Predictors and costs of readmissions at an academic head and neck surgery service.
Health care metrics, such as readmission rates, are being scrutinized to improve quality and decrease cost of care. The purpose of this study was to determine the rate, predictors, and costs of 30-day unplanned readmissions (30dURs) in patients who undergo head and neck surgery.



All patients undergoing head and neck surgery at the Ohio State University from July 1, 2011, to June 30, 2012, were retrospectively reviewed. Univariate and multivariate logistic regression analyses were performed to identify risk factors for 30dURs.



\Six hundred seven patients underwent 660 operations. Forty-eight cases (7.3%) had a 30dUR. Significant independent risk factors for readmissions included: coronary artery disease (odds ratio [OR] = 2.80; confidence interval [CI] = 1.3-5.9), chronic renal failure (OR = 3.56; CI = 1.5-8.5), not attending the preoperative clinic (OR = 2.74; CI = 1.2-6.3), length of stay (LOS) >5 days (OR = 3.19; CI = 1.6-6.5), and presence of a gastrostomy tube (OR = 2.75; CI = 1.3-5.8).The total cost of 30dURs was $1.68 million.



The 30dURs in patients who undergo head and neck surgery can be low, but costly. Identifying patients at risk for 30dUR will help develop preventative strategies. © 2015 Wiley Periodicals, Inc. Head Neck 38: E502-E510, 2016.
Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.|Comprehensive Cancer Center, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, Ohio.|Department of Otolaryngology, University of Florida, Gainesville, Florida.
Peter T
PT
Dziegielewski
Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.|Comprehensive Cancer Center, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, Ohio.
Brian
B
Boyce
Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.|Comprehensive Cancer Center, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, Ohio.
Amy
A
Manning
Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.|Comprehensive Cancer Center, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, Ohio.
Amit
A
Agrawal
Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.|Comprehensive Cancer Center, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, Ohio.
Matthew
M
Old
Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.|Comprehensive Cancer Center, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, Ohio.
Enver
E
Ozer
Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.|Comprehensive Cancer Center, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, Ohio.
Theodoros N
TN
Teknos
D015897:Comorbidity; D003324:Coronary Artery Disease / Q000453:epidemiology; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009820:Ohio; D010359:Patient Readmission / Q000191:economics*; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies; D012307:Risk Factors
complication; costs; head and neck surgery; quality outcomes; readmission; unplanned