2024
Incorporating Medicare Advantage Admissions Into the CMS Hospital-Wide Readmission Measure
Kyanko K, Sahay K, Wang Y, Li S, Schreiber M, Hager M, Myers R, Johnson W, Zhang J, Krumholz H, Suter L, Triche E. Incorporating Medicare Advantage Admissions Into the CMS Hospital-Wide Readmission Measure. JAMA Network Open 2024, 7: e2414431. PMID: 38829614, PMCID: PMC11148674, DOI: 10.1001/jamanetworkopen.2024.14431.Peer-Reviewed Original ResearchConceptsCenters for Medicare & Medicaid ServicesSpecialty subgroupsPerformance quintileMedicare AdvantageReadmission ratesRisk-standardized readmission ratesHospital-wide readmission measureHospital outcome measuresTest-retest reliabilityRisk-adjustment variablesMeasurement reliabilityAdministrative claims dataReadmission measuresImprove measurement reliabilityIntegrated data repositoryMA beneficiariesQuintile rankingsMedicare beneficiariesMedicaid ServicesAll-causePublic reportingStudy assessed differencesClaims dataOutcome measuresMA cohort
2022
Analysis of Hospital-Level Readmission Rates and Variation in Adverse Events Among Patients With Pneumonia in the United States
Wang Y, Eldridge N, Metersky ML, Rodrick D, Faniel C, Eckenrode S, Mathew J, Galusha DH, Tasimi A, Ho SY, Jaser L, Peterson A, Normand ST, Krumholz HM. Analysis of Hospital-Level Readmission Rates and Variation in Adverse Events Among Patients With Pneumonia in the United States. JAMA Network Open 2022, 5: e2214586. PMID: 35639379, PMCID: PMC9157270, DOI: 10.1001/jamanetworkopen.2022.14586.Peer-Reviewed Original ResearchConceptsRisk-standardized readmission ratesMedicare Patient Safety Monitoring SystemCause readmission rateAdverse eventsReadmission ratesHigh riskHospital-level readmission ratesHigher patient riskHospital adverse eventsAdverse event dataCross-sectional studyHospital performanceIndex hospitalizationMedian ageHospital characteristicsMedical recordsReadmission dataPatient riskHospital careMAIN OUTCOMEPneumoniaHospital levelPatientsReadmissionGreater risk
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
Accounting 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 proportionPercentAdjustmentProportionCommunity-Level Association Between Home Health and Nursing Home Performance on Quality and Hospital 30-Day Readmissions for Medicare Patients
Wang Y, Pandolfi MM, Fine J, Metersky ML, Wang C, Ho SY, Galusha D, Nuti SV, Murugiah K, Spenard A, Elwell T, Krumholz HM. Community-Level Association Between Home Health and Nursing Home Performance on Quality and Hospital 30-Day Readmissions for Medicare Patients. Home Health Care Management & Practice 2016, 28: 201-208. PMID: 27974869, PMCID: PMC5152769, DOI: 10.1177/1084822316639032.Peer-Reviewed Original ResearchRisk-standardized readmission ratesHome health agenciesReadmission ratesMedicare patientsHealth agenciesCommunity level hospitalCommunity-level associationsNursing home performanceHome healthNursing homesPatientsMedicaid ServicesHospitalMixed effects modelsHealth performanceEffects modelHome performanceFinal sampleReadmissionAssociation 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
Hospital Strategy Uptake and Reductions in Unplanned Readmission Rates for Patients with Heart Failure: A Prospective Study
Bradley EH, Sipsma H, Horwitz LI, Ndumele CD, Brewster AL, Curry LA, Krumholz HM. Hospital Strategy Uptake and Reductions in Unplanned Readmission Rates for Patients with Heart Failure: A Prospective Study. Journal Of General Internal Medicine 2014, 30: 605-611. PMID: 25523470, PMCID: PMC4395590, DOI: 10.1007/s11606-014-3105-5.Peer-Reviewed Original ResearchConceptsRisk-standardized readmission ratesUnplanned readmission rateUptake of strategiesReadmission ratesHeart failureProspective studyGreater reductionAvoidable Rehospitalizations (STAAR) initiativeSame time pointsFinal analytic sampleParticipantsThe studyMain MeasuresWeHospitalPatientsWeb-based surveyAnalytic sampleTime pointsBaselineHospital strategiesSignificant reductionOne-quarterMonthsMore strategiesNational sampleAssociationDevelopment 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
Correlations among risk‐standardized mortality rates and among risk‐standardized readmission rates within hospitals
