2020
Disability and Recovery After Hospitalization for Medical Illness Among Community‐Living Older Persons: A Prospective Cohort Study
Dharmarajan K, Han L, Gahbauer EA, Leo‐Summers L, Gill TM. Disability and Recovery After Hospitalization for Medical Illness Among Community‐Living Older Persons: A Prospective Cohort Study. Journal Of The American Geriatrics Society 2020, 68: 486-495. PMID: 32083319, PMCID: PMC7735402, DOI: 10.1111/jgs.16350.Peer-Reviewed Original ResearchConceptsAcute medical illnessProspective cohort studyMedical illnessNew disabilityCohort studySelf-managing health conditionsCommunity-living older personsHealth conditionsImmediate transitional periodCommunity-living personsPost-discharge careChronic health conditionsMean recovery timeSubgroup of personsMobility activitiesIncident disabilityHospital dischargePeriod of vulnerabilityMonth 2Follow-up interviewHospitalizationDisability prevalenceOlder personsPrior monthIllness
2019
Home Health Care After Skilled Nursing Facility Discharge Following Heart Failure Hospitalization
Weerahandi H, Bao H, Herrin J, Dharmarajan K, Ross JS, Jones S, Horwitz LI. Home Health Care After Skilled Nursing Facility Discharge Following Heart Failure Hospitalization. Journal Of The American Geriatrics Society 2019, 68: 96-102. PMID: 31603248, PMCID: PMC6964248, DOI: 10.1111/jgs.16179.Peer-Reviewed Original ResearchConceptsSkilled nursing facilitiesHF hospitalizationReadmission ratesReadmission riskHeart failure readmission ratesDays of dischargeHeart failure hospitalizationRetrospective cohort studyHospital discharge practicesMore functional impairmentHome health careFailure hospitalizationHF patientsUnplanned readmissionCohort studyHospital dischargePrimary outcomeRestorative therapySNF stayFunctional impairmentHome healthcare servicesService Medicare dataAdjusted modelCox modelNursing facilitiesRisk of Readmission After Discharge From Skilled Nursing Facilities Following Heart Failure Hospitalization: A Retrospective Cohort Study
Weerahandi H, Li L, Bao H, Herrin J, Dharmarajan K, Ross JS, Kim KL, Jones S, Horwitz LI. Risk of Readmission After Discharge From Skilled Nursing Facilities Following Heart Failure Hospitalization: A Retrospective Cohort Study. Journal Of The American Medical Directors Association 2019, 20: 432-437. PMID: 30954133, PMCID: PMC6486375, DOI: 10.1016/j.jamda.2019.01.135.Peer-Reviewed Original ResearchConceptsSkilled nursing facilitiesSNF dischargeRetrospective cohort studySNF lengthHeart failureHF hospitalizationComposite outcomeCohort studyNursing facilitiesService beneficiaries 65Heart failure hospitalizationRisk of readmissionHazard rate ratiosFailure hospitalizationUnplanned readmissionHF diagnosisHospital dischargePostdischarge outcomesSNF stayMedicare patientsMedicare feeHome transitionPatientsReadmissionDay 3
2018
Association of the Hospital Readmissions Reduction Program With Mortality During and After Hospitalization for Acute Myocardial Infarction, Heart Failure, and Pneumonia
Khera R, Dharmarajan K, Wang Y, Lin Z, Bernheim SM, Wang Y, Normand ST, Krumholz HM. Association of the Hospital Readmissions Reduction Program With Mortality During and After Hospitalization for Acute Myocardial Infarction, Heart Failure, and Pneumonia. JAMA Network Open 2018, 1: e182777. PMID: 30646181, PMCID: PMC6324473, DOI: 10.1001/jamanetworkopen.2018.2777.Peer-Reviewed Original ResearchConceptsHospital Readmissions Reduction ProgramAcute myocardial infarctionPostdischarge mortalityHeart failureHRRP announcementReadmissions Reduction ProgramMedicare beneficiariesRisk-adjusted ratesMyocardial infarctionService Medicare beneficiariesReduction programsInterrupted time series frameworkHospital mortalityReduced readmissionsCohort studyPneumonia hospitalizationsReadmission ratesMAIN OUTCOMEPneumoniaMedicare dataHospitalizationHospitalMortalityReadmissionConcomitant harm
2017
Age Differences in Hospital Mortality for Acute Myocardial Infarction: Implications for Hospital Profiling.
