Relative Effects of the Hospital Readmissions Reduction Program on Hospitals That Serve Poorer Patients

Importance: Hospitals that serve poorer populations have higher readmission rates. It is unknown whether these hospitals effectively lowered readmission rates in response to the Hospital Readmissions Reduction Program (HRRP). Objective: To compare pre-post differences in readmission rates among hospitals with different proportion of dual-eligible patients both generally and among the most highly penalized (ie, low performing) hospitals. Design: Retrospective cohort study using piecewise linear model with estimated hospital-level risk-standardized readmission rates (RSRRs) as the dependent variable and a change point at HRRP passage (2010). Economic burden was assessed by proportion of dual-eligibles served. Setting: Acute care hospitals within the United States. Participants: Medicare fee-for-service beneficiaries aged 65 years or older discharged alive from January 1, 2003 to November 30, 2014 with a principal discharge diagnosis of acute myocardial infarction (AMI), congestive heart failure (CHF), and pneumonia. Main Outcome and Measure: Decrease in hospital-level RSRRs in the post-law period, after controlling for the pre-law trend. Results: For AMI, the pre-post difference between hospitals that service high and low proportion of dual-eligibles was not significant (−65 vs. −64 risk-standardized readmissions per 10000 discharges per year, P=0.0678). For CHF, RSRRs declined more at high than low dual-eligible hospitals (−79 vs. −7...
Source: Medical Care - Category: Health Management Tags: Original Articles Source Type: research

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ConclusionsBlack and Hispanic patients had lower odds of IHT, largely explained by a higher likelihood of being hospitalized at urban teaching hospitals. Racial/ethnic disparities in transfer were demonstrated at community hospitals, in certain geographic regions and among patients with specific diseases.
Source: Journal of General Internal Medicine - Category: Internal Medicine Source Type: research
Medicare bundled payments for acute myocardial infarction, congestive heart failure, COPD, and pneumonia are associated with reduced spending and less use of skilled nursing, a US study suggests.Reuters Health Information
Source: Medscape Medical News Headlines - Category: Consumer Health News Tags: Hospital Medicine News Source Type: news
Conclusion: Level 1 trauma center designation was not associated with improved mortality for high-acuity, nonsurgical medical conditions in this study. PMID: 32337565 [PubMed - in process]
Source: Journal of the American Osteopathic Association - Category: Complementary Medicine Tags: J Am Osteopath Assoc Source Type: research
Based on reports from China, we know that most COVID-19 patients (about 80%) will develop mild flulike symptoms, including fever, dry cough, and body aches that can be managed at home. 20% will develop more serious symptoms, such as pneumonia requiring hospitalization, with about a quarter of these requiring ICU-level care. Initial reports focused on the respiratory effects of COVID-19, such as pneumonia and difficulty breathing. But more recent literature has described serious cardiovascular complications occurring in about 10% to 20% of hospitalized patients. Someone with pre-existing heart disease who becomes ill with C...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Health Heart Health Hypertension and Stroke Infectious diseases Source Type: blogs
CONCLUSION: This pharmacist-led transitional care intervention was associated with significantly decreased inpatient readmissions. The analysis indicates that pharmacist interventions can significantly reduce 30-day readmissions for high-risk populations and 90-day readmissions in patients with CHF. PMID: 32086512 [PubMed - as supplied by publisher]
Source: American Journal of Health-System Pharmacy : AJHP - Category: Drugs & Pharmacology Authors: Tags: Am J Health Syst Pharm Source Type: research
ConclusionsThe overall VTE rate after CABG has been low. However, the condition has been associated with worse 30-day postoperative outcomes and complications. The independent predictors of VTE development included a history of bleeding disorders, congestive heart failure in the 30 days before surgery, and operative time of ≥310 minutes. Understanding these risk factors should aid physicians in the decisions regarding prophylaxis and treatment.
Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders - Category: Surgery Source Type: research
FRIDAY, June 28, 2019 -- Medicare Advantage patients have higher risk-adjusted hospital readmission rates than traditional Medicare patients for acute myocardial infarction, congestive heart failure, and pneumonia, according to a new study published...
Source: Drugs.com - Pharma News - Category: Pharmaceuticals Source Type: news
Conclusion: The HEDIS data underreported hospital admissions for 3 common medical conditions, and readmission rates were higher among patients with underreported admissions. Medicare Advantage beneficiaries had higher risk-adjusted 30-day readmission rates than traditional Medicare beneficiaries. Primary Funding Source: National Institute on Aging. PMID: 31234205 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - Category: Internal Medicine Authors: Tags: Ann Intern Med Source Type: research
Conclusions: The mFI-5 is an independent predictor of postoperative morbidity and mortality in elderly patients undergoing surgery for hip fractures. This clinical tool can be used by hospitals and surgeons to identify high-risk patients, accurately council patients and families with transparency, and guide perioperative care to optimize patient outcomes. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Source: Journal of Orthopaedic Trauma - Category: Orthopaedics Tags: Original Article Source Type: research
Marco Vacante1, Antonio Biondi1, Francesco Basile1, Roberto Ciuni1, Salvatore Luca1, Salomone Di Saverio2, Carola Buscemi3, Enzo Saretto Dante Vicari3 and Antonio Maria Borzì3* 1Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy 2Cambridge Colorectal Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom 3Department of Clinical and Experimental Medicine, Specialization School in Geriatrics, University of Catania, Catania, Italy There is a high prevalence of hypothyroidism in the elderly population, mainly among women. The mo...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
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