Featured Publications
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 ResearchMeSH KeywordsAgedHospitalsHumansOutcome Assessment, Health CarePatient ReadmissionQuality Indicators, Health CareRisk AdjustmentUnited StatesConceptsRisk-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 qualityQuartileAssociation of Changing Hospital Readmission Rates With Mortality Rates After Hospital Discharge
Dharmarajan K, Wang Y, Lin Z, Normand ST, Ross JS, Horwitz LI, Desai NR, Suter LG, Drye EE, Bernheim SM, Krumholz HM. Association of Changing Hospital Readmission Rates With Mortality Rates After Hospital Discharge. JAMA 2017, 318: 270-278. PMID: 28719692, PMCID: PMC5817448, DOI: 10.1001/jama.2017.8444.Peer-Reviewed Original ResearchConceptsRisk-adjusted readmission ratesRisk-adjusted mortality ratesAcute myocardial infarctionHeart failureReadmission ratesMortality rateMyocardial infarctionMedicare feeService beneficiariesHospital readmission ratesMean hospitalHospital mortalityPostdischarge mortalityHospital dischargeHospital readmissionRetrospective studyAffordable Care ActReadmission reductionMAIN OUTCOMEPneumoniaHospitalSecondary analysisWeighted Pearson correlation coefficientMortalityCare ActAccounting 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 proportionPercentAdjustmentProportionRelationship 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 relationshipAn 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
2024
Measuring Equity in Readmission as a Distinct Assessment of Hospital Performance
Nash K, Weerahandi H, Yu H, Venkatesh A, Holaday L, Herrin J, Lin Z, Horwitz L, Ross J, Bernheim S. Measuring Equity in Readmission as a Distinct Assessment of Hospital Performance. JAMA 2024, 331: 111-123. PMID: 38193960, PMCID: PMC10777266, DOI: 10.1001/jama.2023.24874.Peer-Reviewed Original ResearchConceptsBlack patientsPatient populationHospital characteristicsHospital-wide readmission measureDual-eligible patientsHospital patient populationCross-sectional studyMeasures of hospitalHealth care qualityPatient demographicsReadmission ratesClinical outcomesPatient raceEligible hospitalsReadmissionMAIN OUTCOMEReadmission measuresMedicare dataUS hospitalsHospitalCare qualityPatientsMedicaid ServicesOutcomesLower percentage
2020
Post-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
Substantial Differences Between Cohorts of Patients Hospitalized With Heart Failure in Canada and the United States
Lin Z, Li SX. Substantial Differences Between Cohorts of Patients Hospitalized With Heart Failure in Canada and the United States. JAMA Cardiology 2019, 4: 1178-1179. PMID: 31532467, DOI: 10.1001/jamacardio.2019.3314.Peer-Reviewed Original ResearchEvaluation of 30-Day Hospital Readmission and Mortality Rates Using Regression-Discontinuity Framework
Khera R, Wang Y, Nasir K, Lin Z, Krumholz HM. Evaluation of 30-Day Hospital Readmission and Mortality Rates Using Regression-Discontinuity Framework. Journal Of The American College Of Cardiology 2019, 74: 219-234. PMID: 31296295, PMCID: PMC8669780, DOI: 10.1016/j.jacc.2019.04.060.Peer-Reviewed Original ResearchMeSH KeywordsHeart FailureHumansMyocardial InfarctionPatient ReadmissionPneumoniaRegression AnalysisConceptsAcute myocardial infarctionHospital Readmissions Reduction ProgramHeart failureReadmission ratesElderly Medicare feeMedian readmission rateReadmissions Reduction ProgramPost-discharge daysInstitution of strategiesHospital readmissionReadmission riskMyocardial infarctionReadmission reductionCardiovascular conditionsEligible hospitalsMedicare feeReadmission penaltiesMortality rateDay 1Day 30ReadmissionDay 60HospitalU.S. hospitalsHospitalization
2018
Defining Multiple Chronic Conditions for Quality Measurement