Horwitz LI, Wang Y, Desai MM, Curry LA, Bradley EH, Drye EE, Krumholz HM. Correlations among risk‐standardized mortality rates and among risk‐standardized readmission rates within hospitals. Journal Of Hospital Medicine 2012, 7: 690-696. PMID: 22865546, PMCID: PMC3535010, DOI: 10.1002/jhm.1965.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesAcute myocardial infarctionRisk-standardized readmission ratesReadmission ratesRisk-standardized mortalityHeart failureMortality rateReadmission measuresUS hospitalsMortality measuresCross-sectional studyMortality cohortReadmission cohortHospital outcomesSame hospitalMyocardial infarctionMedicare patientsMedicare feeService beneficiariesTeaching hospital membersHospitalSame quartileHospital membersPneumoniaCohortRegional Associations Between Medicare Advantage Penetration and Administrative Claims-based Measures of Hospital Outcomes
Kulkarni VT, Shah SJ, Bernheim SM, Wang Y, Normand SL, Han LF, Rapp MT, Drye EE, Krumholz HM. Regional Associations Between Medicare Advantage Penetration and Administrative Claims-based Measures of Hospital Outcomes. Medical Care 2012, 50: 406-409. PMID: 22456113, PMCID: PMC5459365, DOI: 10.1097/mlr.0b013e318245a0f9.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesAcute myocardial infarctionRisk-standardized readmission ratesHospital outcomesReadmission ratesHeart failureMyocardial infarctionPopulation riskOutcome measuresMortality rateMedicare Advantage patientsHospital referral region levelHospital outcome measuresClaims-based measuresMedicaid Services measuresFFS patientsAdvantage patientsRetrospective studyService patientsMedicare feeMedicare Advantage penetrationPatientsMedicaid ServicesInfarctionPneumoniaSkilled 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
Quality of Care in the US Territories
Nunez-Smith M, Bradley EH, Herrin J, Santana C, Curry LA, Normand SL, Krumholz HM. Quality of Care in the US Territories. JAMA Internal Medicine 2011, 171: 1528-1540. PMID: 21709184, PMCID: PMC3251926, DOI: 10.1001/archinternmed.2011.284.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionRisk-standardized readmission ratesRisk-standardized mortality ratesHeart failureMortality rateReadmission ratesProcess measuresHospital characteristicsHighest risk-standardized mortality ratesPrincipal discharge diagnosisQuality of careHealth care qualityDischarge diagnosisService patientsMyocardial infarctionTerritorial HospitalNonfederal hospitalsUS territoriesMedicare feePneumoniaHospitalCare qualityPatientsPerformance of hospitalsUS statesAn 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 StatesConceptsAcute myocardial infarctionRisk-standardized readmission ratesCause readmission rateReadmission ratesMyocardial infarctionAdjusted readmission ratesAdministrative Claims MeasureUnadjusted readmission rates
2010
The performance of US hospitals as reflected in risk‐standardized 30‐day mortality and readmission rates for medicare beneficiaries with pneumonia
Lindenauer PK, Bernheim SM, Grady JN, Lin Z, Wang Y, Wang Y, Merrill AR, Han LF, Rapp MT, Drye EE, Normand S, Krumholz HM. The performance of US hospitals as reflected in risk‐standardized 30‐day mortality and readmission rates for medicare beneficiaries with pneumonia. Journal Of Hospital Medicine 2010, 5: e12-e18. PMID: 20665626, DOI: 10.1002/jhm.822.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesReadmission ratesHospital referral regionsReferral regionsMedicare beneficiariesMortality rateRisk-standardized readmission ratesNonfederal acute care hospitalsNational quality improvement effortsPattern of hospitalAcute care hospitalsCross-sectional studyService Medicare beneficiariesQuality improvement effortsMedian hospitalHospital dischargeElderly patientsHospital admissionCare hospitalReadmission analysisOutpatient MedicareLeading causePrincipal diagnosisPneumoniaPatientsIs Same-Hospital Readmission Rate a Good Surrogate for All-Hospital Readmission Rate?
Nasir K, Lin Z, Bueno H, Normand SL, Drye EE, Keenan PS, Krumholz HM. Is Same-Hospital Readmission Rate a Good Surrogate for All-Hospital Readmission Rate? Medical Care 2010, 48: 477-481. PMID: 20393366, DOI: 10.1097/mlr.0b013e3181d5fb24.Peer-Reviewed Original ResearchConceptsRisk-standardized readmission ratesHospital readmission ratesSame-hospital readmissionsSame-hospital readmission ratesDays of dischargeReadmission ratesHeart failureUS acute care hospitalsThirty-day readmissionStandard Analytic FilesAcute care hospitalsHierarchical logistic regression modelsLogistic regression modelsCause readmissionHF readmissionIndex hospitalizationCare hospitalHospital readmissionAnalytic FilesMedicare inpatientReadmissionStudy populationHospital measuresReadmission measuresHospitalization