Readmissions on Teaching Versus Non-Teaching Services: Are They Any Different?

摘要

Introduction There is a paucity of comparative data on readmissions between teaching services (TS) and nonteaching services (NTS). Therefore, we designed this study to determine if there are any differences in readmissions between the two services. Materials and methods A unique cohort of 384 readmissions during one year was retrospectively examined at Hunter Holmes McGuire Veterans Medical Center. The data on patient demographics, baseline characteristics, comorbid illnesses, length of stay (LOS), and reasons for readmission within 30 days were extracted. Results There were no differences in readmission rates (8.2% vs. 10.2%;?P?= .135), LOS during index admission (4.2 ± 4.8 vs. 4.1 ± 3.5;?P?= .712), and age-adjusted Charlson Comorbid Index Score (6.1 ± 3.0 vs. 6.8 ± 2.8;?P?= .037) between the TS and NTS groups. However, the reasons for readmissions between the two groups were statistically significantly different (P? .01). Specifically, these differences were found between system issues and new diagnoses. The NTS showed higher rates of readmissions secondary to new diagnoses and systems issues, whereas the TS showed higher rates of secondary to clinician issues and disease progression. Conclusions We have a new understanding of the difference in reasons for readmissions between TS and NTS; it possibly results from the different structures of the two teams, which may help us address readmissions in a different light to improve overall readmission rate.