Length of stay and readmissions in mastectomy patients

Susie X. Sun, Anna N. Leung, Peter W. Dillon, Christopher S. Hollenbeak

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Interest is growing in preventing readmissions as payers start to link reimbursement to readmission rates. The purpose of this study was to assess factors that contribute to 30-day readmission rates for women undergoing mastectomy for breast cancer. Data from the Pennsylvania Health Care Cost Containment Council were queried for women undergoing mastectomy for breast cancer during 2011 (n = 2,919). The outcomes measured were length of stay (LOS) and 30-day readmission. Univariate comparisons between characteristics of readmitted (n = 172) and nonreadmitted patients were performed using t-tests and chi-square tests. Readmission was modeled using logistic regression; LOS was modeled using linear regression and controlled for potential confounders. In multivariate analyses, patients with peripheral vascular disease were more likely to be readmitted (OR 4.36, p = 0.002). Increased LOS was also associated with increased odds of readmission (OR 1.26, p = <0.0001). Since LOS was an important predictor of readmission we also estimated determinants of LOS using linear regression. The occurrence of reconstructive surgery (p = <0.0001) and renal disease (p < 0.0001) were highly predictive of longer LOS. This study showed peripheral vascular disease and longer lengths of stay were associated with higher odds of readmission in women undergoing mastectomy. Clinicians should be cognizant that optimizing a patient's vascular status before mastectomy may lead to lower rates of readmission. Additional research is needed to determine whether the relationship between readmissions and length of hospital stay is a causative versus associative phenomenon since LOS is a modifiable factor that may lead to lower readmissions.

Original languageEnglish (US)
Pages (from-to)526-532
Number of pages7
JournalBreast Journal
Volume21
Issue number5
DOIs
StatePublished - Sep 1 2015

Fingerprint

Mastectomy
Length of Stay
Peripheral Vascular Diseases
Linear Models
Reconstructive Surgical Procedures
Breast Neoplasms
Cost Control
Chi-Square Distribution
Health Care Costs
Blood Vessels
Multivariate Analysis
Logistic Models
Kidney

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Surgery
  • Oncology

Cite this

@article{071a37f73c0a4017b898e900d1582886,
title = "Length of stay and readmissions in mastectomy patients",
abstract = "Interest is growing in preventing readmissions as payers start to link reimbursement to readmission rates. The purpose of this study was to assess factors that contribute to 30-day readmission rates for women undergoing mastectomy for breast cancer. Data from the Pennsylvania Health Care Cost Containment Council were queried for women undergoing mastectomy for breast cancer during 2011 (n = 2,919). The outcomes measured were length of stay (LOS) and 30-day readmission. Univariate comparisons between characteristics of readmitted (n = 172) and nonreadmitted patients were performed using t-tests and chi-square tests. Readmission was modeled using logistic regression; LOS was modeled using linear regression and controlled for potential confounders. In multivariate analyses, patients with peripheral vascular disease were more likely to be readmitted (OR 4.36, p = 0.002). Increased LOS was also associated with increased odds of readmission (OR 1.26, p = <0.0001). Since LOS was an important predictor of readmission we also estimated determinants of LOS using linear regression. The occurrence of reconstructive surgery (p = <0.0001) and renal disease (p < 0.0001) were highly predictive of longer LOS. This study showed peripheral vascular disease and longer lengths of stay were associated with higher odds of readmission in women undergoing mastectomy. Clinicians should be cognizant that optimizing a patient's vascular status before mastectomy may lead to lower rates of readmission. Additional research is needed to determine whether the relationship between readmissions and length of hospital stay is a causative versus associative phenomenon since LOS is a modifiable factor that may lead to lower readmissions.",
author = "Sun, {Susie X.} and Leung, {Anna N.} and Dillon, {Peter W.} and Hollenbeak, {Christopher S.}",
year = "2015",
month = "9",
day = "1",
doi = "10.1111/tbj.12442",
language = "English (US)",
volume = "21",
pages = "526--532",
journal = "Breast Journal",
issn = "1075-122X",
publisher = "Wiley-Blackwell",
number = "5",

}

Length of stay and readmissions in mastectomy patients. / Sun, Susie X.; Leung, Anna N.; Dillon, Peter W.; Hollenbeak, Christopher S.

