National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
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AHRQ Research Studies Date
Topics
- Adverse Events (3)
- Blood Clots (1)
- Cancer (1)
- Cardiovascular Conditions (4)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children/Adolescents (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Diagnostic Safety and Quality (1)
- Elderly (2)
- Electronic Health Records (EHRs) (1)
- Emergency Department (1)
- Evidence-Based Practice (1)
- Healthcare-Associated Infections (HAIs) (5)
- Healthcare Cost and Utilization Project (HCUP) (3)
- Healthcare Costs (2)
- Health Information Technology (HIT) (2)
- Health Insurance (1)
- Health Systems (1)
- Heart Disease and Health (5)
- Hospital Discharge (2)
- Hospitalization (2)
- Hospital Readmissions (9)
- (-) Hospitals (28)
- Infectious Diseases (1)
- Injuries and Wounds (2)
- Inpatient Care (1)
- Medicare (9)
- Mortality (6)
- Outcomes (1)
- Patient-Centered Outcomes Research (1)
- Patient Experience (2)
- Patient Safety (5)
- Payment (7)
- Pneumonia (1)
- Prevention (1)
- Provider (1)
- (-) Provider Performance (28)
- Public Reporting (1)
- Quality Improvement (3)
- Quality Indicators (QIs) (7)
- Quality Measures (7)
- Quality of Care (18)
- Respiratory Conditions (2)
- Sepsis (1)
- Stroke (2)
- Surgery (2)
- Telehealth (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 28 Research Studies DisplayedJacobs PD, Basu J
AHRQ Author: Jacobs PD, Basu J
Medicare Advantage and postdischarge quality: evidence from hospital readmissions.
This study compared relative readmission rates for beneficiaries enrolled in Medicare Advantage (MA) and traditional Medicare (TM). HCUP State Inpatient Databases data for 4 states was used from 2009 and 2014. The outcome compared was the probability of a hospital readmission within 30 days of an index admission. There were significantly lower all-cause readmission rates among MA enrollees relative to those in TM in both 2009 and 2014, but MA enrollment was not associated with an increased reduction in readmission rates relative to TM during that time period.
AHRQ-authored
Citation: Jacobs PD, Basu J .
Medicare Advantage and postdischarge quality: evidence from hospital readmissions.
Am J Manag Care 2020 Dec;26(12):524-29. doi: 10.37765/ajmc.2020.88540..
Keywords: Healthcare Cost and Utilization Project (HCUP), Elderly, Medicare, Hospital Readmissions, Hospitals, Quality of Care, Provider Performance
Short MN, Ho V
Weighing the effects of vertical integration versus market concentration on hospital quality.
Provider organizations are increasing in complexity, as hospitals acquire physician practices and physician organizations grow in size. At the same time, hospitals are merging with each other to improve bargaining power with insurers. In this study, the investigators analyzed 29 quality measures reported to the Center for Medicare and Medicaid Services' Hospital Compare database for 2008 to 2015 to test whether vertical integration between hospitals and physicians or increases in hospital market concentration influenced patient outcomes.
AHRQ-funded; HS024727.
Citation: Short MN, Ho V .
Weighing the effects of vertical integration versus market concentration on hospital quality.
Med Care Res Rev 2020 Dec;77(6):538-48. doi: 10.1177/1077558719828938.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Patient Experience, Hospitals, Medicare, Provider Performance, Health Systems
Jin B, Nembhard IM
Voluntary hospital reporting of performance in cancer care: does volume make a difference?
The authors hypothesized that patient volume is positively associated with both reporting and performance in cancer care. Studying 72 Pennsylvania hospitals accredited by the Commission on Cancer, they found that hospitals that publicly reported their performance had higher patient volumes than hospitals that did not release performance. Among reporting hospitals, no association was found between patient volume and performance on process of care metrics, suggesting that volume is not a predictor of performance for reporting hospitals. They recommended further research to identify other factors that differentiate performance within and across reporting and nonreporting hospitals.
