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AHRQ Research Studies Date
Topics
- Adverse Events (2)
- Behavioral Health (1)
- Cardiovascular Conditions (2)
- Dialysis (1)
- Elderly (2)
- Healthcare Cost and Utilization Project (HCUP) (1)
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- (-) Hospital Readmissions (17)
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- Pneumonia (2)
- Policy (1)
- Provider Performance (1)
- Public Reporting (1)
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- Racial and Ethnic Minorities (1)
- Respiratory Conditions (1)
- Surgery (3)
- Teams (1)
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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 17 of 17 Research Studies DisplayedBuxbaum JD, Lindenauer PK, Cooke CR
Changes in coding of pneumonia and impact on the hospital readmission reduction program.
Researchers evaluated whether changes in diagnosis assignment explain reductions in 30-day readmission for patients with pneumonia following the Hospital Readmission Reduction Program (HRRP). They conducted a retrospective cohort study of Medicare discharges in HRRP-eligible hospitals; outcomes were 30-day readmission rates for pneumonia under both "narrow" and "broad" definitions that included certain diagnoses of sepsis and aspiration pneumonia. They concluded that changes in the coding of inpatient pneumonia admissions do not explain readmission reduction following the HRRP.
AHRQ-funded; HS000055.
Citation: Buxbaum JD, Lindenauer PK, Cooke CR .
Changes in coding of pneumonia and impact on the hospital readmission reduction program.
Health Serv Res 2019 Dec;54(6):1326-34. doi: 10.1111/1475-6773.13207..
Keywords: Pneumonia, Hospital Readmissions, Medicare, Hospitalization
Jones CD, Falvey J, Hess E
Predicting hospital readmissions from home healthcare in Medicare beneficiaries.
The authors used patient-level clinical variables to develop and validate a parsimonious model to predict hospital readmissions from home healthcare (HHC) in Medicare fee-for-service beneficiaries. They found that variables available to HHC clinicians at the first post-discharge HHC visit can predict readmission risk and inform care plans in HHC. They recommend that future analyses incorporating measures of social determinants of health, such as housing instability or social support, have the potential to enhance prediction of this outcome.
AHRQ-funded; HS024569.
Citation: Jones CD, Falvey J, Hess E .
Predicting hospital readmissions from home healthcare in Medicare beneficiaries.
J Am Geriatr Soc 2019 Dec;67(12):2505-10. doi: 10.1111/jgs.16153..
Keywords: Home Healthcare, Hospital Readmissions, Medicare, Elderly, Transitions of Care
McWilliams JM, Barnett ML, Roberts ET
Did hospital readmissions fall because per capita admission rates fell?
In this study examining the cause of falling hospital readmission rates, the investigators found that the probability of an admission occurring soon after another was lower when there were fewer admissions per patient. The authors indicate that the reduction in admission rates may explain much of the reduction in readmission rates.
AHRQ-funded; HS026727.
Citation: McWilliams JM, Barnett ML, Roberts ET .
Did hospital readmissions fall because per capita admission rates fell?
Health Aff 2019 Nov;38(11):1840-44. doi: 10.1377/hlthaff.2019.00411..
Keywords: Hospital Readmissions, Hospitals, Hospitalization, Quality of Care, Medicare
Schwarzkopf R, Behery OA, Yu H
Patterns and costs of 90-day readmission for surgical and medical complications following total hip and knee arthroplasty.
Unplanned readmissions following elective total hip (THA) and knee (TKA) arthroplasty as a result of surgical complications likely have different quality improvement targets and cost implications than those for nonsurgical readmissions. In this study, the investigators compared payments, timing, and location of unplanned readmissions with Center for Medicare and Medicaid Services (CMS)-defined surgical complications to readmissions without such complications.
AHRQ-funded; HS022882.
Citation: Schwarzkopf R, Behery OA, Yu H .
Patterns and costs of 90-day readmission for surgical and medical complications following total hip and knee arthroplasty.
J Arthroplasty 2019 Oct;34(10):2304-07. doi: 10.1016/j.arth.2019.05.046..
