Case Management in Prevention of 30-Day Readmission in Post-Coronary Artery Bypass Graft Surgery.
Journal
Professional case management
ISSN: 1932-8095
Titre abrégé: Prof Case Manag
Pays: United States
ID NLM: 101291585
Informations de publication
Date de publication:
01 Mar 2024
01 Mar 2024
Historique:
medline:
29
2
2024
pubmed:
29
2
2024
entrez:
29
2
2024
Statut:
aheadofprint
Résumé
Thirty-day readmission is associated with increased morbidity and mortality among postoperative coronary artery bypass graft (CABG) surgery patients. Interventions such as case management and follow-up care may reduce 30-day readmission. The purpose of this article is to report a study on modifiable factors that may have significant implications for case management in the prevention of readmission after CABG surgery. The study population included all the adult patients who underwent first-time CABG surgery from January 1, 2013, to January 1, 2016, from a Mid-South hospital. A retrospective case-control study was employed to examine 1,712 patients who underwent CABG surgery. The results revealed that patients readmitted within 30 days had a significantly shorter length of stay (LOS) (6 days vs. 10 days; p < .0001), more days in intensive care unit (6 days vs. 4 days; p = .0391), and significantly higher diabetes/renal (4% vs. 1%), infection (17% vs. 2%), and respiratory-related diagnoses (10% vs. 1%; p < .0001). Among these factors, hospital LOS is a major factor that can be addressed through case management in addition to other modifiable risk factors. Understanding modifiable factors associated with higher readmission risk is crucial for effective intervention and case management planning.
Identifiants
pubmed: 38421737
doi: 10.1097/NCM.0000000000000718
pii: 01269241-990000000-00015
doi:
Types de publication
Journal Article
Langues
eng
Informations de copyright
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors report no conflicts of interest.
Références
Alghafees M. A., Alsubaie N. A., Alsadoon L. K., Aljafari S. A., Alshehri E. A., Suliman I. F. (2020). Thirty-day readmission rates and associated risk factors after coronary artery bypass grafting. Journal of Taibah University Medical Sciences, 15(4), 292–297. https://doi.org/10.1016/j.jtumed.2020.05.004
doi: 10.1016/j.jtumed.2020.05.004
Alshabanat A., Otterstatter M. C., Sin D. D., Road J., Rempel C., Burns J., van Eeden S. F., FitzGerald J. M. (2017). Impact of a COPD comprehensive case management program on hospital length of stay and readmission rates. International Journal of Chronic Obstructive Pulmonary Disease, 12, 961–971. https://doi.org/10.2147/COPD.S124385
doi: 10.2147/COPD.S124385
American Case Management Association. (2013). Standards of Practice & Scope of Services for Health Care Delivery System Case Management and Transitions of Care (TOC) Professionals. American Case Management Association.
Case R., George J., Li Q., Arnaoutakis G. J., Keeley E. C. (2020). Unplanned 30-day readmission after coronary artery bypass in patients with acute myocardial infarction. Cardiovascular Revascularization Medicine, 21(4), 518–521. https://doi.org/10.1016/j.carrev.2019.08.005
doi: 10.1016/j.carrev.2019.08.005
Chudgar N. P., Zhu R., Gray K. D., Chiu R., Carrera A. D., Lang S. J., Avgerinos D. V., Mack C. A. (2022). Implementing a high-value care discharge protocol in patients undergoing CABG reduces readmission. The Annals of Thoracic Surgery, 113(4), 1112–1118. https://doi.org/10.1016/j.athoracsur.2021.07.036
doi: 10.1016/j.athoracsur.2021.07.036
De Waard D., Fagan A., Minnaar C., Horne D. (2021). Management of patients after coronary artery bypass grafting surgery: A guide for primary care practitioners. Canadian Medical Association Journal, 193(19), E689–E694. https://doi.org/10.1503/cmaj.191108
doi: 10.1503/cmaj.191108
Gjeka R., Patel K., Reddy C., Zetsche N. (2021). Patient engagement with digital disease management and readmission rates: The case of congestive heart failure. Health Informatics Journal, 27(3), 146045822110309. https://doi.org/10.1177/14604582211030959
doi: 10.1177/14604582211030959
Godwin-Akpan T. G., Diaconu K., Edmiston M., Smith J. S., Sosu F., Weiland S., Kollie K. K. (2023, June 29). Assessing the cost-effectiveness of integrated case management of Neglected Tropical Diseases in Liberia. BMC Health Services Research, 23(1), 705. https://doi.org/10.1186/s12913-023-09685-0
doi: 10.1016/j.athoracsur.2021.07.036
Hoyler M. M., Tam C. W., Thalappillil R., Jiang S., Ma X., Lui B., White R. S. (2020). The impact of hospital safety-net burden on mortality and readmission after CABG surgery. Journal of Cardiac Surgery, 35(9), 2232–2241. https://doi.org/10.1111/jocs.14738
doi: 10.1111/jocs.14738
Hudon C., Kessler R. (2023, January 24). Integrating case management for patients with complex needs in the ground practice: The importance of context in evaluative designs. Health Research Policy and Systems, 21(1), 9. https://doi.org/10.1186/s12961-023-00960-4
doi: 10.1016/j.surg.2020.08.015
