2019
Comparative 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 infarction
2018
Variation in and Hospital Characteristics Associated With the Value of Care for Medicare Beneficiaries With Acute Myocardial Infarction, Heart Failure, and Pneumonia
Desai NR, Ott LS, George EJ, Xu X, Kim N, Zhou S, Hsieh A, Nuti SV, Lin Z, Bernheim SM, Krumholz HM. Variation in and Hospital Characteristics Associated With the Value of Care for Medicare Beneficiaries With Acute Myocardial Infarction, Heart Failure, and Pneumonia. JAMA Network Open 2018, 1: e183519. PMID: 30646247, PMCID: PMC6324438, DOI: 10.1001/jamanetworkopen.2018.3519.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesAcute myocardial infarctionHeart failureHigh-value careHospital characteristicsValue of careMyocardial infarctionNational cross-sectional studyHospital risk-standardized mortality ratesMedian risk-standardized mortality rateProportion of patientsSafety-net statusAcute care hospitalsCross-sectional studyLow socioeconomic statusCharacteristics of hospitalsValue-based payment modelsWeak inverse correlationCare hospitalHospital variationHospital typeHospitalizationMAIN OUTCOMEPneumoniaMedicare beneficiaries
2015
Hospital variation in admission to intensive care units for patients with acute myocardial infarction
Chen R, Strait KM, Dharmarajan K, Li SX, Ranasinghe I, Martin J, Fazel R, Masoudi FA, Cooke CR, Nallamothu BK, Krumholz HM. Hospital variation in admission to intensive care units for patients with acute myocardial infarction. American Heart Journal 2015, 170: 1161-1169. PMID: 26678638, PMCID: PMC5459386, DOI: 10.1016/j.ahj.2015.09.003.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overAnterior Wall Myocardial InfarctionCoronary Care UnitsHealth Care RationingHospital MortalityHumansLength of StayMaleMiddle AgedOutcome and Process Assessment, Health CarePatient AdmissionQuality ImprovementRetrospective StudiesRisk AssessmentTriageUnited StatesConceptsAcute myocardial infarctionIntensive care unitCritical care therapiesRisk-standardized mortality ratesHospital risk-standardized mortality ratesICU admissionResource-intensive settingsCare therapyAMI patientsCare unitMyocardial infarctionMortality rateAdult hospitalizationsHospital variationNinth RevisionClinical ModificationICU triageInternational ClassificationBetter outcomesPatientsHospitalAdmissionPremier databaseTherapyAppropriate useDevelopment of a Hospital Outcome Measure Intended for Use With Electronic Health Records
McNamara RL, Wang Y, Partovian C, Montague J, Mody P, Eddy E, Krumholz HM, Bernheim SM. Development of a Hospital Outcome Measure Intended for Use With Electronic Health Records. Medical Care 2015, 53: 818-826. PMID: 26225445, DOI: 10.1097/mlr.0000000000000402.Peer-Reviewed Original ResearchConceptsElectronic health recordsOutcome measuresClinical dataMortality rateClinical practiceFuture quality improvement measuresRisk-standardized mortality ratesHospital risk-standardized mortality ratesLow-mortality hospitalsHealth recordsSystolic blood pressureOdds of mortalityClinical registry dataAcute myocardial infarctionHigh-mortality hospitalsHospital outcome measuresEHR dataFinal risk modelCurrent clinical practiceStandard clinical practiceFirst outcome measureNational Quality ForumCurrent electronic health recordsQuality improvement measuresChart abstraction
2014
Hospital Variation in Noninvasive Positive Pressure Ventilation for Acute Decompensated Heart Failure
Kulkarni VT, Kim N, Dai Y, Dharmarajan K, Safavi KC, Bikdeli B, Lindenauer PK, Testani J, Dries DL, Krumholz HM. Hospital Variation in Noninvasive Positive Pressure Ventilation for Acute Decompensated Heart Failure. Circulation Heart Failure 2014, 7: 427-433. PMID: 24633829, PMCID: PMC4386575, DOI: 10.1161/circheartfailure.113.000698.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureNoninvasive positive pressure ventilationDecompensated heart failureRisk-standardized mortality ratesPositive pressure ventilationHeart failureIntubation rateMortality ratePressure ventilationUse of NPPVHospital risk-standardized mortality ratesHigher intubation rateHospital practice patternsHospital-level outcomesCross-sectional studyHierarchical logistic regression modelsLogistic regression modelsNIPPV useHospital variationSuch hospitalizationsPractice patternsHospitalizationHospitalQuartileBottom quartile
