title: Patient experiences after hospitalizations for elective surgery.
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.
authors.affiliation: Division of Hospital Medicine, Northwestern University Feinberg School of Medicine, 211 E. Ontario Street, 7-727, Chicago, IL 60611, USA. Electronic address: khinami@nmh.org.
authors.forename: Keiki
authors.initials: K
authors.lastname: Hinami
authors.affiliation: Surgical Outcomes and Quality Improvement Center, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Karl Y
authors.initials: KY
authors.lastname: Bilimoria
authors.affiliation: Division of Hospital Medicine, Northwestern University Feinberg School of Medicine, 211 E. Ontario Street, 7-727, Chicago, IL 60611, USA.
authors.forename: Peter G
authors.initials: PG
authors.lastname: Kallas
authors.affiliation: Division of Hospital Medicine, Northwestern University Feinberg School of Medicine, 211 E. Ontario Street, 7-727, Chicago, IL 60611, USA.
authors.forename: Yael M
authors.initials: YM
authors.lastname: Simons
authors.affiliation: Division of Hospital Medicine, Northwestern University Feinberg School of Medicine, 211 E. Ontario Street, 7-727, Chicago, IL 60611, USA.
authors.forename: Nicholas P
authors.initials: NP
authors.lastname: Christensen
authors.affiliation: Division of Hospital Medicine, Northwestern University Feinberg School of Medicine, 211 E. Ontario Street, 7-727, Chicago, IL 60611, USA.
authors.forename: Mark V
authors.initials: MV
authors.lastname: Williams
mesh_terms: D000368:Aged; D015897:Comorbidity; D017558:Elective Surgical Procedures; D005260:Female; D006760:Hospitalization; D006801:Humans; D007087:Illinois / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: Care coordination; Patient-centered outcomes; Rehospitalization; Surgical complications