Institutional Cost of Unplanned 30-Day Readmission Following Open and Endovascular Surgery

Adam S A Gracon, Tiffany W. Liang, Thomas S. Easterday, Daniel J. Weber, James Butler, James E. Slaven, Gary Lemmon, Raghu Motaganahalli

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Abstract

Background: Vascular surgical patients have a high rate of readmission, and the cost of readmission for these patients has not been described. Herein, we characterize and compare institutional index hospitalization and 30-day readmission cost following open and endovascular vascular procedures. Methods: The American College of Surgeons National Surgical Quality Improvement Program database was used to identify inpatient open and endovascular procedures at a single institution, from January 2011 through June 2012. Variable and fixed costs for index hospitalization and unplanned 30-day readmissions were obtained using SAP BusinessObjects. Patient characteristics and outcome variables were analyzed using Student t tests or Wilcoxon rank-sum nonparametric tests for continuous variables and Fisher exact tests for categorical variables. Results: One thousand twenty-six inpatient procedures were included in the analysis. There were 605 (59%) open and 421 (41%) endovascular procedures with a 30-day unplanned readmission rate of 16.9% and 17.8%, respectively (P =.679). The mean index hospitalization costs for open and endovascular procedures were US$27 653 and US$23 999, respectively (P =.146). The mean costs for 30-day unplanned readmission for open and endovascular procedures were US$19 117 and US$17 887, respectively (P =.635). Among open procedures, the mean cost for patients not readmitted was US$28 321 compared to US$31 115 for those readmitted (P =.003). Among endovascular procedures, the mean cost for patients not readmitted was US$26 908 compared to US$32 262 for those readmitted (P =.028). Conclusion: The cost of index hospitalization and 30-day unplanned readmission are similar for open and endovascular procedures. Readmitted patients had a higher mean index hospitalization cost irrespective of open or endovascular procedure.

Original languageEnglish (US)
Pages (from-to)398-404
Number of pages7
JournalVascular and Endovascular Surgery
Volume50
Issue number6
DOIs
StatePublished - Aug 1 2016

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Keywords

  • Affordable Care Act
  • hospital cost
  • readmission
  • vascular surgery

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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