Subsequent admissions of a patient to a hospital or other health care institution for treatment.
The administrative process of discharging the patient, alive or dead, from hospitals or other health facilities.
The period of confinement of a patient to a hospital or other health facility.
Federal program, created by Public Law 89-97, Title XVIII-Health Insurance for the Aged, a 1965 amendment to the Social Security Act, that provides health insurance benefits to persons over the age of 65 and others eligible for Social Security benefits. It consists of two separate but coordinated programs: hospital insurance (MEDICARE PART A) and supplementary medical insurance (MEDICARE PART B). (Hospital Administration Terminology, AHA, 2d ed and A Discursive Dictionary of Health Care, US House of Representatives, 1976)
Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.
A heterogeneous condition in which the heart is unable to pump out sufficient blood to meet the metabolic need of the body. Heart failure can be caused by structural defects, functional abnormalities (VENTRICULAR DYSFUNCTION), or a sudden overload beyond its capacity. Chronic heart failure is more common than acute heart failure which results from sudden insult to cardiac function, such as MYOCARDIAL INFARCTION.
A system for classifying patient care by relating common characteristics such as diagnosis, treatment, and age to an expected consumption of hospital resources and length of stay. Its purpose is to provide a framework for specifying case mix and to reduce hospital costs and reimbursements and it forms the cornerstone of the prospective payment system.
The expenses incurred by a hospital in providing care. The hospital costs attributed to a particular patient care episode include the direct costs plus an appropriate proportion of the overhead for administration, personnel, building maintenance, equipment, etc. Hospital costs are one of the factors which determine HOSPITAL CHARGES (the price the hospital sets for its services).
Physicians who are employed to work exclusively in hospital settings, primarily for managed care organizations. They are the attending or primary responsible physician for the patient during hospitalization.
The confinement of a patient in a hospital.
An assessment of a patient's illness, its chronicity, severity, and other qualitative aspects.
Institutions with an organized medical staff which provide medical care to patients.
The care and treatment of a convalescent patient, especially that of a patient after surgery.
The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.
Norms, criteria, standards, and other direct qualitative and quantitative measures used in determining the quality of health care.
Method of charging whereby a physician or other practitioner bills for each encounter or service rendered. In addition to physicians, other health care professionals are reimbursed via this mechanism. Fee-for-service plans contrast with salary, per capita, and prepayment systems, where the payment does not change with the number of services actually used or if none are used. (From Discursive Dictionary of Health Care, 1976)
A vital statistic measuring or recording the rate of death from any cause in hospitalized populations.
Evaluation procedures that focus on both the outcome or status (OUTCOMES ASSESSMENT) of the patient at the end of an episode of care - presence of symptoms, level of activity, and mortality; and the process (ASSESSMENT, PROCESS) - what is done for the patient diagnostically and therapeutically.
An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.
Research aimed at assessing the quality and effectiveness of health care as measured by the attainment of a specified end result or outcome. Measures include parameters such as improved health, lowered morbidity or mortality, and improvement of abnormal states (such as elevated blood pressure).
Special hospitals which provide care to the mentally ill patient.
Review of claims by insurance companies to determine liability and amount of payment for various services. The review may also include determination of eligibility of the claimant or beneficiary or of the provider of the benefit; determination that the benefit is covered or not payable under another policy; or determination that the service was necessary and of reasonable cost and quality.
Health care provided on a continuing basis from the initial contact, following the patient through all phases of medical care.
The use of severity-of-illness measures, such as age, to estimate the risk (measurable or predictable chance of loss, injury or death) to which a patient is subject before receiving some health care intervention. This adjustment allows comparison of performance and quality across organizations, practitioners, and communities. (from JCAHO, Lexikon, 1994)
Elements of limited time intervals, contributing to particular results or situations.
Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.
Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.
Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.
The process of accepting patients. The concept includes patients accepted for medical and nursing care in a hospital or other health care institution.
Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor.
A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables.
Persons admitted to health facilities which provide board and room, for the purpose of observation, care, diagnosis or treatment.
Hospitals engaged in educational and research programs, as well as providing medical care to the patients.
Situations or conditions requiring immediate intervention to avoid serious adverse results.
Institutions with permanent facilities and organized medical staff which provide the full range of hospital services primarily to a neighborhood area.
The formal process of obtaining a complete and accurate list of each patient's current home medications including name, dosage, frequency, and route of administration, and comparing admission, transfer, and/or discharge medication orders to that list. The reconciliation is done to avoid medication errors.
Hospitals providing medical care to veterans of wars.
Schedules of medical and nursing procedures, including diagnostic tests, medications, and consultations designed to effect an efficient, coordinated program of treatment. (From Mosby's Medical, Nursing & Allied Health Dictionary, 4th ed)
The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival.
Special hospitals which provide care for ill children.
Surgery performed on an outpatient basis. It may be hospital-based or performed in an office or surgicenter.
Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.
Infection of the lung often accompanied by inflammation.
Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.
Hospital department responsible for the administration and provision of immediate medical or surgical care to the emergency patient.
A professional society in the United States whose membership is composed of hospitals.
Disease having a short and relatively severe course.
NECROSIS of the MYOCARDIUM caused by an obstruction of the blood supply to the heart (CORONARY CIRCULATION).

Recurrence in affective disorder: analyses with frailty models. (1/1240)

The risk of recurrence in affective disorder is influenced by the number of prior episodes and by a person's tendency toward recurrence. Newly developed frailty models were used to estimate the effect of the number of episodes on the rate of recurrence, taking into account individual frailty toward recurrence. The study base was the Danish psychiatric case register of all hospital admissions for primary affective disorder in Denmark during 1971-1993. A total of 20,350 first-admission patients were discharged with a diagnosis of major affective disorder. For women with unipolar disorder and for all kinds of patients with bipolar disorder, the rate of recurrence was affected by the number of prior episodes even when the effect was adjusted for individual frailty toward recurrence. No effect of episodes but a large effect of the frailty parameter was found for unipolar men. The authors concluded that the risk of recurrence seems to increase with the number of episodes of bipolar affective disorder in general and for women with unipolar disorder.  (+info)

Randomized, controlled trial of long-term moderate exercise training in chronic heart failure: effects on functional capacity, quality of life, and clinical outcome. (2/1240)

BACKGROUND: It is still a matter of debate whether exercise training (ET) is a beneficial treatment in chronic heart failure (CHF). METHODS AND RESULTS: To determine whether long-term moderate ET improves functional capacity and quality of life in patients with CHF and whether these effects translate into a favorable outcome, 110 patients with stable CHF were initially recruited, and 99 (59+/-14 years of age; 88 men and 11 women) were randomized into 2 groups. One group (group T, n=50) underwent ET at 60% of peak &f1;O2, initially 3 times a week for 8 weeks, then twice a week for 1 year. Another group (group NT, n=49) did not exercise. At baseline and at months 2 and 14, all patients underwent a cardiopulmonary exercise test, while 74 patients (37 in group T and 37 in group NT) with ischemic heart disease underwent myocardial scintigraphy. Quality of life was assessed by questionnaire. Ninety-four patients completed the protocol (48 in group T and 46 in group NT). Changes were observed only in patients in group T. Both peak &f1;O2 and thallium activity score improved at 2 months (18% and 24%, respectively; P<0. 001 for both) and did not change further after 1 year. Quality of life also improved and paralleled peak VO2. Exercise training was associated both with lower mortality (n=9 versus n=20 for those with training versus those without; relative risk (RR)=0.37; 95% CI, 0.17 to 0.84; P=0.01) and hospital readmission for heart failure (5 versus 14; RR=0.29; 95% CI, 0.11 to 0.88; P=0.02). Independent predictors of events were ventilatory threshold at baseline (beta-coefficient=0.378) and posttraining thallium activity score (beta-coefficient -0.165). CONCLUSIONS: Long-term moderate ET determines a sustained improvement in functional capacity and quality of life in patients with CHF. This benefit seems to translate into a favorable outcome.  (+info)

Depression during the longitudinal course of schizophrenia. (3/1240)

This prospective research investigated the occurrence and persistence of depression during the longitudinal course of schizophrenia. The research goals were to (1) compare depression in schizophrenia with that in schizoaffective and major depressive disorders, (2) assess whether some schizophrenia patients are vulnerable to depression, and (3) assess the relationship of depression to posthospital adjustment in schizophrenia. A total of 70 schizophrenia, 31 schizoaffective depressed, 17 psychotic unipolar major depressed, and 69 nonpsychotic unipolar major depressed patients were assessed during hospitalization and prospectively assessed for depression, psychosis, and posthospital functioning at 4.5- and 7.5-year followups. A large number (30% to 40%) of schizophrenia patients evidenced full depressive syndromes at each followup, including a subgroup of patients who evidenced repeated depression. Even when considering the influence of psychosis on outcome, depression in schizophrenia was associated with poor overall outcome, work impairment, lower activity, dissatisfaction, and suicidal tendencies. During the post-acute phase assessed, neither the rates nor the severity of depressive syndromes differentiated depression in schizophrenia from schizodepressive or major depressive disorders. However, the depressed schizophrenia patients showed poorer posthospital adjustment in terms of less employment, more rehospitalizations, and more psychosis than the patients with primary major depression. The high prevalence of depression in schizophrenia warrants its incorporation into theory about the disorder. A continuum of vulnerability to depression contributes to the heterogeneity of schizophrenia, with some schizophrenia patients being prone to depression even years after the acute phase. Depression in schizophrenia is one factor, in addition to psychosis, associated with poor outcome and requires specific attention to the treatment strategies by psychiatrists.  (+info)

Need to measure outcome after discharge in surgical audit. (4/1240)

OBJECTIVE: To assess the accuracy of outcome data on appendicectomy routinely collected as part of a surgical audit and to investigate outcome in the non-audited period after discharge. DESIGN: Retrospective analysis of audit data recorded by the Medical Data Index (MDI) computer system for all patients undergoing emergency appendicectomy in one year; subsequent analysis of their hospital notes and notes held by their general practitioners for patients identified by a questionnaire who had consulted their general practitioner for a wound complication. SETTING: One district general hospital with four consultant general surgeons serving a population of 250,000. PATIENTS: 230 patients undergoing emergency appendicectomy during 1989. MAIN MEASURES: Comparison of postoperative complications recorded in hospital notes with those recorded by the MDI system and with those recorded by patients' general practitioners after discharge. RESULTS: Of the 230 patients, 29 (13%) had a postoperative complication recorded in their hospital notes, but only 14 (6%) patients had these recorded by the MDI system. 189 (82%) of the patients completed the outcome questionnaire after discharge. The number of wound infections as recorded by the MDI system, the hospital notes, and notes held by targeted patients' general practitioners were three (1%), eight (3%), and 18 (8%) respectively. None of 12 readmissions with complications identified by the hospital notes were identified by the MDI system. CONCLUSIONS: Accurate audit of postoperative complications must be extended to the period after discharge. Computerised audit systems must be able to relate readmissions to specific previous admissions.  (+info)

Does a dedicated discharge coordinator improve the quality of hospital discharge? (5/1240)

OBJECTIVE: To evaluate the effectiveness of the role of a discharge coordinator whose sole responsibility was to plan and coordinate the discharge of patients from medical wards. DESIGN: An intervention study in which the quality of discharge planning was assessed before and after the introduction of a discharge coordinator. Patients were interviewed on the ward before discharge and seven to 10 days after being discharged home. SETTING: The three medical wards at the Homerton Hospital in Hackney, East London. PATIENTS: 600 randomly sampled adult patients admitted to the medical wards of the study hospital, who were resident in the district (but not in institutions), were under the care of physicians (excluding psychiatry), and were discharged home from one of the medical wards. The sampling was conducted in three study phases, over 18 months. INTERVENTIONS: Phase I comprised base line data collection; in phase II data were collected after the introduction of the district discharge planning policy and a discharge form (checklist) for all patients; in phase III data were collected after the introduction of the discharge coordinator. MAIN MEASURES: The quality and out come of discharge planning. Readmission rates, duration of stay, appropriateness of days of care, patients' health and satisfaction, problems after discharge, and receipt of services. RESULTS: The discharge coordinator resulted in an improved discharge planning process, and there was a reduction in problems experienced by patients after discharge, and in perceived need for medical and healthcare services. There was no evidence that the discharge coordinator resulted in a more timely or effective provision of community services after discharge, or that the appropriateness or efficiency of bed use was improved. CONCLUSIONS: The introduction of a discharge coordinator improved the quality of discharge planning, but at additional cost.  (+info)

Readmission rates are associated with differences in the process of care in acute asthma. (6/1240)

OBJECTIVE: To test the hypothesis that sustained differences in readmission rate for acute asthma were associated with variations in clinical practice. DESIGN: Data were collected by retrospective review of case notes, using the criteria recommended by the British Thoracic Society. SETTING: Two city National Health Service (NHS) hospitals that had recorded a sustained difference in readmission rate for acute asthma. SUBJECTS: A random sample of 50 from each hospital, selected from all 16-44 year old patients discharged in 1992 with acute asthma (ninth revision of the international classification of diseases (ICD-9) 493). RESULTS: Hospital A had a lower readmission rate than hospital B. The sample groups were similar for age, sex, deprivation of area of residence, and severity of episode. Systemic corticosteroids were given early more often (p = 0.02) and oral corticosteroids were prescribed at discharge more often (p = 0.04) in hospital A. When a short course of oral corticosteroids was prescribed the duration stated was longer (p = 0.02) and inhaled corticosteroids were started or the dose increased more often (p = 0.02) in hospital A. CONCLUSIONS: These results support the hypothesis that differences in readmission rates for acute asthma are associated with variations in clinical practice. Sustained variation in readmission rates is an outcome of health care, for acute asthma. The findings also support audit of the process of hospital asthma care as a proxy for outcome.  (+info)

