2021
Administrative Claims Measure for Profiling Hospital Performance Based on 90-Day All-Cause Mortality Following Coronary Artery Bypass Graft Surgery
Mori M, Nasir K, Bao H, Jimenez A, Legore SS, Wang Y, Grady J, Lama SD, Brandi N, Lin Z, Kurlansky P, Geirsson A, Bernheim SM, Krumholz HM, Suter LG. Administrative Claims Measure for Profiling Hospital Performance Based on 90-Day All-Cause Mortality Following Coronary Artery Bypass Graft Surgery. Circulation Cardiovascular Quality And Outcomes 2021, 14: e006644. PMID: 33535776, DOI: 10.1161/circoutcomes.120.006644.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesCoronary artery bypass graft surgeryArtery bypass graft surgeryBypass graft surgeryMortality rateGraft surgeryC-statisticMedicaid ServicesAdministrative Claims MeasureCause mortality ratesMortality measuresUnadjusted mortality ratesProfiling Hospital PerformanceHierarchical logistic regression modelsAlternate payment modelsHospital performanceLogistic regression modelsCABG recoveryPayment modelsCABG surgeryCause mortalityCABG proceduresDays postsurgeryHospital levelSurgery
2019
Association of Hospital Payment Profiles With Variation in 30-Day Medicare Cost for Inpatients With Heart Failure or Pneumonia
Krumholz HM, Wang Y, Wang K, Lin Z, Bernheim SM, Xu X, Desai NR, Normand ST. Association of Hospital Payment Profiles With Variation in 30-Day Medicare Cost for Inpatients With Heart Failure or Pneumonia. JAMA Network Open 2019, 2: e1915604. PMID: 31730185, PMCID: PMC6902811, DOI: 10.1001/jamanetworkopen.2019.15604.Peer-Reviewed Original ResearchConceptsHeart failureSame patientSame diagnosisMortality rateRisk-standardized mortality ratesHighest quartile hospitalsObservational cohort studyMedian hospitalQuartile hospitalsIndex hospitalizationCohort studyCritical access hospitalsPatient characteristicsHospital variationAcute careEpisode paymentsPrincipal diagnosisMAIN OUTCOMEMedicare feePneumoniaMedicare beneficiariesPatientsCase mixService Part ADifferent hospitalsComparative 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
Variation in and Hospital Characteristics Associated With the Value of Care for Medicare Beneficiaries With Acute Myocardial Infarction, Heart Failure, and Pneumonia
Desai NR, Ott LS, George EJ, Xu X, Kim N, Zhou S, Hsieh A, Nuti SV, Lin Z, Bernheim SM, Krumholz HM. Variation in and Hospital Characteristics Associated With the Value of Care for Medicare Beneficiaries With Acute Myocardial Infarction, Heart Failure, and Pneumonia. JAMA Network Open 2018, 1: e183519. PMID: 30646247, PMCID: PMC6324438, DOI: 10.1001/jamanetworkopen.2018.3519.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesAcute myocardial infarctionHeart failureHigh-value careHospital characteristicsValue of careMyocardial infarctionNational cross-sectional studyHospital risk-standardized mortality ratesMedian risk-standardized mortality rateProportion of patientsSafety-net statusAcute care hospitalsCross-sectional studyLow socioeconomic statusCharacteristics of hospitalsValue-based payment modelsWeak inverse correlationCare hospitalHospital variationHospital typeHospitalizationMAIN OUTCOMEPneumoniaMedicare beneficiariesAssociation 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 OUTCOMEGeographical Health Priority Areas For Older Americans
Krumholz HM, Normand ST, Wang Y. Geographical Health Priority Areas For Older Americans. Health Affairs 2018, 37: 104-110. PMID: 29309217, DOI: 10.1377/hlthaff.2017.0744.Peer-Reviewed Original ResearchConceptsHealth priority areasMortality rateHigher adjusted mortality ratesRisk-standardized mortality ratesAdjusted mortality rateHealth careUnique Medicare beneficiariesMedicare beneficiariesUS populationHealth disparitiesOlder adultsStudy periodGeographic disparitiesOlder AmericansCarePercentDisparitiesPriority areasWide disparity
2017
Incorporating Stroke Severity Into Hospital Measures of 30-Day Mortality After Ischemic Stroke Hospitalization