AHRQ-funded; HS017589.
Citation: Jin B, Nembhard IM .
Voluntary hospital reporting of performance in cancer care: does volume make a difference?
J Healthc Qual 2020 Nov/Dec;42(6):e75-e82. doi: 10.1097/jhq.0000000000000225..
Keywords: Cancer, Provider Performance, Hospitals, Quality Indicators (QIs), Quality Measures, Quality of Care
Mohr NM, Zebrowski AM, Gaieski DF
Inpatient hospital performance is associated with post-discharge sepsis mortality.
The objective of this study was to test the hypothesis that hospitals with high risk-adjusted inpatient sepsis mortality also have high post-discharge mortality, readmissions, and discharge to nursing homes. Sepsis hospitalization survivors among age-qualifying Medicare beneficiaries were followed for 180 days post-discharge; mortality, readmissions, and new admission to skilled nursing facilities were measured. Findings showed that hospitals with the highest risk-adjusted sepsis inpatient mortality also had higher post-discharge mortality and increased readmissions, suggesting that post-discharge complications were a modifiable risk that may be affected during inpatient care. Recommendations for future work include seeking to elucidate inpatient and healthcare practices that can reduce sepsis post-discharge complications.
AHRQ-funded; HS023614; HS025753.
Citation: Mohr NM, Zebrowski AM, Gaieski DF .
Inpatient hospital performance is associated with post-discharge sepsis mortality.
Crit Care 2020 Oct 27;24(1):626. doi: 10.1186/s13054-020-03341-3..
Keywords: Sepsis, Mortality, Hospital Discharge, Hospitals, Provider Performance, Quality of Care, Inpatient Care, Hospital Readmissions
Spatz ES, Bernheim SM, Horwitz LI
Community factors and hospital wide readmission rates: does context matter?
The purpose of this study was to estimate the influence of community factors on the Centers for Medicare & Medicaid Services risk-standardized hospital-wide readmission measure (HWR)-a quality performance measure in the U.S. The investigators concluded that readmissions for a wide range of clinical conditions were influenced by factors relating to the communities in which patients reside.
AHRQ-funded; HS022882.
Citation: Spatz ES, Bernheim SM, Horwitz LI .
Community factors and hospital wide readmission rates: does context matter?
PLoS One 2020 Oct 23;15(10):e0240222. doi: 10.1371/journal.pone.0240222..
Keywords: Hospital Readmissions, Hospitals, Provider Performance, Quality Measures, Quality of Care
Hoffman GJ, Yakusheva O
Association between financial incentives in Medicare's hospital readmissions reduction program and hospital readmission performance.
This study compared the outcome of penalties versus rewards to prevent hospital readmission in Medicare’s Hospital Readmissions Reduction Program (HRRP). This retrospective cohort study used Medicare readmissions data from 2823 US short-term acute care hospitals participating in HRRP. Data from pre-HRRP in 2016 was compared with 2016-2019 3-year follow-up readmission performance classified by tertile of hospitals using baseline marginal incentives for 5 HRRP-targeted conditions: acute myocardial infarction (AMI), heart failure, chronic obstructive pulmonary disease (COPD), pneumonia, and hip and/or knee surgery. Of the 2823 hospitals participating in HRRP from baseline to follow-up, 81% had more than 1 excess readmission for 1 or more applicable condition and 19% did not. Financial incentives ranged from a mean range of $8762 to $58,158 per 1 avoided readmission. Hospitals with greater incentives for readmission avoidance had greater decreases than hospitals with smaller incentives. An additional $5000 in the incentive amount was associated with up to a 26% decrease in readmissions. The findings suggest that incentives work better than penalties to reduce hospital readmissions for those 5 conditions.
AHRQ-funded; HS025838.
Citation: Hoffman GJ, Yakusheva O .
Association between financial incentives in Medicare's hospital readmissions reduction program and hospital readmission performance.
