The 30-day readmission rate in neurosurgery: a useful indicator for quality assessment?

Stephanie Schipmann, Eric Suero Molina, Julia Windheuser, Justin Doods, Michael Schwake, Eike Wilbers, Samer Zawy Alsofy, Nils Warneke, Walter Stummer

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)

Abstract

Background: A shift in how we evaluate healthcare outcomes has driven the introduction of quality indicators as potential parameters to evaluate value-based healthcare delivery. So far, only few studies have been performed evaluating quality indicators in the context of neurosurgery, especially in the European region. The purpose of this study was to evaluate the 30-day readmission rate, identify reasons for readmission regarding the various neurosurgical diagnoses, and discuss the usefulness of this rate as a potential quality indicator.

Methods: During a 6-year period, a total of 8878 hospitalized patients in our neurosurgical department were retrospectively analyzed and included in this study. Reasons for readmission were identified. Patients’ diagnoses and baseline characteristics were obtained in order to identify possible risk factors for readmission.

Results: The 30-day readmission rate was 2.9%. The most common reason for unplanned readmissions were surgical site infections. The reasons for readmissions varied significantly between the different underlying neurosurgical diseases (p < 0.001). Multivariate logistic regression revealed hydrocephalus (OR, 4) and shorter length of stay during index admission (OR, 0.9) as risk factors for readmission.

Conclusions: We provided an analysis of reasons for readmission for various neurosurgical diseases in a large patient spectrum in Germany. Although readmission rates are easy to track and an attractive tool for quality assessment, the rate alone cannot be seen as an adequate measure for quality in neurosurgery as it lacks a homogenous definition and depends on the underlying health care system. In addition, strategies for risk adjustment are required.
Original languageEnglish
Pages (from-to)2659-2669
Number of pages11
JournalActa Neurochirurgica
Volume162
Issue number11
DOIs
Publication statusPublished - Nov 2020
Externally publishedYes

Keywords

  • Quality indicators
  • Neurosurgery
  • Readmission
  • Outcome
  • Risk factors

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