Featured Publications
Disparities in Excess Mortality Associated with COVID-19 — United States, 2020
Rossen LM, Ahmad FB, Anderson RN, Branum AM, Du C, Krumholz HM, Li SX, Lin Z, Marshall A, Sutton PD, Faust JS. Disparities in Excess Mortality Associated with COVID-19 — United States, 2020. MMWR Morbidity And Mortality Weekly Report 2021, 70: 1114-1119. PMID: 34411075, PMCID: PMC8375709, DOI: 10.15585/mmwr.mm7033a2.Peer-Reviewed Original ResearchConceptsMortality incidence ratesIncidence rateExcess mortalityAge groupsHighest excess mortality ratesExcess Mortality AssociatedGreater excess mortalityExcess mortality ratesAI/AN populationsNon-Hispanic American IndianNon-Hispanic blacksNational Vital Statistics SystemCOVID-19 pandemicPublic health messagingNon-Hispanic white populationRace/ethnicityVital Statistics SystemMortality AssociatedLack of adjustmentMortality rateExcess deathsAN populationsEthnic groupsHealth messagingHispanic personsAll-Cause Excess Mortality and COVID-19–Related Mortality Among US Adults Aged 25-44 Years, March-July 2020
Faust JS, Krumholz HM, Du C, Mayes KD, Lin Z, Gilman C, Walensky RP. All-Cause Excess Mortality and COVID-19–Related Mortality Among US Adults Aged 25-44 Years, March-July 2020. JAMA 2021, 325: 785-787. PMID: 33325994, PMCID: PMC7745134, DOI: 10.1001/jama.2020.24243.Peer-Reviewed Original ResearchHospital-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 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
Inclusion of Veterans Health Administration hospitals in Centers for Medicare & Medicaid Services Overall Hospital Quality Star Ratings
Bagshaw K, Gettel C, Qin L, Lin Z, Suter L, Rothenberg E, Omotosho P, Duseja R, Krabacher J, Schreiber M, Nakashima T, Myers R, Venkatesh A. Inclusion of Veterans Health Administration hospitals in Centers for Medicare & Medicaid Services Overall Hospital Quality Star Ratings. Journal Of Hospital Medicine 2024 PMID: 39434547, DOI: 10.1002/jhm.13523.Peer-Reviewed Original ResearchVeterans Health Administration hospitalsNon-VHA hospitalsVeterans Health AdministrationCenters for Medicare & Medicaid ServicesQuality star ratingsStar ratingsQuality measure scoresAcute care hospitalsInformed healthcare decisionsOverall star ratingVHA hospitalsHealthcare decisionsRate hospitalsHealth AdministrationMedicaid ServicesMeasure scoresCare hospitalFive-star ratingAdministration HospitalMatching analysisQuality ratingsHospitalVeteransOverall analysisHigher ratesAutomated Identification of Heart Failure With Reduced Ejection Fraction Using Deep Learning-Based Natural Language Processing
Nargesi A, Adejumo P, Dhingra L, Rosand B, Hengartner A, Coppi A, Benigeri S, Sen S, Ahmad T, Nadkarni G, Lin Z, Ahmad F, Krumholz H, Khera R. Automated Identification of Heart Failure With Reduced Ejection Fraction Using Deep Learning-Based Natural Language Processing. JACC Heart Failure 2024 PMID: 39453355, DOI: 10.1016/j.jchf.2024.08.012.Peer-Reviewed Original ResearchReduced ejection fractionEjection fractionHeart failureLeft ventricular ejection fractionVentricular ejection fractionYale-New Haven HospitalIdentification of patientsCommunity hospitalIdentification of heart failureLanguage modelNorthwestern MedicineMeasure care qualityQuality of careNew Haven HospitalDeep learning-based natural language processingHFrEFGuideline-directed careDeep learning language modelsMIMIC-IIIDetect HFrEFNatural language processingReclassification improvementHospital dischargePatientsCare qualityRacial and Ethnic Disparities in Age-Specific All-Cause Mortality During the COVID-19 Pandemic
