• Raul A Vasquez, Silky Chotai, Thomas H Freeman, Harrison F Kay, Joseph S Cheng, Matthew J McGirt, and Clinton J Devin.
• Department of Neurosurgery, University of Kentucky, Lexington, Kentucky.
• Neurosurgery. 2017 Nov 1; 81 (5): 772-778.

BackgroundReadmissions are a significant economic burden on the health care system and increasingly being utilized as a metric of quality. Patients discharged to home vs an inpatient facility have different characteristics, which might influence the readmissions following spine surgery.ObjectiveTo determine the effect of discharge disposition on readmission rates and causes of readmission after spine surgery.MethodsPatients enrolled in a prospective registry and undergoing elective spine surgery were analyzed. Readmissions (30 d), demographic, clinical variables, and baseline patient-reported outcomes were recorded. Patients were dichotomized as discharged home vs inpatient facility.ResultsOf total 1631 patients, 1444 (89%) patients were discharged home and 187 (11%) discharged to an inpatient facility. Sixty-five (4%) patients were readmitted at 30 d. There was no significant difference in readmissions between patients discharged to a facility 10 (5%) vs home 55 (4%; P = .210). In a multivariable analysis, adjusting for all the comorbidities, the discharge destination was not associated with readmission within 30 d. The medical complications (80%) were the most common cause of readmission in those discharged to a facility. Patients discharged home had significantly higher readmissions related to surgical wound issues (67%; P = .034).ConclusionDespite the older age and higher comorbidities in patients discharged to an inpatient facility, the proportion of readmissions was comparable to those discharged home. Patients discharged home had a higher proportion of readmissions related to surgical wound complications and those discharged to facility had higher readmissions associated with medical complications. Understanding causes of readmission based on discharge destination may allow targeted intervention to reduce the readmission rates following spine surgery.Copyright © 2017 by the Congress of Neurological Surgeons

27 keywords...

hide…