JAMA Netw Open 2020 Apr;3(4):e202044. doi: 10.1001/jamanetworkopen.2020.2044..
Keywords: Medicare, Hospital Readmissions, Provider Performance, Payment, Health Insurance, Hospitals
Colton K, Richards CT, Pruitt PB
Early stroke recognition and time-based emergency care performance metrics for intracerebral hemorrhage.
This study compared time for early stroke recognition for intracerebral hemorrhage for hospitals with and without stroke teams. An observational cohort study was conducted at an urban comprehensive stroke center from 2009 to 2017 with 204 cases included. Stroke team activation resulted in faster emergency care compared to no activation. This process resulted in shorter onset-to-arrival times, higher NIH Stroke Scale scores, and higher Glasgow Coma Scale scores.
AHRQ-funded; HS023437.
Citation: Colton K, Richards CT, Pruitt PB .
Early stroke recognition and time-based emergency care performance metrics for intracerebral hemorrhage.
J Stroke Cerebrovasc Dis 2020 Feb;29(2):104552. doi: 10.1016/j.jstrokecerebrovasdis.2019.104552..
Keywords: Stroke, Emergency Department, Provider Performance, Diagnostic Safety and Quality, Quality Improvement, Quality Indicators (QIs), Patient-Centered Outcomes Research, Outcomes, Quality of Care, Evidence-Based Practice, Hospitals
Langhoff E, Siu A, Boockvar K
The VA and Non-VA experience of tracking good care.
This study compared how well Department of Veterans Affairs (VA) hospitals perform against non-VA hospitals. Three widely referenced public health care ranking models: the U.S. News America’s Best Hospitals, Truven Health Analytics, and Hospital Compare along with the VA model were examined. The authors found that the metrics used across the 4 models are neither comparable nor transparent. They found there were 6-46% reporting deficiencies in reporting hospital metrics in non-VA hospitals, while VA reporting is 100% of their metrics. VA inpatient satisfaction fell far short of the private sector, but both sets of rankings increased over time.
AHRQ-funded; HS022924.
Citation: Langhoff E, Siu A, Boockvar K .
The VA and Non-VA experience of tracking good care.
Popul Health Manag 2020 Feb;23(1):92-100. doi: 10.1089/pop.2019.0039..
Keywords: Hospitals, Provider Performance, Patient Experience, Quality of Care
Beaulieu ND, Dafny LS, Landon BE
Changes in quality of care after hospital mergers and acquisitions.
Using Medicare claims and Hospital Compare data on performance on four quality care measures and data on hospital mergers and acquisitions, researchers conducted analyses comparing changes in the performance of acquired hospitals from the time before acquisition to the time after acquisition. They found that hospital acquisition by another hospital or hospital system was associated with modestly worse patient experiences and no significant changes in readmission or mortality rates. Effects on process measures of quality were inconclusive.
AHRQ-funded; HS024072.
Citation: Beaulieu ND, Dafny LS, Landon BE .
Changes in quality of care after hospital mergers and acquisitions.
N Engl J Med 2020 Jan 2;382(1):51-59. doi: 10.1056/NEJMsa1901383..
Keywords: Quality of Care, Hospitals, Provider Performance
Meddings J, Smith SN, Hofer TP
Mixed messages to consumers from Medicare: Hospital Compare grades versus value-based payment penalty.
This study examined the discrepancy of ratings with hospitals with low readmission grades for heart failure (HF) and acute myocardial infarction (AMI) on the Hospital Compare website, yet received penalties for excessive readmissions under the hospital Readmissions Reduction Program. A retrospective data analysis was conducted of 2956 hospitals that had publicly reported HF grades on Hospital Compare. Of those, 92% were graded as “no different” than the national rate for HD readmissions, yet included 48.6% that were scored as having excessive HF admissions and 87% received an overall readmission penalty. Of the 120 hospitals graded as “better”, none were scored as having excessive HF readmissions and 50% were penalized. There were similar results for AMI.
