ArticleSurgery2025
Factors associated with coronary artery bypass grafting excess readmission ratios.
Article in Surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
4 authors.
Funding
Abstract
backgroundThe Hospital Readmissions Reduction Program determines Medicare readmission penalties through risk-adjusted excess readmissions ratios. This study uses interpretable machine learning to identify associations with coronary artery bypass grafting excess readmissions ratios.
methodsFlorida Agency for Healthcare Administration database (2017-2019) was queried for patients with Medicare who underwent coronary artery bypass grafting and linked to Hospital Readmissions Reduction Program and RAND Hospital data. Univariable analysis compared hospitals above compared with below the median excess readmissions ratios. LightGBM and XGBoost modeled excess readmissions ratios using patient data. SHapley Additive exPlanations were used for interpretation.
resultsThe cohort had 7,776 patients from 64 hospitals. Hospitals above the median excess readmissions ratios had more emergent admissions (35.4 vs 29.8%, P < .01), greater mortality (2.1 vs 1.3%, P < .01), and more expensive postoperative care charges (P < .01). Models had mean absolute errors <0.06 and R
conclusionHospitals with greater excess readmissions ratios charge more for postoperative care. Whether this association is caused by hospital differences alone or also by unadjusted differences in patient severity and functional status is unknown. The association of shorter length of stay with greater excess readmissions ratios could suggest that hospitals with greater excess readmissions ratios discharge patients too early. Future research should investigate the causes of these associations and their impact on excess readmissions ratios to ensure that hospitals are not unfairly penalized.
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