Dharmarajan K, McNamara RL, Wang Y, Masoudi FA, Ross JS, Spatz EE, Desai NR, de Lemos JA, Fonarow GC, Heidenreich PA, Bhatt DL, Bernheim SM, Slattery LE, Khan YM, Curtis JP. Age Differences in Hospital Mortality for Acute Myocardial Infarction: Implications for Hospital Profiling. Annals Of Internal Medicine 2017, 167: 555-564. PMID: 28973634, PMCID: PMC9359429, DOI: 10.7326/m16-2871.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesAcute myocardial infarctionOlder patientsYounger patientsMyocardial infarctionAge groupsHospital risk-standardized mortality ratesRetrospective cohort studyHospital mortality rankingsNational Quality ForumHospital mortalityMedian hospitalHospital outcomesCohort studyACTION RegistryAMI mortalityAmerican CollegeMedicare beneficiariesAMI hospitalizationPatientsMortality rateHospitalQuality ForumHospital ValueHospital profiling
2016
Association Between Hospital Penalty Status Under the Hospital Readmission Reduction Program and Readmission Rates for Target and Nontarget Conditions
Desai NR, Ross JS, Kwon JY, Herrin J, Dharmarajan K, Bernheim SM, Krumholz HM, Horwitz LI. Association Between Hospital Penalty Status Under the Hospital Readmission Reduction Program and Readmission Rates for Target and Nontarget Conditions. JAMA 2016, 316: 2647-2656. PMID: 28027367, PMCID: PMC5599851, DOI: 10.1001/jama.2016.18533.Peer-Reviewed Original ResearchConceptsHospital Readmissions Reduction ProgramAcute myocardial infarctionReadmission ratesReadmissions Reduction ProgramHeart failurePenalty statusNontarget conditionsMedicare feeMean readmission rateThirty-day riskRetrospective cohort studyUnplanned readmission rateReduction programsHRRP announcementHRRP implementationPenalized hospitalsCohort studyService patientsMyocardial infarctionMAIN OUTCOMEExcess readmissionsMedicare beneficiariesService beneficiariesHospitalPatientsTreatment for Multiple Acute Cardiopulmonary Conditions in Older Adults Hospitalized with Pneumonia, Chronic Obstructive Pulmonary Disease, or Heart Failure
Dharmarajan K, Strait KM, Tinetti ME, Lagu T, Lindenauer PK, Lynn J, Krukas MR, Ernst FR, Li SX, Krumholz HM. Treatment for Multiple Acute Cardiopulmonary Conditions in Older Adults Hospitalized with Pneumonia, Chronic Obstructive Pulmonary Disease, or Heart Failure. Journal Of The American Geriatrics Society 2016, 64: 1574-1582. PMID: 27448329, PMCID: PMC4988873, DOI: 10.1111/jgs.14303.Peer-Reviewed Original ResearchMeSH KeywordsAdrenal Cortex HormonesAgedAged, 80 and overAnti-Bacterial AgentsCardiotonic AgentsCohort StudiesComorbidityCross-Sectional StudiesDiureticsDrug Therapy, CombinationFemaleHeart FailureHospitalizationHumansMalePneumoniaPulmonary Disease, Chronic ObstructiveRetrospective StudiesUnited StatesVasodilator AgentsConceptsChronic obstructive pulmonary diseaseAcute cardiopulmonary conditionsObstructive pulmonary diseaseHeart failureCardiopulmonary conditionsOlder adultsPulmonary diseasePremier Research DatabaseEpisodes of pneumoniaRetrospective cohort studyReal-world treatmentHF hospitalizationCohort studyHospital daysPneumonia hospitalizationsCOPD hospitalizationsClinical syndromeAcute conditionsPneumoniaDiagnostic uncertaintyResearch DatabaseHospitalizationDiagnostic categoriesU.S. hospitalsAdults
2015
Trajectories of risk after hospitalization for heart failure, acute myocardial infarction, or pneumonia: retrospective cohort study
Dharmarajan K, Hsieh AF, Kulkarni VT, Lin Z, Ross JS, Horwitz LI, Kim N, Suter LG, Lin H, Normand SL, Krumholz HM. Trajectories of risk after hospitalization for heart failure, acute myocardial infarction, or pneumonia: retrospective cohort study. The BMJ 2015, 350: h411. PMID: 25656852, PMCID: PMC4353309, DOI: 10.1136/bmj.h411.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionRetrospective cohort studyHeart failureRisk of deathMyocardial infarctionFirst readmissionAbsolute riskOlder patientsCohort studyRelative riskMedicare feeService beneficiariesRisk of readmissionGeneral elderly populationGeneral older populationRisk trajectoriesHigh-risk periodHospital dischargeHospital admissionDischarge diagnosisAdverse outcomesReadmissionHospitalizationTrajectories of riskElderly populationIntravenous Fluids in Acute Decompensated Heart Failure
Bikdeli B, Strait KM, Dharmarajan K, Li SX, Mody P, Partovian C, Coca SG, Kim N, Horwitz LI, Testani JM, Krumholz HM. Intravenous Fluids in Acute Decompensated Heart Failure. JACC Heart Failure 2015, 3: 127-133. PMID: 25660836, PMCID: PMC4438991, DOI: 10.1016/j.jchf.2014.09.007.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overCohort StudiesDatabases, FactualFemaleFluid TherapyHeart FailureHospital MortalityHospitalizationHumansInfusions, IntravenousIntensive Care UnitsIntubation, IntratrachealIsotonic SolutionsMaleMiddle AgedRenal Replacement TherapyRetrospective StudiesRinger's SolutionSaline Solution, HypertonicSodium Potassium Chloride Symporter InhibitorsUnited StatesYoung AdultConceptsAcute decompensated heart failureDecompensated heart failureHeart failureIntravenous fluidsRetrospective cohort studyCritical care admissionRenal replacement therapyDays of hospitalizationProportion of hospitalizationsHalf-normal salineWarrants further investigationOnly diureticsCare admissionHospital deathHospital outcomesCohort studyLoop diureticsPatient groupReplacement therapyWorse outcomesNormal salineInpatient careMedian volumePatientsHospitalization
2014
Readmissions after Hospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia among Young and Middle-Aged Adults: A Retrospective Observational Cohort Study
Ranasinghe I, Wang Y, Dharmarajan K, Hsieh AF, Bernheim SM, Krumholz HM. Readmissions after Hospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia among Young and Middle-Aged Adults: A Retrospective Observational Cohort Study. PLOS Medicine 2014, 11: e1001737. PMID: 25268126, PMCID: PMC4181962, DOI: 10.1371/journal.pmed.1001737.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMiddle-aged adultsTiming of readmissionHeart failureReadmission ratesAMI cohortReadmission diagnosesHF cohortReadmission riskMyocardial infarctionAge groupsRetrospective observational cohort studyIndex admission diagnosisObservational cohort studySimilar risk patternNon-cardiac diagnosisPneumonia cohortAdmission diagnosisElderly patientsCohort studyPatient characteristicsPrimary outcomePayer statusReadmissionHospitalization
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 time