AHRQ-funded; HS018334; HS019767.
Citation: Meddings J, Smith SN, Hofer TP .
Mixed messages to consumers from Medicare: Hospital Compare grades versus value-based payment penalty.
Am J Manag Care 2018 Dec;24(12):e399-e403..
Keywords: Medicare, Hospital Readmissions, Heart Disease and Health, Hospitals, Quality of Care, Cardiovascular Conditions, Provider Performance, Payment
Huckfeldt P, Escarce J, Wilcock A
HF mortality trends under Medicare readmissions reduction program at penalized and nonpenalized hospitals.
After announcement and implementation of the Medicare Hospital Readmissions Reduction Program (HRRP), 30-day readmissions declined rapidly among seniors with heart failure (HF) while 30-day mortality rose. This raised questions about whether the policy was responsible, because lower HF readmission rates have historically been associated with higher mortality. In this study, the investigators compared trends in heart failure (HF) mortality at penalized and nonpenalized hospitals nationally.
AHRQ-funded; HS024284.
Citation: Huckfeldt P, Escarce J, Wilcock A .
HF mortality trends under Medicare readmissions reduction program at penalized and nonpenalized hospitals.
J Am Coll Cardiol 2018 Nov 13;72(20):2539-40. doi: 10.1016/j.jacc.2018.08.2174..
Keywords: Mortality, Heart Disease and Health, Cardiovascular Conditions, Hospital Readmissions, Medicare, Hospitals, Provider Performance, Payment
Rolnick JA, Ryskina KL
The use of individual provider performance reports by US Hospitals.
In this study, the investigators examined overall trends in how hospitals use the electronic health record to track and provide feedback on provider performance. They used data from 2013 to 2015 from the American Hospital Association (AHA) Annual Survey Information Technology Supplement, which asked hospitals if they have used electronic data to create performance profiles. They linked these data to AHA Annual Survey responses for all general adult and pediatric hospitals and used Multivariable logistic regression to model the odds of use as a function of hospital characteristics.
AHRQ-funded; HS022198.
Citation: Rolnick JA, Ryskina KL .
The use of individual provider performance reports by US Hospitals.
J Hosp Med 2018 Aug;13(8):562-65. doi: 10.12788/jhm.2922..
Keywords: Provider Performance, Quality of Care, Provider, Hospitals, Electronic Health Records (EHRs), Health Information Technology (HIT)
Kaiser SV, Lam R, Joseph GB
Limitations of using pediatric respiratory illness readmissions to compare hospital performance.
Researcher sought to determine if a National Quality Forum (NQF)-endorsed measure for pediatric lower respiratory illness (LRI) 30-day readmission rates can meaningfully identify high- and low-performing hospitals. Subjects were children with LRI (bronchiolitis, influenza, or pneumonia as primary diagnosis, or with an LRI as a secondary diagnosis with a primary diagnosis of respiratory failure, sepsis, bacteremia, or asthma) from all hospital admissions in California from 2012 to 2014. The researchers were unable to identify meaningful variation in hospital performance without broadening the metric definition and merging multiple years of data. They recommend that utilizers of pediatric-quality measures consider modifying metrics to better evaluate the quality of pediatric care at low-volume hospitals.
AHRQ-funded; HS024385; HS022835; HS024592; HS025297.
Citation: Kaiser SV, Lam R, Joseph GB .
Limitations of using pediatric respiratory illness readmissions to compare hospital performance.
J Hosp Med 2018 Nov;13(11):737-42. doi: 10.12788/jhm.2988..
Keywords: Children/Adolescents, Respiratory Conditions, Provider Performance, Hospital Readmissions, Hospitals, Quality Indicators (QIs), Quality Measures, Quality of Care, Quality Improvement
Yokoe DS, Avery TR, Platt R
Ranking hospitals based on colon surgery and abdominal hysterectomy surgical site infection outcomes: impact of limiting surveillance to the operative hospital.
