATES, LENGTH OF STAY, AND OPERATIVE TIME ASSOCIATED WITH ROTATOR CUFF SURGERY

2003 ◽  
Vol 85 (9) ◽  
pp. 1784-1789 ◽  
Author(s):  
LINDSAY B. GREEN ◽  
RICARDO PIETROBON ◽  
ELIZABETH PAXTON ◽  
LAURENCE D. HIGGINS ◽  
DONALD FITHIAN
Keyword(s):  
Rotator Cuff ◽  
Length Of Stay ◽  
Operative Time ◽  
Readmission Rates ◽  
Sources Of Variation ◽  
Rotator Cuff Surgery

Reasons for 30-day Postoperative Readmissions for Medicare Patients at a Community-based Teaching Hospital

2015 ◽  
Vol 81 (4) ◽  
pp. 381-386
Author(s):  
Jennifer L. Kirsch ◽  
Shanu N. Kothari ◽  
Janelle M. Ausloos ◽  
Jacob D. Gundrum ◽  
Kara J. Kallies
Keyword(s):  
Length Of Stay ◽  
Operative Time ◽  
Reform Initiatives ◽  
Readmission Rates ◽  
Community Based ◽  
Related Factors ◽  
Medicare Patients ◽  
Patient Noncompliance ◽  
American Society ◽  
American Society Of Anesthesiologists

Healthcare reform initiatives have proposed reducing reimbursement for certain 30-day readmissions among Medicare patients. Our objective was to evaluate the incidence and reasons for 30-day postoperative readmissions at our institution. The medical records of Medicare patients who underwent surgery from January 1, 2010, through May 16, 2011, were reviewed. Statistical analysis included χ2, Wilcoxon rank sum, and t tests. Two thousand eight hundred sixty-five patients were included; 199 (7%) had a 30-day readmission. The readmission group included a higher proportion of men (53.8 vs 43.6%, P = 0.005), and patients with an American Society of Anesthesiologists (ASA) Class 3 or greater (84 vs 66%, P < 0.001) versus the nonreadmission group. Mean index length of stay and operative time were longer in the readmitted versus nonreadmitted group (4.8 vs 2.8 days, P < 0.001; 122.8 vs 98.2 minutes, P < 0.001). Readmission reasons were surgically related (53%), surgically unrelated (35%), planned (7%), and patient-related (5%). Higher 30-day postoperative readmission rates were associated with male sex, higher ASA class, and longer index length of stay and operative time. Reasons for readmission included surgical- and patient-related factors. Decreased reimbursement should be discouraged for readmissions directly related to patient noncompliance.

scholarly journals The impact of resident involvement in minimally-invasive urologic oncology procedures

2014 ◽  
Vol 8 (9-10) ◽  
pp. 334 ◽  
Author(s):  
Nedim Ruhotina ◽  
Julien Dagenais ◽  
Giorgio Gandaglia ◽  
Akshay Sood ◽  
Firas Abdollah ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Minimally Invasive ◽  
Partial Nephrectomy ◽  
Operative Time ◽  
Readmission Rates ◽  
Improvement Program ◽  
Urologic Oncology ◽  
Invasive Approach ◽  
Resident Involvement ◽  
The Impact

Introduction: Robotic and laparoscopic surgical training is an integral part of resident education in urology, yet the effect of resident involvement on outcomes of minimally-invasive urologic procedures remains largely unknown. We assess the impact of resident participation on surgical outcomes using a large multi-institutional prospective database.Methods: Relying on the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Participant User Files (2005-2011), we abstracted the 3 most frequently performed minimally-invasive urologic oncology procedures. These included radical prostatectomy, radical nephrectomy and partial nephrectomy. Multivariable logistic regression models were constructed to assess the impact of trainee involvement (PGY 1-2: junior, PGY 3-4: senior, PGY ≥5: chief) versus attending-only on operative time, length-of-stay, 30-day complication, reoperation and readmission rates.Results: A total of 5459 minimally-invasive radical prostatectomies,1740 minimally-invasive radical nephrectomies and 786 minimally-invasive partial nephrectomies were performed during the study period, for which data on resident surgeon involvement was available. In multivariable analyses, resident involvement was not associated with increased odds of overall complications, reoperation, or readmission rates for minimally-invasive prostatectomy, radical and partial nephrectomy. However, operative time was prolonged when residents were involved irrespective of the type of procedure. Length-of-stay was decreased with senior resident involvement in minimally-invasive partial nephrectomies (odds ratio [OR] 0.49, p = 0.04) and prostatectomies (OR 0.68, p = 0.01). The major limitations of this study include its retrospective observational design, inability to adjust for the case complexity and surgeon/hospital characteristics, and the lack of information regarding the minimally-invasive approach utilized (whether robotic or laparoscopic).Conclusions: Resident involvement is associated with increased operative time in minimally-invasive urologic oncology procedures. However, it does not adversely affect the complication, reoperation or readmission rates, as well as length-of-stay.

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

Impact of length of stay in psychiatric intensive care on the episode trajectory

2021 ◽  
Author(s):  
H. Thomas de Burgh ◽  
Jeremy McCabe ◽  
Kamal Gupta
Keyword(s):  
Intensive Care ◽  
Length Of Stay ◽  
Extended Period ◽  
Post Discharge ◽  
Readmission Rates ◽  
Rapid Turnover ◽  
Complex Patients ◽  
Step Down ◽  
The Uk ◽  
Relationship Of

Background: Length of stay (LOS) on admission to psychiatric intensive care in the UK varies widely, with few studies examining the relationship of LOS to clinical outcomes. Data from two South London male PICUs delivering care with the contrasting philosophies of rapid turnover versus slower stepdown were investigated to determine if additional LOS correlated with clinical benefit.Method: Data on admissions to the PICUs were collected over six months and assessed for outliers and then for variance using Levene’s test. The variables were compared using independent samples t-tests. Pearson correlations were alsocalculated for the major variables.Results: Mean LOS was 8.4 days higher on PICU 1 (p = 0.026) and readmission rates to hospital 6 months post discharge were 27% higher on PICU 1 (p = 0.025). There were no strong correlations between LOS on either PICU and the other five variables examined.Conclusion: It was intuitive to expect better outcomes in the PICU with a slower turnover where complex patients could receive an extended period of re-evaluation of pharmacological treatments and engagement with services and could achieve a fuller recovery from the episode. However, this group had no reduction in LOS following step-down to the wards, readmission rates to PICU during in the index episode or re-hospitalisation six months following discharge. The PICU with a policy of rapid-turnover, concentrating on reducing acuity and risk and rapid step down, was equally effective on the measures evaluated.

Sign in / Sign up

Export Citation Format

Share Document