2023
Race and Ethnicity and Emergency Department Discharge Against Medical Advice
Tsai J, Janke A, Krumholz H, Khidir H, Venkatesh A. Race and Ethnicity and Emergency Department Discharge Against Medical Advice. JAMA Network Open 2023, 6: e2345437. PMID: 38015503, PMCID: PMC10685883, DOI: 10.1001/jamanetworkopen.2023.45437.Peer-Reviewed Original ResearchMeSH KeywordsAdultCross-Sectional StudiesEmergency Service, HospitalEthnicityFemaleHospitals, TeachingHumansMaleMiddle AgedPatient DischargeYoung AdultConceptsWhite patientsHispanic patientsEmergency departmentCross-sectional studyED visitsBlack patientsDAMA rateMedical adviceMAIN OUTCOMEEthnic disparitiesNationwide Emergency Department SampleNational cross-sectional studyHospital ED visitsEmergency department dischargeHospital-level variationEmergency Department SampleMetropolitan teaching hospitalHealth care resourcesMedian ageGreater morbidityHospital variationUnadjusted analysesTeaching hospitalAdditional adjustmentLower odds
2022
Changes in Emergency Department Arrival Times for Acute Myocardial Infarction During the COVID-19 Pandemic Suggest Delays in Care Seeking
Janke AT, Gettel CJ, Haimovich A, Kocher KE, Krumholz HM, Venkatesh AK. Changes in Emergency Department Arrival Times for Acute Myocardial Infarction During the COVID-19 Pandemic Suggest Delays in Care Seeking. Circulation Cardiovascular Quality And Outcomes 2022, 15: e008402. PMID: 35105172, PMCID: PMC8833230, DOI: 10.1161/circoutcomes.121.008402.Peer-Reviewed Original ResearchCOVID-19Emergency Service, HospitalHumansMyocardial InfarctionPandemicsSARS-CoV-2ST Elevation Myocardial Infarction
2020
Variation in Risk-standardized Rates and Causes of Unplanned Hospital Visits Within 7 Days of Hospital Outpatient Surgery
Desai MM, Zogg CK, Ranasinghe I, Parzynski CS, Lin Z, Gorbaty M, Merrill A, Krumholz HM, Drye EE. Variation in Risk-standardized Rates and Causes of Unplanned Hospital Visits Within 7 Days of Hospital Outpatient Surgery. Annals Of Surgery 2020, 276: e714-e720. PMID: 33214469, DOI: 10.1097/sla.0000000000004627.Peer-Reviewed Original ResearchMeSH KeywordsAgedAmbulatory Surgical ProceduresEmergency Service, HospitalFee-for-Service PlansHospitalizationHospitalsHumansMedicareRetrospective StudiesUnited StatesConceptsUnplanned hospital visitsHospital outpatient surgeryHospital outpatient departmentsHospital visitsOutpatient surgeryShort-term safety outcomesFacility-level variationHierarchical logistic regression modelingPost-surgical visitSame-day surgeryHalf of proceduresLogistic regression modelingUrinary retentionStudy cohortUnplanned visitsClinical comorbiditiesOutpatient departmentOutpatient settingPreventable conditionPreventable reasonsBACKGROUND DATASafety outcomesMedicare feeSurgeryService beneficiariesUnscheduled Care Access in the United States-A Tale of Two Emergency Departments
Venkatesh AK, Greenwood-Ericksen MB, Mei H, Rothenberg C, Lin Z, Krumholz HM. Unscheduled Care Access in the United States-A Tale of Two Emergency Departments. The American Journal Of Emergency Medicine 2020, 45: 374-377. PMID: 33143957, PMCID: PMC8076339, DOI: 10.1016/j.ajem.2020.08.095.Peer-Reviewed Original ResearchMeSH KeywordsAgedEmergency Service, HospitalFemaleHealth Services AccessibilityHumansMaleMedicareRural PopulationUnited StatesUrban PopulationUtilization ReviewConceptsHospital referral regionsED visit ratesEmergency departmentCare ratesVisit ratesMedicare Chronic Conditions WarehouseHospital-based emergency departmentsRole of EDsChronic Conditions WarehouseProportion of beneficiariesDartmouth Atlas hospital referral regionHealthcare delivery systemED utilizationED visitsED useUnscheduled careReferral regionsUrban zip codesCare accessMedicare beneficiariesCare needsCare deliveryOffice settingCare capabilitiesDisproportionate barriersNational Trends in Emergency Department Care Processes for Acute Myocardial Infarction in the United States, 2005 to 2015
