IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0353361.html

Association of care fragmentation with financial and clinical outcomes of transcatheter aortic valve replacement in the US: A retrospective cohort study

Author

Listed:
  • Arjun Chaturvedi
  • Saad Mallick
  • Nguyen K Le
  • Kevin Tabibian
  • Jeffrey Balian
  • Dariush Yalzadeh
  • Barzin Badiee
  • Radoslav Zinoviev
  • Peyman Benharash

Abstract

Purpose: Care fragmentation (CF), defined as readmission to a non-index facility, has historically been linked with adverse clinical and financial outcomes for a variety of cardiac procedures. However, its impact on patients undergoing transcatheter aortic valve replacement (TAVR) remains understudied. Methods: This retrospective study investigated the prevalence and impact of CF on outcomes of patients undergoing TAVR. All adults (≥18 years) undergoing an isolated TAVR procedure, who were readmitted within 90 days, were tabulated using the Nationwide Readmissions Database from 2016 to 2021. A 90-day readmission window was chosen in accordance with prior literature on readmission. Patients treated at a non-index facility were categorized into the CF cohort. Multivariable logistic models were developed to characterize the association of care fragmentation status with perioperative complications and resource utilization; candidate variables were selected using elastic net regularization to minimize variable collinearity. Results: Of an estimated 55,891 patients who were readmitted within 90 days, 37.4% were treated at a non-index facility. While TAVR utilization more than doubled, both the readmission and care fragmentation rates fell during the study period. Following adjustment, CF status was associated with respiratory (AOR [Adjusted Odds Ratio] 1.20, 95% CI [Confidence Interval] 1.11–1.29, p

Suggested Citation

  • Arjun Chaturvedi & Saad Mallick & Nguyen K Le & Kevin Tabibian & Jeffrey Balian & Dariush Yalzadeh & Barzin Badiee & Radoslav Zinoviev & Peyman Benharash, 2026. "Association of care fragmentation with financial and clinical outcomes of transcatheter aortic valve replacement in the US: A retrospective cohort study," PLOS ONE, Public Library of Science, vol. 21(7), pages 1-14, July.
    • Handle: RePEc:plo:pone00:0353361
    DOI: 10.1371/journal.pone.0353361
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0353361
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0353361&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0353361?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Kobayashi, Daisuke & Otsubo, Tetsuya & Imanaka, Yuichi, 2015. "The effect of centralization of health care services on travel time and its equality," Health Policy, Elsevier, vol. 119(3), pages 298-306.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Huguet, Marius, 2020. "Centralization of care in high volume hospitals and inequalities in access to care," Social Science & Medicine, Elsevier, vol. 260(C).
    2. Versteeg, S.E. & Ho, V.K.Y. & Siesling, S. & Varkevisser, M., 2018. "Centralisation of cancer surgery and the impact on patients’ travel burden," Health Policy, Elsevier, vol. 122(9), pages 1028-1034.
    3. I. Josa & A. Aguado, 2020. "Measuring Unidimensional Inequality: Practical Framework for the Choice of an Appropriate Measure," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 149(2), pages 541-570, June.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0353361. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.