Cardiac Surgery Patients Making Return Trips to Hospital

According to a report of Pennsylvania hospitals, 16% of patients who underwent coronary artery bypass graft (CABG) and/or valve surgery in 2008 were readmitted to within 30 days, resulting in millions of dollars in additional costs.

“Approximately one in six open heart surgery patients in Pennsylvania were readmitted within 30 days of discharge,” said Joe Martin, executive director of the Pennsylvania Health Care Cost Containment Council (PHC4), which conducted the analysis. “This illustrates why the medical community, researchers and policymakers are focused on identifying the causes of readmissions and implementing evidence-based strategies to reduce those that are preventable.”

While not all readmissions can be avoided, even with optimal care, they are a significant cost driver. The 2,208 readmissions documented in the PHC4 report amounted to an additional 11,065 hospital days and over $81 million in additional hospital charges.

“Reducing readmissions requires looking at the processes of care received in the hospital, as well as what happens with patients post-discharge,” said Martin.

The report, Cardiac Surgery in Pennsylvania 2007-2008, includes data on approximately 31,300 CABG and/or valve surgeries performed in Pennsylvania hospitals in 2007 and 2008 involving four cardiac surgical reporting groups.

Other findings from the analysis are as follows:

• Patients who underwent valve with CABG surgery had a higher 30-day readmission rate (21%) compared with patients who underwent valve without CABG surgery (17.8%) or CABG without valve surgery (14.6%).
• For patients undergoing valve surgery, either with or without a CABG procedure, 7-day readmission rates decreased from 8.4% in 2007 to 7.9% in 2008.
• For patients undergoing valve surgery, either with or without a CABG procedure, 30-day readmission rates decreased from 20.3% in 2007 to 19.2% in 2008.
• After declining for more than a decade, in-hospital mortality rates for patients undergoing CABG surgery increased from 1.8% in 2007 to 1.9% in 2008. Between 1994 and 2007, CABG mortality rates in the state dropped 45.8%.
• When examining all open heart surgeries, the average number of cases per surgeon increased from 108 in 2007 to 115 in 2008—down from 149 in 2000. The average number of open heart surgeries per hospital was 315 in 2007 and 316 in 2008—down from 499 in 2000.

To access the full report, click here.

For more information:

• Will a Patient be Readmitted? Let His Walking do the Talking
• What Are the Factors Behind Readmission Rates of HF Patients?

Hospitals around the country are facing increased costs resulting from readmissions. What is your institution doing to address this issue? How do you think health care reform will impact readmissions?