Pendyal A, Rothenberg C, Scofi JE, Krumholz HM, Safdar B, Dreyer RP, Venkatesh AK. National Trends in Emergency Department Care Processes for Acute Myocardial Infarction in the United States, 2005 to 2015. Journal Of The American Heart Association 2020, 9: e017208. PMID: 33047624, PMCID: PMC7763391, DOI: 10.1161/jaha.120.017208.Peer-Reviewed Original ResearchConceptsST-segment elevation myocardial infarctionAcute myocardial infarctionMedian ED lengthUS emergency departmentsEmergency departmentED visitsMyocardial infarctionED administrationED lengthAMI careNational Hospital Ambulatory Medical Care SurveyCare processesAmbulatory Medical Care SurveyEvidence-based medicationsNonaspirin antiplatelet agentsEarly invasive strategyAnnual ED visitsRegionalization of careED care processesReal-world trendsAntiplatelet therapyAnnual incidenceAntiplatelet agentsYearly incidenceCare SurveyWhere Skilled Nursing Facility Residents Get Acute Care: Is the Emergency Department the Medical Home?
Venkatesh AK, Gettel CJ, Mei H, Chou SC, Rothenberg C, Liu SL, D’Onofrio G, Lin Z, Krumholz HM. Where Skilled Nursing Facility Residents Get Acute Care: Is the Emergency Department the Medical Home? Journal Of Applied Gerontology 2020, 40: 828-836. PMID: 32842827, PMCID: PMC7904961, DOI: 10.1177/0733464820950125.Peer-Reviewed Original ResearchMeSH KeywordsAgedCross-Sectional StudiesEmergency Service, HospitalHumansMedicarePatient DischargePatient-Centered CareSkilled Nursing FacilitiesUnited StatesConceptsAcute care visitsCare visitsEmergency departmentMedicare beneficiariesSNF staySNF servicesSkilled nursing facility residentsNursing facility residentsSkilled nursing facility servicesAcute care capabilitiesCross-sectional analysisNursing facility servicesHigher proportionAcute careMedical homeFacility residentsCare capabilitiesVisitsNumber of daysStayCareDepartmentFacility servicesBeneficiariesProportionCross‐sectional Analysis of Emergency Department and Acute Care Utilization Among Medicare Beneficiaries
Venkatesh AK, Mei H, Shuling L, D’Onofrio G, Rothenberg C, Lin Z, Krumholz HM. Cross‐sectional Analysis of Emergency Department and Acute Care Utilization Among Medicare Beneficiaries. Academic Emergency Medicine 2020, 27: 570-579. PMID: 32302034, DOI: 10.1111/acem.13971.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAmbulatory Care FacilitiesChronic DiseaseCross-Sectional StudiesEmergency Service, HospitalFemaleHumansMaleMedicareUnited StatesVulnerable PopulationsConceptsMultiple chronic conditionsEmergency departmentUnscheduled careMedicare beneficiariesCross-sectional analysisVisit ratesCare servicesHighest ED visit ratesNumber of EDVulnerable subpopulationsSkilled nursing facility useAmbulatory office settingNon-ED settingsUnscheduled care servicesAcute care utilizationED visit ratesOffice-based visitsAcute care servicesClaims-based definitionNursing facility useMedicare beneficiaries age 65Dual-eligible beneficiariesOlder adult populationBeneficiaries age 65Care visitsPost-discharge acute care and outcomes following readmission reduction initiatives: national retrospective cohort study of Medicare beneficiaries in the United States
Khera R, Wang Y, Bernheim SM, Lin Z, Krumholz HM. Post-discharge acute care and outcomes following readmission reduction initiatives: national retrospective cohort study of Medicare beneficiaries in the United States. The BMJ 2020, 368: l6831. PMID: 31941686, PMCID: PMC7190056, DOI: 10.1136/bmj.l6831.Peer-Reviewed Original ResearchConceptsAcute care utilizationAcute myocardial infarctionRetrospective cohort studyHeart failureCare utilizationPost-discharge periodEmergency departmentMyocardial infarctionDay mortalityCohort studyHospital admissionObservation unitAcute careNational retrospective cohort studyPost-acute care utilizationHospital Readmissions Reduction ProgramObservation unit carePost-discharge mortalityDay readmission rateRisk of deathReadmissions Reduction ProgramReadmission reduction initiativesReadmission ratesUnit careInpatient unit
2019
Patient-Reported Quality of Hospital Discharge Transitions: Results from the SILVER-AMI Study
