Patient experiences after hospitalizations for elective surgery

• 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
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2013.04.014

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.