Featured Publications
Association 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 ActRelationship 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
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
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
Persistence on Novel Cardioprotective Antihyperglycemic Therapies in the United States
Nargesi A, Clark C, Aminorroaya A, Chen L, Liu M, Reddy A, Amodeo S, Oikonomou E, Suchard M, McGuire D, Lin Z, Inzucchi S, Khera R. Persistence on Novel Cardioprotective Antihyperglycemic Therapies in the United States. The American Journal Of Cardiology 2023, 196: 89-98. PMID: 37012183, PMCID: PMC11007258, DOI: 10.1016/j.amjcard.2023.03.002.Peer-Reviewed Original ResearchConceptsSGLT-2iGLP-1RAsGlucagon-like peptide-1 receptor agonistsUnited States administrative claims databasesSodium-glucose cotransporter 2 inhibitorsCommercial insurancePeptide-1 receptor agonistsType 2 diabetes mellitusSodium-glucose cotransporter-2 inhibitorsConsistent medication useHealth outcome benefitsCotransporter 2 inhibitorsElevated cardiovascular riskInitiation of therapyAdministrative claims databaseProportion of daysCotransporter-2 inhibitorsRate of prescriptionAntihyperglycemic therapyCardiovascular riskDiabetes mellitusMedication useCardioprotective effectsPrescription practicesClaims databaseAdjustment for Social Risk Factors in a Measure of Clinician Quality Assessing Acute Admissions for Patients With Multiple Chronic Conditions
Lipska K, Altaf F, Barthel A, Spatz E, Lin Z, Herrin J, Bernheim S, Drye E. Adjustment for Social Risk Factors in a Measure of Clinician Quality Assessing Acute Admissions for Patients With Multiple Chronic Conditions. JAMA Health Forum 2023, 4: e230081. PMID: 36897581, DOI: 10.1001/jamahealthforum.2023.0081.Peer-Reviewed Original ResearchConceptsMultiple chronic conditionsSocial risk factorsMedicare-Medicaid dual eligibilityRisk factorsChronic conditionsSocioeconomic status indexMeasure scoresAcute admissionsCohort studyDual eligibilityHealthcare ResearchDual-eligible patientsRetrospective cohort studyUnplanned hospital admissionsRisk of hospitalizationArea Health Resource FileService beneficiaries 65 yearsBeneficiaries 65 yearsRisk factor adjustmentStatus indexMedicare administrative claimsHospital admissionOutcome measuresAdministrative claimsMAIN OUTCOME
2020
Post-discharge acute care and outcomes following readmission reduction initiatives: national retrospective cohort study of Medicare beneficiaries in the United States
Khera R, Wang Y, Bernheim SM, Lin Z, Krumholz HM. Post-discharge acute care and outcomes following readmission reduction initiatives: national retrospective cohort study of Medicare beneficiaries in the United States. The BMJ 2020, 368: l6831. PMID: 31941686, PMCID: PMC7190056, DOI: 10.1136/bmj.l6831.Peer-Reviewed Original ResearchConceptsAcute care utilizationAcute myocardial infarctionRetrospective cohort studyHeart failureCare utilizationPost-discharge periodEmergency departmentMyocardial infarctionDay mortalityCohort studyHospital admissionObservation unitAcute careNational retrospective cohort studyPost-acute care utilizationHospital Readmissions Reduction ProgramObservation unit carePost-discharge mortalityDay readmission rateRisk of deathReadmissions Reduction ProgramReadmission reduction initiativesReadmission ratesUnit careInpatient unit
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
Defining 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
2017
Identification of Emergency Department Visits in Medicare Administrative Claims: Approaches and Implications
Venkatesh AK, Mei H, Kocher KE, Granovsky M, Obermeyer Z, Spatz E, Rothenberg C, Krumholz H, Lin Z. Identification of Emergency Department Visits in Medicare Administrative Claims: Approaches and Implications. Academic Emergency Medicine 2017, 24: 422-431. PMID: 27864915, PMCID: PMC5905698, DOI: 10.1111/acem.13140.Peer-Reviewed Original ResearchConceptsED visitsEmergency department visitsClaims-based definitionED visitationAdministrative claimsDepartment visitsClaims dataAdministrative claims data setsHealthcare resource utilizationMore ED visitsAcute care practiceAdministrative claims dataQuality improvement interventionsEmergency care researchMedicare administrative claimsClaims data setsED useCritical careED servicesMedicare feeMedicare dataCare practicesService beneficiariesImprovement interventionsProvider definitions
2014
Variation in Hospital-Level Risk-Standardized Complication Rates Following Elective Primary Total Hip and Knee Arthroplasty
Bozic KJ, Grosso LM, Lin Z, Parzynski CS, Suter LG, Krumholz HM, Lieberman JR, Berry DJ, Bucholz R, Han L, Rapp MT, Bernheim S, Drye EE. Variation in Hospital-Level Risk-Standardized Complication Rates Following Elective Primary Total Hip and Knee Arthroplasty. Journal Of Bone And Joint Surgery 2014, 96: 640-647. PMID: 24740660, DOI: 10.2106/jbjs.l.01639.Peer-Reviewed Original ResearchConceptsElective total hip arthroplastyTotal hip arthroplastyComplication rateBlack patientsStudy cohortTKA proceduresMedicaid patientsU.S. hospitalsMedicare feeElective primary total hip arthroplastyPrimary total hip arthroplastyElective primary total hipTotal knee arthroplasty proceduresPrimary total hipPeriprosthetic joint infectionKnee arthroplasty proceduresNational Medicare feeHigher proportionHospital-level riskNational Quality ForumCross-sectional analysisHierarchical logistic regressionTKA patientsCommon complicationPatient comorbidities
2012
Skilled 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
An 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 States