Disease management interventions to improve outcomes in congestive heart failure. (7/1240)

This study is part of a planned 24-month, multicenter, longitudinal comparison of a comprehensive congestive heart failure (CHF) disease management program and was designed to determine effectiveness after 12 months of implementation. The impact of interventions such as telemonitoring of patients, post-hospitalization follow-up, and provider education on selected primary outcomes (hospital admission and readmission rates, length of stay, total hospital days, and emergency room utilization) in a managed care setting was evaluated. Subjects in the study included all participants in the managed care plan, as well as 149 selected program participants. The effects of the program were analyzed for pure CHF and CHF-related diagnoses, with outcomes for the third quarter of 1996 (postintervention follow-up) being compared with those for the third quarter of 1995 (preintervention baseline). Overall, the data demonstrated significantly reduced admission and readmission rates for patients with the pure CHF diagnosis. Among the entire CHF patient population, the third quarter admission rate declined 63% (P = 0.00002), and the 30-day and 90-day readmission rates declined 75% (P = 0.02) and 74% (P = 0.004), respectively. Among program participants with pure CHF diagnoses, the 30-day readmission rate was reduced to 0, and an 83% reduction occurred for both the third quarter admission (P = 0.008) and 90-day readmission (P = 0.06) rates. In addition, the average length of stay for patients with CHF-related diagnoses was significantly reduced among both plan participants (P = 0.03) and program participants (P = 0.001). Reductions were also seen in total hospital days and emergency room utilization. These data thus indicate that a comprehensive disease management program can reduce healthcare utilization not only among CHF patients in the program but also among the entire managed care plan population.  (+info)

Longer hospital length of stay is not related to better clinical outcomes in congestive heart failure. (8/1240)

Efforts to reduce hospital lengths of stay (LOS) are prevalent, despite limited understanding of the clinical impact of duration of hospitalization. Thus, we sought to evaluate the clinical relevance of LOS in congestive heart failure (CHF) by studying its relationship to inpatient and post-discharge outcomes among individuals with this disorder. Ten acute care community hospitals in New York State participated in this investigation. The study population consisted of 1,402 consecutive patients, predominantly elderly, who were hospitalized for evaluation and treatment of moderately severe or severe CHF. The patients' medical records were abstracted by trained personnel immediately after hospital discharge. Patients were followed forward for six month's time to track death and readmission rates, as well as functional status, quality of life, and satisfaction. Mean LOS for the group was 7.9 +/- 9.2 days. Longer LOS had a neutral or negative association with patient outcomes. Specifically, longer LOS was linked to a higher adjusted mortality rate during the index hospitalization, as well as a greater adjusted risk of death during the post-discharge period. Moreover, longer LOS was associated with worse post-discharge functional class and a trend for less patient satisfaction with their physicians' care. We conclude that death becomes more prevalent and functional measures decline in association with prolonged hospital stays for heart failure. Although these findings may be of use in planning management strategies, they offer no proof that reducing the costs of care will improve clinical outcomes in CHF.  (+info)

