Objectives: We aimed to identify the frequency and costs of, and the disease predictors and inpatient process issues that may predispose to, 30-day readmission for an inflammatory bowel disease (IBD) patient.
Methods: IBD patients admitted to an inpatient gastroenterology service were followed for a time-to-readmission analysis assessing factors associated with readmission within 30 days.
Results: Index admissions were more costly among those readmitted than among those not readmitted. Patients admitted with evidence of increased inflammation, infection, or obstruction or for dehydration or pain control had a higher risk of readmission. Patients treated with opioid analgesia during index admission were no less likely to be readmitted, and there was a 2.2-fold increase in readmissions when patients were discharged with no opioid analgesia. Scheduling variability and outpatient follow-up compliance were associated with readmission.
Conclusions: Predicting readmission is complex. A predictive model developed to be used at discharge yielded an area under the curve of 0.757.
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http://dx.doi.org/10.1038/ajg.2012.343 | DOI Listing |
Am J Manag Care
January 2025
Institute of Health Policy and Management and Master of Public Health Program, College of Public Health, National Taiwan University, No. 17 Xu-Zhou Road, Taipei 100, Taiwan. Email:
Objectives: Patients who revisit the emergency department (ED) shortly after discharge are a high-risk group for complications and death, and these revisits may have been seriously affected by the COVID-19 pandemic. Detecting suspected COVID-19 cases in EDs is resource intensive. We examined the associations of screening workload for suspected COVID-19 cases with in-hospital mortality and intensive care unit (ICU) admission during short-term ED revisits.
View Article and Find Full Text PDFAm J Manag Care
January 2025
Department of Orthopedic Surgery, Duke University School of Medicine, 311 Trent Dr, Durham, NC 27710. Email:
Objectives: Patients are often discharged to a skilled nursing facility (SNF) for postacute rehabilitation. Functional outcomes achieved in SNFs are variable, and costs are high. Especially for accountable care organizations (ACOs), home-based postacute rehabilitation offers a high-value option if outcomes are not compromised.
View Article and Find Full Text PDFJAMA Netw Open
January 2025
America's Physician Groups, Washington, DC.
Importance: Many physician groups are in 2-sided risk payment arrangements with Medicare Advantage plans (at-risk MA). Analysis of quality and health resource use under such arrangements may inform ongoing Medicare policy concerning payment and service delivery.
Objective: To compare quality and efficiency measures under 2 payment models: at-risk MA and fee-for-service (FFS) MA.
Hernia
January 2025
Center for Perioperative Optimization, Department of Surgery, Herlev Hospital, University of Copenhagen, Herlev, Denmark.
Purpose: The AFTERHERNIA Project aims to shift the focus of hernia surgery towards patient-reported outcomes by examining the impact of surgical methods and long-term complications on a national level. Groin and ventral hernia repairs are common surgical procedures with significant impact on patient quality of life and healthcare costs. Most large-scale studies focus on clinical outcomes like reoperation and readmission rates, rather than patient-reported outcomes.
View Article and Find Full Text PDFArch Orthop Trauma Surg
January 2025
Trauma Unit, Department of Surgery, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands.
Introduction: Surgical site infections (SSI) are one of the more severe complications following ankle surgery. It is associated with worse outcomes and re-admissions. Therefore, identification of risk factors is essential.
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