Janjua H., Barry T. M., Cousin-Peterson E., Kuo P. C. (2021). Defining the relative contribution of health care environmental components to patient outcomes in the model of 30-day readmission after coronary artery bypass graft (CABG). Surgery, 169(3), 557–566. https://doi.org/10.1016/j.surg.2020.08.015
doi: 10.1016/j.surg.2020.08.015
Lazar H. L., Fitzgerald C. A., Ahmad T., Bao Y., Colton T., Shapira O. M., Shemin R. J. (2001). Early discharge after coronary artery bypass graft surgery: Are patients really going home earlier? The Journal of Thoracic and Cardiovascular Surgery, 121(5), 943–950. https://doi.org/10.1067/mtc.2001.113751
doi: 10.1067/mtc.2001.113751
Li Y., Cai X., Mukamel D. B., Cram P. (2013). Impact of length of stay after coronary bypass surgery on short-term readmission rate: An instrumental variable analysis. Medical Care, 51(1), 45–51. https://doi.org/10.1097/MLR.0b013e318270bc13
doi: 10.1097/MLR.0b013e318270bc13
Martin M., Suri Y., Doebbeling B., Andrew R., Kathol R. (2022, January-February 1). Value-based integrated case management at payor level: Implementation and impact. Professional Case Management, 28(1), 11–19. https://doi.org/10.1097/NCM.0000000000000572
doi: 10.1097/NCM.0000000000000359
McCants K. M., Reid K. B., Williams I., Miller D. E., Rubin R., Dutton S. (2019). the impact of case management on reducing readmission for patients diagnosed with heart failure and diabetes. Professional Case Management, 24(4), 177–193. https://doi.org/10.1097/NCM.0000000000000359
doi: 10.1097/NCM.0000000000000359
Oehler A., Kent K., Davis J. (2018, December 15). Assessment of discharge readiness and readmission risk in patients with acute decompensated heart failure. The American Journal of Cardiology, 122(12), 2086–2094. https://doi.org/10.1016/j.amjcard.2018.08.061
doi: 10.1016/j.amjcard.2018.08.061
Pignatti M., Dolci G., Zamagni E., Pascale R., Piccin O., Ammar A., Zeneli F., Miralles M. E. L., Mancuso K., Cipriani R., Viale P., Pacini D., Martin-Suarez S. (2023, November 3). Multidisciplinary management of sternal osteomyelitis due to klebsiella aerogenes after open heart surgery in a patient with multiple myeloma: A case report and discussion of the literature. Microorganisms, 11(11), 2699. https://doi.org/10.3390/microorganisms11112699
doi: 10.1016/j.athoracsur.2021.07.036
Posri N., Srisatidnarakul B., Hickman R. L. (2022). Development of a readiness for hospital discharge assessment tool in Thai patients with stroke. Belitung Nursing Journal, 8(1), 75–83. https://doi.org/10.33546/bnj.1968
doi: 10.33546/bnj.1968
Price J. D., Romeiser J. L., Gnerre J. M., Shroyer L. W. A., Rosengart T. K. (2013). Risk analysis for readmission after coronary artery bypass surgery: Developing a strategy to reduce readmissions. Journal of the American College of Surgeons, 216(3), 412–419. https://doi.org/10.1016/j.jamcollsurg.2012.11.009
doi: 10.1016/j.jamcollsurg.2012.11.009
Rao V., DeLeon G., Thamba A., Flanagan M., Nickel K., Gerue M., Gray D. (2023). A retrospective review of 30-day hospital readmission risk after open heart surgery in patients with atrial fibrillation. Cureus, 15(9), e45755. https://doi.org/10.7759/cureus.45755
doi: 10.7759/cureus.45755
Sadler E., Khadjesari Z., Ziemann A., Sheehan K. J., Whitney J., Wilson D., Bakolis I., Sevdalis N., Sandall J., Soukup T., Corbett T., Goncalves-Bradley D. C., Walker D. M. (2023, May 23). Case management for integrated care of older people with frailty in community settings. Cochrane Database of Systematic Reviews, 5(5), CD013088. https://doi.org/10.1002/14651858.CD013088.pub2
doi: 10.1016/j.athoracsur.2021.07.036
Shah R. M., Zhang Q., Chatterjee S., Cheema F., Loor G., Lemaire S. A., Wall M. J., Coselli J. S., Rosengart T. K., Ghanta R. K. (2019). Incidence, cost, and risk factors for readmission after coronary artery bypass grafting. The Annals of Thoracic Surgery, 107(6), 1782–1789. https://doi.org/10.1016/j.athoracsur.2018.10.077
doi: 10.1016/j.athoracsur.2018.10.077
Shawon M. S. R., Odutola M., Falster M. O., Jorm L. R. (2021). Patient and hospital factors associated with 30-day readmissions after coronary artery bypass graft (CABG) surgery: A systematic review and meta-analysis. Journal of Cardiothoracic Surgery, 16(1), 172. https://doi.org/10.1186/s13019-021-01556-1
doi: 10.1186/s13019-021-01556-1
Sultana I., Erraguntla M., Kum H.-C., Delen D., Lawley M. (2022). The Interrelationships between the length of stay, readmission, and post-acute care referral in cardiac surgery patients. Healthcare Analytics, 2, 100062. https://doi.org/10.1016/j.health.2022.100062
doi: 10.1016/j.health.2022.100062
Tsai T. C., Joynt K. E., Orav E. J., Gawande A. A., Jha A. K. (2013). Variation in surgical-readmission rates and quality of hospital care. New England Journal of Medicine, 369(12), 1134–1142. https://doi.org/10.1056/NEJMsa1303118
doi: 10.1056/NEJMsa1303118
Weston C. M., Yune S., Bass E. B., Berkowitz S. A., Brotman D. J., Deutschendorf A., Howell E. E., Richardson M. B., Sylvester C., Wu A. W. (2017, October). A concise tool for measuring care coordination from the provider's perspective in the hospital setting. Journal of Hospital Medicine, 12(10), 811–817. https://doi.org/10.12788/jhm.2795
doi: 10.12788/jhm.2795