Transarterial Chemoembolization in the Coming Era of Decreased Reimbursement for Readmissions

Purpose: CMS has identified readmission of patients within 30 days of discharge as a targeted quality metric and has instituted financial penalties to encourage hospitals to reduce readmissions. The aims of this study were to examine the rate of 30-day admissions after transarterial chemoembolization (TACE) at a single institution and to identify potential factors associated with readmission. Methods: A total of 275 patients were identified who underwent a total of 457 TACE procedures over a 21-year period. Their electronic medical records were reviewed to evaluate the 30-day readmission rate in all patients undergoing TACE, and multiple logistic regression analysis was used to ascertain any clinical or demographic factors affecting the risk for readmission. Results: Nineteen patients (4.2%) required readmission to the hospital within 30 days; 11 of these readmissions were directly attributable to TACE, with inpatient stays upon readmission ranging from 2 to 27 days. Fourteen patients (3.1%) returned to the emergency department (ED) within 30 days of TACE. Medicare patients were more likely to be readmitted to the hospital or require emergency department treatment within 30 days than patients with private health insurance (P = .006). Patients with worse performance status (Eastern Cooperative Oncology Group) were also more likely to require emergency department care within 30 days (P = .04). Conclusions: TACE patients are at risk for readmission, often related to underlying medical comorbidities. Although extensively studied in other specialties, the Hospital Readmissions Reduction Program has received little attention in the radiology literature, and radiologists should familiarize themselves with this continually expanding initiative.