Post-Surgical Complications Treated Best at Same Hospital

Hospital readmissions are common for patients with complications who undergo major surgeries—nearly a quarter of patients are readmitted within 90 days of the procedure. In a national study that included 9 million Americans, researchers found that the hospital a patient returns to for readmission has an impact on the quality of care the patient receives.

The study, published in The Lancet, found that patients readmitted to the hospital with complications after a major surgery were 26% more likely to survive if they returned to the same hospital from which they received the surgery. Researchers took into account certain measures of surgical quality that can affect mortality, such as hospital size, teaching status, and volume of procedures, when analyzing the results as well as incorporated instrumental variable analyses to eliminate any potential unmeasured bias.

“With up to one in four patients hospitalized following complex surgery, our results could potentially translate into thousands of lives saved every year in the USA alone if patients returned to the hospital where they had the procedure and received care from their original surgical team,” Benjamin Brooke, MD, PhD, of the University of Utah School of Medicine, said in a statement.

The researchers also noted that many patients travel far distances to have their operations done at certain hospitals because the facility is either well-known for providing high-quality care or is a better option in terms of costs with health insurers.

“The assumption has been that if patients need readmission for complications they can seek care at local hospitals without compromising outcomes,” Dr Brooke said in a statement. “However, our findings suggest that maintaining continuity of care when readmissions occur is a more important predictor of survival than other established surgical quality measures.”

The report also found that 65.8% of patients who received coronary artery bypass grafting needed to be readmitted to the hospital within 30 days of the procedure in addition to 82% of patients who had colectomy procedures within the same timeframe. Researchers suggest that the findings might have important implications for cost effectiveness-driven regional centralization of surgical care, as the findings contradict health policies in practice today.