2018
Association of Racial and Socioeconomic Disparities With Outcomes Among Patients Hospitalized With Acute Myocardial Infarction, Heart Failure, and Pneumonia
Downing NS, Wang C, Gupta A, Wang Y, Nuti SV, Ross JS, Bernheim SM, Lin Z, Normand ST, Krumholz HM. Association of Racial and Socioeconomic Disparities With Outcomes Among Patients Hospitalized With Acute Myocardial Infarction, Heart Failure, and Pneumonia. JAMA Network Open 2018, 1: e182044. PMID: 30646146, PMCID: PMC6324513, DOI: 10.1001/jamanetworkopen.2018.2044.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBlack PeopleCohort StudiesFee-for-Service PlansFemaleHealth Status DisparitiesHeart FailureHospitalizationHospitalsHumansMaleMedicareMiddle AgedMyocardial InfarctionOutcome Assessment, Health CarePneumoniaRacial GroupsRetrospective StudiesSocial ClassUnited StatesWhite PeopleConceptsAcute myocardial infarctionRisk-standardized mortality ratesRisk-standardized readmission ratesReadmission ratesHeart failureMyocardial infarctionMortality rateIntraclass correlation coefficientAnalysis cohortBlack patientsHospital proportionSocioeconomic disparitiesHospital analysisRisk-standardized outcomesRisk-standardized ratesRetrospective cohort studySocioeconomic statusNeighborhood income levelHospital performanceHospital outcomesCohort studyNumber of hospitalsBroader systemic effectsPatient raceMAIN OUTCOME
2017
Hospital-Readmission Risk — Isolating Hospital Effects from Patient Effects
Krumholz HM, Wang K, Lin Z, Dharmarajan K, Horwitz LI, Ross JS, Drye EE, Bernheim SM, Normand ST. Hospital-Readmission Risk — Isolating Hospital Effects from Patient Effects. New England Journal Of Medicine 2017, 377: 1055-1064. PMID: 28902587, PMCID: PMC5671772, DOI: 10.1056/nejmsa1702321.Peer-Reviewed Original ResearchConceptsRisk-standardized readmission ratesReadmission ratesObserved readmission ratesSimilar diagnosesHospital effectsDifferent hospitalsHospital readmission performanceRate of readmissionHospital readmission ratesLower readmission ratesStudy sampleYears of ageSignificant differencesMultiple admissionsReadmission outcomesOnly significant differencePatient effectsSame patientMedicare recipientsPatientsReadmission performanceRisk-standardized hospital readmission ratesHospitalHospital qualityQuartileHospital Characteristics Associated With Risk-standardized Readmission Rates
Horwitz LI, Bernheim SM, Ross JS, Herrin J, Grady JN, Krumholz HM, Drye EE, Lin Z. Hospital Characteristics Associated With Risk-standardized Readmission Rates. Medical Care 2017, 55: 528-534. PMID: 28319580, PMCID: PMC5426655, DOI: 10.1097/mlr.0000000000000713.Peer-Reviewed Original Research
2016
Hospital Use of Observation Stays
Venkatesh AK, Wang C, Ross JS, Altaf FK, Suter LG, Vellanky S, Grady JN, Bernheim SM. Hospital Use of Observation Stays. Medical Care 2016, 54: 1070-1077. PMID: 27579906, PMCID: PMC5850934, DOI: 10.1097/mlr.0000000000000601.Peer-Reviewed Original ResearchConceptsRisk-standardized readmission ratesAcute myocardial infarctionObservation staysHeart failureReadmission measuresHospital useHospital risk-standardized readmission ratesCross-sectional analysisModest inverse correlationPostdischarge periodReadmission ratesHospital observationMyocardial infarctionMedicare feeStayPneumoniaService beneficiariesMeasures of qualityMedicaid ServicesHospitalInverse correlationModest correlationReadmissionPublic reportingFailureAccounting For Patients’ Socioeconomic Status Does Not Change Hospital Readmission Rates
