... en chir cardiaque Readmission After CABG Is a Useful Measure of Provider Quality
By Anthony J. Brown, MD NEW YORK (Reuters Health) Aug 12 - In addition to in-hospital mortality, readmission after coronary artery bypass grafting (CABG) is a useful gauge of how well a hospital or surgeon performs the procedure. The finding is based on a study of all patients who were discharged after CABG in the state of New York in 1999. Of the 16,325 patients studied, 2111 were readmitted within 30 days of hospital discharge for reasons related to CABG. "Readmission is a big problem after CABG," lead author Dr. Edward L. Hannan, from the State University of New York in Rensselaer, told Reuters Health. "In our study, nearly 13% of patients were readmitted for reasons related to CABG complications. Moreover, most of the reasons were pretty serious." The most common reasons were postsurgical infection and heart failure, according to a report in the August 13th issue of the Journal of the American Medical Association. "Based on these findings, we concluded that readmission seems to be an important quality measure to look at," Dr. Hannan said. "So, we decided to evaluate the predictors of readmission." The authors identified several risk factors that were independently tied to readmission. Patient preoperative factors included older age, female gender, African American race, and greater body surface area, while postoperative factors included initial hospital stay of 5 or more days and discharge to a nursing home. "The patient characteristics can be useful to hospitals and surgeons in identifying people who may need special attention," Dr. Hannan noted. Provider factors included surgeons who performed < 100 cases per year and hospitals with high risk-adjusted mortality rates. "Readmission seems to be a decent supplementary measure to mortality in assessing provider quality," Dr. Hannan concluded. If made available by each state, "such information could be used by patients when selecting a provider or it could be used by providers to compare themselves with other providers." JAMA 2003;290:773-780. __________________________________ Do you Yahoo!? Yahoo! SiteBuilder - Free, easy-to-use web site design software http://sitebuilder.yahoo.com --- URG-L Pour modifier votre adresse de courriel sur URG-L, envoyez un avis a [EMAIL PROTECTED] en indiquant votre nouvelle adresse ainsi que l'ancienne et le nom de la liste.