2013
Relationship 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
Development of 2 Registry-Based Risk Models Suitable for Characterizing Hospital Performance on 30-Day All-Cause Mortality Rates Among Patients Undergoing Percutaneous Coronary Intervention
Curtis JP, Geary LL, Wang Y, Chen J, Drye EE, Grosso LM, Spertus JA, Rumsfeld JS, Weintraub WS, Masoudi FA, Brindis RG, Krumholz HM. Development of 2 Registry-Based Risk Models Suitable for Characterizing Hospital Performance on 30-Day All-Cause Mortality Rates Among Patients Undergoing Percutaneous Coronary Intervention. Circulation Cardiovascular Quality And Outcomes 2012, 5: 628-637. PMID: 22949491, DOI: 10.1161/circoutcomes.111.964569.Peer-Reviewed Original ResearchMeSH KeywordsAcute Coronary SyndromeAgedAged, 80 and overAngina PectorisChi-Square DistributionComorbidityFemaleHeart DiseasesHospital MortalityHospitalsHumansLogistic ModelsMaleMyocardial InfarctionOdds RatioOutcome and Process Assessment, Health CarePercutaneous Coronary InterventionQuality Indicators, Health CareRegistriesRisk AssessmentRisk FactorsShock, CardiogenicTime FactorsTreatment OutcomeUnited StatesConceptsST-segment elevation myocardial infarctionPercutaneous coronary interventionRisk-standardized mortality ratesElevation myocardial infarctionPatient mortality ratesMyocardial infarctionMortality rateCardiogenic shockCoronary interventionDerivation cohortHospital risk-standardized mortality ratesCause mortality ratesAdministrative claims dataQuality of careHierarchical logistic regression modelsNational Quality ForumLogistic regression modelsObserved mortality rateCathPCI RegistryNational HospitalClaims dataInfarctionPatientsQuality ForumFinal modelHospital strategies for reducing risk-standardized mortality rates in acute myocardial infarction.
Bradley EH, Curry LA, Spatz ES, Herrin J, Cherlin EJ, Curtis JP, Thompson JW, Ting HH, Wang Y, Krumholz HM. Hospital strategies for reducing risk-standardized mortality rates in acute myocardial infarction. Annals Of Internal Medicine 2012, 156: 618-26. PMID: 22547471, PMCID: PMC3386642, DOI: 10.7326/0003-4819-156-9-201205010-00003.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesAcute myocardial infarctionLower risk-standardized mortality ratesMyocardial infarctionNurse championsMortality rateHospital strategiesHospital risk-standardized mortality ratesHospital-level factorsIntensive care unitAcute care hospitalsCardiac catheterization laboratoryCross-sectional surveyUnited Health FoundationCare hospitalCare unitCross-sectional designAMI casesAMI volumeCatheterization laboratoryHospital cliniciansHospitalMultivariate analysisPatientsHealth FoundationComparison of hospital risk-standardized mortality rates calculated by using in-hospital and 30-day models: an observational study with implications for hospital profiling.
Drye EE, Normand SL, Wang Y, Ross JS, Schreiner GC, Han L, Rapp M, Krumholz HM. Comparison of hospital risk-standardized mortality rates calculated by using in-hospital and 30-day models: an observational study with implications for hospital profiling. Annals Of Internal Medicine 2012, 156: 19-26. PMID: 22213491, PMCID: PMC3319769, DOI: 10.7326/0003-4819-156-1-201201030-00004.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesAcute myocardial infarctionHospital risk-standardized mortality ratesHospital mortality measuresHeart failureMortality rateObservational studyNonfederal acute care hospitalsMortality measuresAcute care hospitalsMean LOSPrimary outcomeStandardized followCare hospitalBlood InstituteService patientsMyocardial infarctionNational HeartPatient LOSMedicare feePneumoniaHospitalAdmissionHospital qualityHospital profiling