This study examined how hospitals are ranked based on colon surgery and abdominal surgical site infection (SSI) outcomes. This ranking can impact how financial penalties are determined. Currently SSI surveillance focuses mainly on the operative hospital, but patients sometimes go to a different hospital after an SSI as opposed to readmission in the operative hospital. The authors used data from a California statewide hospital registry to assess for evidence of SSI for surgeries performed from March 2011 through November 2013. This analysis showed show that operational hospital surveillance alone would have missed 7.2% of colon surgery and 13.4% of abdominal hysterectomy SSIs. This leads to an inaccurate assignment or avoidance of financial penalties for approximately 1 in 11-16 hospitals.
AHRQ-funded; HS021424.
Citation: Yokoe DS, Avery TR, Platt R .
Ranking hospitals based on colon surgery and abdominal hysterectomy surgical site infection outcomes: impact of limiting surveillance to the operative hospital.
Clin Infect Dis 2018 Sep 14;67(7):1096-102. doi: 10.1093/cid/ciy223..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Infectious Diseases, Injuries and Wounds, Adverse Events, Hospitals, Payment, Patient Safety, Provider Performance
Moreno A, Schwamm LH, Siddiqui KA
Frequent hub-spoke contact is associated with improved spoke hospital performance: results from the Massachusetts General Hospital Telestroke Network.
This study investigated the association of a strong hub-spoke hospital connection with improved spoke hospital performance for acute ischemic stroke patients associated with the Massachusetts General Hospital Telestroke Network. Investigators identified 375 patients treated with tPA by conventional or telestroke methods from 2006-2015 with 16 spoke hospitals. There was a positive association between more frequent contact between a telestroke spoke and its hub and faster tPA delivery for patients.
AHRQ-funded; HS024561.
Citation: Moreno A, Schwamm LH, Siddiqui KA .
Frequent hub-spoke contact is associated with improved spoke hospital performance: results from the Massachusetts General Hospital Telestroke Network.
Telemed J E Health 2018 Sep;24(9):678-83. doi: 10.1089/tmj.2017.0252..
Keywords: Health Information Technology (HIT), Hospitals, Provider Performance, Quality of Care, Stroke, Telehealth
Masnick M, Morgan DJ, Sorkin JD
Can national healthcare-associated infections (HAIs) data differentiate hospitals in the United States?
This study was designed to determine whether patients using the Centers for Medicare and Medicaid Services (CMS) Hospital Compare website can use nationally reported healthcare-associated infection (HAI) data to differentiate hospitals. The authors concluded that HAI data generally are reported by enough hospitals to meet minimal criteria for useful comparisons in many geographic locations, though this varies by type of HAI.
AHRQ-funded; HS018111.
Citation: Masnick M, Morgan DJ, Sorkin JD .
Can national healthcare-associated infections (HAIs) data differentiate hospitals in the United States?
Infect Control Hosp Epidemiol 2017 Oct;38(10):1167-71. doi: 10.1017/ice.2017.179..
Keywords: Quality of Care, Healthcare-Associated Infections (HAIs), Hospitals, Provider Performance, Quality Measures
Smith SN, Reichert HA, Ameling JM
Dissecting Leapfrog: how well do Leapfrog safe practices scores correlate with Hospital Compare ratings and penalties, and how much do they matter?
Voluntary Leapfrog Safe Practices Score (SPS) measures were among the first public reports of hospital performance. Recently, Medicare's Hospital Compare website has reported compulsory measures. Leapfrog's Hospital Safety Score (HSS) grades incorporate SPS and Medicare measures. The researchers evaluated associations between Leapfrog SPS and Medicare measures. They found that voluntary Leapfrog SPS measures skew toward positive self-report and bear little association with compulsory Medicare outcomes and penalties.
AHRQ-funded; HS019767; HS024385; HS018334.