Schwartz J, Wang Y, Qin L, Schwamm LH, Fonarow GC, Cormier N, Dorsey K, McNamara RL, Suter LG, Krumholz HM, Bernheim SM. Incorporating Stroke Severity Into Hospital Measures of 30-Day Mortality After Ischemic Stroke Hospitalization. Stroke 2017, 48: 3101-3107. PMID: 28954922, DOI: 10.1161/strokeaha.117.017960.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesElectronic health record dataHealth record dataStroke severityClaims dataMortality rateAmerican Heart Association/American Stroke AssociationHealth Stroke Scale scoreRisk variablesMedicaid ServicesRisk adjustmentMedian risk-standardized mortality rateGuidelines-Stroke registryLow-mortality hospitalsStroke Scale scoreAcute ischemic strokeAmerican Stroke AssociationOdds of mortalityMortality measuresRecord dataIschemic stroke hospitalizationsHigh-mortality hospitalsService claims dataRisk-adjustment variablesHospital admissionQuality of Care in Chinese Hospitals: Processes and Outcomes After ST‐segment Elevation Myocardial Infarction
Downing NS, Wang Y, Dharmarajan K, Nuti SV, Murugiah K, Du X, Zheng X, Li X, Li J, Masoudi FA, Spertus JA, Jiang L, Krumholz HM. Quality of Care in Chinese Hospitals: Processes and Outcomes After ST‐segment Elevation Myocardial Infarction. Journal Of The American Heart Association 2017, 6: e005040. PMID: 28645937, PMCID: PMC5669155, DOI: 10.1161/jaha.116.005040.Peer-Reviewed Original ResearchConceptsST-elevation myocardial infarctionRisk-standardized mortality ratesQuality of careGuideline-recommended careGuideline-recommended treatmentMyocardial infarctionMortality rateST-segment elevation myocardial infarctionChina PEACE-Retrospective AMI StudyComposite rateMedian risk-standardized mortality rateProportion of patientsElevation myocardial infarctionQuality improvement initiativesProportion of opportunitiesDefect-free rateHospital levelInfarctionHospitalChinese hospitalsPatientsCareAMI studyImprovement initiativesHigh rate
2016
Life Expectancy after Myocardial Infarction, According to Hospital Performance
Bucholz EM, Butala NM, Ma S, Normand ST, Krumholz HM. Life Expectancy after Myocardial Infarction, According to Hospital Performance. New England Journal Of Medicine 2016, 375: 1332-1342. PMID: 27705249, PMCID: PMC5118048, DOI: 10.1056/nejmoa1513223.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionRisk-standardized mortality ratesMyocardial infarctionLife expectancyMortality rateHospital performanceCooperative Cardiovascular ProjectProportional hazards modelLong-term survivalCase-mix severityLonger life expectancySurvival benefitInfarctionMedicare beneficiariesPatientsHospital case mixCase mixHospitalSurvival curvesQuintileStudy sampleSignificant differencesEarly survivalExpectancySurvivalAssociation 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
2015
Hospital variation in admission to intensive care units for patients with acute myocardial infarction
Chen R, Strait KM, Dharmarajan K, Li SX, Ranasinghe I, Martin J, Fazel R, Masoudi FA, Cooke CR, Nallamothu BK, Krumholz HM. Hospital variation in admission to intensive care units for patients with acute myocardial infarction. American Heart Journal 2015, 170: 1161-1169. PMID: 26678638, PMCID: PMC5459386, DOI: 10.1016/j.ahj.2015.09.003.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overAnterior Wall Myocardial InfarctionCoronary Care UnitsHealth Care RationingHospital MortalityHumansLength of StayMaleMiddle AgedOutcome and Process Assessment, Health CarePatient AdmissionQuality ImprovementRetrospective StudiesRisk AssessmentTriageUnited StatesConceptsAcute myocardial infarctionIntensive care unitCritical care therapiesRisk-standardized mortality ratesHospital risk-standardized mortality ratesICU admissionResource-intensive settingsCare therapyAMI patientsCare unitMyocardial infarctionMortality rateAdult hospitalizationsHospital variationNinth RevisionClinical ModificationICU triageInternational ClassificationBetter outcomesPatientsHospitalAdmissionPremier databaseTherapyAppropriate useDevelopment of a Hospital Outcome Measure Intended for Use With Electronic Health Records