In: Breast Journal, Vol. 21, No. 5, 01.09.2015, p. 526-532.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Length of stay and readmissions in mastectomy patients

AU - Sun, Susie X.

AU - Leung, Anna N.

AU - Dillon, Peter W.

AU - Hollenbeak, Christopher S.

PY - 2015/9/1

Y1 - 2015/9/1

N2 - Interest is growing in preventing readmissions as payers start to link reimbursement to readmission rates. The purpose of this study was to assess factors that contribute to 30-day readmission rates for women undergoing mastectomy for breast cancer. Data from the Pennsylvania Health Care Cost Containment Council were queried for women undergoing mastectomy for breast cancer during 2011 (n = 2,919). The outcomes measured were length of stay (LOS) and 30-day readmission. Univariate comparisons between characteristics of readmitted (n = 172) and nonreadmitted patients were performed using t-tests and chi-square tests. Readmission was modeled using logistic regression; LOS was modeled using linear regression and controlled for potential confounders. In multivariate analyses, patients with peripheral vascular disease were more likely to be readmitted (OR 4.36, p = 0.002). Increased LOS was also associated with increased odds of readmission (OR 1.26, p = <0.0001). Since LOS was an important predictor of readmission we also estimated determinants of LOS using linear regression. The occurrence of reconstructive surgery (p = <0.0001) and renal disease (p < 0.0001) were highly predictive of longer LOS. This study showed peripheral vascular disease and longer lengths of stay were associated with higher odds of readmission in women undergoing mastectomy. Clinicians should be cognizant that optimizing a patient's vascular status before mastectomy may lead to lower rates of readmission. Additional research is needed to determine whether the relationship between readmissions and length of hospital stay is a causative versus associative phenomenon since LOS is a modifiable factor that may lead to lower readmissions.

AB - Interest is growing in preventing readmissions as payers start to link reimbursement to readmission rates. The purpose of this study was to assess factors that contribute to 30-day readmission rates for women undergoing mastectomy for breast cancer. Data from the Pennsylvania Health Care Cost Containment Council were queried for women undergoing mastectomy for breast cancer during 2011 (n = 2,919). The outcomes measured were length of stay (LOS) and 30-day readmission. Univariate comparisons between characteristics of readmitted (n = 172) and nonreadmitted patients were performed using t-tests and chi-square tests. Readmission was modeled using logistic regression; LOS was modeled using linear regression and controlled for potential confounders. In multivariate analyses, patients with peripheral vascular disease were more likely to be readmitted (OR 4.36, p = 0.002). Increased LOS was also associated with increased odds of readmission (OR 1.26, p = <0.0001). Since LOS was an important predictor of readmission we also estimated determinants of LOS using linear regression. The occurrence of reconstructive surgery (p = <0.0001) and renal disease (p < 0.0001) were highly predictive of longer LOS. This study showed peripheral vascular disease and longer lengths of stay were associated with higher odds of readmission in women undergoing mastectomy. Clinicians should be cognizant that optimizing a patient's vascular status before mastectomy may lead to lower rates of readmission. Additional research is needed to determine whether the relationship between readmissions and length of hospital stay is a causative versus associative phenomenon since LOS is a modifiable factor that may lead to lower readmissions.

UR - http://www.scopus.com/inward/record.url?scp=84940721929&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84940721929&partnerID=8YFLogxK

U2 - 10.1111/tbj.12442

DO - 10.1111/tbj.12442

M3 - Article

C2 - 26104795

AN - SCOPUS:84940721929

VL - 21

SP - 526

EP - 532

JO - Breast Journal

JF - Breast Journal

SN - 1075-122X

IS - 5

ER -