Bernheim SM, Parzynski CS, Horwitz L, Lin Z, Araas MJ, Ross JS, Drye EE, Suter LG, Normand SL, Krumholz HM. Accounting For Patients’ Socioeconomic Status Does Not Change Hospital Readmission Rates. Health Affairs 2016, 35: 1461-1470. PMID: 27503972, PMCID: PMC7664840, DOI: 10.1377/hlthaff.2015.0394.Peer-Reviewed Original ResearchConceptsHospital Readmissions Reduction ProgramPatients' socioeconomic statusMedicare's Hospital Readmissions Reduction ProgramLow socioeconomic statusReadmission ratesSocioeconomic statusRisk-standardized readmission ratesHospital readmission ratesReadmissions Reduction ProgramMedicaid Services methodologyReadmission measuresHospital resultsPatientsHospitalSuch hospitalsPayment penaltiesReduction programsStatusCurrent CentersLower proportionLarge proportionPercentAdjustmentProportionAssociation of Admission to Veterans Affairs Hospitals vs Non–Veterans Affairs Hospitals With Mortality and Readmission Rates Among Older Men Hospitalized With Acute Myocardial Infarction, Heart Failure, or Pneumonia
Nuti SV, Qin L, Rumsfeld JS, Ross JS, Masoudi FA, Normand SL, Murugiah K, Bernheim SM, Suter LG, Krumholz HM. Association of Admission to Veterans Affairs Hospitals vs Non–Veterans Affairs Hospitals With Mortality and Readmission Rates Among Older Men Hospitalized With Acute Myocardial Infarction, Heart Failure, or Pneumonia. JAMA 2016, 315: 582-592. PMID: 26864412, PMCID: PMC5459395, DOI: 10.1001/jama.2016.0278.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionNon-VA hospitalsReadmission ratesHeart failureVA hospitalsMortality rateVeterans AffairsMyocardial infarctionOlder menMedicare Standard Analytic FilesRisk-standardized mortality ratesCause readmission rateCause mortality ratesHigher readmission ratesStandard Analytic FilesVeterans Affairs hospitalRisk-standardized readmission ratesAdministrative claims dataAcute care hospitalsAssociation of admissionLittle contemporary informationLower mortality rateCross-sectional analysisAnalysis cohortCare hospital
2014
Development and use of an administrative claims measure for profiling hospital-wide performance on 30-day unplanned readmission.
Horwitz LI, Partovian C, Lin Z, Grady JN, Herrin J, Conover M, Montague J, Dillaway C, Bartczak K, Suter LG, Ross JS, Bernheim SM, Krumholz HM, Drye EE. Development and use of an administrative claims measure for profiling hospital-wide performance on 30-day unplanned readmission. Annals Of Internal Medicine 2014, 161: s66-75. PMID: 25402406, PMCID: PMC4235629, DOI: 10.7326/m13-3000.Peer-Reviewed Original ResearchConceptsUnplanned readmissionReadmission measuresReadmission ratesReadmission riskMedicare feeHospital-wide readmission measureRisk-standardized readmission ratesPayer dataAdministrative Claims MeasureRisk-standardized ratesAverage-risk patientsUnplanned readmission rateDays of dischargeHospital risk-standardized readmission ratesAdult hospitalizationsComorbid conditionsPrincipal diagnosisClaims dataService claimsService beneficiariesReadmissionMeasure development studiesMedicaid ServicesRisk adjustmentHospital
2013
Hospital readmission performance and patterns of readmission: retrospective cohort study of Medicare admissions
