Ettyreddy Abhinav R, Kao Wee Tin Katherine, Roland Lauren T, Rich Jason T, Chi John J
1 Department of Otolaryngology-Head & Neck Surgery, Washington University in St Louis, St Louis, MO, USA.
Ear Nose Throat J. 2019 Apr-May;98(4):220-222. doi: 10.1177/0145561319827908. Epub 2019 Feb 7.
In the current value-based health-care environment, 30-day unplanned hospital readmissions have been identified as a quality measure and an opportunity to help reduce health-care costs. The LACE Index Scoring Tool for Risk Assessment of Death and Readmission utilizes length of stay, acuity of admission, comorbidities, and emergency department visits to stratify patients into high and low risk of readmission. A retrospective chart review of 161 patients who underwent a tracheotomy or laryngectomy for head and neck indications at a tertiary care academic center demonstrated that the readmitted patient cohort was not statistically or clinically different from the nonreadmitted cohort when comparing LACE scores ( P = .789), length of hospital stay ( P = .237), discharge disposition ( P = .569), or insurance status ( P = .85). Addressing the problem of unplanned 30-day readmissions will likely require enhanced patient education, improved coordination of care, and further research.
在当前基于价值的医疗环境中,30天非计划住院再入院已被确定为一项质量指标,也是帮助降低医疗成本的一个契机。用于死亡和再入院风险评估的LACE指数评分工具利用住院时间、入院急症程度、合并症以及急诊就诊情况,将患者分为再入院高风险和低风险两类。对在一家三级医疗学术中心因头颈部疾病接受气管切开术或喉切除术的161例患者进行的回顾性病历审查表明,在比较LACE评分(P = 0.789)、住院时间(P = 0.237)、出院处置情况(P = 0.569)或保险状况(P = 0.85)时,再入院患者队列与未再入院患者队列在统计学或临床上并无差异。解决非计划30天再入院问题可能需要加强患者教育、改善护理协调并开展进一步研究。