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CNS: Rates of Readmission Post Spinal Surgery Overestimated

Manual chart review shows related readmission rate overestimated by 25 percent

WEDNESDAY, Oct. 10 (HealthDay News) -- Current algorithms may overestimate readmission rates related to spinal surgery, according to a study presented at the annual meeting of the Congress of Neurological Surgeons, held from Oct. 6 to 10 in Chicago.

To assess the appropriateness of the University Health-System Consortium (UHC) in classifying readmissions, Beejal Amin, M.D., from the Loyola University Chicago Stritch School of Medicine, and colleagues performed a retrospective analysis of 5,780 consecutive patient encounters by 10 spine surgeons at the University of California San Francisco from 2007 to 2011. After evaluating predictors of readmission, the authors suggested an improved algorithm for calculation of the readmission rate.

The researchers found that, according to the UHC database, 4.9 percent of patients (281) were readmitted within 30 days. Based on manual chart review, 69 of these cases should not have been included in the readmission rate, including 39 planned readmissions for staged procedures; 14 cases that were cancelled or rescheduled; and 16 cases that were unrelated to the index surgery. The true readmission rate was determined to be 3.7 percent. The current UHC algorithm overestimated readmissions related to spinal surgery by 25 percent.

"Our analysis identified potential pitfalls in the current calculation of readmission rates and highlights the need for defining a clinically relevant algorithm that accurately calculates readmission rates in spine surgery," Amin said in a statement. "Readmissions should be determined not only by hospital readmission, but also require the presence of a diagnosis code that indicates a spine-related complication. This will help prevent false positive readmission classification."

Abstract No. 195
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