Measuring readmissions after surgery: do different methods tell the same story?

Chen Q, Mull HJ, Rosen AK, Borzecki AM, Pilver C, Itani KM. Measuring readmissions after surgery: do different methods tell the same story? American journal of surgery. 2016 Jul 1; 212(1):24-33.

Related HSR&D Project(s)

• IIR 09-369 – Validating and Classifying VA Readmissions For Quality Assessment and Improvement

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Abstract:

BACKGROUND: Readmission is widely used as a quality metric to assess hospital performance. However, different methods to calculate readmissions may produce various results, leading to differences in classification with respect to hospital performance. This study compared 2 commonly used approaches to measure surgical readmissions: the 30-day all-cause hospital-wide readmissions (HWRs) and the potentially preventable readmissions (PPRs). METHODS: We examined the correlation between hospitals' risk-adjusted HWR and PPR rates and whether there was agreement in categorizing hospital performance between these measures among 111 hospitals with inpatient surgical programs in the Veterans Health Administration. RESULTS: We found that hospitals' HWR and PPR rates were highly correlated (r = .85, P < .0001). The overall agreement between these 2 methods in categorizing hospital performance was 82% for all surgeries, 82% for colectomy, 84% for coronary bypass, and 87% for hip/knee replacement, respectively. CONCLUSIONS: Despite differences in methodologies, the HWR and the PPR measures provided relatively consistent perceptions of hospitals' performance on surgical readmissions.