Abstract
BackgroundUnplanned 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).MethodsRetrospective 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.ResultsFollowing 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).ConclusionRate 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.
Highlights
Unplanned returns to hospital are common, costly, and potentially avoidable
From its 2012 report, surgical patients were identified as having the second highest overall rate of readmission as IP and return to the Emergency Department (ED), contributing to the $1.8 billion dollar annual cost associated with 30-day readmissions
Of the 1281 patients who underwent head and neck surgery (HNS) during the study period, 120 (9.37%) patients returned to hospital within 30-days of discharge
Summary
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). Unplanned returns to hospital, including readmissions as in-patients (IPs) and visits to the Emergency Department (ED) are identified as costly, common, and potentially avoidable with proper planning and patient education [1,2,3,4,5,6]. From its 2012 report, surgical patients were identified as having the second highest overall rate of readmission as IP and return to the ED, contributing to the $1.8 billion dollar annual cost associated with 30-day readmissions. Studies on surgery patients have identified risk factors for unplanned readmission that differ from medical patients [16].
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