The Relationship Between Performance Indicators and Readmission of Patients With Open Heart Surgery: A Case Study in Iran

Abstract

Background: Open heart surgery is a prevalent therapeutic intervention for cardiovascular diseases. Significant adverse effects occur after heart surgery, one of which is patient readmission to the hospital. Objective: The present study aimed to determine the relationship between performance indicators and the readmission of patients with open heart surgery in a teaching hospital in Iran. Methods: This study was performed using a cross-sectional and descriptive method with a retrospective approach. Data was collected on a data collection form. The statistical population of this study comprised all patients who underwent open heart surgery from mid-September 2015 to mid-September 2016 in a teaching hospital in the north of Iran (n=849). Those patients readmitted to the hospital within 90 days after discharge, based on a review of patient records, were included in the study. Descriptive statistics and Spearman correlation coefficient were used for data analysis by SPSS 20. Results: Among the patients who had open heart surgery in the selected hospital, 12.5% were readmitted within 90 days after discharge. The most important reasons for readmission in this study were infection in surgery place (25.8%), pleural effusion (18.7%), warfarin toxicity (9.8%), and tamponade (8.9%). There were inverse relationships between patient readmission and the two performance indicators of bed occupancy percentage (r = -0.594, P=0.042) and bed turnover rate (r = -0.664, P=0.018). There were no statistically significant relationships between any of the other indicators (length of stay, mortality, and bed turnover interval) and readmission rate (P>0.1). Conclusion: Hospital authorities can use these results for bed management and targeting interventions to reduce costs and readmissions as a measure of hospital quality. However, further research into readmission factors in other hospitals is recommended.

The Magnitude of 30-Day Readmission and Factors Associated with Patients Underwent Cardiac Surgery in Tikur Anbessa Specialized Hospital Cardiac Center, Ethiopia

“…This study was similar to the study conducted by Parvin, where 55.4% were female. 1 However, contradicting to this study was the study conducted in Egypt where the majority of respondents were male (67.7%). The reason for this contradiction may be due to their sampling technique where convenience sampling technique was used compared to the simple random sampling technique in the present study.…”

“…9 A study conducted in Iran in 2019 found that 30 days of readmission after open-heart surgery was 11.7%, which is nearly comparable to the present study. 1 Similarly, a study in the UK between 2004 and 2010 reported that the 30-day readmission after discharge following cardiac surgery was 7%, which supports these findings. 6 Moreover, a study conducted by Shajedur and reported that the 30-day readmission after discharge following CABG surgery was 12.9%, which is consistent with the present study.…”

“…Globally, around one million cardiac operations are performed yearly, including coronary artery bypass graft (CABG) and valvular surgery, accounting for the most frequently performed procedures. 1 Although cardiac surgery has improved significantly over the past several years, postoperative hospital readmissions remain significant challenges after cardiac operations. 2 A hospital readmission is a return to a hospital after an initial admission and release within a specific time limit.…”

“…A study found that hospitals with low readmission rates also had low mortality rates. 1,4,7,[11][12][13][14] Readmission within 30 days of hospital admission can be costly for patients and their families, and according to Polites et al, risk markers of 30-day readmission are more common in patients with stress and high stress was associated with a threefold increased risk of re-admittance. 7,15 Formulation of policies such as substantial penalties makes readmission a more significant concern for health care in developed countries.…”

Assessment of performance in teaching hospitals: Using multicriteria decision-making techniques

“…Studies indicated that there are various indices to assess the hospital performance which four of them are the most significant and applicable ones: bed occupancy, bed turnover rate (BTR), average length of stay (LOS), and bed turnover interval (BTI). [ 8 ]…”