Measuring Quality of Neurosurgical Care: Readmission Is Affected by Patient Factors

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective The Hospital Readmission Reduction Program section of the Patient Protection and Affordable Care Act uses readmission rates as a proxy for measuring quality of care. Multiple studies have demonstrated that readmission rates are highly imprecise proxies for quality of care because readmission rates contain large amounts of statistical noise and are dependent on disease type, insurance type, severity, population, and a multitude of other factors. The current study was conducted to investigate characteristics associated with readmission and the quality of neurosurgical care. Methods Admissions data were gleaned from the University Health System Consortium database for neurosurgical patient (both cranial and spine) readmissions to assess patient-related factors relating to readmission from January 2011 to December 2014. Results Among 257,212 admissions for neurosurgical disease analyzed, patients with Medicaid and private payers as a primary insurance source had increased rates of readmission (odds ratio for readmission of 1.38 and 1.17, respectively) compared with patients with Medicare or other primary insurers. Patients with greater severity of disease and emergent or urgent admission also had statistically significant rates of readmission. Conclusions The findings suggest that readmission is affected by patient factors that are beyond the control of treating physicians. These findings also suggest that readmission rates may not be a good proxy for measurement of quality of care in neurosurgical patients.

Original languageEnglish (US)
Pages (from-to)21-24
Number of pages4
JournalWorld Neurosurgery
Volume88
DOIs
StatePublished - 2016

Fingerprint

Quality of Health Care
Proxy
Insurance
Patient Protection and Affordable Care Act
Patient Readmission
Insurance Carriers
Medicaid
Medicare
Spine
Odds Ratio
Databases
Physicians
Health
Population

Keywords

  • Key words Insurance payer
  • Quality
  • Readmission rates
  • University Hospital Consortium

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Measuring Quality of Neurosurgical Care : Readmission Is Affected by Patient Factors. / Bina, Robert W.; Lemole, Gerald M; Dumont, Travis M.

In: World Neurosurgery, Vol. 88, 2016, p. 21-24.

Research output: Contribution to journalArticle

@article{942dc690064640de96fbf12a69008b47,
title = "Measuring Quality of Neurosurgical Care: Readmission Is Affected by Patient Factors",
abstract = "Objective The Hospital Readmission Reduction Program section of the Patient Protection and Affordable Care Act uses readmission rates as a proxy for measuring quality of care. Multiple studies have demonstrated that readmission rates are highly imprecise proxies for quality of care because readmission rates contain large amounts of statistical noise and are dependent on disease type, insurance type, severity, population, and a multitude of other factors. The current study was conducted to investigate characteristics associated with readmission and the quality of neurosurgical care. Methods Admissions data were gleaned from the University Health System Consortium database for neurosurgical patient (both cranial and spine) readmissions to assess patient-related factors relating to readmission from January 2011 to December 2014. Results Among 257,212 admissions for neurosurgical disease analyzed, patients with Medicaid and private payers as a primary insurance source had increased rates of readmission (odds ratio for readmission of 1.38 and 1.17, respectively) compared with patients with Medicare or other primary insurers. Patients with greater severity of disease and emergent or urgent admission also had statistically significant rates of readmission. Conclusions The findings suggest that readmission is affected by patient factors that are beyond the control of treating physicians. These findings also suggest that readmission rates may not be a good proxy for measurement of quality of care in neurosurgical patients.",
keywords = "Key words Insurance payer, Quality, Readmission rates, University Hospital Consortium",
author = "Bina, {Robert W.} and Lemole, {Gerald M} and Dumont, {Travis M}",
year = "2016",
doi = "10.1016/j.wneu.2015.12.091",
language = "English (US)",
volume = "88",
pages = "21--24",
journal = "World Neurosurgery",
issn = "1878-8750",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Measuring Quality of Neurosurgical Care

T2 - Readmission Is Affected by Patient Factors

AU - Bina, Robert W.

AU - Lemole, Gerald M

AU - Dumont, Travis M

PY - 2016

Y1 - 2016

N2 - Objective The Hospital Readmission Reduction Program section of the Patient Protection and Affordable Care Act uses readmission rates as a proxy for measuring quality of care. Multiple studies have demonstrated that readmission rates are highly imprecise proxies for quality of care because readmission rates contain large amounts of statistical noise and are dependent on disease type, insurance type, severity, population, and a multitude of other factors. The current study was conducted to investigate characteristics associated with readmission and the quality of neurosurgical care. Methods Admissions data were gleaned from the University Health System Consortium database for neurosurgical patient (both cranial and spine) readmissions to assess patient-related factors relating to readmission from January 2011 to December 2014. Results Among 257,212 admissions for neurosurgical disease analyzed, patients with Medicaid and private payers as a primary insurance source had increased rates of readmission (odds ratio for readmission of 1.38 and 1.17, respectively) compared with patients with Medicare or other primary insurers. Patients with greater severity of disease and emergent or urgent admission also had statistically significant rates of readmission. Conclusions The findings suggest that readmission is affected by patient factors that are beyond the control of treating physicians. These findings also suggest that readmission rates may not be a good proxy for measurement of quality of care in neurosurgical patients.

AB - Objective The Hospital Readmission Reduction Program section of the Patient Protection and Affordable Care Act uses readmission rates as a proxy for measuring quality of care. Multiple studies have demonstrated that readmission rates are highly imprecise proxies for quality of care because readmission rates contain large amounts of statistical noise and are dependent on disease type, insurance type, severity, population, and a multitude of other factors. The current study was conducted to investigate characteristics associated with readmission and the quality of neurosurgical care. Methods Admissions data were gleaned from the University Health System Consortium database for neurosurgical patient (both cranial and spine) readmissions to assess patient-related factors relating to readmission from January 2011 to December 2014. Results Among 257,212 admissions for neurosurgical disease analyzed, patients with Medicaid and private payers as a primary insurance source had increased rates of readmission (odds ratio for readmission of 1.38 and 1.17, respectively) compared with patients with Medicare or other primary insurers. Patients with greater severity of disease and emergent or urgent admission also had statistically significant rates of readmission. Conclusions The findings suggest that readmission is affected by patient factors that are beyond the control of treating physicians. These findings also suggest that readmission rates may not be a good proxy for measurement of quality of care in neurosurgical patients.

KW - Key words Insurance payer

KW - Quality

KW - Readmission rates

KW - University Hospital Consortium

UR - http://www.scopus.com/inward/record.url?scp=84959523557&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84959523557&partnerID=8YFLogxK

U2 - 10.1016/j.wneu.2015.12.091

DO - 10.1016/j.wneu.2015.12.091

M3 - Article

C2 - 26806064

AN - SCOPUS:84959523557

VL - 88

SP - 21

EP - 24

JO - World Neurosurgery

JF - World Neurosurgery

SN - 1878-8750

ER -