Purpose: Analyze associations between patients' characteristics and treatment factors with 30-day unplanned readmissions in hospitalized otolaryngology patients in the German Diagnosis Related Group (D-DRG) system.
Methods: A retrospective cohort study was performed on 15.271 otolaryngology admissions of 12.859 patients in 2015 in Thuringia, Germany. The medical records of the 1173 cases (7.6%) with readmission within 30-days were analyzed in detail.
Results: The 30-day readmission was planned in 747 cases (4.9%) and was unplanned in 422 cases (2.8%). The median interval between primary and next inpatient treatment was 11 days. The principal diagnosis was the same as during the primary index treatment in 72% of the cases. The most frequent reasons for readmission were: Need for non-surgical therapy (31.2%), need for further surgery (26.3%), post-surgical complaints (16.9%), and recurrence of primary complaints (10.7%). The multivariate analysis revealed that discharge due to patient's request against medical advice was a strong independent factor with high risk for unplanned readmission (Odds Ratio [OR] = 9.62]; confidence interval [CI] = 2.69-34.48). Surgery at index admission (OR = 3.33; CI = 1.86-5.96) was the second important independent risk factor for unplanned readmission. Unplanned readmission had more frequently a non-surgical treatment at readmission than a surgical treatment (OR = 3.92; CI = 2.24-6.84) and needed more frequently further diagnostics (OR = 2.34; CI = 1.34-4.11). The following index International Classification of Diseases (ICD) categories had the highest risk for unplanned readmission: Injury, poisoning and certain other consequences of external causes, ICD: S00-T98 (OR = 66.67; CI = 15.87-333.33), symptoms, signs, abnormal findings, ill-defined causes, not otherwise classified, ICD: R00-R99 (OR = 62.5; CI = 11.76-333.33), blood forming organ diseases, ICD: D50-D90 (OR = 21.276; CI = 3.508-125), and eye/ ear diseases, ICD: H00-H95 (OR = 12.66; CI = 4.29-37.03).
Conclusions: The causes of unplanned 30-day readmission in German otolaryngology inpatients are multifactorial. Specific patient and treatment characteristics were identified to be targeted with health care interventions to decrease unplanned readmissions.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6797198 | PMC |
| http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0224146 | PLOS |
Publication Analysis
Top Keywords
Similar Publications
Non-Operative Management of Cholecystitis in Pregnant Patients Remains Common.
Surg Infect (Larchmt)
January 2025
Division of Trauma, Surgical Critical Care, Burns, and Acute Care Surgery, Department of Surgery, UC San Diego, San Diego, California, USA.
Cholecystectomy is the recommended treatment for acute cholecystitis in pregnancy, leading to fewer pregnancy-related complications than non-operative management. However, past research demonstrated high rates of non-operative management despite these recommendations. Rates of cholecystostomy tube usage and outcomes in pregnancy are not well described.
View Article and Find Full Text PDFChimeric anterolateral thigh-vastus lateralis free flap with propeller skin island for functional quadriceps reconstruction.
J Hand Microsurg
March 2025
Operative Research Unit of Plastic, Reconstructive and Aesthetic Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.
Introduction: Soft-tissue sarcomas arising in the thigh may require total or subtotal compartmentectomy, with subsequent need for functional reconstruction with free functional muscle transfer (FFMT). We present our series, describing a new approach with chimeric propeller antero-lateral thigh-vastus lateralis (ALT-VL) free flap, which allows for independent muscle inset and soft tissue defect resurfacing.
Patient And Methods: A retrospective review of a prospectively maintained database was performed, analyzing all patients referred to Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy, between 2018 and 2023 for soft-tissue sarcomas of the thigh requiring wide excision and reconstruction with functional ALT-VL.
Mapping the landscape of Hospital at home (HaH) care: a validated taxonomy for HaH care model classification.
BMC Health Serv Res
January 2025
Institute Patient-Centered Digital Health, Bern University of Applied Sciences, Quellgasse 21, Biel, 2502, Switzerland.
Background: Hospital at home (HaH) care models have gained significant attention due to their potential to reduce healthcare costs, improve patient satisfaction, and lower readmission rates. However, the lack of a standardized classification system has hindered systematic evaluation and comparison of these models. Taxonomies serve as classification systems that simplify complexity and enhance understanding within a specific domain.
View Article and Find Full Text PDFEvaluation of PCORnet as an Approach to Accessing Electronic Health Record (EHR) Data for Cleft Outcomes Research: Advantages and Limitations.
Cleft Palate Craniofac J
January 2025
Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Health System, Durham, NC, USA.
To evaluate the feasibility of using the National Patient-Centered Clinical Research Network (PCORnet) as a source of electronic health record (EHR) data for cleft outcomes research. Exploratory retrospective analysis of multi-year, administrative and clinical, structured data stored in PCORnet. Academic institution with an ACPA-approved cleft and craniofacial team.
View Article and Find Full Text PDFPatient-Centered mHealth Intervention to Improve Self-Care in Patients With Chronic Heart Failure: Phase 1 Randomized Controlled Trial.
J Med Internet Res
January 2025
Indiana University, Indianapolis, IN, United States.
Background: Heart failure (HF) is one of the most common causes of hospital readmission in the United States. These hospitalizations are often driven by insufficient self-care. Commercial mobile health (mHealth) technologies, such as consumer-grade apps and wearable devices, offer opportunities for improving HF self-care, but their efficacy remains largely underexplored.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!