Background: Among ambulatory patients with heart failure (HF), hospital admission is associated with higher subsequent mortality. HF is the leading cause of 30-day all-cause readmission, reduction of which is a goal of the Affordable Care Act. We examined the association of 30-day all-cause readmission with subsequent all-cause mortality in a propensity-matched cohort of hospitalized HF patients.. Methods: Of the 8049 Medicare beneficiaries hospitalized for HF and discharged alive from 106 U.S. hospitals (1998-2001), 7578 were alive 30-day post-discharge, of which 1519 had 30-day all-cause readmission. Using propensity scores for 30-day all-cause readmission, we assembled a matched cohort of 1516 pairs of patients with and without 30-day all-cause readmission, balanced on 34 baseline characteristics.. Results: During 2-12 months of post-discharge follow-up, all-cause mortality occurred in 41% and 27% of matched patients with and without 30-day all-cause readmission, respectively (HR, 1.68; 95% ...
TY - JOUR. T1 - Impact of race/ethnicity and socioeconomic status on risk-adjusted hospital readmission rates following hip and knee arthroplasty. AU - Martsolf, Grant R.. AU - Barrett, Marguerite L.. AU - Weiss, Audrey J.. AU - Kandrack, Ryan. AU - Washington, Raynard. AU - Steiner, Claudia A.. AU - Mehrotra, Ateev. AU - Hoo, Nelson F.Soo. AU - Coffey, Rosanna. PY - 2016/1/1. Y1 - 2016/1/1. N2 - Background: Readmission rates following total hip arthroplasty (THA) and total knee arthroplasty (TKA) are increasingly used to measure hospital performance. Readmission rates that are not adjusted for race/ethnicity and socioeconomic status, patient risk factors beyond a hospitals control, may not accurately reflect a hospitals performance. In this study, we examined the extent to which risk-adjusting for race/ethnicity and socioeconomic status affected hospital performance in terms of readmission rates following THA and TKA. Methods: We calculated 2 sets of risk-adjusted readmission rates by (1) ...
Delivery of quality healthcare in resource-limited settings is an important, understudied public health priority. Thirty-day (early) hospital readmission is often avoidable and an important indicator of healthcare quality. We investigated the prevalence of all-cause early readmission and its associated factors using age and sex adjusted risk ratios (RR) and 95% confidence intervals (CI). A retrospective review of the medical ward database at Kamuzu Central Hospital in Lilongwe, Malawi was conducted between February and December 2013. There were 3547 patients with an index admission of which 2776 (74.4%) survived and were eligible for readmission. Among these patients: 49.7% were male, mean age was 39.7 years, 36.1% were HIV-positive, 34.6% were HIV-negative, and 29.3% were HIV-unknown. The prevalence of early hospital readmission was 5.5%. Diagnoses associated with 30-day readmission were HIV-positive status (RR = 2.41; 95% CI: 1.64-3.53) and malaria (RR = 0.45; 95% CI: 0.22-0.91). Other factors
The Particulars: Medicare reduces compensation rates for hospitals with high readmission rates. However, many hospitals can only track same-hospital readmissions. It has not been established if same-hospital readmission rates correlate with all-hospital readmission rates.. Data Breakdown: Study investigators evaluated 30-day same-hospital and all-hospital readmission rates for patients who underwent one of three common surgeries. When institutions in the worst performing quintile of same-hospital readmissions were evaluated based on all-hospital readmission, 95% were reclassified. When hospitals ranked in the top quintile of same-hospital readmissions were evaluated based on all-hospital readmission, 62% were reclassified, with 11% moving to a ranking in the worst quintile.. Take Home Pearls: Same-hospital readmission rates appear to be an unreliable predictor of all-hospital readmission rates. Novel approaches to accurately track postoperative readmissions in real-time are necessary to prevent ...
|p|Unplanned readmissions to hospital have been identified as common, costly and potentially avoidable. Understanding the factors that contribute to unplanned readmissions can inform strategies to reduce unplanned readmission rates. |/p| |p| |em|All-Cause Readmission to Acute Care and Return to the Emergency Department|/em| provides an overview of unplanned readmissions to acute care hospitals in Canada within thirty days of discharge. It is also the first study in Canada to report rates of return to the emergency department (ED) within seven days of discharge for three jurisdictions (Alberta, Ontario and Yukon). The study focuses on factors associated with readmissions and ED returns at the patient level (e.g. age, clinical condition), hospital (e.g. length of stay, size) and community level (e.g. urban/rural, income quintile). It also describes the costs associated with readmissions and the provincial variation in readmission rates.|/p| |p||strong|Companion Product |/strong||/p| |UL| |LI||A
The use of electronic discharge orders aimed at providing evidence-based decision support and clear instructions to heart failure patients helped increase compliance with quality care measures and lowered hospital readmission rates, according to research presented at the American College of Cardiologys 62nd Annual Scientific Session.. Despite more widespread use of standardized discharge orders and evidence suggesting their effectiveness, little is known about how they impact adherence to quality measures or hospital readmission rates among heart failure patients. This study showed use of a computerized discharge system was associated with a 23 percent lower all-cause hospital readmission rate and a 10-fold increase in compliance with quality care measures.. Researchers conducted a retrospective study of heart failure patients discharged from 11 hospitals across Utah between January 2011 and September 2012 to determine whether the use of an electronic discharge orders tool was associated with ...
The analysis looked at patients 65 and older (Medicare-eligible) from the CHAMPION trial and found that there was a 58% reduction in all-cause hospital readmissions (hospitalisation for any reason) and a 78% reduction in heart failure hospital readmissions when patients were managed with the CardioMEMS HF system compared to standard-of-care medical management. These findings suggest that use of the CardioMEMS HF system can significantly reduce the hospitals risk of government-imposed penalties that are designed to reduce patient readmissions within 30 days of treatment.. The CardioMEMS system uses a miniaturised, wireless monitoring sensor that is implanted in the pulmonary artery during a minimally invasive procedure to directly measure pulmonary artery pressure. Measuring pressure allows clinicians to proactively manage treatment with medication changes for patients with worsening heart failure before visible symptoms, such as weight and blood pressure changes, occur. The system allows ...
BACKGROUND. Reducing hospital readmission rates is a top national priority. Unplanned hospital readmission is estimated to have accounted for more than $17 billion of the roughly $103 billion hospital payments made by Medicare in 2004.1 For patients in Medicare fee-for-service programs, the 30-day hospital readmission rates was recently found to be 19.6% nationally, and 20.7% in New York State (Jencks et al., 2009). Hospitals have urgent incentives to address readmission rates: readmission rates have been added to the National Quality Forum performance metrics (National Quality Forum, 2007); readmission rate comparisons are posted on www.hospitalcompare.hss.gov as public indicators of hospital quality; and provisions in health care reform legislation will soon mean that hospitals will not receive payment for many readmissions within 30 days of discharge.. Targeted transitional programs and better coordination of care between inpatient and outpatient settings have the potential to reduce hospital ...
There has been a relentless increase in emergency medical admissions in the UK over recent years. Many of these patients suffer with chronic conditions requiring continuing medical attention. We wished to determine whether conventional outpatient clinic follow up after discharge has any impact on the rate of readmission to hospital. Two consultant general physicians with the same patient case-mix but markedly different outpatient follow-up practice were chosen. Of 1203 patients discharged, one consultant saw twice as many patients in the follow-up clinic than the other (Dr A 9.8% v Dr B 19.6%). The readmission rate in the twelve months following discharge was compared in a retrospective analysis of hospital activity data. Due to the specialisation of the admitting system, patients mainly had cardiovascular or cerebrovascular disease or had taken an overdose. Few had respiratory or infectious diseases. Outpatient follow-up was focussed on patients with cardiac disease. Risk of readmission increased
Hospital readmission after discharge is often a costly failing of the U.S. health care system to adequately manage patients who are ill. Increasing the numbers of family physicians (FPs) is associated with significant reductions in hospital readmissions and substantial cost savings.
Medicares Hospital Readmissions Reduction Program raises concerns about the effect of payment penalties on safety-net hospitals, which treat a disproportionate share of patients with low socioeconomic status. We examined how the programs current risk-adjustment methods and patient and hospital factors explained differences in readmission rates between safety-net and other hospitals. Patient socioeconomic status explains some of the differences, but unmeasured factors, such as hospital performance, may also play a role. We must evaluate policies that incorporate socioeconomic status to determine whether it would affect penalties while remaining consistent with objectives for delivery system transformation ...
NQF will conduct an ad hoc review requested by the Centers for Medicare and Medicaid Services for the endorsed measures: 1551, hospital-level 30-day all-cause risk-standardized readmission rate following elective primary total hip arthroplasty and total knee arthroplasty; 0330, hospital 30-day all-cause risk-standardized readmission rate following heart failure hospitalization for patients 18 and older; and 0505, hospital 30-day all-cause risk-standardized readmission rate following acute myocardial infarction hospitalization. This review is being completed due to material changes to a currently endorsed measure (eg, expansion of a measure to a different population or setting). This is intended as a focused review of the planned readmission algorithms that have been incorporated into each of the condition/procedure specific readmission measures. ...
People discharged from hospital with heart failure have relatively poor outcomes. In this study, just over one in ten patients died before discharge, and of those discharged, 4% died within a month and one in five had an unplanned readmission. While unplanned readmission and post-discharge mortality rates did vary across hospitals, in our study this between-hospital variation did not account for a significant proportion of the total variation in outcomes once individual patient characteristics were accounted for. A range of patient characteristics were associated with a higher risk of unplanned readmission, including being male, prior hospitalisation for cardiovascular disease and for anemia, comorbidities at the time of admission, lower BMI and lower social interaction scores. Similarly, risk of 30-day mortality was associated with patient-level factors, in particular age and comorbidity.. Heart failure is one of the most common underlying medical conditions in patients readmitted to hospital ...
TY - GEN. T1 - Impact of Mandated Public Reporting in California on 30-Day readmission following CABG surgery. T2 - 2019 IEEE International Conference on Big Data, Big Data 2019. AU - Ray, Monika. AU - Sadeghi, Banafsheh. AU - Ritley, Dominique. AU - Romano, Patrick S.. PY - 2019/12. Y1 - 2019/12. N2 - The 30-day all-cause readmission rate following coronary artery bypass graft (CABG) surgery is considered an important outcome measure for patients because higher rates can be an indicator of low quality and unnecessary health care costs. Our research uses rigorous methods to explore the impact of mandatory public reporting of all-cause readmission rates following CABG surgery in California. We used a hierarchical logistic regression model on 173, 823 CABG patient records. This model standardised outcomes across 10 U.S. states that were not previously comparable due to different CABG definitions and metrics. Additionally, in order to account for the differences in medical practice across different ...
TY - JOUR. T1 - Majority of 30-day readmissions after intracerebral hemorrhage are related to infections. AU - Lord, Aaron S.. AU - Lewis, Ariane. AU - Czeisler, Barry. AU - Ishida, Koto. AU - Torres, Jose. AU - Kamel, Hooman. AU - Woo, Daniel. AU - Elkind, Mitchell S.V.. AU - Boden-Albala, Bernadette. PY - 2016/7/1. Y1 - 2016/7/1. N2 - Background and Purpose - Infections are common after intracerebral hemorrhage, but little is known about the risk of serious infection requiring readmission after hospital discharge. Methods - To determine if infections are prevalent in patients readmitted within 30 days of discharge, we performed a retrospective cohort study of patients discharged from nonfederal acute care hospitals in California with a primary diagnosis of intracerebral hemorrhage between 2006 and 2010. We excluded patients who died during the index admission, were discharged against medical advice, or were not California residents. Our main outcome was 30-day unplanned readmission with ...
A hospitals quality of care with surgical procedures affects unplanned readmission rates. Those with high volume or low mortality rates have fewer readmissions.
BACKGROUND: Gaining a better understanding of the probability, timing and prediction of rehospitalisation amongst preterm babies could help improve outcomes. There is limited research addressing these topics amongst extremely and very preterm babies. In this context, unplanned rehospitalisations constitute an important, potentially modifiable adverse event. We aimed to establish the probability, time-distribution and predictability of unplanned rehospitalisation within 30 days of discharge in a population of French preterm babies. METHODS: This study used data from EPIPAGE 2, a population-based prospective study of French preterm babies. Only those babies discharged home alive and whose parents responded to the one-year survey were eligible for inclusion in our study. For Kaplan-Meier analysis, the outcome was unplanned rehospitalisation censored at 30 days. For predictive modelling, the outcome was binary, recording unplanned rehospitalisation within 30 days of discharge. Predictors included
Readmission after coronary artery bypass graft (CABG) surgery is associated with adverse outcomes and significant healthcare costs, and 30-day readmission rate is considered as a key indicator of the quality of care. This study aims to: quantify rates of readmission within 30 days of CABG surgery; explore the causes of readmissions; and investigate how patient- and hospital-level factors influence readmission. We conducted systematic searches (until June 2020) of PubMed and Embase databases to retrieve observational studies that investigated readmission after CABG. Random effect meta-analysis was used to estimate rates and predictors of 30-day post-CABG readmission. In total, 53 studies meeting inclusion criteria were identified, including 8,937,457 CABG patients. The pooled 30-day readmission rate was 12.9% (95% CI: 11.3-14.4%). The most frequently reported underlying causes of 30-day readmissions were infection and sepsis (range: 6.9-28.6%), cardiac arrythmia (4.5-26.7%), congestive heart failure (5.8
Reducing hospital readmissions is a major patient safety priority. The Centers for Medicare and Medicaid Services policy of nonpayment for readmissions for certain conditions has decreased their incidence. However, the impact of this policy on 30-day postdischarge mortality remains unknown.
Harrisburg, PA - December 17, 2014 - In-hospital mortality rates decreased significantly statewide between 2008 and 2013 for eight of the 16 illnesses for which mortality was reported in the 2013 Hospital Performance Report (HPR), released today by the Pennsylvania Health Care Cost Containment Council (PHC4). The sharpest decrease was in Septicemia, where the mortality…
Uses a dataset that covers inpatient hospital admissions of a population of commercially insured patients under age 65 from California during 2003-2012, this dissertation makes contributions to the knowledge gap in the literature.
When a patient is treated at a hospital and released she should know exactly what medications and continued care shell need. If shes underinsured or uninsured, she should be connected to nearby free clinics and drug assistance programs. These are just a few ways to help prevent her…. Maine news, sports, politics, election results, and obituaries from the Bangor Daily News.