Keywords: Orthopedics, Surgery, Hospital Readmissions, Adverse Events, Quality Improvement, Quality of Care, Medicare, Hospitals
Ross KH, Jaar BG, Lea JP
Long-term outcomes among Medicare patients readmitted in the first year of hemodialysis: a retrospective cohort study.
This retrospective cohort study examined long-term outcomes among Medicare patients with end-stage renal disease (ESRD) during the first year of hemodialysis. The goal was to determine hospital readmission patterns in the first year of dialysis and outcomes in the second year. Data from the United States Renal Data System (USRDS) was used and readmission patterns were summarized as either no readmission within 30 days, at least one admission, but not within 30 days, and admission with at least one readmission within 30 days. About half of all patients did not get readmitted (51%), but 18.5% were readmitted within 30 days, and 30.5% were admitted but not within 30 days. Those who were readmitted within 30 days had the highest long-term risk of mortality, hospitalization and lower likelihood of kidney transplantation compared to patients who were not admitted or readmitted.
AHRQ-funded; HS025018.
Citation: Ross KH, Jaar BG, Lea JP .
Long-term outcomes among Medicare patients readmitted in the first year of hemodialysis: a retrospective cohort study.
BMC Nephrol 2019 Jul 29;20(1):285. doi: 10.1186/s12882-019-1473-0..
Keywords: Dialysis, Elderly, Hospital Readmissions, Kidney Disease and Health, Medicare, Outcomes
Kaplan CM, Thompson MP, Waters TM
How have 30-day readmission penalties affected racial disparities in readmissions?: an analysis from 2007 to 2014 in five US states.
The purpose of this study was to examine changes in Black-White disparities in 30-day readmissions for acute myocardial infarction (AMI), congestive heart failure (CHF), or pneumonia following the passage and implementation of the Hospital Readmission Reduction Program (HRRP), and to compare disparities across safety-net and non-safety-net hospitals. Prior to the passage of HRRP, Black and White readmission rates and disparities in readmissions were decreasing, with largest reductions at safety-net hospitals. Findings showed that improvements in readmissions have not reversed following the implementation of HRRP. In contrast, disparities continue to persist at non-safety-net hospitals.
AHRQ-funded; HS023783.
Citation: Kaplan CM, Thompson MP, Waters TM .
How have 30-day readmission penalties affected racial disparities in readmissions?: an analysis from 2007 to 2014 in five US states.
J Gen Intern Med 2019 Jun;34(6):878-83. doi: 10.1007/s11606-019-04841-x..
Keywords: Hospital Readmissions, Racial and Ethnic Minorities, Hospitals, Medicare, Payment
Borza T, Oerline MK, Skolarus TA
Association between hospital participation in Medicare Shared Savings Program Accountable Care Organizations and readmission following major surgery.
Accountable Care Organizations (ACOs) and readmission rates following major surgery. A retrospective cohort study was conducted using a 20% national Medicare sample to identify beneficiaries undergoing 1 of 7 common surgical procedures: abdominal aortic aneurysm repair, colectomy, cystectomy, prostatectomy, lung resection, total knee arthroplasty, and total hip arthroplasty between 2010 and 2014. Thirty-day risk-adjusted readmission rates was the primary outcome studied. Out of 2974 hospitals in the study, 389 were ACO affiliated. While rates fell for both cohorts, ACO hospitals had a higher decrease in hospitalizations over the same time period.
AHRQ-funded; HS024728; HS024525.
Citation: Borza T, Oerline MK, Skolarus TA .
Association between hospital participation in Medicare Shared Savings Program Accountable Care Organizations and readmission following major surgery.
Ann Surg 2019 May;269(5):873-78. doi: 10.1097/sla.0000000000002737..
Keywords: Hospitals, Surgery, Hospital Readmissions, Medicare, Healthcare Costs, Healthcare Delivery
Blecker S, Herrin J, Li L
Trends in hospital readmission of Medicare-covered patients with heart failure.
