Patient experiences after hospitalizations for elective surgery

Abstract Background Little is known from patients' perspective about the quality of postdischarge care and the causes of rehospitalization after elective surgery. Methods A prospective observational cohort study was conducted. Results Of 400 patient participants, 374 completed the 30-day follow...

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Bibliographic Details
Published in:The American journal of surgery 2014-06, Vol.207 (6), p.855-862
Main Authors: Hinami, Keiki, M.D., M.S, Bilimoria, Karl Y., M.D., M.S, Kallas, Peter G., M.D, Simons, Yael M., B.A, Christensen, Nicholas P., M.A, Williams, Mark V., M.D
Format: Article
Language:English
Subjects:
Aged
Asthma
Care coordination
Chronic obstructive pulmonary disease
Classification
Comorbidity
Elective Surgical Procedures
Female
Heart failure
Hospitalization
Hospitals
Humans
Illinois - epidemiology
Infections
Joint surgery
Male
Middle Aged
Outcome Assessment (Health Care)
Pain
Patient Discharge - statistics & numerical data
Patient Readmission - statistics & numerical data
Patient Satisfaction
Patient-centered outcomes
Patients
Physicians
Postoperative Complications - epidemiology
Prospective Studies
Questionnaires
Rehospitalization
Risk Factors
Studies
Surgery
Surgical complications
Surveys and Questionnaires
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Summary:Abstract Background Little is known from patients' perspective about the quality of postdischarge care and the causes of rehospitalization after elective surgery. Methods A prospective observational cohort study was conducted. Results Of 400 patient participants, 374 completed the 30-day follow-up questionnaire (completion rate, 94%). Half of all unplanned rehospitalizations (experienced by 13% of patients) and nonrehospitalization emergency department visits (experienced by 6%) occurred within 10 days of discharge. Patients used emergency departments and were rehospitalized at facilities near their homes (mean distance traveled, 12.1 mi). The most common primary reason for rehospitalization was postoperative complications, according to patient report, clinical records, and administrative data. Poor perceived care coordination was associated with higher readmission risk. Conclusions Patients perceive surgical complications as dominating the reasons for rehospitalizations after elective surgery. Strategies to improve care quality around elective surgery at referral centers should target the discharge process and the coordinated management of postoperative complications through care received at regional hospitals.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2013.04.014