Rates and causes of 30-day readmission and emergency room utilization following head and neck surgery

Abstract Background Unplanned returns to hospital are common, costly, and potentially avoidable. We aimed to investigate and characterize reasons for all-cause readmissions to hospital as in-patients (IPs) and visits to the Emergency Department (ED) within 30-days following patient discharge post he...

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Main Authors: Vincent Wu, Stephen F. Hall
Format: Article
Language:English
Published: SAGE Publishing 2018-05-01
Series:Journal of Otolaryngology - Head and Neck Surgery
Subjects:
Online Access:http://link.springer.com/article/10.1186/s40463-018-0283-x
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author Vincent Wu
Stephen F. Hall
author_facet Vincent Wu
Stephen F. Hall
author_sort Vincent Wu
collection DOAJ
description Abstract Background Unplanned returns to hospital are common, costly, and potentially avoidable. We aimed to investigate and characterize reasons for all-cause readmissions to hospital as in-patients (IPs) and visits to the Emergency Department (ED) within 30-days following patient discharge post head and neck surgery (HNS). Methods Retrospective case series with chart review. All patients within the Department of Otolaryngology – Head and Neck Surgery who underwent HNS for benign and malignant disease from January 1, 2010 to May 31, 2015 were identified. The electronic medical records of readmitted patients were reviewed for reasons of readmission, demographic data, and comorbidities. Results Following 1281 surgical cases, there were 41 (3.20%) IP readmissions and 109 (8.43%) ED visits within 30-days after discharge for HNS. For IP readmissions, most common causes included infection (26.8%), respiratory symptoms (17.1%), and pain (17.1%). Most common reasons for ED visits were for pain (31.5%), bleeding (17.6%), and infection (14.8%). Readmitted IPs had significantly higher health burden at pre-operative baseline as compared to patients who visited the ED when assessed with the American Society of Anesthesiology scores (p = 0.002) and the Cumulative Illness Rating Scale (p = 0.004). Conclusion Rate of 30-day IP readmission and ED utilization was 3.20 and 8.43%, respectively. Pain and infection were common causes for returns to hospital. Discharge planning may be improved to target common causes for post-surgical hospital visits in order to decrease readmission rates.
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spelling doaj-art-61f7ee716ec2465d8a38a57ae67c7a692025-02-02T23:08:46ZengSAGE PublishingJournal of Otolaryngology - Head and Neck Surgery1916-02162018-05-014711510.1186/s40463-018-0283-xRates and causes of 30-day readmission and emergency room utilization following head and neck surgeryVincent Wu0Stephen F. Hall1School of Medicine, Faculty of Health Sciences, Queen’s UniversityDepartment of Otolaryngology – Head and Neck Surgery, Queen’s Cancer Research Institute, Queen’s UniversityAbstract Background Unplanned returns to hospital are common, costly, and potentially avoidable. We aimed to investigate and characterize reasons for all-cause readmissions to hospital as in-patients (IPs) and visits to the Emergency Department (ED) within 30-days following patient discharge post head and neck surgery (HNS). Methods Retrospective case series with chart review. All patients within the Department of Otolaryngology – Head and Neck Surgery who underwent HNS for benign and malignant disease from January 1, 2010 to May 31, 2015 were identified. The electronic medical records of readmitted patients were reviewed for reasons of readmission, demographic data, and comorbidities. Results Following 1281 surgical cases, there were 41 (3.20%) IP readmissions and 109 (8.43%) ED visits within 30-days after discharge for HNS. For IP readmissions, most common causes included infection (26.8%), respiratory symptoms (17.1%), and pain (17.1%). Most common reasons for ED visits were for pain (31.5%), bleeding (17.6%), and infection (14.8%). Readmitted IPs had significantly higher health burden at pre-operative baseline as compared to patients who visited the ED when assessed with the American Society of Anesthesiology scores (p = 0.002) and the Cumulative Illness Rating Scale (p = 0.004). Conclusion Rate of 30-day IP readmission and ED utilization was 3.20 and 8.43%, respectively. Pain and infection were common causes for returns to hospital. Discharge planning may be improved to target common causes for post-surgical hospital visits in order to decrease readmission rates.http://link.springer.com/article/10.1186/s40463-018-0283-xRatesCauses30-dayReadmissionEmergency departmentOtolaryngology
spellingShingle Vincent Wu
Stephen F. Hall
Rates and causes of 30-day readmission and emergency room utilization following head and neck surgery
Journal of Otolaryngology - Head and Neck Surgery
Rates
Causes
30-day
Readmission
Emergency department
Otolaryngology
title Rates and causes of 30-day readmission and emergency room utilization following head and neck surgery
title_full Rates and causes of 30-day readmission and emergency room utilization following head and neck surgery
title_fullStr Rates and causes of 30-day readmission and emergency room utilization following head and neck surgery
title_full_unstemmed Rates and causes of 30-day readmission and emergency room utilization following head and neck surgery
title_short Rates and causes of 30-day readmission and emergency room utilization following head and neck surgery
title_sort rates and causes of 30 day readmission and emergency room utilization following head and neck surgery
topic Rates
Causes
30-day
Readmission
Emergency department
Otolaryngology
url http://link.springer.com/article/10.1186/s40463-018-0283-x
work_keys_str_mv AT vincentwu ratesandcausesof30dayreadmissionandemergencyroomutilizationfollowingheadandnecksurgery
AT stephenfhall ratesandcausesof30dayreadmissionandemergencyroomutilizationfollowingheadandnecksurgery