This study sought to compare trends in Medicare risk-adjusted, 30-day readmissions following principal heart failure (HF) hospitalizations and other hospitalizations with HF. The investigators found that patients with HF are often hospitalized for other causes, and these hospitalizations have high readmission rates. Policy changes led to decreases in readmission rates for both principal and secondary HF hospitalizations. Readmission rates in both groups remained high, suggesting that initiatives targeting all hospitalized patients with HF continue to be warranted.
AHRQ-funded; HS022882; HS023683.
Citation: Blecker S, Herrin J, Li L .
Trends in hospital readmission of Medicare-covered patients with heart failure.
J Am Coll Cardiol 2019 Mar 12;73(9):1004-12. doi: 10.1016/j.jacc.2018.12.040..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Hospital Readmissions, Hospitalization, Medicare, Policy
Ody C, Msall L, Dafny LS
Decreases in readmissions credited to Medicare's program to reduce hospital readmissions have been overstated.
This study examines the assumption that Medicare's Hospital Readmissions Reduction Program (HRRP) can lower risk-adjusted readmission rates at general acute care hospitals for targeted conditions. Prior studies of HRRP have relied upon the control groups' having lower baseline readmission rates, which could falsely create the appearance that readmission rates are changing more in the treatment than in the control group. After adjustment for differences in pre-HRRP readmission rates across samples, the study found that declines for targeted conditions were statistically indistinguishable from declines for two control samples. The authors conclude that either the HRRP had no effect on readmissions, or it has led to a systemwide reduction in readmissions roughly half as large as prior estimates have suggested.
AHRQ-funded; HS024072.
Citation: Ody C, Msall L, Dafny LS .
Decreases in readmissions credited to Medicare's program to reduce hospital readmissions have been overstated.
Health Aff 2019 Jan;38(1):36-43. doi: 10.1377/hlthaff.2018.05178..
Keywords: Hospital Readmissions, Medicare, Patient-Centered Outcomes Research
Desai NR, Ross JS, Kwon JY
Association between hospital penalty status under the hospital readmission reduction program and readmission rates for target and nontarget conditions.
This study compared trends in readmission rates for target and nontarget conditions, stratified by hospital penalty status after the announcement of the Hospital Readmission Reduction Program (HRRP). It found that Medicare fee-for-service patients at hospitals subject to penalties under the HRRP had greater reductions in readmission rates compared with those at nonpenalized hospitals. Changes were greater for target vs nontarget conditions for patients at the penalized hospitals but not at the other hospitals.
AHRQ-funded; HS022882; HS023000.
Citation: Desai NR, Ross JS, Kwon JY .
Association between hospital penalty status under the hospital readmission reduction program and readmission rates for target and nontarget conditions.
JAMA 2016 Dec 27;316(24):2647-56. doi: 10.1001/jama.2016.18533.
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Keywords: Heart Disease and Health, Hospital Readmissions, Hospitals, Medicare, Pneumonia
Hollingsworth JM, Funk RJ, Garrison SA
Association between physician teamwork and health system outcomes after coronary artery bypass grafting.
The researchers tested whether teamwork (assessed with the bipartite clustering coefficient) among multiple providers dispersed across many care locations is a determinant of surgical outcomes by examining national Medicare data from patients undergoing CABG. They found that health systems with higher teamwork levels had significantly lower 60-day rates of emergency department visit, readmission, and mortality.
AHRQ-funded; HS020927.
Citation: Hollingsworth JM, Funk RJ, Garrison SA .
Association between physician teamwork and health system outcomes after coronary artery bypass grafting.
Circ Cardiovasc Qual Outcomes 2016 Nov;9(6):641-48. doi: 10.1161/circoutcomes.116.002714.
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Keywords: Teams, Outcomes, Medicare, Surgery, Hospital Readmissions, Cardiovascular Conditions
Carey K, Lin MY
Hospital readmissions reduction program: safety-net hospitals show improvement, modifications to penalty formula still needed.
This study addressed the fundamental question of whether the Medicare's Hospital Readmissions Reduction Program (HRRP) has been an effective tool for reducing thirty-day readmissions in safety-net hospitals. It found that in the first three years of the program, these hospitals reduced readmissions for heart attack by 2.86 percent, heart failure by 2.78 percent, and pneumonia by 1.77 percent.
