Identification of factors that define surgical quality traditionally centers on where operations take place, who performs the operations, and events which occur while the patient is in the hospital. Far less attention focuses on events which occur after patients leave the hospital. However, complications following major surgery frequently arise after patients are discharged, and up to 25% of patients who undergo major surgery will require readmission.
University of Utah Health investigator Benjamin Brooke, MD, PhD, and colleagues sought to determine whether patients who are readmitted following major surgery achieve better outcomes if they return to the same hospital and surgeons who performed their initial operation. They used Medicare claims data from over 9 million beneficiaries to identify patients who were readmitted within 30 days following a major surgery across all specialties. They found that when complications arose, patients who returned to the index hospital and received care from their original surgical team achieved significantly greater 90-day survival than those whose readmission occurred at a different hospital. These findings suggest the importance of continuity of care following surgery as a measure of quality.
Readmission destination and risk of mortality after major surgery: an observational cohort study. Brooke BS, Goodney PP, Kraiss LW, Gottlieb DJ, Samore MH, Finlayson SRG. Lancet. 2015 Aug 29;386(9996):884-95.
Fragmentation in the post-discharge period: surgical readmissions, distance of travel, and postoperative mortality. Tsai TC, Orav EJ, Jha AK. JAMA Surg. 2015 Jan;150(1):59-64.
Contributors to increased mortality associated with care fragmentation after emergency general surgery. McCrum ML, Cannon AR, Allen CM, Presson AP, Huang LC, Brooke BS. JAMA Surg. 2020 Sep 1;155(9):841-848.
Press Releases and Media:
University of Utah Health: “Patients Less Likely to Die if Readmitted to Same Hospital”