Faust J, Renton B, Bongiovanni T, Chen A, Sheares K, Du C, Essien U, Fuentes-Afflick E, Haywood T, Khera R, King T, Li S, Lin Z, Lu Y, Marshall A, Ndumele C, Opara I, Loarte-Rodriguez T, Sawano M, Taparra K, Taylor H, Watson K, Yancy C, Krumholz H. Racial and Ethnic Disparities in Age-Specific All-Cause Mortality During the COVID-19 Pandemic. JAMA Network Open 2024, 7: e2438918. PMID: 39392630, PMCID: PMC11581672, DOI: 10.1001/jamanetworkopen.2024.38918.Peer-Reviewed Original ResearchConceptsCOVID-19 public health emergencyNon-HispanicPublic health emergencyOther Pacific IslanderExcess mortalityAlaska NativesUS populationExcess deathsRates of excess mortalityCross-sectional study analyzed dataYears of potential lifeMortality relative riskNon-Hispanic whitesCross-sectional studyPacific IslandersStudy analyzed dataAll-cause mortalityEthnic groupsMortality disparitiesMortality ratioTotal populationDeath certificatesEthnic disparitiesMain OutcomesDecedent ageProcedural Volume and Outcomes with Atrial Fibrillation Ablation: A Report from the NCDR AFib Ablation Registry
Kattel S, Tan Z, Lin Z, Mszar R, Sanders P, Zeitler E, Zei P, Bunch T, Mansour M, Akar J, Curtis J, Friedman D, Freeman J. Procedural Volume and Outcomes with Atrial Fibrillation Ablation: A Report from the NCDR AFib Ablation Registry. Heart Rhythm 2024 PMID: 38960302, DOI: 10.1016/j.hrthm.2024.06.056.Peer-Reviewed Original ResearchProcedure volumeProcedural successVolume outcome relationshipAblation RegistryPhysician procedure volumeAtrial fibrillationPhysician volumeFirst-time AF ablationU.S. hospitalsNational cohortLikelihood of procedural successHospital volumeAcute procedural successAtrial fibrillation ablationPhysiciansHospitalAF ablationCompare outcomesNCDRRegistryAdverse eventsOutcome relationshipAnnual volumeMAE rateOutcomesProcedure Volume and Outcomes With WATCHMAN Left Atrial Appendage Occlusion
Friedman D, Du C, Zimmerman S, Tan Z, Lin Z, Vemulapalli S, Kosinski A, Piccini J, Pereira L, Minges K, Faridi K, Masoudi F, Curtis J, Freeman J. Procedure Volume and Outcomes With WATCHMAN Left Atrial Appendage Occlusion. Circulation Cardiovascular Interventions 2024, 17: e013466. PMID: 38889251, PMCID: PMC11189610, DOI: 10.1161/circinterventions.123.013466.Peer-Reviewed Original ResearchConceptsVolume-outcome relationshipLikelihood of procedural successLeft atrial appendage occlusionProcedural successProcedure volumeAppendage occlusionNational Cardiovascular Data Registry LAAO RegistryVolume quartilesLeft atrial appendage occlusion devicesThree-level hierarchical generalized linear modelsMinimum volume thresholdsWatchman FLX deviceProcedural success rateHierarchical generalized linear modelsAssociated with outcomePhysician volumeWATCHMAN procedureFLX deviceOcclusion deviceVolume thresholdCardiovascular proceduresPhysiciansHospitalNational analysisSuccess rateCalculation of Overall Hospital Quality Star Ratings With and Without Inclusion of the Peer Grouping Step
Gettel C, Bagshaw K, Qin L, Lin Z, Rothenberg E, Omotosho P, Goutos D, Herrin J, Suter L, Schreiber M, Fleisher L, Myers R, Spivack S, Venkatesh A. Calculation of Overall Hospital Quality Star Ratings With and Without Inclusion of the Peer Grouping Step. JAMA Network Open 2024, 7: e2411933. PMID: 38753326, PMCID: PMC11099678, DOI: 10.1001/jamanetworkopen.2024.11933.Peer-Reviewed Original ResearchConceptsCenters for Medicare & Medicaid ServicesCross-sectional studyHospital characteristicsHigher star ratingsStar ratingsOverall hospital qualityLowest-performing hospitalsOverall star ratingQuality star ratingsHospital star ratingsStar Ratings scoresHospital qualityHospital performanceStratified hospitalsMedicaid ServicesMain OutcomesFace validityPeer groupPeer group approachPrimary outcomePeer comparisonHospitalRating scoresPeerMeasurement groupHospital Variation in Delivery of Skilled Rehabilitation to Mechanically Ventilated Older Adults With Acute Respiratory Failure