AHRQ-funded; HS024853.
Citation: Carey K, Lin MY .
Hospital readmissions reduction program: safety-net hospitals show improvement, modifications to penalty formula still needed.
Health Aff 2016 Oct 1;35(10):1918-23. doi: 10.1377/hlthaff.2016.0537.
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Keywords: Hospital Readmissions, Hospitals, Medicare
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
Singh G, Zhang W, Kuo YF
Association of psychological disorders with 30-day readmission rates in patients with COPD.
Using a 5 percent sample of Medicare beneficiaries, the researchers examined the association of psychological disorders such as depression, anxiety, psychosis, alcohol abuse and drug abuse with early readmission for patients with COPD. They found that psychological disorders like depression, anxiety, psychosis, alcohol abuse and drug abuse are independently associated with higher all-cause 30-day readmission rates for Medicare beneficiaries with COPD.
AHRQ-funded; HS020642; HS022134.
Citation: Singh G, Zhang W, Kuo YF .
Association of psychological disorders with 30-day readmission rates in patients with COPD.
Chest 2016 Apr;149(4):905-15. doi: 10.1378/chest.15-0449..
Keywords: Behavioral Health, Hospital Readmissions, Medicare, Respiratory Conditions
DeVore AD, Hammill BG, Hardy NC
Has public reporting of hospital readmission rates affected patient outcomes?: Analysis of Medicare claims data.
Following the implementation of Centers for Medicare & Medicaid Services (CMS) public reporting, this study assessed trends of 30-day readmission rates and post-discharge care for patients discharged with acute myocardial infarction (MI), heart failure (HF), or pneumonia. It found that the release of the CMS public reporting of hospital readmission rates did not change 30-day readmission trends for MI, HF, or pneumonia, but it was associated with less hospital-based acute care for HF.
AHRQ-funded; HS021092.
Citation: DeVore AD, Hammill BG, Hardy NC .
Has public reporting of hospital readmission rates affected patient outcomes?: Analysis of Medicare claims data.
J Am Coll Cardiol 2016 Mar 1;67(8):963-72. doi: 10.1016/j.jacc.2015.12.037.
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Keywords: Public Reporting, Hospital Readmissions, Outcomes, Medicare, Patient-Centered Outcomes Research
Berry SA, Fleishman JA, Moore RD
AHRQ Author: Fleishman JA
Thirty-day hospital readmissions for adults with and without HIV infection.
This study compared 30-day readmission rates by HIV status in a multi-state sample with planned subgroup comparisons by insurance and diagnostic categories. After adjustment for age, gender, race, insurance, and diagnostic category, HIV infection was associated with 1.5 times higher odds of readmission. Predicted, adjusted readmission rates were higher for persons living with HIV within every insurance category, including Medicaid.
AHRQ-authored.
Citation: Berry SA, Fleishman JA, Moore RD .
Thirty-day hospital readmissions for adults with and without HIV infection.
HIV Med 2016 Mar;17(3):167-77. doi: 10.1111/hiv.12287.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Human Immunodeficiency Virus (HIV), Hospital Readmissions, Medicaid, Medicare
Jubelt LE, Goldfeld KS, Chung WY
Changes in discharge location and readmission rates under Medicare bundled payment.
To control costs, NYU Langone Medical Center attempted to shift referrals from facility-based to home-based postacute care. In the context of this shift in referrals, the researchers examined the change in hospital readmission rates. Their findings suggest that institutions may be able to shift some patients from facility-based to home-based postacute care without adversely affecting hospital readmission rates or the length of hospital stay.
AHRQ-funded; HS023683; HS022882.
Citation: Jubelt LE, Goldfeld KS, Chung WY .
Changes in discharge location and readmission rates under Medicare bundled payment.
JAMA Intern Med 2016 Jan;176(1):115-7. doi: 10.1001/jamainternmed.2015.6265.
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Keywords: Medicare, Hospital Discharge, Hospital Readmissions, Home Healthcare, Healthcare Costs