Key result
The CMS 30-day All-Cause Hospital Readmission measure calculates risk-standardized unplanned readmission rates for Medicare beneficiaries aged 65 and older to evaluate healthcare quality.
Why the study?
Data regarding the incidence and risk factors for 30-day readmission after traumatic brain injury are sparse despite increasing interest in its use as a quality metric.
The 30-day readmission rate after craniotomy for traumatic brain injury is approximately 15.5%, with rates slightly decreasing but associated costs increasing between 2010 and 2014.
CMS readmission metric enables standardized quality benchmarking in Medicare patients; leaves open its relevance for neurosurgical cohorts.
OBJECTIVE: There is increasing interest in the use of 30-day readmission (30dRA) as a quality metric to represent hospital and provider performance. Data regarding the incidence and risk factors for 30dRA after traumatic brain injury (TBI) are sparse. The authors sought to characterize these variables using a national database. METHODS: The Nationwide Readmissions Database was used to identify patients with a primary diagnosis of TBI who underwent craniotomy or craniectomy between 2010 and 2014. Our primary outcome of interest was 30dRA. Binary logistic regression was used to identify variables related to patient demographics, comorbidities, and index hospital admission that were associated with 30dRA. RESULTS: A total of 25,354 patients met the inclusion criteria. The 30dRA rate during the entire study period was 15.5%. In 2010 the 30dRA rate was 16.8% and in 2014 it decreased to 15.1% (pooled OR 0.90, 95% CI 0.87-0.94). The mean cost associated with a 30dRA increased slightly but significantly, from $9999 in 2010 to $10,114 in 2014 (p = 0.021). Factors associated with increased odds of 30dRA in the binary logistic regression included increased age, greater comorbidity burden, more severe injury, tracheostomy, gastrostomy, sodium abnormality, and venous thromboembolism. In order of decreasing frequency, the most common causes for 30dRA were neurological, injury/iatrogenic, cardiovascular/cerebrovascular, infectious, and respiratory. CONCLUSIONS: The incidence of 30dRA after craniotomy for TBI decreased slightly from 2010 to 2014. This study identified several variables associated with 30dRA that require confirmation in a prospective study, which could direct attempts to prevent readmissions.
No takes yet. Share an insight, caveat, or question.
Hoffman et al. (2019) studied Hospital readmission. Hospital discharge was evaluated on 30-day unplanned all-cause hospital readmission. The CMS 30-day All-Cause Hospital Readmission measure calculates risk-standardized unplanned readmission rates for Medicare beneficiaries aged 65 and older to evaluate healthcare quality.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: