Council on Cardio-Thoracic and Vascular Surgery. American Heart Association. Scientific Sessions. Orlando, FL, USA, 1997/11/09.
Background-Intense medical and economic pressures have created « fast track » cardiac surgery in which clinical services are streamlined and early discharge is encouraged.
Does this strategy promote significant cost saving or merely cost shifting ?
In a global system of reimbursement, the economic benefit of decreasing patient length of stay may be offset by high rates of patient readmission.
This study was undertaken to determine the 30-day readmission rate after cardiac surgery and to analyze trends of readmission diagnoses.
Methods and Results-From October 1,1996 to July 31,1997,460 consecutive cardiac surgical operations were performed at I institution.
There were 25 deaths and 8 patients who remained as inpatients at the 30-day postoperative deadline for readmission.
Two patients had 2 operations.
Therefore, 527 operations were performed on 525 patients.
There were 110 readmissions after 527 operations for a readmission rate of 20.9%. A significant number of readmissions (49%) were to outside hospitals.
Readmission diagnoses were :
atrial fibrillation (23%) ;
angina, congestive heart failure, or ventricular tachycardia (20%) ;
leg wound (15%) ;
sternal wound (5%) ;
pneumonia (5%) ;
gastrointestinal complaints (5%) ;
neurologic event (2%) ;
and miscellaneous (25%). Patients discharged >=7 days postoperatively were twice as likely to be readmitted as those discharged on postoperative days 4,5, or 6. (...)
Mots-clés Pascal : Chirurgie, Coeur, Analyse coût, Economie santé, Hospitalisation, Durée, Traitement, Pronostic, Homme
Mots-clés Pascal anglais : Surgery, Heart, Cost analysis, Health economy, Hospitalization, Duration, Treatment, Prognosis, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0068871
Code Inist : 002B25E. Création : 31/05/1999.