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Predictors of readmission to non-index hospitals after colorectal surgery
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Predictors of readmission to non-index hospitals after colorectal surgery
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Predictors of readmission to non-index hospitals after colorectal surgery
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Journal Article
Predictors of readmission to non-index hospitals after colorectal surgery
2017
Overview
Although a significant proportion of patients are readmitted to non-index hospitals after surgery, risk factors for non-index hospital readmission are not well defined.
Using the California Office of State Health Planning and Development database from 2008 to 2012, patients readmitted to index versus non-index hospitals after colorectal surgery were directly compared. Risk factors for non-index hospital readmission were assessed through logistic regression.
Among the 14,401 patients requiring readmission, 10,890 (75.6%) were readmitted to index hospitals, whereas 3,511 (24.4%) were readmitted to non-index hospitals. Patients readmitted to non-index hospitals were more likely to be men and have a greater Charlson comorbidity index, non-private insurance, longer initial length of stay, longer travel distance, and non-home discharge disposition. On multivariable logistic regression analysis, living ≥10 miles from the index hospital was strongly predictive of non-index hospital readmission (odds ratio, 1.8; 95% confidence interval, 1.63 to 2.00).
Approximately 25% of readmissions after colorectal surgery will be to non-index hospitals. Risks factors include greater comorbidities, non-private health insurance, occurrence of an inpatient complication, longer length of stay, greater travel distance, and non-home discharge disposition.
•Up to one fourth of readmissions after colorectal surgery will be to non-index hospitals.•Substantial variability in non-index hospital readmission rates exists.•Multiple factors are associated with non-index hospital readmission.•Greater travel distance is one of the strongest predictors.
