Using Same Hospital for Complications After Surgery Lowers Death Risk: Study

Patients also did slightly better when original team of doctors treated them on readmission

By Robert Preidt

Thursday, June 18, 2015

THURSDAY, June 18, 2015 (HealthDay News) -- Surgery patients who suffer complications after discharge from a hospital are more likely to die if they're readmitted to a different hospital than where they had their original operation, a new study finds.

University of Utah researchers reviewed information on millions of Medicare patients who underwent one of 12 major surgical procedures between 2001 and 2011. They found that up to one-fifth of the patients were readmitted to a hospital within 30 days due to complications.

Up to 83 percent of patients with complications were readmitted to the same hospital where they had their initial surgery. Overall, readmission to the same hospital was associated with a 26 percent lower risk of death within 90 days, the study revealed.

For specific types of surgeries, the risk of death associated with readmission to the same hospital ranged from 44 percent lower for those who had all or part of their pancreas removed to 13 percent lower for those who had heart bypass surgery.

Patients also did slightly better if they were treated by the same surgical team, according to the study.

It's important to note, however, the study only found an association between readmission to the same hospital and the risk of death. It did not prove a cause-and-effect relationship or point to the reasons why such an association exists.

The study was published online June 18 in The Lancet.

"This is not a small issue. Between 5 to 22 percent of patients were readmitted in our study, depending on the type of surgery," lead author Dr. Benjamin Brooke, an assistant professor of surgery at the University of Utah, said in a university news release.

"Our work suggests that striving to maintain continuity of care in the same hospital, and by the same medical team when possible, is critical to achieve the best outcomes should complications arise after surgery," he added.

The findings are important in light of the growing trend of "domestic medical tourism" in the United States, the researchers said.

Some large businesses negotiate lower prices for surgery at some of the nation's leading hospitals and encourage their employees to have complex elective surgeries performed at these hospitals, the study authors said.

In many such cases, patients have to travel long distances from home to reach these hospitals, which means it might be difficult for them to return if they develop complications, the researchers explained.

"Most people do not think about the implications of traveling far for an operation," study senior author Dr. Sam Finlayson, professor and chair of surgery at the University of Utah, said in the news release.

"As with many health care decisions, there are trade-offs to consider. Traveling may confer the best chance of a favorable outcome with surgery, but it may hinder access to optimal care in the event of a serious complication after discharge."

SOURCE: University of Utah, news release, June 17, 2015

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