2020
Association Between Medicare Expenditures and Adverse Events for Patients With Acute Myocardial Infarction, Heart Failure, or Pneumonia in the United States
Wang Y, Eldridge N, Metersky ML, Sonnenfeld N, Rodrick D, Fine JM, Eckenrode S, Galusha DH, Tasimi A, Hunt DR, Bernheim SM, Normand ST, Krumholz HM. Association Between Medicare Expenditures and Adverse Events for Patients With Acute Myocardial Infarction, Heart Failure, or Pneumonia in the United States. JAMA Network Open 2020, 3: e202142. PMID: 32259263, PMCID: PMC7139276, DOI: 10.1001/jamanetworkopen.2020.2142.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMedicare Patient Safety Monitoring SystemAdverse event ratesAdverse eventsHeart failureMedicare expendituresService patientsMyocardial infarctionMedicare feeEvent ratesHigher adverse event ratesCare expendituresRisk-standardized ratesPatients 65 yearsAdverse event dataAcute care hospitalsCross-sectional studyFinal study sampleInpatient care expendituresRate of occurrenceDates of analysisPatient characteristicsCare hospitalMean ageInpatient care
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 OUTCOMEDefining 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
2015
Differences in Colonoscopy Quality Among Facilities: Development of a Post-Colonoscopy Risk-Standardized Rate of Unplanned Hospital Visits
Ranasinghe I, Parzynski CS, Searfoss R, Montague J, Lin Z, Allen J, Vender R, Bhat K, Ross JS, Bernheim S, Krumholz HM, Drye EE. Differences in Colonoscopy Quality Among Facilities: Development of a Post-Colonoscopy Risk-Standardized Rate of Unplanned Hospital Visits. Gastroenterology 2015, 150: 103-113. PMID: 26404952, DOI: 10.1053/j.gastro.2015.09.009.Peer-Reviewed Original ResearchConceptsUnplanned hospital visitsDay of colonoscopyHospital visitsOutpatient facilitiesColonoscopy qualityHealthcare costsRisk-standardized ratesHospital outpatient departmentsUtilization Project dataAmbulatory surgery centersLogistic regression modelsHierarchical logistic regressionQuality improvement effortsPrior arrhythmiaAbdominal painElectrolyte imbalanceOutpatient departmentSurgery centersCommon causeHospital careOutcome measuresPsychiatric disordersColonoscopyUtilization ProjectPatient choice
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 adjustmentHospitalHospital Variation in Intravenous Inotrope Use for Patients Hospitalized With Heart Failure
Allen LA, Fonarow GC, Grau-Sepulveda MV, Hernandez AF, Peterson PN, Partovian C, Li SX, Heidenreich PA, Bhatt DL, Peterson ED, Krumholz HM. Hospital Variation in Intravenous Inotrope Use for Patients Hospitalized With Heart Failure. Circulation Heart Failure 2014, 7: 251-260. PMID: 24488983, PMCID: PMC5459367, DOI: 10.1161/circheartfailure.113.000761.Peer-Reviewed Original ResearchMeSH KeywordsAgedCardiotonic AgentsCross-Sectional StudiesDose-Response Relationship, DrugFemaleFollow-Up StudiesGuideline AdherenceHeart FailureHospital MortalityHospitalsHumansInfusions, IntravenousInpatientsLength of StayMaleOutcome Assessment, Health CarePractice Patterns, Physicians'RegistriesRetrospective StudiesSurvival RateUnited StatesConceptsInotrope useHeart failureInotropic therapyInotropic agentsGuidelines-Heart Failure registryIntravenous inotropic agentsIntravenous inotropic therapyRisk-standardized ratesUse of inotropesHeart failure hospitalizationHospital-level ratesRandom hospital effectsFailure hospitalizationClinical characteristicsHospital factorsInpatient mortalityClinical factorsClinical outcomesHospital variationHospital characteristicsHospital effectsPatientsUS hospitalsHospitalStudy period
2012
Hospital Patterns of Use of Positive Inotropic Agents in Patients With Heart Failure
Partovian C, Gleim SR, Mody PS, Li SX, Wang H, Strait KM, Allen LA, Lagu T, Normand SL, Krumholz HM. Hospital Patterns of Use of Positive Inotropic Agents in Patients With Heart Failure. Journal Of The American College Of Cardiology 2012, 60: 1402-1409. PMID: 22981548, PMCID: PMC3636773, DOI: 10.1016/j.jacc.2012.07.011.Peer-Reviewed Original ResearchConceptsPositive inotropic agentsRisk-standardized ratesInotropic agentsHeart failureInotrope useHospital patternsMortality rateRisk-standardized mortality ratesHospital mortality rateHeart failure patientsLittle clinical evidenceLength of stayPatient case mixHierarchical logistic regression modelsLogistic regression modelsIntraclass correlation coefficientFailure patientsHospital variationClinical evidenceInterhospital variationClinical guidelinesIndividual hospital effectsHospital ratesHospital effectsPatterns of useBased On Key Measures, Care Quality For Medicare Enrollees At Safety-Net And Non-Safety-Net Hospitals Was Almost Equal
