A nationwide analysis of readmission rates after colorectal cancer surgery in the US in the Era of the Affordable Care Act.
Adolescent
Adult
Aged
Aged, 80 and over
Colorectal Neoplasms
/ surgery
Databases, Factual
Digestive System Surgical Procedures
/ methods
Elective Surgical Procedures
/ methods
Female
Humans
Incidence
Male
Middle Aged
Patient Protection and Affordable Care Act
Patient Readmission
/ trends
Postoperative Complications
/ epidemiology
Prognosis
Risk Factors
Survival Rate
/ trends
United States
/ epidemiology
Young Adult
Colorectal neoplasms
Population-based
Postoperative
Readmission
Surgery
Journal
American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
04
11
2019
revised:
22
01
2020
accepted:
13
04
2020
pubmed:
5
5
2020
medline:
24
11
2020
entrez:
5
5
2020
Statut:
ppublish
Résumé
The Hospital Readmissions Reduction Program (HRRP), which was instituted in 2012, may have affected readmission rates for non-target conditions, including colorectal cancer (CRC). We aimed to analyze the nationwide all-cause 30-day readmission rate following CRC surgery in a US nationwide database. We queried the 2010-2015 Nationwide Readmissions Database to estimate readmission rates. All results were weighted for national estimates. Among 616,348 index cases, the overall 2010-2015 30-day readmission rate was 14.7% (95% confidence interval, 14.5%-14.9% [n = 90,555]), with a decreasing trend from 15.5% in 2010 and 2011 to 13.5% in 2015 (p-trend<0.001). Rectal resection, longer length of stay, non-invasive cancer, surgery at a metropolitan teaching hospital, non-routine discharge, elective admission, and higher Elixhauser comorbidity score were associated with subsequent readmission. In the US, 30-day readmission rates after CRC surgery showed a decreasing trend during 2010-2015, which could represent a spillover effect of the HRRP.
Sections du résumé
BACKGROUND & AIMS
The Hospital Readmissions Reduction Program (HRRP), which was instituted in 2012, may have affected readmission rates for non-target conditions, including colorectal cancer (CRC). We aimed to analyze the nationwide all-cause 30-day readmission rate following CRC surgery in a US nationwide database.
METHODS
We queried the 2010-2015 Nationwide Readmissions Database to estimate readmission rates. All results were weighted for national estimates.
RESULTS
Among 616,348 index cases, the overall 2010-2015 30-day readmission rate was 14.7% (95% confidence interval, 14.5%-14.9% [n = 90,555]), with a decreasing trend from 15.5% in 2010 and 2011 to 13.5% in 2015 (p-trend<0.001). Rectal resection, longer length of stay, non-invasive cancer, surgery at a metropolitan teaching hospital, non-routine discharge, elective admission, and higher Elixhauser comorbidity score were associated with subsequent readmission.
CONCLUSIONS
In the US, 30-day readmission rates after CRC surgery showed a decreasing trend during 2010-2015, which could represent a spillover effect of the HRRP.
Identifiants
pubmed: 32362379
pii: S0002-9610(20)30217-8
doi: 10.1016/j.amjsurg.2020.04.013
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1015-1022Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest The authors disclose no conflicts.