000			03937nam a22005417a 4500
008			210310s20212021 xxu||||| |||| 00| 0 eng d
022			_a1559-047X
024			_a10.1093/jbcr/iraa203 [doi]
024			_a6138196 [pii]
040			_aOvid MEDLINE(R)
099			_a33591321
245			_aUtility of 30-Day Readmission Metrics in the Burn Population: Navigating Quality Metric Limitations in Special Populations.
251			_aJournal of Burn Care & Research. 42(4):711-715, 2021 08 04.
252			_aJ Burn Care Res. 42(4):711-715, 2021 08 04.
252			_zJ Burn Care Res. 2021 Feb 16
253			_aJournal of burn care & research : official publication of the American Burn Association
260			_c2021
260			_fFY2021
265			_saheadofprint
265			_sppublish
266			_d2021-03-10
268			_aJournal of Burn Care & Research. 2021 Feb 16
269			_fFY2021
501			_aAvailable online through MWHC library: 2006 - present, Available in print through MWHC library: 2006 - present
520			_aHospital readmission data may be a useful tool in identifying risk factors leading to higher costs of care or poorer overall outcomes. Several studies have emerged utilizing these datasets to examine the trauma and burn population, which have been unable to distinguish planned from unplanned readmissions. The 2014 Nationwide Readmissions Database was queried for 363 burn-specific ICD-9 DX codes and filtered by age and readmission status to capture the adult burn population. Additionally, burn-related excision and grafting procedures were filtered from 25 ICD-9 SG codes to distinguish planned readmissions. A total of 26,719 burn patients were identified with 781 all-cause unscheduled 30-day readmissions. Further filtering by burn-related excision and grafting procedures then identified 468 patients undergoing a burn-related excision and grafting procedure on readmission, reducing the dataset to 313 patients and identifying up to 60% of readmissions as possibly improperly coded planned readmissions. From this dataset, nonoperative management on initial admission was found to have the strongest correlation with readmission (OR 5.00; 3.33-7.14). Notably corrected data, when stratified by annual burn patient admission volume, identified a significant likelihood of readmission (OR 4.57; 2.15-9.70) of centers receiving the lowest annual number of burn patients, which was not identified in the unfiltered dataset. Healthcare performance statistics may be a powerful metric when utilized appropriately; however, these databases must be carefully applied to small and special populations. This study has determined that as many as 60% of burn patient readmissions included in prior studies may be improperly coded planned readmissions. Copyright (c) The Author(s) 2021. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For permissions, please e-mail: [email protected].
546			_aEnglish
650			_a*Benchmarking/mt [Methods]
650			_a*Burns/th [Therapy]
650			_a*Clinical Coding/mt [Methods]
650			_a*Databases, Factual
650			_a*Patient Readmission/sn [Statistics & Numerical Data]
650			_aHumans
650			_aPostoperative Complications/th [Therapy]
650			_aRetrospective Studies
650			_aRisk Factors
650			_aUnited States
651			_aMedStar Health Research Institute
651			_aMedStar Washington Hospital Center
656			_aFirefighters' Burn and Surgical Research Laboratory
656			_aSurgery/Burn Services
657			_aJournal Article
700			_aJohnson, Laura
700			_aPrindeze, Nicholas J
700			_aShupp, Jeffrey W
790			_aJohnson LS, Prindeze NJ, Shupp JW
856			_uhttps://dx.doi.org/10.1093/jbcr/iraa203 _zhttps://dx.doi.org/10.1093/jbcr/iraa203
942			_cART _dArticle
999			_c6223 _d6223