TY - JOUR. T1 - Discharge Hemoglobin Level and 30-Day Readmission Rates After Coronary Artery Bypass Surgery. AU - Cho, Brian C.. AU - DeMario, Vincent M.. AU - Grant, Michael C.. AU - Hensley, Nadia B.. AU - Brown, Charles H.. AU - Hebbar, Sachidanand. AU - Mandal, Kaushik. AU - Whitman, Glenn J.. AU - Frank, Steven M.. N1 - Copyright: This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine. PY - 2019/2/1. Y1 - 2019/2/1. N2 - BACKGROUND: Restrictive transfusion strategies supported by large randomized trials are resulting in decreased blood utilization in cardiac surgery. What remains to be determined, however, is the impact of lower discharge hemoglobin (Hb) levels on readmission rates. We assessed patients with higher versus lower Hb levels on discharge to compare 30-day readmission rates after coronary artery bypass grafting (CABG). METHODS: We retrospectively evaluated 1552 patients undergoing isolated CABG at our institution from January 2013 to May ...
BACKGROUND CONTEXT: Recent studies suggest that prospective registration more accurately reflects the true incidence of adverse events (AEs). To our knowledge, no previous study has investigated prospectively registered AEs influence on hospital readmission following spine surgery.. PURPOSE: To determine the frequency and type of unplanned readmissions after complex spine surgery, and to investigate if prospectively registered AEs can predict readmissions.. DESIGN: This is a prospective, consecutive cohort study.. PATIENT SAMPLE: We conducted a single-center study of 679 consecutive patients who underwent complex spine surgery defined as conditions deemed too complicated for surgery at a secondary institute, or patients with severe comorbidities requiring multidisciplinary observation and treatment.. OUTCOME MEASURES: The outcomes in this study were (1) readmission to any hospital department within 30 days of discharge and (2) readmission to a surgical spine center at any time in ...
A recently published study in The American Journal of Accountable Care finds that home health care may result in lower costs and a lower hospital readmission rate for Medicare beneficiaries after emergency room visits. The study, Improved Cost and Utilization Among Medicare Beneficiaries Dispositioned From the ED to Receive Home Health Care Compared With Inpatient Hospitalization, notes that total 90-day costs were lower for beneficiaries receiving home health care after an emergency room visit when compared to beneficiaries treated at the hospital ($13,012 and $20,325, respectively). Furthermore, the study finds that beneficiaries receiving home health care had lower readmission rates (23.7%) compared to beneficiaries receiving hospital care (33%).. As part of our Medicare Platform, the Center for Medicare Advocacy (the Center) has long been working to ensure beneficiaries with longer-term, chronic, and/or debilitating conditions have full access to skilled nursing, therapy and related care ...
Background Therapy with evidence-based center failure (HF) medicines has been proven to be connected with lower threat of 30-day time all-cause readmission in individuals with HF and reduced ejection small fraction (HFrEF). association with 30-day time all-cause mortality (HR, 0.84; 95% CI, 0.38C1.88; p=0.678) or HF readmission (HR, 0.74; 95% CI, 0.41 1.31; p=0.301). These organizations continued to be unchanged during a year of post-discharge follow-up. Summary A release prescription for spironolactone got no association with 30-day time all-cause readmission among old, hospitalized Medicare beneficiaries with HFrEF qualified to receive spironolactone therapy. solid course=kwd-title Keywords: spironolactone, 30-day time all-cause readmission, Medicare beneficiaries, center failure 1. Intro HF is a significant public medical condition and may be 694433-59-5 IC50 the leading reason behind 30-day time all-cause readmission, an result which includes been identified from the Inexpensive Care ...
Results:. After adjustment was made for demographic characteristics, severity of illness, and need for care, adherence scores correlated with early unplanned readmission (P , 0.05). For patients with diabetes and heart failure, decreased readiness-for-discharge adherence scores correlated with increased risk for readmission (P = 0.001 and P = 0.016, respectively). In patients with obstructive lung disease, decreased admission-workup scores correlated with increased risk for readmission (P = 0.013). One of 7 readmissions in patients with diabetes, 1 of 5 readmissions in patients with heart failure, and 1 of 12 readmissions in patients with obstructive lung disease were attributable to substandard care. ...
TY - JOUR. T1 - Length of stay and hospital readmission for persons with disabilities. AU - Ottenbacher, K. J.. AU - Smith, P. M.. AU - Illig, S. B.. AU - Fiedler, R. C.. AU - Granger, C. V.. PY - 2000. Y1 - 2000. N2 - Objectives. Length of stay (LOS) and hospital readmission for persons receiving medical rehabilitation were examined. Methods. A total of 96473 patient records (1994-1998) were analyzed. Mean age of patients was 68.97 years; 61% were female and 83% were non-Hispanic White. Results. A decrease in LOS of 6.07 days (SD=3.23) and increase in hospital readmission were found across all impairment groups (P,.001). Readmission increases tanged from 6.7% for amputations to 1.4% for orthopedic conditions. LOS was longer (2.1 days) for readmitted patients (P,.01). Age was not a significant predictor of rehospitalization. Conclusions. Understanding variables associated with rehospitalization is important as prospective payment systems are introduced for postacute care.. AB - Objectives. ...
Background: Randomized clinical trials and observational studies have demonstrated the effect of multidisciplinary teams on heart failure readmissions. We report on the effect of heart failure trained nurses (Heart Failure Advocates) on readmission risk and costs during readmissions.. Methods and Results: Catholic Healthcare Partners (CHP) placed Heart Failure Advocates at 2 hospitals as part of an AHRQ funded initiative. Readmission rates and LOS at these 2 hospitals in Heart Failure Advocate supervised populations (n=311) versus usual care (control, n=716) were compared. Both populations were identified using ICD-9 codes designating patients admitted for heart failure. The Heart Failure Advocate supervised patients were tracked for readmission occurring after their enrollment date (first post-hospital contact). Control patients were tracked for readmission after the first admission during the time frame. All admissions for 2004 and 2005 at the 2 hospitals were used for analysis. The ...
Nearly one-quarter of patients hospitalized with heart failure and one-third of patients hospitalized with acute myocardial infarction (AMI) are readmitted within 30 days of discharge, despite evidence that a substantial portion of readmissions may be preventable. While these and other readmissions increase Medicare costs by an estimated $17 billion per year, little is known about the extent to which hospitals have employed recommended strategies to reduce readmission risk. As part of a Commonwealth Fund-supported study, researchers surveyed more than 500 U.S. hospitals to determine their use of 10 practices associated with lower readmission rates.. ...
Examination of a Proposed 30-Day Readmission Risk Score on Discharge Location and Cost. Ann Thorac Surg. 2019 Nov 07;: Authors: Barnett SD, Sarin E, Kiser AC, Ailawadi G, Hawkins RB, Mehaffey JH, Tyerman Z, Rich JB, Quader MA, Speir AM Abstract BACKGROUND: Readmissions cost an estimated $41 billion in the United States each year. To address this, a single institution recently...
Research has revealed that the use of electronic discharge orders helped increase compliance with quality care measures and lowered hospital readmission rates in heart failure patients.
Background Center failure may be the leading trigger for 30-time all-cause readmission, the reduced amount of which really is a objective from the Affordable Treatment Action. all-cause mortality (HR, 0.56; 95% CI, 0.33C0.98; p=0.041) and of the combined endpoint of 30-time all-cause readmission or 30-time all-cause mortality (HR, 0.73; 95% CI, 0.56C0.94; p=0.017). All organizations continued to be significant at 1-season post-discharge. Conclusions Among hospitalized sufferers with heart failing and decreased ejection fraction, the usage of ACEI-ARBs was connected with a considerably lower threat of 30-time all-cause readmission and 30-time all-cause mortality; both helpful organizations persisted during long-term follow-up. solid course=kwd-title Keywords: ACEI or ARB, center failure, medical center readmission Center failure may be the leading reason behind hospital entrance and readmission for Medicare beneficiaries aged 65 years and old in america.1 The 2010 Individual Protection and ...
Are you effectively reducing hospital readmission rates for your heart failure patients? You need to - or pay a penalty. These 4 steps will help reduce rates…
Background: Smoking is a risk factor for postoperative pulmonary complications (PPC) following non-small cell lung cancer (NSCLC) surgery. The optimal timing for preoperative smoking cessation has not been identified. Our study aimed to observe the impact of preoperative smoking cessation on PPC incidence and other postoperative outcomes including long-term survival. Methods: A prospective study included consecutive patients following resection for NSCLC in a regional thoracic centre over a 4-year period (2010-2014). Patients were stratified according to self-reported preoperative smoking status. The primary endpoint was PPC incidence, which was assessed from postoperative day one onwards using the Melbourne Group Scale. Secondary endpoints included short-term outcomes (hospital length of stay [LOS], intensive therapy unit [ITU] admission, 30-day hospital readmission rate) and long-term survival. Results: Four hundred and sixty-two patients included 111 (24%) current smokers, 55 (12%) ex-smokers ...
The duration of birth hospitalization correlates with gestational age at birth.47,48 Among 235 LPTs at 1 birth center, the length of the birth hospitalization (mean ± SD) was 12.6 ± 10.6 days at 34 weeks gestation, 6.1 ± 5.8 days at 35 weeks gestation, and 3.8 ± 3.6 days at 36 weeks gestation. The usual hospital stay for a term infant is 2 days for a vaginal delivery and 3 days for a cesarean delivery. In addition, hospital readmission rates are increased for LPT (3.5%) versus term (2.0%) infants.49 Even among infants who were never in a NICU, the readmission rate was threefold higher in LPT than in term infants.50 Many LPT infants are discharged early but require readmission for jaundice, feeding problems, respiratory distress, and proven or suspected sepsis because of physiologic and metabolic immaturity.. Early discharge among LPT infants affected by discharge criteria established for term infants show an increase in morbidities. In statewide data from Massachusetts, all state-resident ...
Acute and post-acute providers are increasingly uniting around a shared goal - to lower hospital readmission rates for elderly and other vulnerable patients. Many caregivers and payers agree that readmission rates are unacceptably high.
Learn about Spine Center Quality and Safety data, including spine center patients who had unplanned readmissions to BIDMC within 30 days of discharge.
By Lynn Razzano, RN, MSN, ONCC A recently published study, December 2013, on preventable readmissions within 30 days of ischemic stroke among Medicare beneficiaries looked at the proportion of post stroke readmissions that are potentially preventable or avoidable. This continues to remain unknown. Preventable readmissions were identified based on 14 Prevention Quality Indicators developed for…
TY - JOUR. T1 - Hospital readmission among new dialysis patients associated with young age and poor functional status. AU - Hickson, Latonya J.. AU - Thorsteinsdottir, Bjorg. AU - Ramar, Priya. AU - Reinalda, Megan S.. AU - Crowson, Cynthia S.. AU - Williams, Amy W.. AU - Albright, Robert C.. AU - Onuigbo, Macaulay A.. AU - Rule, Andrew D.. AU - Shah, Nilay D.. PY - 2018/4/1. Y1 - 2018/4/1. N2 - Background/Aims: Over one-Third of hospital discharges among dialysis patients are followed by 30-day readmission. The first year after dialysis start is a high-risk time frame. We examined the rate, causes, timing, and predictors of 30-day readmissions among adult, incident dialysis patients. Methods: Hospital readmissions were assessed from the 91st day to the 15th month after the initiation of dialysis using a Mayo Clinic registry linkage to United States Renal Data System claims during the period January 2001-December 2010. Results: Among 1,727 patients with ≥1 hospitalization, 532 (31%) had ≥1, ...
The Particulars: Some studies suggest that the 30-day readmission rate for patients with heart failure (HF) is as high as 25%. Excess HF readmissions now come with financial penalties from CMS. A nurse-based home telemonitoring program may be a cost-effective approach to reducing readmission rates among HF patients.. Data Breakdown: For a study, HF patients were randomized to usual care or a telemonitoring program that consisted to two home visits by a nurse. The home visits focused on HF education and used home telemonitoring equipment. The equipment transmitted daily vital signs, weight, and pulse oximetry readings for 3 months. The All-cause readmission rate was 12.5% for the telemonitoring group, compared with a 27.5% rate observed in the usual care group. Respective HF 30-day readmission rates were 2.5% for those receiving telemonitoring and 10% for those receiving usual care. The telemonitoring program costs about $51,000, which is less expensive than the estimated $183,500 that comes with ...
We have developed and validated a model to predict 90-day readmission/death without readmission in patients hospitalised with an AECOPD, the PEARL score. The tool was designed to be easily applied at the bedside using indices routinely available at admission, and performance was superior to alternative scores. The risk of readmission/readmission without death was considerably higher in the first 90 days than during the rest of the year, both overall and within the moderate-risk and high-risk PEARL groups, which justifies our chosen timeframe. Rates of readmission were similar to those seen in the European National Audit 2016.34 Our composite end point is more appropriate than readmission alone, as the latter would include both those who are neither readmitted nor die and those who die without readmission in the favourable outcome group. Accurate risk stratification of patients should help efficiently direct resources aimed to reduce readmissions, such as supported discharge services, ...
In this analysis, being exposed to wood and farming dust in the previous year more than doubled the risk of hospital readmission for asthma patients but not COPD patients. Analyses stratified by wood and farming dust exposure showed even higher risk estimates for farming-dust-exposed workers. Studies suggest that hospital readmissions for asthma and COPD are related to the level of ambient air pollution (7). However, we are not aware of studies investigating how occupational dust exposure impacts hospital readmissions for workers with asthma or COPD. A 40% increased risk of COPD (but not asthma) exacerbations has previously been reported among COPD patients living within a radius of 500 m of a livestock farm (8). People with asthma more often report uncontrolled asthma in jobs with airborne exposures compared to jobs without (9), and ongoing occupational exposure has been associated with a poorer prognosis for individuals with asthma caused by occupational agents (10). Barely any knowledge on ...
Background and Purpose- Kidney dysfunction is common among patients hospitalized for ischemic stroke. Understanding the association of kidney disease with poststroke outcomes is important to properly adjust for case mix in outcome studies, payment models and risk-standardized hospital readmission rates. Methods- In this cohort study of fee-for-service Medicare patients admitted with ischemic stroke to 1579 Get With The Guidelines-Stroke participating hospitals between 2009 and 2014, adjusted multivariable Cox proportional hazards models were used to determine the independent associations of estimated glomerular filtration rate (eGFR) and dialysis status with 30-day and 1-year postdischarge mortality and rehospitalizations. Results- Of 204 652 patients discharged alive (median age [25th-75th percentile] 80 years [73.0-86.0], 57.6% women, 79.8% white), 48.8% had an eGFR ≥ 60, 26.5% an eGFR 45 to 59, 16.3% an eGFR 30 to 44, 5.1% an eGFR 15 to 29, 0.6% an eGFRdialysis, and 2.8% were receiving dialysis.
Little is known about the etiology of hospitalizations among HF patients. Fang et al. (21) examined hospitalizations from the National Hospital Discharge Survey from 1979 through 2004. They found that the proportion of hospitalizations with HF as a first-listed diagnosis remained at approximately 30% over the study period. However, there was a decline in the proportion of admissions due to coronary or other cardiovascular diseases, and an increase in the proportion due to noncardiovascular diseases. Curtis et al. (8) examined hospital readmission rates among Medicare beneficiaries hospitalized with HF from 2001 through 2005 and found that approximately 27% of readmissions were due to HF. This analysis did not include patients without a prior HF hospitalization and only examined the first readmission, and thus cannot provide information on the total burden of hospitalizations. To date, the cause of hospitalization among community HF patients, and potential temporal changes, remain unclear.. The ...