Richards BG, Hajduk AM, Perry J, Krumholz HM, Khan AM, Chaudhry SI. Patient-Reported Quality of Hospital Discharge Transitions: Results from the SILVER-AMI Study. Journal Of General Internal Medicine 2019, 35: 808-814. PMID: 31654359, PMCID: PMC7080904, DOI: 10.1007/s11606-019-05414-8.Peer-Reviewed Original ResearchConceptsDays of dischargeEmergency department utilizationAcute myocardial infarctionPatient-reported qualityHospital discharge processOlder patientsAcute Myocardial Infarction StudyMyocardial Infarction StudyProspective cohort studyMedical record reviewEmergency room utilizationAdults age 75Key ResultsA totalHospital Consumer AssessmentSILVER-AMI StudyHospital discharge transitionsHigh-risk periodDesignMulti-centerCohort studyHospital dischargeMedian ageClinical outcomesRecord reviewAdverse outcomesResultsA totalAssociation Between Insurance Status and Access to Hospital Care in Emergency Department Disposition
Venkatesh AK, Chou SC, Li SX, Choi J, Ross JS, D’Onofrio G, Krumholz HM, Dharmarajan K. Association Between Insurance Status and Access to Hospital Care in Emergency Department Disposition. JAMA Internal Medicine 2019, 179: 686-693. PMID: 30933243, PMCID: PMC6503571, DOI: 10.1001/jamainternmed.2019.0037.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAsthmaCritical CareCross-Sectional StudiesDatabases, FactualEmergency Service, HospitalFemaleHealth Services AccessibilityHospitalizationHumansInsurance CoverageInsurance, HealthLung DiseasesMaleMedicaidMedically UninsuredMiddle AgedPatient DischargePatient TransferPneumoniaPulmonary Disease, Chronic ObstructiveUnited StatesConceptsNational Emergency Department SampleEmergency Department SampleCommon medical conditionsUninsured patientsCritical care capabilitiesED dischargeED visitsED transfersPulmonary diseaseCare capabilitiesInsurance statusHigher oddsMedicaid beneficiariesMedical conditionsChronic obstructive pulmonary diseaseAcute pulmonary diseaseEmergency department transfersAdult ED visitsHospital admission ratesObstructive pulmonary diseaseEmergency department dispositionPatient insurance statusPatient case mixHospital ownership statusIntensive care capabilities
2018
Emergency Department Volume and Outcomes for Patients After Chest Pain Assessment
Ko DT, Dattani ND, Austin PC, Schull MJ, Ross JS, Wijeysundera HC, Tu JV, Eberg M, Koh M, Krumholz HM. Emergency Department Volume and Outcomes for Patients After Chest Pain Assessment. Circulation Cardiovascular Quality And Outcomes 2018, 11: e004683. PMID: 30354285, DOI: 10.1161/circoutcomes.118.004683.Peer-Reviewed Original ResearchConceptsAcute coronary syndromeChest painHigh-volume EDsCoronary syndromeED volumeVolume thresholdCardiac medication useChest pain assessmentLower adverse outcomesEmergency department visitsAdjusted odds ratioPopulation-based dataProcess of carePotential confounding variablesHigher ED volumesHierarchical logistic regression modelsLogistic regression modelsEmergency department volumeCause deathCardiac testingComposite outcomeDepartment visitsDiabetes mellitusMedication usePrimary outcomeTime to hospital arrival among patients with acute myocardial infarction in China: a report from China PEACE prospective study
Guan W, Venkatesh AK, Bai X, Xuan S, Li J, Li X, Zhang H, Zheng X, Masoudi FA, Spertus JA, Krumholz HM, Jiang L. Time to hospital arrival among patients with acute myocardial infarction in China: a report from China PEACE prospective study. European Heart Journal - Quality Of Care And Clinical Outcomes 2018, 5: 63-71. PMID: 29878087, PMCID: PMC6307335, DOI: 10.1093/ehjqcco/qcy022.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionHospital arrivalSymptom onsetMyocardial infarctionMedical insuranceLower household incomeRural medical insuranceChest discomfortChest painIndex hospitalizationMedian timeMultivariable analysisAMI symptomsProspective studyAssociated FactorsPatients' perceptionsCare seekingAMI hospitalizationPatientsSymptomsHousehold incomeAMI studyHospitalizationInfarctionAverage time
2017
Outcomes after observation stays among older adult Medicare beneficiaries in the USA: retrospective cohort study
