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Invited Commentary
August 2018

All Surgical Readmissions Are Not Created Equal

Author Affiliations
  • 1Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
JAMA Surg. 2018;153(8):737. doi:10.1001/jamasurg.2018.0616

Hospital readmissions are an important quality indicator1; however, Mull et al2 emphasize that, unlike for patients with an index admission for medical treatment, all-cause readmission is not an appropriate indicator of quality of care for postoperative patients. In a modified Delphi process, a multidisciplinary panel assessed diagnosis codes related to 30-day postoperative readmission in a Veterans Affairs population and found that one-third of postoperative readmissions are unlikely to reflect deficiencies in surgical quality. Their findings are similar to those reported by Marks and colleagues3 in a smaller pediatric population. As government and private payers implement pay-for-performance metrics, the current study cautions that not every surgical readmission reflects poor quality and not every readmission should be penalized.

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