Dharmarajan K, Hsieh AF, Lin Z, Bueno H, Ross JS, Horwitz LI, Barreto-Filho JA, Kim N, Suter LG, Bernheim SM, Drye EE, Krumholz HM. Hospital readmission performance and patterns of readmission: retrospective cohort study of Medicare admissions. The BMJ 2013, 347: f6571. PMID: 24259033, PMCID: PMC3898430, DOI: 10.1136/bmj.f6571.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionRetrospective cohort studyReadmission diagnosesReadmission ratesHeart failureMyocardial infarctionCohort studySpecific diagnosisReadmission performanceHospital readmission performancePatterns of readmissionDay readmission rateRisk-standardized readmission ratesLow performing hospitalsHospital performanceHigh performing hospitalsReadmission timingDay readmissionHospital stayIndex admissionHospital dischargeReadmission patternsHospital admissionCommon diagnosisMedian timeHospital-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 volumeRelationship Between Hospital Readmission and Mortality Rates for Patients Hospitalized With Acute Myocardial Infarction, Heart Failure, or Pneumonia
Krumholz HM, Lin Z, Keenan PS, Chen J, Ross JS, Drye EE, Bernheim SM, Wang Y, Bradley EH, Han LF, Normand SL. Relationship Between Hospital Readmission and Mortality Rates for Patients Hospitalized With Acute Myocardial Infarction, Heart Failure, or Pneumonia. JAMA 2013, 309: 587-593. PMID: 23403683, PMCID: PMC3621028, DOI: 10.1001/jama.2013.333.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesAcute myocardial infarctionRisk-standardized readmission ratesHospital risk-standardized mortality ratesHeart failureMyocardial infarctionHospital characteristicsMortality rateReadmission ratesProportion of hospitalsHospital readmissionMedicare feePneumoniaInfarctionService beneficiariesHospitalPatientsMedicaid ServicesHospital performanceSubgroupsFailureCauseReadmissionSignificant negative linear relationship
2012
Skilled Nursing Facility Referral and Hospital Readmission Rates after Heart Failure or Myocardial Infarction
Chen J, Ross JS, Carlson MD, Lin Z, Normand SL, Bernheim SM, Drye EE, Ling SM, Han LF, Rapp MT, Krumholz HM. Skilled Nursing Facility Referral and Hospital Readmission Rates after Heart Failure or Myocardial Infarction. The American Journal Of Medicine 2012, 125: 100.e1-100.e9. PMID: 22195535, PMCID: PMC3246370, DOI: 10.1016/j.amjmed.2011.06.011.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionRisk-standardized readmission ratesSkilled nursing facilitiesHeart failureHospital-level variationReadmission ratesMyocardial infarctionRate of dischargeHospital-level readmission ratesSubstantial hospital-level variationService Medicare patientsCause readmission rateRisk of readmissionHospital readmission ratesHF admissionsRegression modelsAMI patientsFacility referralPrincipal diagnosisMedicare patientsMedicare claimsClaims dataAMI admissionsAMI hospitalizationNursing facilities
2008
An Administrative Claims Measure Suitable for Profiling Hospital Performance on the Basis of 30-Day All-Cause Readmission Rates Among Patients With Heart Failure
Keenan PS, Normand SL, Lin Z, Drye EE, Bhat KR, Ross JS, Schuur JD, Stauffer BD, Bernheim SM, Epstein AJ, Wang Y, Herrin J, Chen J, Federer JJ, Mattera JA, Wang Y, Krumholz HM. An Administrative Claims Measure Suitable for Profiling Hospital Performance on the Basis of 30-Day All-Cause Readmission Rates Among Patients With Heart Failure. Circulation Cardiovascular Quality And Outcomes 2008, 1: 29-37. PMID: 20031785, DOI: 10.1161/circoutcomes.108.802686.Peer-Reviewed Original ResearchConceptsRisk-standardized readmission ratesCause readmission rateReadmission ratesHeart failureHospital-level readmission ratesAdjusted readmission ratesAdministrative Claims MeasureUnadjusted readmission ratesHeart failure patientsHospital risk-standardized readmission ratesMedical record dataProfiling Hospital PerformanceHierarchical logistic regression modelsUse of MedicareMedical record modelNational Quality ForumLogistic regression modelsCause readmissionClaims-based modelsHospital dischargeFailure patientsC-statisticPreventable eventsPatientsQuality Forum