Patients with surgical complications less likely to die if readmitted to same hospital

Patients who are readmitted to the hospital when complications occur after a major surgery are more likely to survive if they return to the facility where that original surgery took place, a new study finds.

University of Utah researchers, who led the study published online in The Lancet, reviewed claims data on more than nine million Medicare patients who underwent 1 of 12 common surgical procedures in U.S. hospitals between 2001 and 2011. They found that up to 22 percent of patients had unexpected complications that required readmission within 30 days.

While the number of patients readmitted or transferred back to the original hospital varied depending on the type of surgery, up to 83 percent of those patients were readmitted to the same hospital where they had the initial surgery. That was more likely the case if the readmission was for a surgical complication. Overall, readmission to the same hospital was associated with a 26 percent lower risk of death within 90 days, researchers found.

The findings could have important implications for cost-effectiveness-driven regional centralization of surgical care, the researchers concluded. If returning to the same hospital is important for recovery, the findings take on new meaning for patients who take part in so-called domestic medical tourism programs, the researchers said in the study announcement.

Some of the country's largest companies encourage employees to travel to large U.S. medical centers for complex elective surgical procedures and are able to negotiate lower prices for patients to receive care there. But many patients travel long distances to these hospitals and may find it difficult to return should complications arise, researchers said.

"This is not a small issue. Between 5 to 22 percent of patients were readmitted in our study, depending on the type of surgery," Benjamin Brooke, M.D., Ph.D., assistant professor of surgery at the University of Utah School of Medicine and the lead author of the study, said in the statement. "Our work suggests that striving to maintain continuity of care in the same hospital, and by the same medical team when possible, is critical to achieve the best outcomes should complications arise after surgery." 

Returning to the site where the original operation was done was associated with improved survival regardless of whether it was a large teaching hospital or smaller community hospital, according to the study announcement. Patients also did slightly better if they were treated by the same surgical team, the study found.

The latest study concurs with previous research, including a study that showed 1 in 10 surgical patients are readmitted with post-op complications. Unplanned hospital readmissions for patients following surgery are primarily due to new surgical complications rather than worsening of previous medical issues, FierceHealthcare previously reported.

To learn more:
- read the study abstract
- here's the study announcement

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