Drye EE, Altaf FK, Lipska KJ, Spatz ES, Montague JA, Bao H, Parzynski CS, Ross JS, Bernheim SM, Krumholz HM, Lin Z. Defining Multiple Chronic Conditions for Quality Measurement. Medical Care 2018, 56: 193-201. PMID: 29271820, DOI: 10.1097/mlr.0000000000000853.Peer-Reviewed Original ResearchConceptsMultiple chronic conditionsChronic conditionsMedicare feeService beneficiariesMedicare Chronic Conditions WarehouseMCC cohortBroad cohortChronic Conditions WarehouseRisk-standardized ratesNational quality measuresUnplanned admissionsFinal cohortTotal admissionsAdmission riskAccountable care organizationsAdmission ratesOutcome measuresAdmissionCohortCohort conditionCare organizationsPatientsStakeholder inputNarrow cohortBeneficiaries
2017
Hospital 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
Declining Admission Rates And Thirty-Day Readmission Rates Positively Associated Even Though Patients Grew Sicker Over Time
Dharmarajan K, Qin L, Lin Z, Horwitz LI, Ross JS, Drye EE, Keshawarz A, Altaf F, Normand SL, Krumholz HM, Bernheim SM. Declining Admission Rates And Thirty-Day Readmission Rates Positively Associated Even Though Patients Grew Sicker Over Time. Health Affairs 2016, 35: 1294-1302. PMID: 27385247, DOI: 10.1377/hlthaff.2015.1614.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCenters for Medicare and Medicaid Services, U.S.Chronic DiseaseDatabases, FactualDisease ProgressionFemaleGeriatric AssessmentHospital MortalityHumansIncidenceLength of StayMaleOutcome Assessment, Health CarePatient AdmissionPatient ReadmissionRetrospective StudiesRisk AssessmentSeverity of Illness IndexTime FactorsUnited States
2015
Association of hospital volume with readmission rates: a retrospective cross-sectional study
Horwitz LI, Lin Z, Herrin J, Bernheim S, Drye EE, Krumholz HM, Hines HJ, Ross JS. Association of hospital volume with readmission rates: a retrospective cross-sectional study. The BMJ 2015, 350: h447. PMID: 25665806, PMCID: PMC4353286, DOI: 10.1136/bmj.h447.Peer-Reviewed Original ResearchMeSH KeywordsAgedCross-Sectional StudiesHospitals, High-VolumeHospitals, Low-VolumeHumansPatient ReadmissionRetrospective StudiesConceptsReadmission ratesHospital volumeRetrospective cross-sectional studyUS acute care hospitalsHospital readmission ratesAcute care hospitalsCross-sectional studyMedical cancer treatmentCare hospitalAdult dischargesHospital characteristicsMedicare feeCancer treatmentHospitalAssociationDaysService dataPatientsCardiovascularGynecologyQuintileNeurology
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
2011
An Administrative Claims Measure Suitable for Profiling Hospital Performance Based on 30-Day All-Cause Readmission Rates Among Patients With Acute Myocardial Infarction
Krumholz HM, Lin Z, Drye EE, Desai MM, Han LF, Rapp MT, Mattera JA, Normand SL. An Administrative Claims Measure Suitable for Profiling Hospital Performance Based on 30-Day All-Cause Readmission Rates Among Patients With Acute Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2011, 4: 243-252. PMID: 21406673, PMCID: PMC3350811, DOI: 10.1161/circoutcomes.110.957498.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCohort StudiesFemaleHumansInsurance Claim ReviewLogistic ModelsMaleMedicareModels, StatisticalMyocardial InfarctionOutcome and Process Assessment, Health CareOutcome Assessment, Health CarePatient ReadmissionQuality of Health CareReproducibility of ResultsRisk FactorsTime FactorsUnited States
2010
Telemonitoring in Patients with Heart Failure
Chaudhry SI, Mattera JA, Curtis JP, Spertus JA, Herrin J, Lin Z, Phillips CO, Hodshon BV, Cooper LS, Krumholz HM. Telemonitoring in Patients with Heart Failure. New England Journal Of Medicine 2010, 363: 2301-2309. PMID: 21080835, PMCID: PMC3237394, DOI: 10.1056/nejmoa1010029.Peer-Reviewed Original ResearchConceptsPrimary end pointUsual care groupSecondary end pointsHeart failureEnd pointHeart failure outcomesNumber of hospitalizationsTelephone-based interactive voice response systemUsual careAdverse eventsPatient's clinicianMedian ageCare groupLarge trialsInteractive voice response systemPatientsSmall studyVoice response systemNumber of daysHospitalizationReadmissionTelemonitoringSignificant differencesCliniciansDeath