Introduction

Readmission within 30 days of discharge following an in-patient admission is increasingly used as a quality metric. Moreover, the Patient Protection and Affordable Care Act (ACA) has associated surgical outcome and hospital readmission rates with potential reimbursement models. Currently, reported 30 day readmission rates to urology services are largely based on pooled national databases from a wide variety of patient populations and health care settings. We wished to determine a 30 day readmission to the urology service of a tertiary care hospital with high 6 year average case mix index (CMI) of 1.5.

Methods

We reviewed all readmissions within 30 days for any cause following discharge from our adult urology service between January 2010 and December 2015. We also reviewed all readmissions, demographics, and variables following 10 major urology procedures. Non-parametric univariate and regression analysis was considered with an alpha set at 0.05.

Results

We found that our 30 day un-planned readmission rate was stable (β=0.2) over a 6 year period with an overall rate of 5.22% (range 3.46-6.76). Excluding cystoprostatectomy which had the highest 30 day readmission rate of 21%, the readmission rate for the remaining 9 index procedures was 2.2% (see table). Readmission was associated with patient age, number of ICD-10 diagnoses, and no medical follow up within 1 week after discharge (P<0.05).

Conclusions

Our data provides a 30 day readmission rate for 10 index procedures at a major tertiary care urology service with a complex patient population. Planned follow up with urologic evaluation as an outpatient within 1 week after elective discharge may improve readmission rates.

Funding

None