Jimenez Ceja J, Zhang L, Lin Z, Walkey A, Krumholz H, Jain S. Hospital Variation in Delivery of Skilled Rehabilitation to Mechanically Ventilated Older Adults With Acute Respiratory Failure. 2024, a1096-a1096. DOI: 10.1164/ajrccm-conference.2024.209.1_meetingabstracts.a1096.Peer-Reviewed Original ResearchOPTIMIZING PHENOTYPING ALGORITHMS FOR IDENTIFYING PULMONARY EMBOLISM IN ELECTRONIC DATABASES: THE MULTICENTER PE-EHR+ STUDY
Bikdeli B, Bejjani A, Lo Y, Khairani C, Mahajan S, Secemsky E, Jimenez J, Aghayev A, Hunsaker A, Wang L, Hussain M, Appah-Sampong A, Mojibian H, Lin Z, Aneja S, Barco S, Klok F, Konstantinides S, Zhou L, Monreal M, Jimenez D, Piazza G, Krumholz H. OPTIMIZING PHENOTYPING ALGORITHMS FOR IDENTIFYING PULMONARY EMBOLISM IN ELECTRONIC DATABASES: THE MULTICENTER PE-EHR+ STUDY. Journal Of The American College Of Cardiology 2024, 83: 2108. DOI: 10.1016/s0735-1097(24)04098-1.Peer-Reviewed Original ResearchSEX DIFFERENCES IN TREATMENT STRATEGIES FOR PULMONARY EMBOLISM IN OLDER ADULTS: THE SERIOUS-PE STUDY
Bikdeli B, Jimenez D, Garcia A, Lin Z, Piazza G, Leyva H, Khairani C, Rosovsky R, Mehdipoor G, O'Donoghue M, LOPEZ-SAEZ J, Madridano O, Grandone E, Lu Y, López-Jiménez L, Gerhard-Herman M, Molina Á, Bertoletti L, Goldhaber S, Bates S, Krumholz H, Monreal M. SEX DIFFERENCES IN TREATMENT STRATEGIES FOR PULMONARY EMBOLISM IN OLDER ADULTS: THE SERIOUS-PE STUDY. Journal Of The American College Of Cardiology 2024, 83: 2262. DOI: 10.1016/s0735-1097(24)04252-9.Peer-Reviewed Original ResearchPre-COVID-19 hospital quality and hospital response to COVID-19: examining associations between risk-adjusted mortality for patients hospitalised with COVID-19 and pre-COVID-19 hospital quality
Peter D, Li S, Wang Y, Zhang J, Grady J, McDowell K, Norton E, Lin Z, Bernheim S, Venkatesh A, Fleisher L, Schreiber M, Suter L, Triche E. Pre-COVID-19 hospital quality and hospital response to COVID-19: examining associations between risk-adjusted mortality for patients hospitalised with COVID-19 and pre-COVID-19 hospital quality. BMJ Open 2024, 14: e077394. PMID: 38553067, PMCID: PMC10982775, DOI: 10.1136/bmjopen-2023-077394.Peer-Reviewed Original ResearchConceptsHospital qualityPatient experiencePre-COVID-19Medicare patientsShort-term acute care hospitalsCritical access hospitalsAcute care hospitalsFuture public health emergenciesHigher odds of mortalityIn-hospitalRisk-adjusted mortalityOdds of mortalityCare deliveryAccess hospitalsEffective careCOVID-19-related deathsAssociated with mortalityCare structuresHospital characteristicsPublic health emergencySummary scoreMedicare beneficiariesHigher oddsHospital responseRSMRsMeasuring 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
2023
Patient-Reported Outcome-Based Performance Measures in Alternative Payment Models: Current Use, Implementation Barriers, and Principles to Succeed
Gettel C, Suter L, Bagshaw K, Sheares K, Balestracci K, Lin Z, Venkatesh A. Patient-Reported Outcome-Based Performance Measures in Alternative Payment Models: Current Use, Implementation Barriers, and Principles to Succeed. Value In Health 2023, 27: 199-205. PMID: 38042334, PMCID: PMC10872237, DOI: 10.1016/j.jval.2023.10.017.Peer-Reviewed Original ResearchState-Level Excess Mortality and Potential Deaths Averted in US Adults During the Delta and Omicron Waves of COVID-19
Renton B, Du C, Chen A, Li S, Lin Z, Krumholz H, Faust J. State-Level Excess Mortality and Potential Deaths Averted in US Adults During the Delta and Omicron Waves of COVID-19. Journal Of General Internal Medicine 2023, 39: 142-146. PMID: 37620716, PMCID: PMC10817860, DOI: 10.1007/s11606-023-08374-2.Peer-Reviewed Original Research