Purpose: The aim of this study is to assess the effect of comorbidities on risk of readmission to an intensive care unit (ICU) and the excess hospital mortality associated with ICU readmissions.. Materials and Methods: A cohort study used clinical data from a 22-bed multidisciplinary ICU in a university hospital and comorbidity data from the Western Australian hospital morbidity database.. Results: From 16 926 consecutive ICU admissions between 1987 and 2002, and 654 (3.9%) of these patients were readmitted to ICU readmissions within the same hospitalization. Patients with readmission were older, more likely to be originally admitted from the operating theatre or hospital ward, had a higher Acute Physiology and Chronic Health Evaluation (APACHE)-predicted mortality, and had more comorbidities when compared with patients without readmission. The number of Charlson comorbidities was significantly associated with late readmission (,72 hours) but not early readmission (≤72 hours) in the ...
Heart attack hospital readmission rates in 2009 are presented. Adult readmissions within 30 days following a hospital stay for acute myocardial infarction (AMI) are provided by age, sex, and community income. Reason for readmission (new AMI diagnosis, scheduled PTCA or CABG surgery, heart failure, other reason) is also provided.
Background: In this study, we aimed to investigate frequency, patterns, etiologies, and costs of unplanned readmissions after left ventricular assist device implantation.. Methods: Between April 2012 and September 2016, 99 unplanned readmissions of a total of 50 consecutive bridge-to-transplant patients (45 males, 5 females; mean age 46.9±10.3 years; range, 19 to 67 years) who were successfully discharged after left ventricular assist device implantation were retrospectively analyzed. Patient demographic data, hemodynamic measurements before implantation, and readmissions after discharge were recorded. Hospitalizations due to major problems which were unable to be managed in routine outpatient clinic were accepted as unplanned readmissions. Survival analysis was performed.. Results: The readmission rate was 1.7 per year after discharge. Survival of patients who were readmitted within the first 90 days was found to be significantly lower than those without early readmission. The most common ...
The Idaho Statesman (http://bit.ly/2curtHe ) reports that the Centers for Medicare and Medicaid Services shows that just one in eight of more than 28,000 hospital admissions in Idaho resulted with patients returning for further care in 2015.. ...
Impact of structured rounding tools on time allocation during multidisciplinary rounds: an observational study. Abraham J, Kannampallil TG, Patel VL, et al. JMIR Hum Factors 2016 Dec 9;3(2):e29. Access the abstract on PubMed®.. How physician perspectives on E-prescribing evolve over time. A case study following the transition between EHRs in an outpatient clinic. Abramson EL, Patel V, Pfoh ER, et al. Appl Clin Inform 2016 Oct 26;7(4):994-1006. Access the abstract on PubMed®.. Enhancing the evidence for behavioral counseling: a perspective from the Society of Behavioral Medicine. Alcántara C, Klesges LM, Resnicow K, et al. Am J Prev Med 2015 Sep;49(3 Suppl 2):S184-93. Access the abstract on PubMed®.. Morbid obesity and use of second generation antipsychotics among adolescents in foster care: evidence from Medicaid. Allaire BT, Raghavan R, Brown DS. Child Youth Serv Rev 2016 Aug;67:27-31. Epub 2016 May 30. Access the abstract on PubMed®.. Population well-being measures help explain geographic ...
Our results indicate that derived health literacy estimates can be used as proxies for test-based measures to conduct health literacy research on a larger scale than previously feasible with direct assessments. Using derived health literacy estimates at the census block group level, our findings suggest that health literacy is a significant, independent predictor of having a readmission within 30-days of discharge from a hospital stay for AMI; it is also predictive of the number of readmissions experienced by a patient within this timeframe. To our knowledge, this is the first study investigating the association between health literacy, albeit a derived estimate, and 30-day hospital readmission on a population level.. Agreement between the derived health literacy estimates and individual, test-based measures was fair, but less than ideal. This is understandable, as the estimates are based on a neighbourhood average and not individual performance. Interestingly, the levels of agreement between ...
3 days. Univariate analysis and multivariable logistic regression were performed to assess the impact of hospital length of stay on unplanned readmission after adjusting for an array of patient factors.. Results:. A total of 91,102 patients, were included in the analysis. The median age of the study sample was 59 years with 50.5% males. Median length of stay varied by procedure: ACDF, Lumbar Discectomy: 1 day; Lumbar Laminectomy: 2 days, PLF: 3 days. Rate of unplanned readmission was 4.1% (3,678 patients) for all four spinal procedures[ACDF: 3.0% (n=525), Lumbar Discectomy: 3.7% (n=377), Lumbar Laminectomy: 4.4%(n=714), PLF: 4.5% (n=2062)]. Overall, LOS > 3 days was associated with an increased likelihood for unplanned readmission(OR: 1.26; CI: 1.14-1.38, Ref: LOS=3 days) while LOS< 3 days did not confer an increased risk(OR: 0.95; CI: 0.87-1.04, Ref: LOS=3 days). Further analyzing by each procedure, LOS>3 days was associated with higher odds of readmission following Lumbar Laminectomy(OR: 1.3; ...
Background. Patients hospitalized for heart failure (HF) are at high risk of readmission. Chronic obstructive pulmonary disease (COPD) is one of the most prevalent comorbidities in this population. However, few data and only small studies describe the impact of COPD on the risk of readmission.. Methods and results. Hospitalizations for HF were identified in the 2012 National Readmissions Database. We compared clinical characteristics and the risk of all-cause, cardiovascular (CV) and respiratory-related readmission for patients with and without COPD. We included 225,160 patients hospitalized for HF among whom 54,953 had comorbid COPD. Patients with COPD were younger (median age 76 years COPD versus 77 years without COPD; p , 0.001), had a higher burden of comorbidity and were more frequently male (53% versus 49%, p , 0.001). Thirty-day all-cause readmission risk was two-fold greater in patients with COPD compared to those without COPD (adjusted HR 2.02, 95%CI 1.97-2.08). Most readmissions were ...
TY - JOUR. T1 - Risk factors for hospital readmission of patients with heart failure. T2 - A cohort study. AU - Sadeq, Adel. AU - Sadeq, Ahmed. AU - Sadeq, Asil. AU - Alkhidir, Israa. AU - Aburuz, Salahedin. AU - Mellal, Abdullah. AU - Al Najjar, Munther. AU - Elnour, Asim. PY - 2020/7/1. Y1 - 2020/7/1. N2 - Aim: The aim of this study was to develop a risk factor model for hospital readmission in patients with heart failure. Background: Identification of risk factors and predictors of readmission to hospital in patients with heart failure is very crucial for improved clinical outcomes. Objective: The objective of the current study was to investigate and delineate the risk factors that may be implicated in putting a patient at greater risk of readmission due to uncontrolled heart failure. Materials and Methods: This is a prospective follow-up cohort study of 170 patients with heart failure at a tertiary hospital in Al Ain city in the United Arab Emirates. We have developed a risk factor model ...
Hospital admission for congestive heart failure is extremely common and quite expensive, although it is frequently preventable. New drugs and therapies have been reported to reduce admissions, decrease morbidity and mortality, and improve the quality of life for these patients. Patients with an ejection fraction less than 40 percent (decreased systolic function) should be treated with medication to improve symptoms and prevent progression of heart failure. Angiotensin-converting enzyme (ACE) inhibitors are a mainstay of treatment in patients who can tolerate them; in patients who cannot take these drugs, angiotensin II receptor blocking agents offer an alternative. Patients with New York Heart Association class II or III heart failure should also receive a beta blocker (metoprolol, carvedilol or bisoprolol). Recent research has shown that treatment with spironolactone improves mortality and hospital readmission rates. An exercise program should also be recommended for all patients with heart failure
Background: Patients, providers, and health systems are focused on reducing readmissions for patients with acute decompensated heart failure (ADHF). Readmission after hospitalization is common and often secondary to HF decompensation, but it remains challenging to identify patients at-risk. Bioimpedance is a validated marker of thoracic fluid accumulation. We examined whether transthoracic bioimpedance, measured using a Fluid Accumulation Vest (FAV), predicted HF decompensation in advance of a clinical event in patients discharged after ADHF.. Methods: Participants included 42 patients hospitalized for ADHF. Participants were trained on the use of a FAV-smartphone dyad to obtain and transmit a 5-minute bioimpedance measurement once daily for 45-days after discharge. Readmission and diuretic dosing adjustments were identified using participant report and causes adjudicated using medical records. Daily bioimpedance was analyzed using the HF detection strategy shown in Figure. Receiver operating ...
TY - JOUR. T1 - Predictors of 30-day readmission after subarachnoid hemorrhage. AU - Singh, Mandeep. AU - Guth, James C.. AU - Liotta, Eric. AU - Kosteva, Adam R.. AU - Bauer, Rebecca M.. AU - Prabhakaran, Shyam. AU - Rosenberg, Neil. AU - Bendok, Bernard R.. AU - Maas, Matthew B.. AU - Naidech, Andrew M.. PY - 2013/12/1. Y1 - 2013/12/1. N2 - Background: Readmission within 30 days is increasingly evaluated as a measure of quality of care. There are few data on the rates of readmission after subarachnoid hemorrhage (SAH). Objective: We sought to determine the predictors of 30-day readmission in patients with SAH. Methods: We prospectively identified 283 patients with SAH admitted between 2006 and 2012. Readmission was determined by means of an automated query with confirmation in the electronic medical record. Results: Overall, 21 (8 %) patients were readmitted for infection (n = 8), headache (n = 5), hydrocephalus (n = 4), cardiovascular causes (n = 2), medication-related complications (n = 1), ...
In a study population comprising 7 diverse hospitals and 39,604 adults of all ages hospitalized for a broad range of medical reasons, an electronic model utilizing EMR data routinely available within 24 h of admission identified patients at high risk of post-discharge death or readmission events early in their hospitalization.. Adding information available on discharge (e.g. length of stay and other comorbidities) to the electronic model had a small incremental benefit in predicting the risk of readmission and death, but no significant impact on predicting the risk of readmission alone. This suggests that meaningful patient-level risk stratification of readmission risk can occur early in the hospital stay without waiting for further information at time of discharge. The electronic model does not require manual computation by staff and was constructed such that it can be calculated directly from the commonly used commercial EMR employed by this diverse group of 7 hospitals. With wide-spread ...
Surgical site infection (SSI) is the third most common healthcare-associated infection, yet is the most costly in terms of resources. Objective: To improve patient care experience, develop better links between acute and community care and reduce readmissions for SSI. Methods: To reduce cardiac SSI, a photo of the surgical wound was taken on the day of hospital discharge (Photo at Discharge = PaD), accompanied by individualised information for patients and carers. Patient feedback was sought via a postal questionnaire (85% return rate) and telephone follow-up. A prospective surveillance service monitored SSI rates on readmission. Results: Observational audit and SSI surveillance data collected over a 21-month period suggest PaD is associated with four times lower readmission rates for incisional SSI (p=0.0344). The potential savings are estimated at £15,000 per deep incisional SSI prevented. Discussion: PaD is associated with improved patient experience, a reduction in incisional SSI readmission rates
Results 18 PEG procedures, out of a total of 812, resulted in a readmission within 8 days (2.2%). These included both push (33.3%) and pull (66.6%) techniques. The table below displays the indication and complication of each readmission. 4 readmissions were deemed innocent patient concerns that could be attributed to trivial post-PEG symptoms.. 3 peritonitis cases were identified (0.3%), all of which were to facilitate head and neck cancer treatment. Case 1 had a BMI of 40, underwent push PEG and was found to have suture dislodgement at laparotomy. Case 2 underwent pull PEG, had peritoneal leakage and was found to have a PEG sited through colonic mesentery into posterior stomach at laparotomy requiring repair. Case 3 underwent push PEG and experienced severe pain post-procedure resulting in early suture removal and subsequent presentation with PEG malposition in peritoneal space. No adverse factors concerning PEG insertion technique were identified. ...
Background: Electroconvulsive therapy, ECT, is an effective acute treatment for severe depression. Today ECT is usually discontinued when the patients depressive symptoms abate, although relapse is common. Some studies suggest that continuation ECT (cECT) may prevent relapse of depression, but there are few studies available. Aims: The aim of this study was to describe the need for inpatient care before, during and after cECT. Methods: A retrospective chart. review was conducted of all patients (n=27) treated with cECT between 2005 and 2007 at Orebro University Hospital, Sweden. All patients were severely depressed at the initiation of index ECT. The DSM-IV diagnoses were major depression (n=19), bipolar depression (n=5) or schizoaffective depression (n=3). Results: The hospital day quotient was lower (HDQ=15) during cECT (mean duration+/-standard deviation=104+/-74 days) than during the 3 years prior to cECT (HDQ=26). The rehospitalization rate was 43% within 6 months and 58% within 2 years ...
This meta-analysis reviewing 44 publications dealing with over 1.5 million patients undergoing LC identified that, on average one in thirty patients are readmitted within 30 days. This reflects the findings of Tang et al. [75], in their meta-analysis comparing day case and inpatient LC, which reported a mean post discharge readmission rate of 2.4%, and an in-patient admission rate of 13.1%. Readmission rates were not found to be statistically significantly different between large studies and small studies (Figures 3 and 4), nor whether the surgery was undertaken in Europe [31, 50] or North America [8, 33]. Readmission has become a quality indicator in the delivery of medical care [70, 75]. This relates to both the inconvenience to patients, the cost, resource utilisation and the associated morbidity and potential mortality. Cholecystectomy itself is one of the commonest procedures undertaken with over one million cholecystectomys performed in the US annually [1, 2]. A readmission rate of 3% ...
Abstract, originally published in Epilepsia. Objective: To assess whether epilepsy is associated with increased odds of 30-day readmission due to psychiatric illness during the postpartum period.. Methods: The 2014 Nationwide Readmissions Database and the International Classification of Disease, Ninth Revision, Clinical Modification codes were used to identify postpartum women up to 50 years old in the United States, including the subgroup with epilepsy. The primary outcome was 30-day readmission and was categorized as (1) readmission due to psychiatric illness, (2) readmission due to all other causes, or (3) no readmission. Secondary outcome was diagnosis at readmission. The association of the primary outcome and presence of epilepsy was examined using multinomial logistic regression.. Results: Of 1 558 875 women with admissions for delivery identified, 6745 (.45%) had epilepsy. Thirteen of every 10 000 women had 30?day psychiatric readmissions in the epilepsy group compared to one of every 10 ...
Boockvar, K. S., Halm, E. A., Litke, A., Silberzweig, S. B., McLaughlin, M., Penrod, J. D., Magaziner, J., Koval, K., Strauss, E. and Siu, A. L. (2003), Hospital Readmissions After Hospital Discharge for Hip Fracture: Surgical and Nonsurgical Causes and Effect on Outcomes. Journal of the American Geriatrics Society, 51: 399-403. doi: 10.1046/j.1532-5415.2003.51115.x ...