Citation: Smith SN, Reichert HA, Ameling JM .
Dissecting Leapfrog: how well do Leapfrog safe practices scores correlate with Hospital Compare ratings and penalties, and how much do they matter?
Med Care 2017 Jun;55(6):606-14. doi: 10.1097/mlr.0000000000000716.
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Keywords: Patient Safety, Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Hospitals, Provider Performance
DeLancey JO, Softcheck J, Chung JW
Associations between hospital characteristics, measure reporting, and the Centers for Medicare & Medicaid Services Overall Hospital Quality Star Ratings.
This study evaluated associations between hospital characteristics, number and types of measures reported, and the star ratings. Of 3,591 hospitals receiving a star rating,4 or 5 stars were awarded to 15.8 percent of major teaching hospitals, 18.8 percent of other teaching hospitals, 30.2 percent of community hospitals, 33.3 percent of critical access hospitals, and 87.3 percent of specialty hospitals.
AHRQ-funded; HS021857.
Citation: DeLancey JO, Softcheck J, Chung JW .
Associations between hospital characteristics, measure reporting, and the Centers for Medicare & Medicaid Services Overall Hospital Quality Star Ratings.
JAMA 2017 May 16;317(19):2015-17. doi: 10.1001/jama.2017.3148.
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Keywords: Hospitals, Quality of Care, Quality Measures, Provider Performance, Patient Safety
Davis JD, Olsen MA, Bommarito K
All-payer analysis of heart failure hospitalization 30-day readmission: comorbidities matter.
In this study, the researchers investigated readmission characteristics and the magnitude of 30-day hospital readmissions after hospital discharge for heart failure using the Healthcare Cost and Utilization Project State Inpatient Databases (SID). They found in this large all-payer cohort, ∼70% of 30-day readmissions were for non-heart failure causes, and the median time to readmission was 12 days.
AHRQ-funded; HS019455.
Citation: Davis JD, Olsen MA, Bommarito K .
All-payer analysis of heart failure hospitalization 30-day readmission: comorbidities matter.
Am J Med 2017 Jan;130(1):93.e9-93.e28. doi: 10.1016/j.amjmed.2016.07.030..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Hospitalization, Hospitals, Provider Performance
George EI, Ročková V, Rosenbaum PR
Mortality rate estimation and standardization for public reporting: Medicare’s Hospital Compare.
The authors calibrated Bayesian recommendation systems by checking, out of sample, whether predictions aggregate to give correct general advice derived from another sample. Their process leads to substantial revisions in the Hospital Compare model for acute myocardial infarction mortality. They found that indirect standardization, as currently used by Hospital Compare, fails to adequately control for differences in patient risk factors and systematically underestimates mortality rates at the low volume hospitals. They proposed direct standardization instead.
AHRQ-funded; HS021854.
Citation: George EI, Ročková V, Rosenbaum PR .
Mortality rate estimation and standardization for public reporting: Medicare’s Hospital Compare.
Journal of the American Statistical Association 2017;112(519):933-47. doi: 10.1080/01621459.2016.1276021.
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Keywords: Hospitals, Medicare, Mortality, Provider Performance
Calderwood MS, Kleinman K, Huang SS
Surgical site infections: volume-outcome relationship and year-to-year stability of performance rankings.
The researchers evaluated the volume-outcome relationship as well as the year-to-year stability of performance rankings following coronary artery bypass graft (CABG) surgery and hip arthroplasty. They concluded that aggregate surgical site infection risk is highest in hospitals with low annual procedure volumes. Even for higher volume hospitals, year-to-year random variation makes past experience an unreliable estimator of current performance.
AHRQ-funded; HS021424.
Citation: Calderwood MS, Kleinman K, Huang SS .
Surgical site infections: volume-outcome relationship and year-to-year stability of performance rankings.
Med Care 2017 Jan;55(1):79-85. doi: 10.1097/mlr.0000000000000620.