McNamara RL, Wang Y, Partovian C, Montague J, Mody P, Eddy E, Krumholz HM, Bernheim SM. Development of a Hospital Outcome Measure Intended for Use With Electronic Health Records. Medical Care 2015, 53: 818-826. PMID: 26225445, DOI: 10.1097/mlr.0000000000000402.Peer-Reviewed Original ResearchConceptsElectronic health recordsOutcome measuresClinical dataMortality rateClinical practiceFuture quality improvement measuresRisk-standardized mortality ratesHospital risk-standardized mortality ratesLow-mortality hospitalsHealth recordsSystolic blood pressureOdds of mortalityClinical registry dataAcute myocardial infarctionHigh-mortality hospitalsHospital outcome measuresEHR dataFinal risk modelCurrent clinical practiceStandard clinical practiceFirst outcome measureNational Quality ForumCurrent electronic health recordsQuality improvement measuresChart abstraction
2014
Strategies to reduce hospital 30-day risk-standardized mortality rates for patients with acute myocardial infarction: a cross-sectional and longitudinal survey
Bradley EH, Sipsma H, Brewster AL, Krumholz HM, Curry L. Strategies to reduce hospital 30-day risk-standardized mortality rates for patients with acute myocardial infarction: a cross-sectional and longitudinal survey. BMC Cardiovascular Disorders 2014, 14: 126. PMID: 25252826, PMCID: PMC4182840, DOI: 10.1186/1471-2261-14-126.Peer-Reviewed Original ResearchMeSH KeywordsCooperative BehaviorCross-Sectional StudiesEmergency Medical ServicesEmergency Medical TechniciansHealth Care SurveysHospital MortalityHospitalsHumansInservice TrainingInterdisciplinary CommunicationLongitudinal StudiesMedical Order Entry SystemsMyocardial InfarctionOrganizational CulturePatient Care TeamQuality ImprovementQuality Indicators, Health CareTime FactorsUnited StatesConceptsAcute myocardial infarctionAMI mortality ratesPercentage of hospitalsMortality rateMyocardial infarctionAMI mortalityHospital AMI mortality ratesRisk-standardized mortality ratesEmergency medical services (EMS) providersHospital strategiesCross-sectional surveyPhysician order entryBackgroundSurvival ratesAMI careMedical service providersResultsBetween 2010HospitalU.S. hospitalsOrder entryRegular trainingInfarctionLongitudinal analysisHospital performanceMortalityCurrent useNational 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 ServicesReadmissionHospital Variation in Noninvasive Positive Pressure Ventilation for Acute Decompensated Heart Failure
Kulkarni VT, Kim N, Dai Y, Dharmarajan K, Safavi KC, Bikdeli B, Lindenauer PK, Testani J, Dries DL, Krumholz HM. Hospital Variation in Noninvasive Positive Pressure Ventilation for Acute Decompensated Heart Failure. Circulation Heart Failure 2014, 7: 427-433. PMID: 24633829, PMCID: PMC4386575, DOI: 10.1161/circheartfailure.113.000698.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureNoninvasive positive pressure ventilationDecompensated heart failureRisk-standardized mortality ratesPositive pressure ventilationHeart failureIntubation rateMortality ratePressure ventilationUse of NPPVHospital risk-standardized mortality ratesHigher intubation rateHospital practice patternsHospital-level outcomesCross-sectional studyHierarchical logistic regression modelsLogistic regression modelsNIPPV useHospital variationSuch hospitalizationsPractice patternsHospitalizationHospitalQuartileBottom quartileTransfer Rates From Nonprocedure Hospitals After Initial Admission and Outcomes Among Elderly Patients With Acute Myocardial Infarction
Barreto-Filho JA, Wang Y, Rathore SS, Spatz ES, Ross JS, Curtis JP, Nallamothu BK, Normand SL, Krumholz HM. Transfer Rates From Nonprocedure Hospitals After Initial Admission and Outcomes Among Elderly Patients With Acute Myocardial Infarction. JAMA Internal Medicine 2014, 174: 213-222. PMID: 24296747, DOI: 10.1001/jamainternmed.2013.11944.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionCoronary artery bypass graft surgeryArtery bypass graft surgeryRisk-standardized mortality ratesBypass graft surgeryPercutaneous coronary interventionLength of stayMyocardial infarctionElderly patientsGraft surgeryRevascularization ratesCoronary interventionMortality rateLower risk-standardized mortality ratesRate of catheterizationHospital transfer ratesInvasive cardiac proceduresTransfer of patientsRisk-standardized mortalityHospital outcomesInitial admissionMedian lengthService patientsCardiac proceduresHospital differences
