Low rehospitalization rate for vascular surgery patients.

Abstract

Reducing rehospitalization rates has been proposed to improve care, reduce costs, and as a pay-for-performance criterion. Recent review of Medicare claims data indicates that vascular surgery patients have among the highest rates of 30-day rehospitalization at 23.9%. We retrospectively examined all live patient discharges (n = 799) from the vascular surgery service at a single university hospital over 12 months. Planned and unplanned 30-day rehospitalizations were distinguished, and predictors of unplanned 30-day rehospitalization were determined. To identify whether patients were readmitted to other hospitals, a prospective study of patient discharges (n = 66) over 1 month was also performed. Ninety-five (11.9%) of the 799 patient discharges from the vascular surgery service were rehospitalized within 30 days. Of these, 71 were unplanned; therefore, the unplanned rehospitalization rate was 8.9%. The most common causes of unplanned 30-day rehospitalization were related to wound complications. Diabetes (P = .039) predicted unplanned 30-day rehospitalization by multivariate analysis. Patients with the diagnosis of critical limb ischemia (14.9%) and patients undergoing open lower extremity revascularization (14.6%) had the highest rates of unplanned 30-day rehospitalization. In the prospective portion of this study, no patient was readmitted to any other hospital. Relatively low 30-day rehospitalization was accomplished in vascular surgery patients at a single university hospital. Moreover, planned rehospitalizations accounted for approximately 25% of readmissions in vascular surgery patients. Strategies designed to reduce rehospitalization in diabetics may be warranted.