Surgery patient readmissions cost $300M, Johns Hopkins says

Nearly one in four colorectal surgery patients are readmitted within 90 days, costing the nation $300 million a year, according to a report by Johns Hopkins researchers to be published in the December issue of the journal Diseases of the Colon & Rectum. That's roughly $9,000 per readmission of privately insured colon surgery patients readmitted within three months of hospital discharge.

"Readmissions after surgery are common and they burden the health care system with exorbitant costs," lead report author Dr. Martin A. Makary, an associate professor of surgery at the Johns Hopkins University School of Medicine, said in a news brief today. "While readmissions are sometimes unavoidable, many times they result from poor coordination of medical care. Everyone knows you can't get readmissions down to zero but, at 23 percent, there's a huge amount of room for improvement. There is no reason we can't cut that rate in half."

For colon surgery patients, the most common reasons for returning to the hospital are surgical site infections, dehydration of the digestive system, and stoma (ostomy) complications, according to researchers.

Researchers looked at more than 10,000 patient records and found that 11.4 percent of patients were readmitted to the hospital within 30 days of discharge, and another 12 percent were readmitted between days 31 and 90. About 7 percent were readmitted two or more times within the first three months after discharge.

To reduce readmissions, Johns Hopkins Hospital nurses are independently reviewing discharge plans before patients leave. They make follow-up appointments and review medication lists, which have shown to prevent return patients visits to the emergency department for minor concerns, according to the news brief.

Starting in 2013, hospitals with high readmission rates for heart attacks, congestive heart failure, and pneumonia patients will face penalties.

"Hospital readmissions are being used as a surrogate measure for determining quality of care," said study leader Dr. Elizabeth Wick, an assistant professor of surgery at Johns Hopkins. "If care isn't as good, patients end up back in the hospital. We need to make sure patients don't have to come back."

For more information:
- read the news brief

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