Thirty-day readmissions after inpatient laparoscopic cholecystectomy: factors and outcomes

Abstract

Background: 30-day readmissions are a considerable financial burden on medical institutions due to penalties faced from the Centers for Medicaid and Medicare.

Methods: A retrospective review of 30-day readmissions was performed. The data were subdivided into medical severity-diagnostic related groups 417, 418, and 419, as categorized by the Centers for Medicaid and Medicare. Perioperative variables, diagnostic workup, operative interventions, and postoperative morbidity and outcomes were analyzed.

Results: Forty-four (5.9%) readmissions were recorded, of 747 inpatient discharges. The data were further divided into DRGs 417, 418, and 419 with readmission rates of 13.6, 3.6%, and 5.4%, respectively. The highest rate of readmission was within the first 7 days. Etiology was divided into surgical (54.5%) and nonsurgical (45.4%).

Conclusions: Patients with major comorbidities had a higher rate of readmission (P < .05). In 45.4% of the readmissions, the cause was found to be nonsurgical. The surgical team was not consulted in 31.8% of the readmissions.

Keywords: 30-day readmissions; Inpatient; Laparoscopic cholecystectomy; Major comorbidities; Reducing readmission rate.