Source: Journal of the American College of Surgeons, Volume 215, Issue 3 , Pages 322-330, September 2012

Hospital Malpractice

Hospital Malpractice continues to be a problem.  An article published recently in the Journal of the American College of Surgeons sheds some rare light on hospital care and legislation aimed at reimbursing Medicare and Medicaid for the additional expenses of readmission and treatment caused by hospital malpractice.

Study Design

Using standard National Surgical Quality Improvement Project protocol, preoperative, intraoperative, and postoperative outcomes were collected on patients undergoing inpatient general surgery procedures and merged with an institutional clinical data warehouse to identify unplanned 30-day readmissions. Demographics, comorbidities, type of procedure, postoperative complications, and ICD-9 coding data were reviewed for patients who were readmitted.

Results and reasons for readmission

1,442 general surgery patients were reviewed. 163 or  (11.3%) were readmitted within 30 days of discharge. The most common reasons for readmission were gastrointestinal problem/complication (27.6%), and surgical infection (22.1%), accounting for nearly 50% of all readmission reasons.  Postoperative occurrences leading to increased risk of readmission were blood transfusion, postoperative pulmonary complication, wound complication, sepsis/shock, urinary tract infection, and vascular complications. Multivariable analysis demonstrates that the most significant independent risk factor for readmission is the occurrence of any postoperative complication (odds ratio = 4.20; 95% CI, 2.89–6.13).

Procedures

Patients undergoing a pancreatectomy had the highest readmission rate (17.9%) for any procedure at our institution, followed by patients undergoing colectomy with or without colostomy (12.6%), small bowel resection (11.8%), gastrectomy (11.4%), and ventral hernia repair (11.0%). Procedures with low 30-day readmission rates in our analysis included parathyroidectomy (7.7%), thyroidectomy (2.9%), and mastectomy (2.0%).

Conclusions

Postoperative complications appear to drive readmissions in surgical patients. Taking appropriate steps to minimize postoperative complications will decrease postoperative readmissions.

The Lewis Law Firm represents patients and their families who are victims of hospital malpractice resulting in serious injury and death.  If you or a loved one were the victim of hospital or physician malpractice, contact the Lewis Law Firm for a FREE consultation and case review today.