Variation in surgical readmissions mostly patient related

Editor's Note

Postoperative readmissions occurred in more than 1 in 10 patients, in this study, with considerable variation across specialties.

The majority of variation was attributable to patient-related factors (82.8%); surgical specialty accounted for 14.5% of the variability, and individual surgeon factors accounted for 2.8%.

After adjusting for patient and surgeon variables, factors associated with readmissions included African American race/ethnicity, number of comorbidities, postoperative complications, and extended length of stay.

The findings echo growing concerns regarding the use of readmission as a quality metric based on the current methods used in the Centers for Medicare & Medicaid's Hospital Readmission Reductions Program, the authors say.

Importance Readmission is a target area of quality improvement in surgery. While variation in readmission is common, to our knowledge, no study has specifically examined the underlying etiology of this variation among a variety of surgical procedures performed in a large academic medical center.