Our dual responsibility of improving quality and questioning the metrics: Reflections on 30-day readmission rate as a quality indicator

The burden of cervical cancer survivorship: Understanding morbidity and survivorship needs through hospital admissions

“…More concerningly, of patients admitted after completion of primary treatment, we found that 17 % were admitted three or more times, with a median of 13.3 months from treatment completion to first admission and approximately 2 months between each admission thereafter. This finding supports the previously proposed ‘revolving door’ of readmissions in gynecologic cancer, ( Huepenbecker and Meyer, 2022 ) and suggests that this pattern extends into the survivorship period.…”

“…In addition to the costs to individual patients, hospitalizations account for the largest proportion of cancer-related healthcare spending during the year after dianosis ( Joynt et al, 2011 ). In one study of gynecologic oncology admissions, which included patients both with active disease and survivors, the mean cost of an index admission for cervical cancer patients was $13,557, while the mean cost for 30-day readmissions was $11,632 ( Huepenbecker and Meyer, 2022 ). In our study, there were a total of 570 unique admissions in the median 3.6 years post-treatment, inferring a total cost of roughly six to seven million dollars during this time period.…”

“…These patient-reported outcomes provide valuable insight into the psychosocial burden faced by survivors of cervical cancer, but less is known about the specifics of health care utilization during the survivorship period. Hospital admissions and related procedures and consultations serve as a quantitative measure of the burden of survivorship, as hospitalization confers not only emotional and physical costs but also significant financial costs both to patients and healthcare systems ( Huepenbecker and Meyer, 2022 , Joynt et al, 2011 ). Previous studies of 30-day readmissions following gynecologic oncology surgery have already demonstrated that primary diagnosis of cervical cancer is associated with increased risk of readmission, suggesting that this is a particularly vulnerable patient population with significant unmet needs ( Kearns et al, 2022 , Maher and Denton, 2008 , McManus et al, 2021 ).…”

Antibiotic resistance of infectious agents associated with prior hospitalization

“…Repeat hospitalization is considered an important indicator of the quality of health care delivery (Huepenbecker and Meyer 2022). One of the frequent causes of re-hospitalization is infectious complications due to previous colonization of patient loci by microorganisms circulating in the hospital environment (Zakaria et al 2020;Balane et al 2023).…”