All medical discharges: All medical DRGs. All surgical discharges: All surgical DRGs. Acute myocardial infarction (CMS definition (excluded one-day stay): principal diagnosis code (ICD-9) 410.00, 410.01, 410.10, 410.11, 410.20, 410.21, 410.30, 410.31, 410.40, 410.41, 410.50, 410.51, 410.60, 410.61, 410.70, 410.71, 410.80, 410.81, 410.90, and 410.91. Congestive heart failure (CMS definition): principal diagnosis code (ICD-9) 402.01, 402.11, 402.91, 404.01, 404.03, 404.11, 404.13, 404.91, 404.93, 428.0, 428.1, 428.20, 428.21, 428.22, 428.23, 428.30, 428.31, 428.32, 428.33, 428.40, 428.41, 428.42, 428.43, and 428.9. Pneumonia (CMS definition): principal diagnosis code (ICD-9) 480.0, 480.1, 480.2, 480.3, 480.8, 480.9, 481, 482.0, 482.1, 482.2, 482.30, 482.31, 482.32, 482.39, 482.40, 482.41, 482.42, 482.49, 482.81, 482.82, 482.83, 482.84, 482.89, 482.9, 483.0, 483.1, 483.8, 485, 486, 487.0, and 488.11. Hip fracture (Dartmouth Atlas definition): principal diagnosis code (ICD-9) 820xx ...
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This study demonstrates elevated readmission rates for ischemic and hemorrhagic stroke in the intermediate 30‐, 60‐, and 90‐day risk periods following common cardiac procedures relative to noncardiac procedures and common medical admissions. Ischemic stroke risk was highest following TAVR and LVAD, and hemorrhagic stroke risk was highest following LVAD, SAVR, and LAA closure. Aside from LAA closure, all cardiac procedures were associated with a higher readmission risk for stroke than noncardiac procedures. The ischemic stroke readmission rates following SAVR, cardiac catheterization, permanent pacemaker placement, and implantable cardioverter defibrillator placement were all higher than rates following admission with UTI, pneumonia, and COPD. Ischemic stroke readmission rates following LVAD and TAVR were higher than rates following admission with CHF. These results suggest that the cardiac procedures and postoperative management confer additional vulnerability to patients who have many ...
Results-There were 2305 SAH and 8708 ICH discharges from JC-PSC-certified hospitals and 3892 SAH and 22 564 ICH discharges from noncertified hospitals. Unadjusted in-hospital mortality (SAH: 27.5% versus 33.2%, P,0.0001; ICH: 27.9% versus 29.6%, P=0.003) and 30-day mortality (SAH: 35.1% versus 44.0%, P,0.0001; ICH: 39.8% versus 42.4%, P,0.0001) were lower in JC-PSC hospitals, but 30-day readmission rates were similar (SAH: 17.0% versus 17.0%, P=0.97; ICH: 16.0% versus 15.5%, P=0.29). Risk-adjusted 30-day mortality was 34% lower (odds ratio, 0.66; 95% confidence interval, 0.58-0.76) after SAH and 14% lower (odds ratio, 0.86; 95% confidence interval, 0.80-0.92) after ICH for patients discharged from JC-PSC-certified hospitals. There was no difference in 30-day risk-adjusted readmission rates for SAH or ICH based on JC-PSC status.. ...
Understanding that a deferred complication is not equal to an avoided complication, we queried hospital databases to determine the number of patients readmitted (to the emergency department [ED] or the orthopedics floor) within 1 week after same-day discharge. Over 4 yr, 30 were readmitted; 24 of these were due to bleeding, infection, swelling, or wound-related complications. Of the remaining six patients, one was readmitted for PONV, another for spinal headache. The remaining four were readmitted for surgical site pain, two of which were discharged from the emergency room. One patient had a diagnostic knee arthroscopy with meniscal repair under spinal anesthesia. The other patient had ACL reconstruction under epidural with femoral nerve block. Both of these patients presented 6 days after surgery. Of the two patients requiring hospital readmission, one patient had ACL reconstruction under lumbar plexus and sciatic nerve blocks, presented the day after surgery (presumably after the effects of ...
Boston University School of Medicine researchers have found that providing health insurance coverage to previously uninsured people does not result in reducing 30-day readmission rates.
For the second time in 6 months, Medicare has erred in calculating hospital readmission penalties for more than 1,000 of the nations hospitals, says a Kaiser Health News article. As a result, Medicare has slightly lessened its readmissions penalties for 1,246 hospitals as part of its Hospital Readmissions Reduction Program. The penalty imposed on St Claire Regional Medical Center in Morehead, Kentucky, will drop the most, from 0.93% to 0.72% of every payment Medicare makes for a patient during the fiscal year that ends in September. Medicare also modestly increased the penalties for 226 hospitals. LaSalle General Hospital in Jena, Louisiana, will see its penalty grow by the greatest percentage. LaSalle will lose 0.84% of each Medicare payment per patient, instead of the 0.65% reduction Medicare previously announced.. The payment changes for most hospitals were small, averaging .03% of each reimbursement. Overall, hospitals will pay $10 million less in penalties than previously calculated, for a ...
A similar pattern was seen for the 1-year risk-adjusted readmission and mortality rates, with a decline in the readmission rate from 57.2 to 56.3% (hazard ratio, 0.92) and an increase in the mortality rate from 31.3 to 36.3%.
Exploratory descriptive study, developed in a governmental hospital of tertiary care in Minas Gerais (Brazil), from January 2008 to December 2009. Medical records and reports of control infection practitioner of 98 patients readmitted with SSI were reviewed and the data were analyzed in relation to gender, age, co morbidities, length of staying, surgery, specialty, type of procedures, wound class, duration of surgery, SSI and micro-organisms. ...
Heart failure (HF) is a growing healthcare burden and one of the leading causes of hospitalizations and readmission. to more effectively prevent readmissions remain areas for continued improvement. Keywords: Heart failure Readmission Prevention Process measures Approximately 5.7 million American adults are living with heart failure (HF) and the projections are that the prevalence of HF will increase 46% from 2012 to 2030 with greater than 8 million adults living with the chronic condition. HF is one of the leading primary diagnoses for hospitalization with an estimated 1 million patients discharged in 2010 2010. The total cost of HF for 2012 was $30.7 billion. According to Medicare from 2009 to 2012 the median risk-standardized 30 day readmission rate for BG45 HF was 23.0%.1 Readmissions receive particular attention from researchers and policy makers as they are perceived as a correctable source of poor quality of care and excessive medical spending. The Affordable Care Act instituted BG45 a ...
Data Synthesis:. 43 articles were identified, and a taxonomy was developed to categorize interventions into 3 domains that encompassed 12 distinct activities. Predischarge interventions included patient education, medication reconciliation, discharge planning, and scheduling of a follow-up appointment before discharge. Postdischarge interventions included follow-up telephone calls, patient-activated hotlines, timely communication with ambulatory providers, timely ambulatory provider follow-up, and postdischarge home visits. Bridging interventions included transition coaches, physician continuity across the inpatient and outpatient setting, and patient-centered discharge instruction. ...
On multivariable lineal regression analyses, the study period (pre-IMCU-CS/post-IMCU-CS) remained significantly independently associated with a shorter ICU (standardized beta value -0077; 95% confidence interval, -0.259 to -0.038; P=.008) and in-hospital mean LoS (standardized beta value -0.066; 95% confidence interval, -0.135 to -0.016; P=.01). Likewise, the study period (pre-IMCU-CS/post-IMCU-CS) did not remain significantly independently associated with in-hospital mortality or 30-day readmission. The main cause of cardiac ICU readmission during hospitalization was respiratory failure; there was no difference in the incidence of cardiac ICU readmission between the study groups (P=.93, Table 4). The mean LoS in the IMCU-CS was 3.5±2.6 days. An analysis of clinical outcomes showed no significant differences in in-hospital mortality (4.9% vs 3.5%, P=.28) or 30-day readmission rate (4.3% vs 4.2%; P=.89) for pre-IMCU-CS compared with post-IMCU-CS, respectively.. In the pre-IMCU-CS period, only ...
Infants born very prematurely can require supplementary oxygen for many months. Rehospitalisation is common in the first 2 years after birth and the majority of admissions are for respiratory disorders. Rehospitalisation is particularly increased in infants with bronchopulmonary dysplasia (BPD) who require supplementary oxygen for more than 28 days after birth, and in infants who have a respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) (see chapter 16). Respiratory symptoms continue to be common in schoolchildren who were born prematurely, and the most severely affected remain symptomatic in adulthood; an adverse outcome that may be more common in females. Prematurely born infants, particularly those who wheeze at follow-up, have evidence of airway obstruction (raised airway resistance and gas trapping) in the first 2 years after birth. Their lung function improves with increasing age, but even in adolescence there is evidence of airflow limitation in those who had had ...
Background. Admissions to hospitals for childhood asthma seem to be increasing, even though admissions for other childhood conditions are decreasing. We studied admissions and readmissions for childhood asthma in Ontario in an attempt to uncover factors relating to the admission patterns.. Methods. Using the hospital discharge data from the Canadian Institute for Health Information, 28 646 children with diagnoses of asthma were identified from April 1, 1989, to March 31, 1992.. Results. The admission rates for asthma among children in Ontario showed a 14.8% decrease from 1987 to 1992. This decline was observed primarily in 5- to 17-year-olds. Younger children had a fourfold risk of hospital admission for asthma. In the 4 years studied, 10 427 children (36.4%) were readmitted at least once, representing 22 114 readmissions, 16 196 (73.2%) of which were for asthma. The 6-month probabilities of readmission for asthma were 20.0% (0- to 4-year-olds) and 11.7% (5- to 17-year-olds). The estimated ...
Capsules.kaiserhealthnews.org: By Diane Webber - AUGUST 17TH, 2012, 8:53 AM.. This week, a KHN analysis of Medicare data showed that 2,211 hospitals will face penalties in October for having too many patients readmitted for care within 30 days of discharge.. Hospital executives around the country have had something to say about those penalties and the new policy. Heres a round-up of how the story played as it was picked up and localized by some of our reporting partners at NPR member stations around the country.. Pennsylvania & Delaware. Taunya English, covering the story at WHYY in Philadelphia, reported on resistance to the policy coming from the regional hospital association.. [Medicare] needs to remember that people are not cars, Curt Schroder, head of the Delaware Valley Healthcare Council, told English. They seem to be treating hospitals like auto repair shops. In other words, You should be able to change the tire, send them on their way and not see them for another 5,000 miles. ...
If patients could recognise themselves, or anyone else could recognise a patient from your description, please obtain the patients written consent to publication and send them to the editorial office before submitting your response [Patient consent forms] ...
JAMA Internal Medicine published a study about patients favoring women as their doctors. The study is centered on readmission and mortality rate among the elderly. The authors selected random data, in which a third of the physician sample were female. For the study, researchers examined hospital readmissions and mortality data for a random sample of traditional Medicare beneficiaries 65 or older who ended up in acute-care hospitals from Jan. 1, 2011, through Dec. 31, 2014. Those data consisted of slightly more than 1.5 million hospitalizations, in which patients were seen by 58,344 physicians. About a third of those physicians were women.. The researchers adjusted the data to account for different characteristics of hospitals and patients, as well as physician characteristics that were not based on sex, such as experience level. These types of adjustments ensure that the studys findings do not simply reflect a situation where male physicians are seeing sicker patients, for instance.. The female ...
Objective:To evaluate causes and predictors of readmission after new ileostomy creation.Background:New ileostomates have been reported to have higher readmission rates compared with other surgical patients, but data on predictors are limited.Methods:A total of 1114 records at 2 associated hospitals
Columbus Community Hospital - Columbus, NE Interdisciplinary Teams Reduce Readmissions Through building relationships among providers across the care continuum and implementing standardized processes, Columbus Community Hospital reduced all-cause 30-day readmissions by 42%, saving $819,797 in hospital care. Download the full case study below.
TBI-related inpatient stays and treat-and-release emergency department (ED) visits are examined for 2017. Patient and injury-related characteristics of TBI-related stays and visits are presented. Outcomes of inpatient stays with a principal diagnosis of TBI are provided, including length of stay, average cost per stay, and rates of in-hospital mortality and all-cause 30-day readmissions.
RESEARCH DESIGN AND METHODS We evaluated 13,621 patient discharges with a primary diagnosis of PE from 185 acute care hospitals in Pennsylvania (from January 2000 to November 2002). Admission glucose levels were analyzed as a categorical variable (≤110, ,110-140, ,140-170, ,170-240, and ,240 mg/dL). The outcomes were 30-day all-cause mortality and hospital readmission. We used random-intercept logistic regression to assess the independent association between admission glucose levels and mortality and hospital readmission, adjusting for patient (age, sex, race, insurance, comorbid conditions, severity of illness, laboratory parameters, and thrombolysis) and hospital (region, size, and teaching status) factors. ...
The studies differ significantly in their objectives and methods, so direct numerical comparisons may not be valid. Oddie et al looked at over 11 000 births in the Northern NHS region of the UK in 1998, excluding infants less than 35 weeks gestation.1 They concentrated on factors associated with early neonatal discharge, and then looked at what influenced readmission to hospital within 28 days. Escobar et al studied a population of over 33 000 using the Kaiser Permanente Medical Care Program (KPMCP) in California and Colorado, for which good data are available, in 1998-2000;2 they included all gestations and did not look at early discharge at all, but analysed in some detail factors associated with readmission within two weeks. The KPMCP, although not government run, is a managed healthcare system which has been described as being in many ways similar to the British National Health Service.3 Its membership is not restricted to the more prosperous sections of society, as may be inferred from the ...
We will be having another session with the same group of hospitals focusing specifically on their CHF readmission reduction initiatives, and we are eager to see how these hospitals have designed processes to combat these root causes.. With many hospitals still remaining on the CHF readmission reduction workgroup waiting list (email Daniel Thomas to join!), the list of root causes and best practices will be updated as we hear from more hospitals, so stay tuned to the blog for more updates!. ...
HCUP Methods Series Overview of Key Readmission Measures and Methods Report # 2012-04 Contact Information: Healthcare Cost and Utilization Project (HCUP) Agency for Healthcare Research and Quality 540 Gaither Road Rockville, MD 20850 http://www.hcup-us.ahrq.gov For Technical Assistance with HCUP Products: Email: [email protected] or Phone: 1-866-290-HCUP Recommended Citation: Barrett M, Raetzman S, Andrews R. Overview of Key Readmission Measures and Methods. 2012. HCUP Methods Series Report #2012-04. ONLINE December 20, 2012. U.S. Agency for Healthcare Research and Quality. Available: http://www.hcupus.ahrq.gov/reports/methods/methods.jsp. TABLE OF CONTENTS OVERVIEW ............................................................................................................................... 1 MEASURE CHARACTERISTICS ............................................................................................... 2 Primary Purpose ...
Lots of news and analysis this week about Medicare reimbursement penalties for patient readmissions and the implications for SNFs and hospitals. Starting Oct. 1, about 2,000 hospitals will face tiered reimbursement penalties for readmitting too many patients with heart attacks, pneumonia and chronic heart failure. As a reminder of the challenge, we see that the best hospitals readmit 19 percent to 20 percent of heart failure patients within 30 days. As the McKnights article observes, strong collaborative relationships and communication between SNFs and hospitals are more important than ever. Also, here is some solid analysis regarding variables that can unfairly...
