About: Early vs Late Readmissions in Pancreaticoduodenectomy Patients: Recognizing Comprehensive Episodic Cost to Help Guide Bundled Payment Plans and Hospital Resource Allocation

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About: Early vs Late Readmissions in Pancreaticoduodenectomy Patients: Recognizing Comprehensive Episodic Cost to Help Guide Bundled Payment Plans and Hospital Resource Allocation Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Early vs Late Readmissions in Pancreaticoduodenectomy Patients: Recognizing Comprehensive Episodic Cost to Help Guide Bundled Payment Plans and Hospital Resource Allocation
Creator	Abbott, Daniel Acher, Alexandra Aiken, Taylor Barrett, James Leverson, Glen Minter, Rebecca Ronnekleiv-Kelly, Sean Schwartz, Patrick Stahl, Chris Weber, Sharon
Source	PMC
abstract	INTRODUCTION: Previous studies on readmission cost in pancreaticoduodenectomy patients use estimated cost data and do not delineate etiology or cost differences between early and late readmissions. We sought to identify relationships between postoperative complication type and readmission timing and cost in pancreaticoduodenectomy patients. METHODS: Hospital cost data from date of discharge to postoperative day 90 were merged with 2008–2018 NSQIP data. Early readmission was within 30 days of surgery, and late readmission was 30 to 90 days from surgery. Regression analyses for readmission controlled for patient comorbidities, complications, and surgeon. RESULTS: Of 230 patients included, 58 (25%) were readmitted. The mean early and late readmission costs were $18,365 ± $20,262 and $24,965 ± $34,435, respectively. Early readmission was associated with index stay deep vein thrombosis (p < 0.01), delayed gastric emptying (p < 0.01), and grade B pancreatic fistula (p < 0.01). High-cost early readmission had long hospital stays or invasive procedures. Common late readmission diagnoses were grade B pancreatic fistula requiring drainage (n = 5, 14%), failure to thrive (n = 4, 14%), and bowel obstruction requiring operation (n = 3, 11%). High-cost late readmissions were associated with chronic complications requiring reoperation. CONCLUSION: Early and late readmissions following pancreaticoduodenectomy differ in both etiology and cost. Early readmission and cost are driven by common complications requiring percutaneous intervention while late readmission and cost are driven by chronic complications and reoperation. Late readmissions are frequent and a significant source of resource utilization. Negotiations of bundled care payment plans should account for significant late readmission resource utilization. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s11605-020-04714-3) contains supplementary material, which is available to authorized users.
has issue date	2020-07-15(xsd:dateTime)
bibo:doi	10.1007/s11605-020-04714-3
bibo:pmid	32671797
has license	no-cc
sha1sum (hex)	c8f386994623842295256bcaa7c8c57475b27201
schema:url	https://doi.org/10.1007/s11605-020-04714-3
resource representing a document's title	Early vs Late Readmissions in Pancreaticoduodenectomy Patients: Recognizing Comprehensive Episodic Cost to Help Guide Bundled Payment Plans and Hospital Resource Allocation
has PubMed Central identifier	PMC7363013
has PubMed identifier	32671797
schema:publication	J Gastrointest Surg
resource representing a document's body	covid:c8f386994623842295256bcaa7c8c57475b27201#body_text
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