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急诊普通外科手术后再入院。

Readmission after emergency general surgery.

机构信息

Eastern Virginia Medical School, Department of Surgery, 825 Fairfax Ave, 6th Floor, Norfolk, VA, 23507, USA.

Eastern Virginia Medical School, EVMS-Sentara Healthcare Analytics and Delivery Science Institute, P. O. Box 1980, Norfolk, VA, 23501, USA.

出版信息

Am J Surg. 2020 Sep;220(3):731-735. doi: 10.1016/j.amjsurg.2020.01.010. Epub 2020 Jan 20.

Abstract

BACKGROUND

Readmission rates are an important metric because they enable an evaluation of care and affect Medicare funding. This study evaluates factors contributing to readmission after emergency general surgery.

METHODS

The Virginia Health Information database was used to identify patients who had undergone the most common emergency general surgery procedures from 1/2011-6/2016. Analyses were performed for 30 and 90-day readmission.

RESULTS

121,223 records met initial inclusion criteria and 54,372 remained after exclusions. In 30 days there were 5050 readmissions and 7896 readmissions in 90 days. Factors significant in contributing to 30-day readmission were length of stay, discharge location, and several comorbidities. For 90-day readmission the same factors were significant with the addition of urgent vs emergency admission and insurance status as well as additional comorbidities. Discharge to rehab, SNF, or with home healthcare had particularly high rates of 90 day readmission.

CONCLUSIONS

We identified factors that contribute to readmission after emergency general surgery providing targets for future interventions. Improved follow up for patients discharged with rehab or home health needs is our next step.

摘要

背景

再入院率是一个重要的指标,因为它可以评估医疗服务质量并影响医疗保险资金。本研究评估了导致急诊普通外科手术后再入院的因素。

方法

使用弗吉尼亚州健康信息数据库,从 2011 年 1 月至 2016 年 6 月,确定接受最常见急诊普通外科手术的患者。对 30 天和 90 天的再入院率进行分析。

结果

121223 份记录符合最初的纳入标准,排除后有 54372 份记录保留。30 天内有 5050 例再入院,90 天内有 7896 例再入院。导致 30 天再入院的显著因素包括住院时间、出院地点和几种合并症。对于 90 天再入院,同样的因素显著,加上紧急与急诊入院、保险状况以及其他合并症。康复、养老院或家庭保健出院的患者 90 天再入院率特别高。

结论

我们确定了导致急诊普通外科手术后再入院的因素,为未来的干预措施提供了目标。下一步是改善对接受康复或家庭健康护理出院患者的随访。

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