McKnights reports about a study in The Journal of the American Medical Association documents how post-acute providers are successfully reducing hospital readmissions by communicating and collaborating more closely with hospitals and other healthcare providers. The research, funded by CMS, studied 14 communities where hospitals collaborated with post-acute providers to improve care transitions, with a 5.7% drop in readmissions withing 30 days. It also noted benefits from nursing homes applying the Interventions to Reduce Acute Care Transfers (INTERACT) model. This coincides with another study by Columbia University Medical Center (also published in The Journal of the American Medical Association) that long-term...
Compliance increased from 48% (n = 167) to 92% (n = 1,037; P , .001) after the SSC was integrated into the electronic health record. Surgeons (91% vs 97%; P , .001), anesthesiologists (89% vs 100%; P , .001), and nurses (55% vs 93%; P , .001) demonstrated an increase in compliance. A comparison between risk events in the pre- and post-rollout period showed a 32% decrease (P , .01). Hospital-wide indicators including length of stay and 30-day readmissions were lower. In a survey to assess the OR personnels perceptions of the new checklist, 76% of surgeons, 86% of anesthesiologists, and 88% of nurses believed the electronic SSC will have a positive impact on patient safety.. ...
Improved HCAHPS and Readmission Rates Interactive patient education can reduce length-of-stay, lower readmission rates, and improve patient satisfaction scores by 36%. Engaged patients have better outcomes and are more satisfied consumers.
  • Readmission of diabetic patients after discharge from hospital has potential value as a quality of care indicator. (who.int)
  • After discharge from an initial COVID-19 hospitalization, 9% of patients were readmitted to the same hospital within 2 months of discharge. (cdc.gov)
  • Risk factors for readmission included age ≥65 years, presence of certain chronic conditions, hospitalization within the 3 months preceding the first COVID-19 hospitalization, and discharge to a skilled nursing facility or with home health care. (cdc.gov)
  • Understanding frequency of, and potential reasons for, readmission after a COVID-19 hospitalization can inform clinical practice, discharge disposition decisions, and public health priorities, such as health care resource planning. (cdc.gov)
  • Few studies have investigated discharge patterns and hospital readmissions among large groups of patients after an initial COVID-19 hospitalization ( 4 - 7 ). (cdc.gov)
  • Using electronic health record and administrative data from the Premier Healthcare Database,* CDC assessed patterns of hospital discharge, readmission, and demographic and clinical characteristics associated with hospital readmission after a patient's initial COVID-19 hospitalization (index hospitalization). (cdc.gov)
  • Among the 106,543 (85%) surviving patients, 9% (9,504) were readmitted to the same hospital within 2 months of discharge through August 2020. (cdc.gov)
  • The odds of hospital readmission increased with age among persons aged ≥65 years, presence of certain chronic conditions, hospitalization within the 3 months preceding the index hospitalization, and if discharge from the index hospitalization was to a SNF or to home with health care assistance. (cdc.gov)
  • Understanding the frequency of, and risk factors for, readmission can inform clinical practice, discharge disposition decisions, and public health priorities such as health care planning to ensure availability of resources needed for acute and follow-up care of COVID-19 patients. (cdc.gov)
  • COVID-19 patients were identified through International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) discharge diagnosis code of U07.1 (COVID-19, virus identified) during April-July 2020 or B97.29 (Other coronavirus as the cause of disease classified elsewhere [recommended before the April 2020 release of U07.1] † ) during March-April 2020. (cdc.gov)
  • The model composed of discharge variables was the only model that predicted readmission at a significant level. (nih.gov)
  • From among 3,109 SICU admissions, the investigators found that 141 patients were readmitted to the SICU within 72 hours of discharge. (medindia.net)
  • The researchers studied 179 possible risk factors--patient demographic factors and clinical and laboratory data collected in the SICU (the most recent measurement before the initial SICU discharge) -- that might contribute to SICU readmission. (medindia.net)
  • For example, providers might extend a high-risk patient's SICU stay, send the patient first to a stepdown unit for intermediate care, or prescribe close monitoring of the patient after discharge to a general inpatient floor, he said. (medindia.net)
  • Effectiveness of Discharge Education With the Teach-Back Method on 30-Day Readmission: A Systematic Review. (semanticscholar.org)
  • The results indicate that discharge education with the teach-back method resulted in a 45% reduction in 30-day readmission, however, only a few studies were included in the analysis, and they showed a high risk of selection bias. (semanticscholar.org)
  • Hospital readmissions within 30 days of initial discharge occur frequently. (jabfm.org)
  • Among adult family medicine patients spanning a wide age range, we hypothesize that previous hospitalizations, length of stay, number of discharge medications, medical comorbidities, and patient demographics are associated with a greater risk of hospital readmission within 30 days. (jabfm.org)
  • Patients readmitted within 30 days had more hospitalizations, more emergency department visits, longer hospital stays, more comorbidities, and more discharge medications and were less likely to be married. (jabfm.org)
  • Hospital readmission within 30 days of discharge occurs in almost 20% of patients receiving US Medicare, costing an estimated $17.4 billion in 2004. (jabfm.org)
  • 29 This study determines the factors present at the initial discharge that are associated with 30-day readmission for adult patients of all ages who are admitted to a family medicine inpatient service. (jabfm.org)
  • Factors such as previous hospitalizations, length of stay, number of discharge medications, and medical comorbidities were hypothesized to be associated with a greater risk of hospital readmission within 30 days, the dependent variable. (jabfm.org)
  • A retrospective chart review of pediatric patients with an index discharge from the pediatric epilepsy monitoring unit (EMU) or general neurology service for functional seizures. (cureepilepsy.org)
  • A substantial proportion of pediatric patients with functional seizures return to the hospital within 30 days of discharge. (cureepilepsy.org)
  • Although the nursing home itself returned few patients to the hospital, many were readmitted to the hospital after discharge home. (ecri.org)
  • The summary should describe events that happened during the stay, current patient status, and a comprehensive discharge plan of care. (ecri.org)
  • The goal was to help reduce heart failure readmissions by ensuring patients are educated during their stay on how to manage their diagnosis post-discharge so they do not end up back in the hospital. (getwellnetwork.com)
  • If the patient is educated during their hospital stay about their diagnosis (such as heart failure, in this instance), how to care for themselves, and how to identify signs their condition is worsening early on, then they are more likely to manage their health better post discharge. (getwellnetwork.com)
  • 1997). For instance, hospital readmission rates for mental illness have been linked to the adequacy of discharge planning and transitional services (Nelson et al. (longwoods.com)
  • Some of the hospitals rated among the best at minimizing 30-day readmissions have actively set out to monitor patients after discharge, or introduced programs to assist patients with medication compliance. (darkdaily.com)
  • The Hospital for Special Surgery (HSS), meanwhile, developed a mobile app that enable staff to interact with patients remotely after discharge, stated Louis Shapiro , MS, HSS, President and CEO, in the Modern Healthcare article. (darkdaily.com)
  • Interventions Patients receiving at least 3 L per minute of oxygen, stable without other indication for inpatient care, were discharged from either emergency or inpatient encounters with home oxygen equipment, educational resources, and nursing telephone follow-up within 12 to 18 hours of discharge. (ama-assn.org)
  • Conclusions and Relevance In this cohort study, patients with COVID-19 pneumonia discharged on home oxygen had low rates of mortality and return admission within 30 days of discharge. (ama-assn.org)
  • Medicare will impose fines on 73 Georgia hospitals for excessive readmissions of patients within 30 days of discharge. (khn.org)
  • Similarly, most other St. Louis-area hospitals have reduced their numbers of Medicare patients who are readmitted within a month of discharge. (khn.org)
  • Allaying concerns about the possible negative effects of pushing for rehospitalization reduction, Dr Krumholz's group reported in July that the recent penalty-driven decline in readmissions is not associated with any increase in 30-day post-discharge mortality. (medscape.com)
  • After statistically adjusting the findings to take into consideration possible effects of demographic and disease-specific risk factors, patients who reported significant symptoms of depression before surgery were more than five times more likely to have a complication or an unplanned hospital readmission within 30 days of hospital discharge. (upmc.edu)
  • The percentage of the 58 patients using the monitors at least once dropped from 83% (42/58) in the first week after discharge to 46% (23/58) in the fourth week. (jmir.org)
  • Given the increasing burden of HF, there is a need for an effective and sustainable remote monitoring system for HF patients following hospital discharge. (jmir.org)
  • About half of discharged HF patients are readmitted within 6 months post discharge. (jmir.org)
  • In matched analyses, relative to those with no aftercare in the month post-discharge, those with aftercare had increased likelihood of combined outcome (hazard ratio [HR] = 1.22, 95% confidence interval [CI] = 1.05-1.42), and readmission (HR = 1.38, 95% CI = 1.14-1.66), but not ED visits (HR = 1.14, 95% CI = 0.95-1.37). (ices.on.ca)
  • Conclusions - The results are provocative: the researchers found that aftercare in the month post-discharge increased the likelihood of readmission but not ED visit. (ices.on.ca)
  • Although large, population-based data sets have limitations, these results elucidate that these patients are at an increased risk for unplanned readmissions, which can guide patient expectations and discharge planning. (utmb.edu)
  • The Centers for Medicare & Medicaid Services (CMS) reported that one in five elderly patients are readmitted within 30 days of discharge. (amalgamatedbenefits.com)
  • Cited as reasons for this still high rate of preventable readmissions are nurse workloads, lack of medication reconciliation after discharge, low quality of healthcare, and a hospital's high number of the neediest patients (i.e., those with certain conditions such as congestive heart failure, stroke, chronic obstructive pulmonary disease, cancer, and co-morbidities). (amalgamatedbenefits.com)
  • Reviewing and evaluating the data extracted by the case manager and all treating healthcare providers to determine potential risk of readmission is also essential in the post discharge stage. (amalgamatedbenefits.com)
  • When patients have been interviewed regarding their discharge, many have conveyed that they too believed their hospital readmission was avoidable had there been better attention paid to the actual timing of discharge, the level of follow-up, and the skills and experience of the care team members. (amalgamatedbenefits.com)
  • For their part, nurse case managers often side with patients on this matter believing that hospitals can do more to improve the patient discharge process which, in turn, would be an important factor in reducing preventable hospital readmissions. (amalgamatedbenefits.com)
  • The Centers for Medicare & Medicaid Services reported that the national readmission rate (i.e., instances when patients return to the same or different hospital within 30 days of discharge) fell to 17.5 percent in 2013, after holding steady at 19 to 19.5 percent for many years. (trusteemag.com)
  • Accordingly, many planned readmissions within 30 days of discharge no longer count as a readmission for the HRRP. (trusteemag.com)
  • At Essentia Health-St. Mary's Medical Center in Duluth the Nurse Care Line program contacts patients with select diagnoses within 24-48 hours of discharge to answer questions, review medications and discuss the importance of attending scheduled follow-up appointments. (mnhospitals.org)
  • This service streamlines the discharge process and works to prevent readmissions. (pegbenefits.com)
  • Hospital patients are contacted after being discharged and receive assistance with discharge instructions, getting and taking prescriptions, follow up appointments, and other issues to increase patient satisfaction and decrease readmissions. (pegbenefits.com)
  • One group of patients and relatives has complaints about inadequate preparation before discharge. (biomedcentral.com)
  • Three deep learning models, namely, recurrent neural network (RNN), gated recurrent unit (GRU), and long short-term memory (LSTM) with attention mechanisms, were trained for the prediction of in-hospital mortality, prolonged LOS, and 30-day readmission with variables collected during the initial 24 h after ICU admission or the last 24 h before discharge. (frontiersin.org)
  • As reported by Medicare, at least 20 percent of all admitted patients undergo readmission within 30 days after discharge. (wellapp.com)
  • Hospital readmission denotes readmitting a patient within 30 days after discharge from an earlier hospital stay. (wellapp.com)
  • CMS reported that since 2012, hospitals have been subject to penalties in the case of too many readmissions soon after discharge. (wellapp.com)
  • However, providers can and should avoid numerous readmissions via improved patient education and engagement during the discharge process. (wellapp.com)
  • In fact, a report indicates that better patient communication and engagement after discharge is tied to reducing hospital readmissions by up to 45 percent - which can also result in millions of dollars in savings in just one year. (wellapp.com)
  • You can say, 'We did everything possible to make sure the patient had all the support and resources when they went home and gave them a good discharge plan,' but it's not always in your control and sometimes not easy to prove they were not compliant. (ahdam.org)
  • To help the patient after discharge with home IV antibiotics and wound care, home health was arranged and follow-up visits were set for primary care, endocrinology, surgery and infectious disease, Wilson said. (ahdam.org)
  • On March 22, the patient showed up at the emergency room with worsened left foot swelling, redness, and discharge, and asked for an amputation below his knee. (ahdam.org)
  • She noted that when the patient was discharged from the hospital the first time around, there was an effective discharge plan in place. (ahdam.org)
  • As research demonstrates, post-discharge follow up plays a critical role in improving patient outcomes and experiences. (cipherhealth.com)
  • Background: There is increasing interest in using prediction models to identify patients at risk of readmission or death after hospital discharge, but existing models have significant limitations. (elsevier.com)
  • Results: Among the 39,604 adults hospitalized for a broad range of medical reasons, 2.8 % of patients died, 12.7 % were readmitted, and 14.7 % were readmitted or died within 30 days after discharge. (elsevier.com)
  • Within 1 week of discharge, patients were recruited from two local hospitals and referred to the community pharmacy for MTM services with the pharmacists, who reconciled the patients' medications, identified drug therapy problems, recommended changes to therapy, and provided self-management education. (uspharmacist.com)
  • At 30 days from hospital discharge, telephone surveys were conducted to assess hospital readmissions and patient satisfaction. (uspharmacist.com)
  • Social workers arrange for the paramedics to meet each patient before discharge and review treatment notes and discharge plans. (mnhospitals.org)
  • It found that frailty was linked with "a substantially increased risk of early readmission or death after discharge. (rc-rc.ca)
  • In addition, surveys may be delivered to patients up to six weeks following discharge. (kevinmd.com)
  • Its importance will grow significantly because of Medicare penalties now imposed to hospitals because of readmissions (with expanding diagnoses and time intervals from discharge in the near future). (kevinmd.com)
