Researchers studied 5,780 consecutive patient encounters managed by 10 spine surgeons at the University of California, San Francisco Medical Center from October 2007 to June 2011. Two hundred eighty-one patients, or 4.9 percent, were readmitted within 30 days of discharge. Readmission was primarily due to infection, at 39.8 percent, followed by nonoperative management at 13.4 percent and planned staged surgery at 12.4 percent.
The authors’ manual chart review found that 69 cases, or 25 percent of the readmissions, should be excluded as non-clinically relevant reasons for readmission, since 39 cases were planned staged procedures, 16 were unrelated to spine surgery and 14 surgical cases were canceled or rescheduled at index admission due to unpredictable reasons. Excluding the readmissions deemed non-clinically relevant reduced the direct cost of readmission by 29 percent.
The authors concluded that hospitals’ readmission rates would be more accurate if they took into account planned staged surgery and unrelated reasons for readmission.
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