Evaluation of readmissions due to surgical site infections: A potential target for quality improvement

Romil Shah, Emily Pavey, Mila Ju, Ryan Merkow, Ravi Rajaram, Michael W. Wandling, Mark E. Cohen, Allison Dahlke, Anthony Yang, Karl Bilimoria*

*Corresponding author for this work

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Introduction: Readmissions have become a focus of pay-for-performance programs. Surgical site infections (SSI) are the reason for most readmissions. Readmissions for SSI could be a unique target for quality improvement. Methods: Readmission risk for SSI were evaluated for patients undergoing colectomies from 2013 to 2014. Hazard models were developed to examine factors associated with and hospital-level variation in risk-adjusted rates of readmission for SSI. Results: Among 59,088 patients at 525 hospitals, the rate of readmissions for SSI ranged from 1.45% to 6.34%. Characteristics associated with a greater likelihood of SSI readmissions include male gender, smoking, open surgery and hospitals with increased socioeconomically-disadvantaged patients. After risk adjustment, there was little correlation between hospital performance with SSI readmission rate and performance with overall SSI or total readmission rate (r2 = 0.29, r2 = 0.14). Conclusions: Readmission for SSI represents a unique aspect of quality beyond that offered by measuring only SSI or readmission rates alone, and may provide actionable quality improvement.

Original languageEnglish (US)
Pages (from-to)773-779
Number of pages7
JournalAmerican journal of surgery
Volume214
Issue number5
DOIs
StatePublished - Nov 2017

ASJC Scopus subject areas

  • Surgery

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