Ross JS, Bernheim SM, Lin Z, Drye EE, Chen J, Normand SL, Krumholz HM. Based On Key Measures, Care Quality For Medicare Enrollees At Safety-Net And Non-Safety-Net Hospitals Was Almost Equal. Health Affairs 2012, 31: 1739-1748. PMID: 22869652, PMCID: PMC3527010, DOI: 10.1377/hlthaff.2011.1028.Peer-Reviewed Original ResearchConceptsSafety-net hospitalNet hospitalReadmission ratesUrban hospitalHeart failure mortalityRisk-standardized ratesAcute myocardial infarctionIndicators of careService Medicare beneficiariesHeart failureClinical outcomesMyocardial infarctionWorse outcomesMedicare beneficiariesHospitalMedicare enrolleesHospital qualityCare qualityVulnerable populationsGreater financial strainOutcomesMortalityFinancial strainCareMore affluent populationsOutcomes for Mitral Valve Surgery Among Medicare Fee-for-Service Beneficiaries, 1999 to 2008
Dodson JA, Wang Y, Desai MM, Barreto-Filho JA, Sugeng L, Hashim SW, Krumholz HM. Outcomes for Mitral Valve Surgery Among Medicare Fee-for-Service Beneficiaries, 1999 to 2008. Circulation Cardiovascular Quality And Outcomes 2012, 5: 298-307. PMID: 22576847, PMCID: PMC3400109, DOI: 10.1161/circoutcomes.112.966077.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overChi-Square DistributionFee-for-Service PlansFemaleHealthcare DisparitiesHeart Valve DiseasesHeart Valve Prosthesis ImplantationHospital MortalityHospitalizationHumansLinear ModelsMaleMedicareMitral ValveOdds RatioPatient ReadmissionQuality ImprovementRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeUnited StatesConceptsMitral valve surgeryValve surgeryMitral valve repairFFS patientsHospitalization ratesValve repairMedicare feeMedicare Standard Analytic FilesMedicare FFS patientsRisk-standardized ratesProportion of patientsStandard Analytic FilesVital Status filesNational surveillance dataMedicare administrative dataSubstantial morbidityMortality outcomesService patientsAnalytic FilesMortality riskMortality rateSurgeryPatientsDenominator fileReadmission
2003
Sex Differences in Use of Coronary Revascularization in Elderly Patients After Acute Myocardial Infarction A Tale of Two Therapies
Rathore SS, Foody JM, Radford MJ, Krumholz HM. Sex Differences in Use of Coronary Revascularization in Elderly Patients After Acute Myocardial Infarction A Tale of Two Therapies. CHEST Journal 2003, 124: 2079-2086. PMID: 14665483, DOI: 10.1378/chest.124.6.2079.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionRisk-standardized ratesPercutaneous coronary interventionCoronary revascularizationElderly patientsCardiac catheterizationRevascularization therapyMedicare patientsCoronary artery bypass graft surgeryArtery bypass graft surgerySex differencesMultivariable logistic regression modelCrude overall ratesBypass graft surgeryCoronary revascularization ratesType of therapyMedical record dataLogistic regression modelsRevascularization useCABG surgeryGraft surgeryMultivariable adjustmentRevascularization ratesCoronary interventionHospital admission
2002
Race and sex differences in the refusal of cardiac catheterization among elderly patients hospitalized with acute myocardial infarction
Rathore SS, Ordin DL, Krumholz HM. Race and sex differences in the refusal of cardiac catheterization among elderly patients hospitalized with acute myocardial infarction. American Heart Journal 2002, 144: 1052-1056. PMID: 12486430, DOI: 10.1067/mhj.2002.126122.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionCardiac catheterizationPatient raceElderly patientsMyocardial infarctionSex differencesRefusal rateWhite womenCardiac catheterization useCardiac procedure useRisk-standardized ratesWhite menBlack womenBlack menMultivariate adjustmentOverall cohortHospital characteristicsMedical recordsMedicare beneficiariesCatheterizationPatientsProcedure useSex differences in cardiac catheterization after acute myocardial infarction: the role of procedure appropriateness.
Rathore SS, Wang Y, Radford MJ, Ordin DL, Krumholz HM. Sex differences in cardiac catheterization after acute myocardial infarction: the role of procedure appropriateness. Annals Of Internal Medicine 2002, 137: 487-93. PMID: 12230349, DOI: 10.7326/0003-4819-137-6-200209170-00008.Peer-Reviewed Original ResearchConceptsCardiac catheterization useAcute myocardial infarctionCardiac catheterizationMyocardial infarctionMultivariable adjustmentEquivocal indicationsSex differencesProcedure useChart-abstracted dataLower crude ratesRisk-standardized ratesU.S. acute care hospitalsDays of hospitalizationAcute care hospitalsClinical guidelinesHospital characteristicsMedicare patientsCrude rateInappropriate treatmentRetrospective analysisCatheterizationInfarctionPatientsElderly personsWomen