FINDINGS
A study has found that the day of the week that a patient is discharged from the hospital does not affect the likelihood that he or she will be readmitted. The study showed comparable readmission rates for weekday and weekend or holiday discharge. It has been speculated that patients who are discharged on a weekend or holiday, when staff levels are typically lower, might be more likely to be readmitted to the hospital.
The researchers found that the use before surgery of beta-blockers, a type of medication used to treat heart conditions; tobacco use; and surgical site infections were independent predictors of readmission within 30 days. The particular day a patient was discharged from the hospital was not a factor for readmission.
BACKGROUND
The Hospital Readmissions Reduction Program enacted by the Centers for Medicare and Medicaid Services encourages hospitals to reduce unplanned readmissions. Up to 22 percent of cardiac surgery patients are readmitted within 30 days. Researchers wanted to investigate factors that could potentially be modified during the complex discharge process and evaluate if the day of discharge affects readmissions.
METHOD
The team reviewed data from The Society of Thoracic Surgeons Adult Cardiac Surgery Database for all patients who underwent non-emergency heart operations between 2008 and 2016 at Ronald Reagan UCLA Medical Center. The researchers identified 4,877 patients, nearly 20 percent of them discharged on a weekend or holiday. This subset was particularly important because of the so-called “weekend effect,” which has been described as worse outcomes because of decreased staffing.
IMPACT
Hospital readmission reduction programs should focus on identifying patients with known risk factors for readmission rather than expanding existing weekend and holiday staff coverage. Programs should also offer patient education and accessibility to expert advice after hospitalization as strategies to prevent readmissions.
AUTHORS
Dr. Yas Sanaiha, Ryan Ou, Gianna Ramos, Dr. Yen-Yi Juo, Dr. Richard Shemin and Dr. Peyman Benharash, all of UCLA.
JOURNAL
The were published Oct. 11 online in The Annals of Thoracic Surgery.
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