A Hidden Cause of Readmissions Comes to Light
What's more, the precise reasons why those patients are being readmitted are rarely tracked and quantified, at least not with the intensity that national efforts to prevent readmissions in patients with medical conditions such as heart failure, pneumonia, and heart attack have been to date.
Public reporting that would shed light on these complications is largely absent. Medicare's Hospital Compare mainly shows rates of complications from surgery that occurred before the patient was discharged, not after, Hawn says.
Her study looked at 59,273 major surgical procedures—such as orthopedic, vascular, or gastrointestinal—performed at 112 VA hospitals from January, 2005 to August 2009. It found that 22.6% of these surgical patients developed a serious complication, and nearly one-third of those, or 28.1%, occurred after discharge.
Almost 12% of patients developed complications so severe, they could not be treated in an outpatient setting and had to return to the hospital for an inpatient stay.
- Surgical site infections that weren't apparent at the time of discharge respiratory complications that required a ventilator or resulted in pneumonia, stroke or coma
- Venous thromboembolism
- Urinary tract infections
- Renal failure or kidney infection
Most surgical readmissions the research discovered were due to infections, discovered when patients develop a fever or redness of the surgical wound a week or two after hospital discharge, Hawn says.
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