Dharmarajan K, Qin L, Bierlein M, Choi JES, Lin Z, Desai NR, Spatz ES, Krumholz HM, Venkatesh AK. Outcomes after observation stays among older adult Medicare beneficiaries in the USA: retrospective cohort study. The BMJ 2017, 357: j2616. PMID: 28634181, PMCID: PMC5476173, DOI: 10.1136/bmj.j2616.Peer-Reviewed Original ResearchPatient–Provider Communication and Health Outcomes Among Individuals With Atherosclerotic Cardiovascular Disease in the United States
Okunrintemi V, Spatz ES, Di Capua P, Salami JA, Valero-Elizondo J, Warraich H, Virani SS, Blaha MJ, Blankstein R, Butt AA, Borden WB, Dharmarajan K, Ting H, Krumholz HM, Nasir K. Patient–Provider Communication and Health Outcomes Among Individuals With Atherosclerotic Cardiovascular Disease in the United States. Circulation Cardiovascular Quality And Outcomes 2017, 10: e003635. PMID: 28373270, DOI: 10.1161/circoutcomes.117.003635.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAspirinAtherosclerosisCommunicationEmergency Service, HospitalFemaleHealth Care CostsHealth Care SurveysHealth ExpendituresHealth StatusHumansHydroxymethylglutaryl-CoA Reductase InhibitorsLength of StayMaleMental HealthMiddle AgedOdds RatioPatient Reported Outcome MeasuresPatient-Centered CarePhysician-Patient RelationsPlatelet Aggregation InhibitorsQuality Indicators, Health CareRisk FactorsUnited StatesYoung AdultConceptsAtherosclerotic cardiovascular diseasePatient-provider communicationHealthcare resource utilizationPatient-reported outcomesCardiovascular diseaseHealth Plans SurveyMedical Expenditure Panel Survey cohortHigher annual healthcare expendituresRepresentative US adult populationHealthcare expendituresAtherosclerotic cardiovascular disease (ASCVD) patientsConsumer AssessmentEmergency room visitsEvidence-based therapiesAnnual healthcare expendituresCardiovascular disease patientsUS adult populationPlans SurveyMental health statusPatient-centered careOutcomes of interestASA useHospital stayRoom visitsPoor outcomeIdentification of Emergency Department Visits in Medicare Administrative Claims: Approaches and Implications
Venkatesh AK, Mei H, Kocher KE, Granovsky M, Obermeyer Z, Spatz E, Rothenberg C, Krumholz H, Lin Z. Identification of Emergency Department Visits in Medicare Administrative Claims: Approaches and Implications. Academic Emergency Medicine 2017, 24: 422-431. PMID: 27864915, PMCID: PMC5905698, DOI: 10.1111/acem.13140.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overClinical CodingEmergency Service, HospitalFemaleHospitalizationHumansMaleMedicareUnited StatesConceptsED visitsEmergency department visitsClaims-based definitionED visitationAdministrative claimsDepartment visitsClaims dataAdministrative claims data setsHealthcare resource utilizationMore ED visitsAcute care practiceAdministrative claims dataQuality improvement interventionsEmergency care researchMedicare administrative claimsClaims data setsED useCritical careED servicesMedicare feeMedicare dataCare practicesService beneficiariesImprovement interventionsProvider definitions
2016
Despite Federal Legislation, Shortages Of Drugs Used In Acute Care Settings Remain Persistent And Prolonged
Chen SI, Fox ER, Hall MK, Ross JS, Bucholz EM, Krumholz HM, Venkatesh AK. Despite Federal Legislation, Shortages Of Drugs Used In Acute Care Settings Remain Persistent And Prolonged. Health Affairs 2016, 35: 798-804. PMID: 27140985, PMCID: PMC6712565, DOI: 10.1377/hlthaff.2015.1157.Peer-Reviewed Original ResearchMeSH KeywordsCritical IllnessDrug IndustryDrug SubstitutionEmergency Service, HospitalFederal GovernmentHumansPrescription DrugsTime FactorsUnited StatesUnited States Food and Drug AdministrationConceptsCare drugsNational drug shortageDrug information servicesDrug shortagesAcute unscheduled careAcute care settingShortage of drugsUtah Drug Information ServiceIll patientsEmergency departmentUnscheduled careDrug Administration SafetyCare settingsAdministration safetyStudy periodDrugsDrug supplyCareEarly evidenceTotal numberPatients
2015
Opportunities and challenges for reducing hospital revisits.
