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- Title
Travel Time Influences Readmission Risk: Geospatial Mapping of Surgical Readmissions.
- Authors
TURRENTINE, FLORENCE E.; BUCKLEY, PATRICK J.; MIN-WOONG SOHN; WILLIAMS, MICHAEL D.; Sohn, Min-Woong
- Abstract
The University of Virginia (UVA) has recently become an Accountable Care Organization (ACO), intensifying efforts to provide better care for individuals. UVA's ACO population resides across the entire Commonwealth, with a large percentage of patients living in rural areas. To provide better health for this population, the central tenet of the ACO mission, we identified geographic risk factors influencing hospital readmission. We analyzed the relationship between the distance of patients' residence to the nearest hospital and 30-day readmission in general surgery patients. A retrospective chart review using January 1, 2011 through October 31, 2013 American College of Surgeons National Surgical Quality Improvement Program data for general surgery procedures was conducted. ArcGIS mapped street addresses provided graphical representation of distance between surgical population and the nearest hospital. We analyzed the impact on readmission, of time traveled, insurance status, and median household income. Each increase of 10 minutes in travel time from the patient's residence to the nearest hospital, not just UVA, was associated with a 9 per cent increase in the probability of readmission after adjusting for patient characteristics, preoperative comorbidities, laboratory values, and postoperative complications before or after discharge (odds ratio = 1.09; 95% confidence interval = 1.01-1.17; P = 0.019). Unlike urban hospitals, those serving rural populations may be at particular risk of postsurgical readmissions. Patients living furthest from a hospital facility are most at risk for readmission after a general surgery procedure. This vulnerable population may benefit most from comprehensive discharge planning.
- Subjects
UNIVERSITY of Virginia; ACCOUNTABLE care organizations; PUBLIC health; SURGICAL complications; AMERICAN College of Surgeons; PATIENT readmissions
- Publication
American Surgeon, 2017, Vol 83, Issue 6, p573
- ISSN
0003-1348
- Publication type
journal article
- DOI
10.1177/000313481708300621