Racial Disparities in 30-Day Readmission Rates After Elective Spine Surgery: A Single Institutional Experience. Issue 21 (1st November 2016)

• Record Type: Journal Article
• Authors: Adogwa, Owoicho; Elsamadicy, Aladine A.; Mehta, Ankit I.; Cheng, Joseph; Bagley, Carlos A.; Karikari, Isaac O.
• Is Part Of: Spine. Volume 41:Issue 21(2016)
• Publication Date: 2016-11-01
• Subjects: disparities -- healthcare -- hospital readmission -- patient reported outcomes -- race -- rehospitalization -- spine surgery -- unplanned readmission; Spine -- Abnormalities -- Periodicals; Spine -- Diseases -- Periodicals; Spine -- Surgery -- Periodicals; 616.73005
• DOI: 10.1097/BRS.0000000000001616
• Languages: English
• ISSNs: 0362-2436

Abstract

Abstract : Study Design: Retrospective cohort review. Objective: The aim of this study is to investigate whether patient race is an independent predictor of unplanned 30-day hospital readmission after elective spine surgery. Summary of Background Data: Racial disparities are known to exist for many aspects of surgical care. However, it is unknown if disparities exist in 30-day readmissions after elective spine surgery, an area that is becoming a prime focus for clinical leaders and policymakers. Methods: Records of 600 patients undergoing elective spine surgery at a major academic medical center were reviewed. We identified all unplanned readmissions within 30 days of discharge. Unplanned readmissions were defined to have occurred as a result of either a surgical or a nonsurgical complication. Patient's records were reviewed to determine the cause of readmission and the length of hospital stay. The main outcome measure was risk-adjusted odds of all-cause 30-day readmission. We used multivariate logistic regression to determine if Black patients had an increased likelihood of 30-day readmission compared with White patients. Results: Baseline characteristics were similar between both groups. Black patients had higher readmission rates than White patients (10.56% vs. 7.86%, P = 0.04). In a univariate analysis, race, body mass index, sex, patient age, smoking, diabetes, and fusion levels were associated with increased 30-day readmission rates. However, in a multivariate logistic regression model, race was an independent predictor of 30-day readmission after elective spine surgery. In addition, no significant differences in baseline, 1-year and 2-year patient reported outcomes measures were observed between both groups. Conclusion: This study suggests that Black patients are more likely to be readmitted within 30-days of discharge after elective spine surgery. Efforts at reducing disparities should focus not only on race-based measures but also effective post discharge care. Level of Evidence: 3