Dharmarajan K, Krumholz HM. Opportunities and challenges for reducing hospital revisits. Annals Of Internal Medicine 2015, 162: 793-4. PMID: 26030636, DOI: 10.7326/m15-0878.Peer-Reviewed Original ResearchVariation in US Hospital Emergency Department Admission Rates by Clinical Condition
Venkatesh AK, Dai Y, Ross JS, Schuur JD, Capp R, Krumholz HM. Variation in US Hospital Emergency Department Admission Rates by Clinical Condition. Medical Care 2015, 53: 237-244. PMID: 25397965, PMCID: PMC4858175, DOI: 10.1097/mlr.0000000000000261.Peer-Reviewed Original ResearchConceptsEmergency Department Admission RatesED admission ratesAdmission ratesClinical conditionsMood disordersChronic obstructive pulmonary diseaseNational Emergency Department SampleAdult ED visitsNonspecific chest painObstructive pulmonary diseaseSoft tissue infectionsUrinary tract infectionEmergency Department SampleClinical Classification SoftwareCross-sectional analysisChest painED visitsTract infectionsPulmonary diseaseSpearman correlation coefficientTissue infectionsHospitalization ratesUS hospitalsCondition-specific variationsHospital correlation
2014
Hospital variation in risk-standardized hospital admission rates from US EDs among adults
Capp R, Ross JS, Fox JP, Wang Y, Desai MM, Venkatesh AK, Krumholz HM. Hospital variation in risk-standardized hospital admission rates from US EDs among adults. The American Journal Of Emergency Medicine 2014, 32: 837-843. PMID: 24881514, DOI: 10.1016/j.ajem.2014.03.033.Peer-Reviewed Original ResearchConceptsHospital admission ratesEmergency departmentAdmission ratesClinical characteristicsED visitsHospital factorsClinical factorsAdult ED visitsUS emergency departmentsHospital teaching statusCross-sectional analysisPatient characteristicsHospital admissionHospital variationPatientsTeaching statusHospitalED dataVisitsRepresentative sampleAdultsRural locationsAdmissionFactorsNational variations
2013
Hospital-Based, Acute Care Use Among Patients Within 30 Days of Discharge After Coronary Artery Bypass Surgery
Fox JP, Suter LG, Wang K, Wang Y, Krumholz HM, Ross JS. Hospital-Based, Acute Care Use Among Patients Within 30 Days of Discharge After Coronary Artery Bypass Surgery. The Annals Of Thoracic Surgery 2013, 96: 96-104. PMID: 23702228, PMCID: PMC3758868, DOI: 10.1016/j.athoracsur.2013.03.091.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overCaliforniaCoronary Artery BypassCoronary Artery DiseaseEmergency Service, HospitalFemaleFollow-Up StudiesHumansIntensive Care UnitsLength of StayLinear ModelsMaleMiddle AgedMorbidityPatient DischargePatient ReadmissionPostoperative ComplicationsPostoperative PeriodPrognosisRecurrenceRetrospective StudiesRisk FactorsSurvival RateTime FactorsYoung AdultConceptsDays of dischargeAcute care needsCABG surgeryED visit ratesED visitsHospital readmissionReadmission ratesCare needsCoronary artery bypass graft surgeryVisit ratesArtery bypass graft surgeryCoronary artery bypass surgeryRisk-standardized readmission ratesAcute care ratesHospital 30 daysBypass graft surgeryAcute care useArtery bypass surgeryCongestive heart failureEmergency department visitsEmergency Department DatabasesChest discomfortGraft surgeryBypass surgeryHospital volume