2021
Incorporating Present-on-Admission Indicators in Medicare Claims to Inform Hospital Quality Measure Risk Adjustment Models
Triche EW, Xin X, Stackland S, Purvis D, Harris A, Yu H, Grady JN, Li SX, Bernheim SM, Krumholz HM, Poyer J, Dorsey K. Incorporating Present-on-Admission Indicators in Medicare Claims to Inform Hospital Quality Measure Risk Adjustment Models. JAMA Network Open 2021, 4: e218512. PMID: 33978722, PMCID: PMC8116982, DOI: 10.1001/jamanetworkopen.2021.8512.Peer-Reviewed Original ResearchConceptsPOA indicatorRisk factorsOutcome measuresQuality outcome measuresRisk-adjustment modelsClaims dataAdmission indicatorsPatient risk factorsAcute myocardial infarctionPatient-level outcomesAdministrative claims dataQuality improvement studyClaims-based measuresComparative effectiveness studiesPatient claims dataInternational Statistical ClassificationMortality outcome measuresRelated Health ProblemsHospital quality measuresRisk model performanceHospital stayIndex admissionCare algorithmHeart failureMortality outcomes
2019
Development and Testing of Improved Models to Predict Payment Using Centers for Medicare & Medicaid Services Claims Data
Krumholz HM, Warner F, Coppi A, Triche EW, Li SX, Mahajan S, Li Y, Bernheim SM, Grady J, Dorsey K, Desai NR, Lin Z, Normand ST. Development and Testing of Improved Models to Predict Payment Using Centers for Medicare & Medicaid Services Claims Data. JAMA Network Open 2019, 2: e198406. PMID: 31411709, PMCID: PMC6694388, DOI: 10.1001/jamanetworkopen.2019.8406.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionHeart failurePopulation-based programsPOA codesSingle diagnostic codeDiagnostic codesComparative effectiveness research studyPublic reportingIndex admission diagnosisDays of hospitalizationClinical Modification codesService claims dataAcute care hospitalsMultiple care settingsPatient-level modelsAdmission diagnosisTotal hospitalizationsCare hospitalPrevious diagnosisNinth RevisionMyocardial infarctionCandidate variablesCare settingsClaims dataMAIN OUTCOMEComparative Effectiveness of New Approaches to Improve Mortality Risk Models From Medicare Claims Data
Krumholz HM, Coppi AC, Warner F, Triche EW, Li SX, Mahajan S, Li Y, Bernheim SM, Grady J, Dorsey K, Lin Z, Normand ST. Comparative Effectiveness of New Approaches to Improve Mortality Risk Models From Medicare Claims Data. JAMA Network Open 2019, 2: e197314. PMID: 31314120, PMCID: PMC6647547, DOI: 10.1001/jamanetworkopen.2019.7314.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionICD-9-CM codesMortality risk modelHeart failureHospital admissionC-statisticMAIN OUTCOMEMortality rateRisk-standardized mortality ratesHospital risk-standardized mortality ratesIndex admission diagnosisPatients 65 yearsDays of hospitalizationComparative effectiveness studiesClaims-based dataHospital-level performance measuresMedicare claims dataPatient-level modelsCMS modelRisk-adjustment modelsRisk modelHospital performance measuresAdmission diagnosisNinth RevisionMyocardial infarctionTrends in Hospital Readmission of Medicare-Covered Patients With Heart Failure
Blecker S, Herrin J, Li L, Yu H, Grady JN, Horwitz LI. Trends in Hospital Readmission of Medicare-Covered Patients With Heart Failure. Journal Of The American College Of Cardiology 2019, 73: 1004-1012. PMID: 30846093, PMCID: PMC7011858, DOI: 10.1016/j.jacc.2018.12.040.Peer-Reviewed Original ResearchConceptsHospital Readmissions Reduction ProgramSecondary heart failureReadmission ratesHeart failureReadmissions Reduction ProgramHF hospitalizationAffordable Care ActMedicare's Hospital Readmissions Reduction ProgramRisk-adjusted readmission ratesCause readmission rateHigher readmission ratesAcute myocardial infarctionCare ActReduction programsLinear spline regression modelsPneumonia hospitalizationsHospital readmissionMedicare hospitalizationsRetrospective studySecondary diagnosisMyocardial infarctionPrincipal diagnosisHospitalizationSpline regression modelsPatients
