1 research outputs found
Readmissions after general surgery: a prospective multicenter audit
Background: Readmission rates after surgical procedures are viewed as a marker of quality
of care and as a driver to improve outcomes in the United Kingdom, they are not remunerated.
However, readmissions are not wholly avoidable. The aim of this study was to
develop a regional overview of readmissions to determine the proportion that might be
avoidable and to examine predictors of readmissions at a unit level.
Methods: We undertook a prospective multicenter audit of readmissions following National
Health Service funded general surgical procedures in five National Health Service hospitals
and three independent sector providers over a 2-wk period. Basic demographic and procedure
data were captured. Readmissions to hospitals were identified through acute admissions
lists. Reason for readmission was identified, and the readmission data assessed
by a senior surgical doctor as to whether it was avoidable.
Results: We identified 752 operations in the study period with all followed up to 30 d. The
overall rate of readmissions was 4.7%, with 40% of these judged as being potentially
avoidable. Pain and wound problems accounted for the vast majority of avoidable readmissions.
The number of unavoidable readmissions was correlated with the workload of
each center (r ¼ 0.63, P ¼ 0.06) and as with the higher (British United Provident Association)
complexity of surgery (r ¼ 0.90, P ¼ 0.01). Patient and demographic factors were not
associated with readmissions.
Conclusions: This prospective audit describes readmission rates after general surgery. Volume
and complexity of work are associated with readmission rates. A large proportion of
readmissions could be reduced by attention to analgesia and outpatient arrangements for
wound management