Readmission rates are used by the Health Care Financing Administration (HCFA) as an indicator of a hospital's quality of care. Specifically, HCFA seeks to relate readmission to complications of the primary admission. A recent study at the Cleveland Clinic Foundation examined @entity1 readmitted within 30 days of dismissal during two non-consecutive months to the cardiovascular surgery, cardiology, and gastroenterology services at this 1,008 bed hospital, accounting for 31% (1640-5342) of all hospital discharges. Only 17% (25/149) of readmissions were due to a complication of the previous hospital admission. Examining those who were readmitted for complications of their primary admission, we found that 36% (9/25) of such readmitted @entity1 had @entity281 that occurred during their primary admission. Otherwise stated, 5.4% (9/149) of readmissions were for @entity580 . These @entity1 were compared with 20 retrospectively matched, non-readmitted @entity1 chosen randomly from a group of 100 @entity1 retrospectively matched for gender, age, type, and date of surgery. Using these controls, a computer-based expert system was used to help identify @entity1 variables that are associated with readmission due to @entity580 . We found if a @entity1 had (1) a weight less than 66 Kilograms or (2) had a first postoperative total serum protein greater than 6.1 or (3) was reoperated, we could predict with 100% specificity and 60% sensitivity that the @entity1 would have an unplanned readmission. Total readmission rates do not accurately reflect complications of the primary admission.(ABSTRACT TRUNCATED AT 250 WORDS)

Enumerative, Bayesian, and analytic statistical analysis of XXXX for quality improvement: first of two parts.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity281 :: ('MESH:D007239', 'Disease') :: ['infections'] @entity580 :: ('MESH:D003428', 'Disease') :: ['nosocomial infection', 'nosocomial infections']
@entity580 :: (MESH:D003428,Disease) :: ['nosocomial infection']