2018
Hospital Characteristics Associated With Postdischarge Hospital Readmission, Observation, and Emergency Department Utilization
Horwitz LI, Wang Y, Altaf FK, Wang C, Lin Z, Liu S, Grady J, Bernheim SM, Desai NR, Venkatesh AK, Herrin J. Hospital Characteristics Associated With Postdischarge Hospital Readmission, Observation, and Emergency Department Utilization. Medical Care 2018, 56: 281-289. PMID: 29462075, PMCID: PMC6170884, DOI: 10.1097/mlr.0000000000000882.Peer-Reviewed Original ResearchMeSH KeywordsCross-Sectional StudiesEmergency Service, HospitalFee-for-Service PlansHeart FailureHospital AdministrationHospitals, PublicHumansMedicareMyocardial InfarctionNursing Staff, HospitalOwnershipPatient ReadmissionPneumoniaResidence CharacteristicsRetrospective StudiesSafety-net ProvidersUnited StatesConceptsAcute care utilizationAcute myocardial infarctionHeart failureCare utilizationAcute careMyocardial infarctionHospital characteristicsNet hospitalExcess daysPublic hospitalsNonsafety net hospitalsHigher readmission ratesEmergency department utilizationProportion of hospitalsAcute care hospitalsSafety-net hospitalService Medicare beneficiariesLarge urban hospitalMajor teaching hospitalType of hospitalCross-sectional analysisPostdischarge utilizationHospital dischargeHospital factorsReadmission rates
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 reportingFailure
2014
National Patterns of Risk-Standardized Mortality and Readmission After Hospitalization for Acute Myocardial Infarction, Heart Failure, and Pneumonia: Update on Publicly Reported Outcomes Measures Based on the 2013 Release
Suter LG, Li SX, Grady JN, Lin Z, Wang Y, Bhat KR, Turkmani D, Spivack SB, Lindenauer PK, Merrill AR, Drye EE, Krumholz HM, Bernheim SM. National Patterns of Risk-Standardized Mortality and Readmission After Hospitalization for Acute Myocardial Infarction, Heart Failure, and Pneumonia: Update on Publicly Reported Outcomes Measures Based on the 2013 Release. Journal Of General Internal Medicine 2014, 29: 1333-1340. PMID: 24825244, PMCID: PMC4175654, DOI: 10.1007/s11606-014-2862-5.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesAcute myocardial infarctionHeart failurePneumonia mortalityMyocardial infarctionMedian risk-standardized mortality rateHospital-level mortalityUnplanned readmission ratePrincipal discharge diagnosisHospital performanceRisk-Standardized MortalityHF mortalityReadmission resultsReadmission ratesDischarge diagnosisOutcome measuresAMI mortalityReadmission measuresPneumoniaMortality rateService MedicareHierarchical logistic modelsMortalityMedicaid ServicesReadmission
2001
Quality of Care for Hospitalized Medicare Patients at Risk for Pressure Ulcers
Lyder C, Preston J, Grady J, Scinto J, Allman R, Bergstrom N, Rodeheaver G. Quality of Care for Hospitalized Medicare Patients at Risk for Pressure Ulcers. JAMA Internal Medicine 2001, 161: 1549-1554. PMID: 11427104, DOI: 10.1001/archinte.161.12.1549.Peer-Reviewed Original ResearchMeSH KeywordsAge DistributionAgedAged, 80 and overCase-Control StudiesCohort StudiesFemaleGuideline AdherenceHospital UnitsHumansIncidenceLength of StayMaleMedicarePressure UlcerProcess Assessment, Health CareQuality Indicators, Health CareRetrospective StudiesRisk AssessmentSex DistributionUnited StatesConceptsProcess of careDaily skin assessmentPressure ulcersPressure ulcer predictionNutritional consultationSkin assessmentMedicare patientsPressure-reducing devicesUS hospitalsMulticenter retrospective cohort studyStage 1 pressure ulcersState's peer review organizationKaplan-Meier survival analysisNutritional risk factorsRetrospective cohort studyCongestive heart failureMedical record abstractionAcute care hospitalsPressure ulcer developmentQuality of careCohort studyCare hospitalHeart failureRecord abstractionPeer review organizations