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 infarction
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 ratesSeasonal Variation in Readmission Risk for Patients Hospitalized with Cardiopulmonary Conditions
Blecker S, Kwon JY, Herrin J, Grady JN, Horwitz LI. Seasonal Variation in Readmission Risk for Patients Hospitalized with Cardiopulmonary Conditions. Journal Of General Internal Medicine 2018, 33: 599-601. PMID: 29464475, PMCID: PMC5910346, DOI: 10.1007/s11606-017-4299-0.Peer-Reviewed Original Research
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
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 diagnosisPneumoniaPatients
2003
Burden of Illness Score for Elderly Persons
Inouye SK, Bogardus ST, Vitagliano G, Desai MM, Williams CS, Grady JN, Scinto JD. Burden of Illness Score for Elderly Persons. Medical Care 2003, 41: 70-83. PMID: 12544545, DOI: 10.1097/00005650-200301000-00010.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overCohort StudiesComorbidityCost of IllnessFemaleFollow-Up StudiesForecastingGeriatric AssessmentHealth StatusHospitalizationHospitals, TeachingHumansMaleMortalityPneumoniaProbabilityProportional Hazards ModelsRisk AdjustmentRisk FactorsSeverity of Illness IndexSex FactorsSurvival AnalysisTime FactorsConceptsGroup IHazard ratioIllness scoresOverall mortalityC-statisticElderly personsHospitalized older personsHigh-risk diagnosesRisk adjustment indexProspective cohortValidation cohortDevelopment cohortUniversity HospitalPhysiologic abnormalitiesRisk factorsFunctional impairmentRisk groupsMedicine serviceMortality predictionMortality rateGroup IICohortOlder personsFinal modelGroup III