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Keywords: Surgery, Healthcare-Associated Infections (HAIs), Adverse Events, Injuries and Wounds, Hospitals, Provider Performance, Quality Indicators (QIs), Quality of Care, Patient Safety, Elderly
Lau BD, Haut ER, Hobson DB
ICD-9 code-based venous thromboembolism performance targets fail to measure up.
Suboptimal prevention practices have prompted payers to consider hospital-associated Venous thromboembolism (VTE) as a potentially preventable condition for which financial incentives or penalties exist to drive practice improvement. The authors reviewed a subset of hospital-associated VTE that were identified by ICD-9 codes used by a state-run pay-for-performance quality improvement program and discuss their findings.
AHRQ-funded; HS017952.
Citation: Lau BD, Haut ER, Hobson DB .
ICD-9 code-based venous thromboembolism performance targets fail to measure up.
Am J Med Qual 2016 Sep;31(5):448-53. doi: 10.1177/1062860615583547.
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Keywords: Healthcare-Associated Infections (HAIs), Quality Indicators (QIs), Prevention, Hospitals, Quality Improvement, Blood Clots, Payment, Provider Performance
Wang Y, Eldridge N, Metersky ML
AHRQ Author: Eldridge N
Association between hospital performance on patient safety and 30-day mortality and unplanned readmission for Medicare fee-for-service patients with acute myocardial infarction.
The researchers studied the relationship between hospital performance on adverse event rates and hospital performance on 30-day mortality and unplanned readmission rates for Medicare fee-for-service patients hospitalized for acute myocardial infarction (AMI). They found that for Medicare fee-for-service patients discharged with AMI, hospitals with poorer patient safety performance were also more likely to have poorer performance on 30-day all-cause mortality and on unplanned readmissions.
AHRQ-authored.
Citation: Wang Y, Eldridge N, Metersky ML .
Association between hospital performance on patient safety and 30-day mortality and unplanned readmission for Medicare fee-for-service patients with acute myocardial infarction.
J Am Heart Assoc 2016 Jul;5(7):pii: e003731. doi: 10.1161/jaha.116.003731.
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Keywords: Adverse Events, Hospital Readmissions, Hospitals, Medicare, Mortality, Heart Disease and Health, Patient Safety, Provider Performance
Jiang HJ, Reiter KL, Wang J
AHRQ Author: Jiang HJ
Measuring mortality performance: How did safety-net hospitals compare with other hospitals?
This study assessed mortality performance of safety-net hospitals (SNHs) using all-payer databases and measures for a broad range of conditions and procedures. It found small differences in risk-adjusted mortality rates between SNHs and non-SNHs only among teaching hospitals. After controlling for hospital factors, these differences were substantially reduced and remained significant only for surgical mortality rates.
AHRQ-authored.
Citation: Jiang HJ, Reiter KL, Wang J .
Measuring mortality performance: How did safety-net hospitals compare with other hospitals?
Med Care 2016 Jul;54(7):648-56. doi: 10.1097/mlr.0000000000000540.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitals, Mortality, Provider Performance
Das A, Norton EC, Miller DC
Adding a spending metric to Medicare's value-based purchasing program rewarded low-quality hospitals.
In fiscal year 2015 the Centers for Medicare and Medicaid Services expanded its Hospital Value-Based Purchasing program by rewarding or penalizing hospitals for their performance on both spending and quality. Using data from 2,679 US hospitals that participated in the program in fiscal years 2014 and 2015, researchers found that the new emphasis on spending rewarded not only low-spending hospitals but some low-quality hospitals as well.
AHRQ-funded; HS020671.
Citation: Das A, Norton EC, Miller DC .
Adding a spending metric to Medicare's value-based purchasing program rewarded low-quality hospitals.
Health Aff 2016 May;35(5):898-906. doi: 10.1377/hlthaff.2015.1190.
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Keywords: Medicare, Provider Performance, Payment, Hospitals, Healthcare Costs, Quality of Care