Use of a comparative database to identify excessive hematology/medical oncology hospital days and readmissions.

Abstract

131 Background: Reducing length of stay and readmissions are important goals to improve healthcare quality and decrease costs. We identified diagnostic categories accounting for excessive hospital days and readmissions on our hematology/medical oncology (HO) service. Methods: We used a third-party comparative clinical database (Vizient Inc, Clinical Data Base/Resource Manager) to identify discharges from our HO service in 2015. Cases were categorized by All Patients Refined Diagnosis Related Groups (APR DRG), and we calculated excess hospital days attributed to each using the number of cases and their observed/expected length of stay. We also collected 30-day readmission rates for each APR DRG on our HO service and hospital wide. Readmission rates were compared using Fisher exact tests. Results: We identified 1,361 discharges from our HO service with 134 APR DRG codes and 880.5 excess hospital days. Fourteen APR DRGs accounted for over 80% of the excess hospital days. Readmission rates ranged from 0% to 66.7%, and were generally higher than rates hospital wide. Readmissions for septicemia and major operating room (OR) procedures for lymphatic neoplasms were significantly higher on the HO service. Conclusions: Relatively few APR DRGs accounted for the majority of our excess hospital days, and also had high readmission rates. We will conduct additional review of these APR DRGs to identify opportunities to improve quality and reduce cost. [Table: see text]