National Healthcare Quality and Disparities Report
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 2 of 2 Research Studies DisplayedHoffman GJ, Alexander Nb, Ha J
Medicare's hospital readmission reduction program reduced fall-related health care use: an unexpected benefit?
This study’s objective was to assess whether the Medicare Hospital Readmissions Reduction Program (HRRP) was associated with a reduction in severe fall-related injuries (FRIs). The authors looked at secondary data from Medicare to assess changes in 30- and 90-day FRI readmissions before and after HRRP's announcement (April 2010) and implementation (October 2012) for conditions targeted by the HRRP (acute myocardial infarction [AMI], congestive heart failure [CHF], and pneumonia) versus "non-targeted" (gastrointestinal) conditions. They tested for modification by hospitals with "high-risk" before HRRP and accounted for potential upcoding. They also explored changes in 30-day FRI readmissions involving emergency department (ED) or outpatient care, care processes (length of stay, discharge destination, and primary care visit), and patient selection (age and comorbidities). They identified 1.5 million (522,596 pre-HRRP, 514,844 announcement, and 474,029 implementation period) index discharges. After its announcement, HRRP was associated with 12%-20% reductions in 30- and 90-day FRI readmissions for patients with CHF (-0.42 percentage points [ppt]) and AMI (-0.35). Two years after implementation, HRRP was associated with reductions in 90-day FRI readmission for AMI (-1.27 ppt) and CHF (-0.98 ppt) patients. After HRRP's announcement, decreases were observed in home health (AMI: -2.43 ppt; CHF: -8.83 ppt; pneumonia: -1.97 ppt) and skilled nursing facility referrals (AMI: -5.95 ppt; CHF: -3.19 ppt; pneumonia: -10.27 ppt).
AHRQ-funded; HS025838.
Citation: Hoffman GJ, Alexander Nb, Ha J .
Medicare's hospital readmission reduction program reduced fall-related health care use: an unexpected benefit?
Health Serv Res 2024 Feb; 59(1):e14246. doi: 10.1111/1475-6773.14246..
Keywords: Hospital Readmissions, Medicare, Falls
Nash KA, Weerahandi H, Yu H
Measuring equity in readmission as a distinct assessment of hospital performance.
This study examined the measure of equitable readmissions in hospitals as developed by the Centers for Medicare & Medicaid Services (CMS). Objectives were to define a measure of equitable readmissions; identify hospitals with equitable readmissions by insurance (dual eligible vs non-dual eligible) or patient race (Black vs White); and compare hospitals with and without equitable readmissions by hospital characteristics and performance on accountability measures (quality, cost, and value). The authors used data from a cross-section of hospitals who were eligible for the CMS Hospital-Wide Readmission measure using Medicare data from July 2018 through June 2019. Of 4638 hospitals, they found that 74% served a sufficient number of dual-eligible patients, and 42% served a sufficient number of Black patients to apply CMS Disparity Methods by insurance and race. Of these eligible hospitals, 17% had equitable readmission rates by insurance and 30% by race. Hospitals with equitable readmissions by insurance or race cared for a lower percentage of Black patients (insurance, 1.9% vs 3.3%, race, 7.6% vs 9.3%), and differed from nonequitable hospitals in multiple domains (teaching status, geography, size. In examining equity by insurance, hospitals with low costs were more likely to have equitable readmissions, and there was no relationship between quality and value, and equity. In examining equity by race, hospitals with high overall quality were more likely to have equitable readmissions, and there was no relationship between cost and value, and equity.
AHRQ-funded; HS022882.
Citation: Nash KA, Weerahandi H, Yu H .
Measuring equity in readmission as a distinct assessment of hospital performance.
JAMA 2024 Jan 9; 331(2):111-23. doi: 10.1001/jama.2023.24874..
Keywords: Hospital Readmissions, Hospitals, Provider Performance, Disparities