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Post-Surgery, Returning to Same Hospital Beneficial, Finds Study

Callie Earliwine checks on a patient at Ohio Valley Medical Center in West Virginia where she works as a critical care nurse. (Photo: http://wexnermedical.osu.edu/)

Representational picture: Callie Earliwine checks on a patient at Ohio Valley Medical Center in West Virginia where she works as a critical care nurse. (Photo: http://wexnermedical.osu.edu/)

Studies show that those who undergo major surgeries will benefit if the return to the same hospital for readmission as a study of 9,440,503 patients’ records from 2001 to 2011 show.

When researchers examined the association between readmission destination and mortality risk in the USA in Medicare beneficiaries after a range of 12 major operations requiring hospital readmission within 30 days after open abdominal aortic aneurysm repair, arterial bypass, coronary artery bypass surgery, colectomy, pancreatectomy, cholecystectomy, ventral hernia repair, craniotomy, hip replacement, or knee replacement, among others.

The number of patients readmitted to the same hospital where their operation was done varied from 186,336 (65·8%) of 283,131 patients who were readmitted after coronary artery bypass grafting, to 142,142 (83·2%) of 170,789 patients who were readmitted after colectomy.

Readmission was more likely to be to the index hospital than to a non-index hospital if the readmission was for a surgical complication, at 189,384 or 23% of 834,070 patients readmitted to the same or index hospital vs 36,792 or 13% of 276,976 patients readmitted non-index hospital.

Readmission to the same hospital showed a 26% lower risk of 90 day mortality than was readmission to a non-index hospital, with inverse probability with odds ratio of 0·74, 95% CI 0·66–0·83. This effect was significant (p<0·0001) for all proceduresand was largest for patients who were readmitted after pancreatectomy (OR 0·56, 95% CI 0·45–0·69) and aortobifemoral bypass (OR 0·69, 95% CI 0·61–0·77), said the study.

In the USA, patients who are readmitted to hospital after various major operations consistently achieve improved survival if they return to the hospital where their surgery took place, concludes the study, which sees key implications for cost-effectiveness-driven regional centralisation of surgical care.

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