title: Validation of new readmission data in the American College of Surgeons National Surgical Quality Improvement Program.
abstract: BACKGROUND
  Hospital readmissions are gathering increasing attention as a measure of health care quality and as a cost-saving target. The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) recently began collecting data related to 30-day postoperative readmissions. Our objectives were to assess the accuracy of the ACS NSQIP readmission variable by comparison with the medical record, and to evaluate the readmission variable against administrative data.
  
  
  METHODS
  Readmission data captured in ACS NSQIP at a single academic institution between January and December 2011 were compared with data abstracted from the medical record and administrative data.
  
  
  RESULTS
  Of 1,748 cases captured in ACS NSQIP, 119 (6.8%) had an all-cause readmission event identified, and ACS NSQIP had very high agreement with chart review for identifying all-cause readmission events (κ = 0.98). For 1,110 inpatient cases successfully matched with administrative data, agreement with chart review for identifying all-cause readmissions was also very high (κ = 0.97). For identifying unplanned readmission events, ACS NSQIP had good agreement with chart review (κ = 0.67). Overall, agreement with chart review on cause of readmission was higher for ACS NSQIP (κ = 0.75) than for administrative data (κ = 0.46).
  
  
  CONCLUSIONS
  The ACS NSQIP accurately captured all-cause and unplanned readmission events and had good agreement with the medical record with respect to cause of readmission. Administrative data accurately captured all-cause readmissions, but could not identify unplanned readmissions and less consistently agreed with chart review on cause. The granularity of clinically collected data offers tremendous advantages for directing future quality efforts targeting surgical readmission.
authors: Surgical Outcomes and Quality Improvement Center, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
authors: Morgan M
authors: MM
authors: Sellers
authors: Ryan P
authors: RP
authors: Merkow
authors: Amy
authors: A
authors: Halverson
authors: Keiki
authors: K
authors: Hinami
authors: Rachel R
authors: RR
authors: Kelz
authors: David J
authors: DJ
authors: Bentrem
authors: Karl Y
authors: KY
authors: Bilimoria
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000458:organization & administration; D010359:Patient Readmission / Q000592:standards*; D058996:Quality Improvement; D013514:Surgical Procedures, Operative / Q000592:standards*; D014481:United States