Patterns of care for readmission after radical cystectomy in New York State and the effect of care fragmentation

• Published in: Urologic oncology 2015-10, Vol.33 (10), p.426.e13-426.e19
• Main Authors: Pak, Jamie S., B.A, Lascano, Danny, B.A, Kabat, Daniel H., M.S, Finkelstein, Julia B., M.D, RoyChoudhury, Arindam, Ph.D, DeCastro, G. Joel, M.D., M.P.H, Gold, William, Ph.D, McKiernan, James M., M.D
• Format: Article
• Language: English
• Subjects: continuity of patient care; Continuity of Patient Care - statistics & numerical data; Cystectomy; Female; Humans; Length of Stay - statistics & numerical data; Male; Mortality; New York; Patient readmission; Patient Readmission - statistics & numerical data; Patient Transfer - statistics & numerical data; Postoperative care; Urinary Bladder Neoplasms - mortality; Urinary Bladder Neoplasms - surgery; Urology
• ISSN: 1078-1439; 1873-2496
• DOI: 10.1016/j.urolonc.2015.06.001

Abstract Objective To determine if readmission after radical cystectomy (RC) to the original hospital of the procedure (OrH) vs. readmission to a different hospital (DiffH) has an effect on outcomes. Methods The New York Statewide Planning and Research Cooperative System database was queried for discharges between January 1, 2009 and November 31, 2012 after RC in New York State. Primary outcome was mortality within 30 and 90 days. Secondary outcomes included length of stay for readmission, rate of transfers/subsequent readmissions, hospital charges per readmission, and, if applicable, length of intensive care unit stays. Multivariate linear regression analyses were performed to adjust for confounding factors in predicting mortality. Results During the study period, 2,338 patients were discharged from 100 New York State hospitals after RC. Overall rate of readmission was 28.5% and 39.7% within 30 and 90 days, respectively. Of all readmitted patients, 80.4% and 77.1% were first readmitted to OrH within 30 and 90 days, respectively. Patients readmitted to OrH were younger ( P