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
Automated 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 quality
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
Substantial Differences Between Cohorts of Patients Hospitalized With Heart Failure in Canada and the United States
Lin Z, Li SX. Substantial Differences Between Cohorts of Patients Hospitalized With Heart Failure in Canada and the United States. JAMA Cardiology 2019, 4: 1178-1179. PMID: 31532467, DOI: 10.1001/jamacardio.2019.3314.Peer-Reviewed Original ResearchComparative 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 infarctionEvaluation of 30-Day Hospital Readmission and Mortality Rates Using Regression-Discontinuity Framework
Khera R, Wang Y, Nasir K, Lin Z, Krumholz HM. Evaluation of 30-Day Hospital Readmission and Mortality Rates Using Regression-Discontinuity Framework. Journal Of The American College Of Cardiology 2019, 74: 219-234. PMID: 31296295, PMCID: PMC8669780, DOI: 10.1016/j.jacc.2019.04.060.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionHospital Readmissions Reduction ProgramHeart failureReadmission ratesElderly Medicare feeMedian readmission rateReadmissions Reduction ProgramPost-discharge daysInstitution of strategiesHospital readmissionReadmission riskMyocardial infarctionReadmission reductionCardiovascular conditionsEligible hospitalsMedicare feeReadmission penaltiesMortality rateDay 1Day 30ReadmissionDay 60HospitalU.S. hospitalsHospitalization
2017
ADMISSION TYPES AMONG PATIENTS WITH HEART FAILURE CARED FOR BY ACCOUNTABLE CARE ORGANIZATIONS: VARIATION BY PERFORMANCE ON A MEASURE OF RISK STANDARDIZED ACUTE ADMISSION RATES
Benchetrit L, Zimmerman C, Bao H, Dharmarajan K, Atlaf F, Herrin J, Lin Z, Krumholz H, Drye E, Lipska K, Spatz E. ADMISSION TYPES AMONG PATIENTS WITH HEART FAILURE CARED FOR BY ACCOUNTABLE CARE ORGANIZATIONS: VARIATION BY PERFORMANCE ON A MEASURE OF RISK STANDARDIZED ACUTE ADMISSION RATES. Journal Of The American College Of Cardiology 2017, 69: 762. DOI: 10.1016/s0735-1097(17)34151-7.Peer-Reviewed Original Research
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
2010
Telemonitoring in Patients with Heart Failure
Chaudhry SI, Mattera JA, Curtis JP, Spertus JA, Herrin J, Lin Z, Phillips CO, Hodshon BV, Cooper LS, Krumholz HM. Telemonitoring in Patients with Heart Failure. New England Journal Of Medicine 2010, 363: 2301-2309. PMID: 21080835, PMCID: PMC3237394, DOI: 10.1056/nejmoa1010029.Peer-Reviewed Original ResearchConceptsPrimary end pointUsual care groupSecondary end pointsHeart failureEnd pointHeart failure outcomesNumber of hospitalizationsTelephone-based interactive voice response systemUsual careAdverse eventsPatient's clinicianMedian ageCare groupLarge trialsInteractive voice response systemPatientsSmall studyVoice response systemNumber of daysHospitalizationReadmissionTelemonitoringSignificant differencesCliniciansDeath
2003
Gender differences in recovery after coronary artery bypass surgery
Vaccarino V, Lin ZQ, Kasl SV, Mattera JA, Roumanis SA, Abramson JL, Krumholz HM. Gender differences in recovery after coronary artery bypass surgery. Journal Of The American College Of Cardiology 2003, 41: 307-314. PMID: 12535827, DOI: 10.1016/s0735-1097(02)02698-0.Peer-Reviewed Original ResearchConceptsPhysical functionCABG surgeryDepressive symptomsHospital readmissionCoronary artery bypass graft surgeryArtery bypass graft surgeryCoronary artery bypass surgeryBypass graft surgeryArtery bypass surgeryCongestive heart failureLow physical functionMore depressive symptomsFirst CABGGraft surgeryBaseline characteristicsBypass surgeryPatient characteristicsHeart failureIllness severityMedical recordsWorse outcomesClinical dataFemale genderHigh riskSide effects