Three out of 10 patients who receive a kidney transplant require readmission to the hospital within 30 days of discharge after the initial surgery, finds a new analysis of national data, but better outpatient monitoring may prevent such readmissions.
The researchers of the analysis, which was published online in the American Journal of Transplantation, suggest that more could be done when it comes to managing transplant patients outside of the hospital in order to prevent costly return visits – especially now that the Centers for Medicare & Medicaid Services has begun the process of decreasing reimbursements to hospitals with high readmission rates.
Study leader, Dorry Segev, an associate professor of surgery at the Johns Hopkins University School of Medicine, examined data provided by the Organ Procurement and Transplantation Network, Medicare and the United States Renal Data System from 32,000 patients who received kidney transplants between Jan. 1, 2000 and Dec. 31, 2005.
According to Segev, while the readmission rates varied from one hospital to another, overall 31 percent of transplant patients were readmitted within 30 days.
"Some of these readmissions are not preventable, but I suspect that many are since the rates at hospitals vary so much," said Segev.
Understanding which patients are at a higher risk for complications ahead of time would likely prevent a number of readmissions, Segev said.
"In an ideal world, you identify patients with the highest risks," he said. "Once you know someone is at high risk, you call them more frequently, bring them to clinics more frequently, make sure you have more careful surveillance of them, put into place processes by which you can treat relatively simple things as an outpatient service with same-day turnaround rather than requiring them to go back to the hospital. With careful surveillance, you can pick things up earlier before a readmission occurs."
He suggested that hospitals with lower readmission rates may schedule more frequent outpatient visits, offer more opportunities to communicate with clinicians through email or telephone, or are better at coordinating services such as blood work that may be needed after discharge so that critical post-transplant medication adjustments can be made quickly before a readmission is required.