Less invasive endovascular procedures were not associated with decreased readmission rates compared with open surgery. The overall readmission rate for claudicant patients was 10.7%, which was unexpectedly high. Predictors of readmission included male sex, longer hospital stays, hospital infection, elevated aspartate aminotransferase, and high numbers of medications ordered and dispensed. Further examination exploring reasons for readmission are required to decrease readmission rates in the vascular surgery population.
Dramatic changes in health care delivery and rising interest in cost containment have increased concern regarding readmission and its cost to the health care system. In USA, in the Medicare population, the readmission rate after vascular surgical procedures is almost 24%, substantially higher than the average rate of 15.6% for other surgical procedures.1 At the same time there has been a dramatic shift in the use of endovascular procedures for the management of lower extremity (LE) occlusive disease.2 Endovascular interventions are now performed much more commonly than bypass surgery in the treatment of LE peripheral artery disease (PAD), and the use of percutaneous transluminal angioplasty (PTA) for claudication has dramatically increased.2 and 3
Despite increased use of more minimally invasive procedures, there is a paucity of information evaluating if less invasive procedures are associated with decreased morbidity and also specifically with decreased use in the form of readmission. This analysis evaluated the readmission rates after LE interventions to specifically compare rates between procedure type and to evaluate factors associated with readmission, because identifying patients with increased risk for readmission after vascular procedures may lead to more effective, higher-quality care.
We are facing this problem in providing the vascular surgical care for the patients under the ARSR scheme. They are not understanding this fact that the readmission rate is much higher in vascular surgery patients compared to the other surgical patients in the hospitals. I am sure papers of this nature will help us make the administrators of the ARSR scheme in andhra pradesh to recognize these difficulties in providing care to vascular patients.
- http://dx.doi.org/10.1016/j.jvs.2012.12.031, How to Cite or Link Using DOI
- Jl of Vascular surgery Volume 58, Issue 1, July 2013, Pages 90–97.e4
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