Descriptive analysis of 30-day readmission after inpatient surgery discharge in the Veterans Health Administration

Importance For the first time to our knowledge, this study analyzes and reports the 30-day all-cause readmission rates for surgical procedures performed in the Veterans Health Administration (VHA). Objective To analyze and report 30-day all-cause readmission rates following discharge from 9 surgical specialties in the VHA for a 10-year period. Design, Setting, and Participants In a retrospective observational study, Veterans Affairs Surgical Quality Improvement Program data for surgery records and VHA administrative discharge data were linked to evaluate all-cause readmission within 30 days of discharge from the surgical inpatient stay. The study population represents 9 surgical specialty groups: general, urology, neurosurgery, orthopedic, otolaryngology, plastic, thoracic, peripheral vascular, and cardiac. Trends of postoperative hospital admission rates for each surgery were investigated using 10 years (fiscal years 2001-2010; N = 894 943) of linked data. Main Outcomes and Measures All-cause 30-day readmission after surgery for each specialty. Results During the 10-year period, the overall 30-day all-cause readmission rate following inpatient surgery discharge significantly decreased from 12.9% to 12.2% ( P P  = .004), otolaryngology ( P  = .005), plastic ( P  = .02), thoracic ( P  = .04), peripheral vascular ( P P  = .003). Postoperative hospital length of stay in individual specialties decreased during this period (each P Conclusions and Relevance This retrospective observational study showed decreasing 30-day readmission rates associated with a decline in postoperative hospital length of stay for 9 surgical specialties in the VHA during a 10-year period. Further study will be required to capture data from patients who had surgery at a VHA facility but were readmitted in the private sector.