2013
Association Between a Hospital’s Quality Performance for In-Hospital Cardiac Arrest and Common Medical Conditions
Chen LM, Nallamothu BK, Krumholz HM, Spertus JA, Tang F, Chan PS. Association Between a Hospital’s Quality Performance for In-Hospital Cardiac Arrest and Common Medical Conditions. Circulation Cardiovascular Quality And Outcomes 2013, 6: 700-707. PMID: 24221831, PMCID: PMC4465597, DOI: 10.1161/circoutcomes.113.000377.Peer-Reviewed Original ResearchConceptsCommon medical conditionsHospital survival rateAcute myocardial infarctionCardiac arrestMedical conditionsSurvival rateInpatient survivalHeart failureMyocardial infarctionMortality rateHospital cardiac arrest registryHospital qualityIn-Hospital Cardiac ArrestRisk-standardized mortality ratesCardiac Arrest RegistryCardiac arrest outcomesCardiac arrest patientsHospital cardiac arrestCardiac arrest survival ratesPublic reportingHospital outcomesArrest patientsHospital CompareArrest outcomesHospitalRelationship 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
Hospital Patterns of Use of Positive Inotropic Agents in Patients With Heart Failure
Partovian C, Gleim SR, Mody PS, Li SX, Wang H, Strait KM, Allen LA, Lagu T, Normand SL, Krumholz HM. Hospital Patterns of Use of Positive Inotropic Agents in Patients With Heart Failure. Journal Of The American College Of Cardiology 2012, 60: 1402-1409. PMID: 22981548, PMCID: PMC3636773, DOI: 10.1016/j.jacc.2012.07.011.Peer-Reviewed Original ResearchConceptsPositive inotropic agentsRisk-standardized ratesInotropic agentsHeart failureInotrope useHospital patternsMortality rateRisk-standardized mortality ratesHospital mortality rateHeart failure patientsLittle clinical evidenceLength of stayPatient case mixHierarchical logistic regression modelsLogistic regression modelsIntraclass correlation coefficientFailure patientsHospital variationClinical evidenceInterhospital variationClinical guidelinesIndividual hospital effectsHospital ratesHospital effectsPatterns of useDevelopment of 2 Registry-Based Risk Models Suitable for Characterizing Hospital Performance on 30-Day All-Cause Mortality Rates Among Patients Undergoing Percutaneous Coronary Intervention
Curtis JP, Geary LL, Wang Y, Chen J, Drye EE, Grosso LM, Spertus JA, Rumsfeld JS, Weintraub WS, Masoudi FA, Brindis RG, Krumholz HM. Development of 2 Registry-Based Risk Models Suitable for Characterizing Hospital Performance on 30-Day All-Cause Mortality Rates Among Patients Undergoing Percutaneous Coronary Intervention. Circulation Cardiovascular Quality And Outcomes 2012, 5: 628-637. PMID: 22949491, DOI: 10.1161/circoutcomes.111.964569.Peer-Reviewed Original ResearchMeSH KeywordsAcute Coronary SyndromeAgedAged, 80 and overAngina PectorisChi-Square DistributionComorbidityFemaleHeart DiseasesHospital MortalityHospitalsHumansLogistic ModelsMaleMyocardial InfarctionOdds RatioOutcome and Process Assessment, Health CarePercutaneous Coronary InterventionQuality Indicators, Health CareRegistriesRisk AssessmentRisk FactorsShock, CardiogenicTime FactorsTreatment OutcomeUnited StatesConceptsST-segment elevation myocardial infarctionPercutaneous coronary interventionRisk-standardized mortality ratesElevation myocardial infarctionPatient mortality ratesMyocardial infarctionMortality rateCardiogenic shockCoronary interventionDerivation cohortHospital risk-standardized mortality ratesCause mortality ratesAdministrative claims dataQuality of careHierarchical logistic regression modelsNational Quality ForumLogistic regression modelsObserved mortality rateCathPCI RegistryNational HospitalClaims dataInfarctionPatientsQuality ForumFinal model