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  1. Hospital readmission after cardiac surgery : Does "fast track" cardiac surgery result in cost saving or cost shifting ? Commentary.

    Article, Communication - En anglais

    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

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 99-0068871

    Code Inist : 002B25E. Création : 31/05/1999.