By Ken Dropiewski, Prime-Core Executive Search (ken@prime-core.com)
As we progress to value-based healthcare system, it’s more important than ever to keep readmissions to a minimum. A recent study, though, found that more than 17 percent of patients undergoing peripheral revascularization for PVD were readmitted within 30 days of having the procedure.The unplanned readmissions were associated with increased mortality and, not surprisingly, higher costs.
The Research
A team of researchers analyzed records from 61,969 patients in the Nationwide Readmissions Database who met the following criteria:
- Were admitted to the hospitali with PAD for patients with
- Subsequently treated with peripheral arterial revascularization
- Survived to discharge
At the one month mark for each case, unplanned readmission rate was around 17.6 percent. Nearly 30 percent of these unplanned readmissions were attributed to complications related to the procedure. Other common causes include comorbidities such as sepsis (8.3 percent), diabetes complications (7.5 percent) and gangrene (5.1 percent).
The Cost of Hospital Readmission
The cost of readmission was very high, with the median cost totaling $11,013 nationally. According to procedure type, costs were:
- $11,567 for endovascular procedures
- $10,541 for surgical procedures and
- $11,796 for hybrid procedures.
All total, the nationally weighted cost of all readmissions was $401,112,036, according to the report.
Patients at Risk
The study noted that readmission rates were higher in older, women, insured by Medicare or Medicaid, and living in low-income areas and counties amongst larger populations. They also tended to have more comorbidities, including chronic limb ischemia, obesity, hypertension, congestive HF, diabetes and renal disease.
Discharge Planning
Researchers noted that in light of the data, physicians should begin profiling high-risk patients and prioritize discharge planning in order to improve outcomes, and reduce the costs associated with hospital readmission.
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