  • The first report, Characteristics of Patients Experiencing Rehospitalization or Death after Hospital Discharge in a National Outbreak of E-cigarette, or Vaping, Product Use-Associated Lung Injury - United States, 2019 , describes the characteristics of patients who experience rehospitalization or death after hospital discharge. (cdc.gov)
  • A complementary report, Interim Guidance for Health Care Professionals Caring for Patients with Suspected EVALI and Reducing the Risk for Rehospitalization and Death Following Hospital Discharge - United States, 2019 , released simultaneously, provides updated clinical guidance for patient management, discharge planning, and follow-up care for hospitalized patients to minimize the risk of readmission or death. (cdc.gov)
  • Patients should be in stable condition for 24-48 hours prior to discharge. (cdc.gov)
  • Patients should have a follow-up visit with a primary care physician or pulmonary specialist optimally within 48 hours of discharge to minimize the risk of rehospitalization or death. (cdc.gov)
  • A high proportion of EVALI patients who were rehospitalized or died after discharge had one or more chronic medical conditions, including cardiac disease, chronic pulmonary disease, and diabetes, and increasing age might be risk factors leading to higher morbidity and mortality among some EVALI patients. (cdc.gov)
  • CDC has created several Resources for Health Care Providers who treat EVALI patients, including an updated algorithm for management of patients with suspected EVALI and an EVALI Discharge Readiness Checklist. (cdc.gov)
  • Care transitions can help reduce hospital readmissions by ensuring that patients clearly understand their discharge instructions. (arizonadailynews.xyz)
  • Care transitions can help by providing patients with written discharge instructions and verbally going over the instructions with them. (arizonadailynews.xyz)
  • When patients are discharged from the hospital, their primary care physician or other care provider must be aware of their discharge information. (arizonadailynews.xyz)
  • Care transitions can help ensure that patients follow their discharge instructions and make their follow-up appointments, thereby reducing the risk of readmission. (arizonadailynews.xyz)
  • Studies have shown that patients receiving transition-related care are less likely to be readmitted to the hospital within 30 days of discharge. (arizonadailynews.xyz)
  • Hospital discharge and readmission. (ahrq.gov)
  • Complications of interest investigated included inpatient mortality, nonroutine discharge (e.g., to locations other than home), length of stay (LOS) within the top quartile (Q1), cost within Q1, and 1-year readmission rates. (caltech.edu)
  • Internal setbacks in patient care can delay discharge. (transonic.com)
  • Another way to ensure the patient understands his or her discharge instructions is to have them repeat the instructions back to the physician. (transonic.com)
  • ABSTRACT: To describe the epidemiological profile and monitoring after discharge of patients hospitalized at an intensive care unit. (bvsalud.org)
  • An admission or discharge between payor sources also requires Form 3618, Resident Transaction Notice, and Form 3619, Patient Transaction Notice. (texas.gov)
  • Including caregivers in the hospital discharge planning process was associated with 25% fewer readmissions. (thelowdownblog.com)
  • Variables significantly associated with readmission included lack of cardiology consult during admission, living status, point of entry of index admission, receiving Medicare, and having pulmonary hypertension. (nih.gov)
  • Our aim was to determine whether MSSP is associated with changes in readmissions and mortality for Medicare patients hospitalized with ischemic stroke, and whether MSSP has a different impact on safety net hospitals (SNHs) compared to non-SNHs. (rand.org)
  • This study was based on the CMS Hospital Compare data for risk-standardized 30-day readmission and mortality rates for Medicare patients hospitalized with ischemic strokes between 2010 and 2017. (rand.org)
  • MSSP led to slightly fewer readmissions without increases in mortality for Medicare patients hospitalized with ischemic stroke. (rand.org)
  • The Centers for Medicare and Medicaid Services reduces reimbursements to hospitals that have excess 30-day readmission rates, including ICU readmissions. (medindia.net)
  • In studies of elderly patients receiving Medicare, readmissions have been associated with poor-quality inpatient care, ineffective hospital-to-home transitions, patient characteristics, disease burden, and socioeconomic status. (jabfm.org)
  • This study demonstrates that factors previously found to be associated with 30-day readmission among elderly patients receiving Medicare also apply to family medicine patients of all ages. (jabfm.org)
  • 1 , 7 ⇓ ⇓ ⇓ - 11 Many of the studies identifying these factors were performed with elderly populations receiving Medicare 1 , 7 ⇓ - 9 , 11 , 12 and may not be applicable to younger patients. (jabfm.org)
  • Accordingly, the Centers for Medicare & Medicaid Services (CMS) recently launched the Hospital Readmission Reduction Program as part of the Affordable Care Act. (aarp.org)
  • The program fines hospitals for excessive rates of readmissions among Medicare patients with certain conditions, including elective hip and knee replacements. (aarp.org)
  • While this study ended before Medicare began fining hospitals for excess readmissions for hip and knee replacement procedures, there is evidence that hospitals have been employing preemptive strategies to lower readmission rates before the program began. (aarp.org)
  • Thus, our finding that rates of hospital readmissions following joint replacement procedures decreased substantially among the 65- to 84-year-old population could be further evidence that the Medicare hospital readmission reduction program is having its intended impact. (aarp.org)
  • Medicare's efforts to reduce hospital readmission rates have left most hospitals facing reductions in Medicare payments. (darkdaily.com)
  • According to an analysis of data from the Centers for Medicare and Medicaid Services (CMS) by Modern Healthcare , only 799 out of more than 3,400 hospitals subject to the Hospital Readmissions Reduction Program (HRRP) in 2015 avoided a penalty. (darkdaily.com)
  • Unplanned readmissions have increasingly drawn attention as drivers of cost, adding more than $17 billion to Medicare expenditures. (cns.org)
  • Data for: Will hospital peer grouping by patient socioeconomic status fix the Medicare Hospital Readmission Reduction Program or create new problems? (mendeley.com)
  • MAIN OUTCOMES AND MEASURES The primary outcome was readmission for thromboembolism (stroke, transient ischemic attack, or systemic embolism) at up to 3 years of follow-up, as defined by Medicare claims data. (northwestern.edu)
  • News coverage continues regarding the Centers for Medicare & Medicaid Services' hospital readmissions reduction program with details of a final rule released Friday and a local look at how hospitals are faring in Georgia and Missouri. (khn.org)
  • The CMS' hospital readmissions reduction program is expected to cut Medicare spending on hospitals by about $227 million during the federal fiscal year starting Oct. 1, according to a 2,225-page final rule published Friday afternoon (Carlson, 8/5). (khn.org)
  • Armed With Bigger Fines, Medicare To Punish 2,225 Hospitals For Excess Readmissions (Rau, 8/2). (khn.org)
  • The two-part study drew on the Centers for Medicare & Medicaid Services hospital-wide 30-day readmission measures cohort, consisting of Medicare fee-for-service recipients aged 65 years and older from July 2014 to June 2015, excluding cancer and primary psychiatric patients. (medscape.com)
  • To minimize the effect of patient-specific factors in readmission rates, the researchers performed a second analysis using data from the remaining Centers for Medicare & Medicaid Services cohort. (medscape.com)
  • The Center for Health Information and Analysis estimates that hospital readmissions cost Medicare approximately $26 billion annually, $17 billion of which is associated with preventable readmissions. (amalgamatedbenefits.com)
  • Thirty-nine hospitals will receive the highest fine, 3% of all Medicare patient payments. (copdfoundation.org)
  • https://khn.org/news/medicare-readmissions-penalties-2015/ Published October 2, 2014. (copdfoundation.org)
  • The campaign was initiated to address the fact that in Minnesota, nearly one in five Medicare patients is readmitted within 30 days. (mnhospitals.org)
  • According to the Health Research and Education Trust, unplanned readmissions cost Medicare $17.5 billion. (mnhospitals.org)
  • Since the patient is treated by such a wide variety of workers, there are weekly case management meetings which are mandated by Medicare, but often also influenced by hospital policy to ensure quality of care. (bartleby.com)
  • The Affordable Care Act established the Hospital Readmission Reduction Program requiring the Centers for Medicare and Medicaid Services to withhold to cut decrease payment to hospitals with a high readmission rate (White et.al, 2014). (bartleby.com)
  • The 30-day readmission rate is the standard point of reference utilized by the Centers for Medicaid and Medicare Services (CMS). (wellapp.com)
  • Medicare Advantage (MA) plans and commercial payers may deny claims for what seem like preventable readmissions, but hospitals may be able to overturn them when patient noncompliance is the driver, an appeals expert said. (ahdam.org)
  • For fiscal year 2022, Medicare penalized 47% of hospitals for readmissions, according to Kaiser Health News.2 The average penalty is a 0.64% reduction in payment for every Medicare patient stay from Oct. 1, 2021, through September 2022. (ahdam.org)
  • Performance of the model was evaluated against the Canadian LACE mortality or readmission model and the Centers for Medicare and Medicaid Services (CMS) Hospital Wide Readmission model. (elsevier.com)
  • Medicare will pay for services rendered to a patient who is readmitted to a facility that is under a DPNA. (palmettogba.com)
  • Direct the Secretary to better inform providers on how to best use underutilized Behavioral Health Integration services already covered by Medicare to better treat patients. (house.gov)
  • The mandate for utilization of patient portals is only for 10% of hospital Medicare patients and 5% of outpatients. (kevinmd.com)
  • In March HRS signed its first client, Hackensack Alliance ACO, an organization that focuses on Medicare patients. (blogspot.com)
  • We also know that CMS [Centers for Medicare & Medicaid Services] does use readmission rates to adjust payments to hospitals, and many are penalized financially. (medscape.com)
  • Form 3619, Medicare/Skilled Nursing Facility Patient Transaction Notice, can only be submitted electronically by completing Form 3619 on the Texas Medicaid & Healthcare Partnership (TMHP) Long Term Care (LTC) Online Portal. (texas.gov)
  • HealthXL ® provides easy-to-implement Chronic Care Management solutions in Virginia to strengthen care quality for Medicare patients suffering from two or more chronic conditions. (gotohealthxl.com)
  • Among 126,137 unique patients with an index COVID-19 admission during March-July 2020, 15% died during the index hospitalization. (cdc.gov)
  • More than a single readmission occurred among 1.6% of patients discharged after the index hospitalization. (cdc.gov)
  • These factors were chosen because in general they are easily obtained within electronic medical records and they have been shown to predict initial hospitalization in elderly patients older than age 60. (jabfm.org)
  • Readmissions were deemed if the individual had more than one episode of hospitalization during the period 2002-2003 to 2003-2004. (longwoods.com)
  • patients aged ≥ 80 years showed a trend of longer hospitalization. (bepress.com)
  • To examine the rates, costs, and 1-year outcomes of patients readmitted within 30 days following their index hospitalization for complications of cirrhosis, we conducted a nationwide, population-based cohort study involving all patients with cirrhosis in Thailand from 2009 through 2013, using data from the National Health Security Office databases, which included those from nationwide hospitalizations. (tropmedres.ac)
  • Average hospitalization costs were high, and only 36.5% of patients readmitted within 30 days survived at 1 year. (tropmedres.ac)
  • The data showed that if galectin-3 is increasing over several months that patient has a much higher risk profile in terms of hospitalization than one whose level stays stable or even decreases over time. (genomeweb.com)
  • The study aims to determine whether aftercare reduces ED visits and/or readmission in adolescents with first psychiatric hospitalization. (ices.on.ca)
  • Furthermore, while hospitals are working to reduce readmissions caused by clinical care practices, there are many other factors beyond their control - sociodemographic factors like poverty and lack of access to supportive services in the community that aid post-hospitalization recovery - that increase the risk of readmission. (trusteemag.com)
  • Electronic medical record (EMR) based models that can be used to predict risk on multiple disease conditions among a wide range of patient demographics early in the hospitalization are needed. (elsevier.com)
  • Readmissions after hospitalization for pneumonia are common, but the few risk-prediction models have poor to modest predictive ability. (the-hospitalist.org)
  • EHR data collected from the entire hospitalization can accurately predict readmission risk among patients hospitalized for pneumonia. (the-hospitalist.org)
  • One objection is that patients might fear retribution during the hospitalization for negative comments. (kevinmd.com)
  • Antiretroviral medication prescribing errors are common with hospitalization of HIV-infected patients. (ahrq.gov)
  • They suggest that being admitted to a hospital with a higher readmission rate is associated with a higher probability of experiencing an adverse event during the hospitalization, but they are unable to speak to the causal mechanism. (medscape.com)
  • Wright said clinicians and hospital administrators "should evaluate whether there are things that they are or are not doing during a patient's hospitalization that may be contributing to both adverse events and readmissions. (medscape.com)
  • Data from nonnewborn patients were weighted to produce national hospitalization may assist in identifying estimates. (cdc.gov)
  • Returning to the ED after hospitalization of ED visits where the patient had been may be an important measure to help improve inpatient care quality. (cdc.gov)
  • A clinical trial published in October 2021 found that empagliflozin - a sodium-glucose cotransporter 2 (SGLT2) inhibitor - reduced the combined risk for cardiovascular death or HF-related hospitalization in patients with HFpEF, regardless of the presence or absence of diabetes. (medscape.com)
  • This comes on the heels of evidence showing that SGLT2 inhibitors reduce the risk for HF-associated hospitalization or death in patients with HFrEF . (medscape.com)
  • Loop diuretics have also been linked to reduced hospital readmission risk in the 30 days after an index hospitalization in patients who have HFpEF, according to a study published in 2020 . (medscape.com)
  • Early evidence suggests that Medicare's hospital readmission reduction program may have reduced hospital readmissions. (aarp.org)
  • Our goal was to determine whether readmission rates after such procedures fell in the years immediately prior to the implementation of the hospital readmission reduction program. (aarp.org)
  • Indeed, hospitals could have reasonably predicted that elective hip and knee replacement procedures would be included in the readmission reduction program based on CMS activities that began in 2009. (aarp.org)
  • Furthermore, since the passage of the Hospital Readmissions Reduction Program in 2012, hospitals can be heavily penalized for increased 30-day readmissions. (cns.org)
  • On October 1 2012, the CMS Readmission Reduction Program kicked in - much to the consternation of 2,217 hospitals that will be penalized. (openhealthnews.com)
  • In fiscal year 2019, the Advisory Board reported that 82% of hospitals in the Hospitals Readmissions Reduction Program incurred hospital readmission penalties. (amalgamatedbenefits.com)
  • To encourage efforts to reduce readmissions, Congress included in the Affordable Care Act the Hospital Readmissions Reduction Program, or HRRP, which instructs CMS to penalize hospitals that have higher-than-expected readmissions for specific clinical conditions like heart attack, pneumonia and heart failure. (trusteemag.com)
  • This Kaiser Health News article provides an update on the status of hospital performance as Year 3 of the Hospital Readmissions Reduction Program begins. (copdfoundation.org)
  • and (2) under the Hospital Readmission Reduction Program, CMS penalizes hospitals with excess readmissions for six conditions/procedures by reducing their total MS-DRG reimbursement up to 3% based on data from prior years. (ahdam.org)
  • Excellence in Patient Education: Evidence-Based Education that 'Sticks' and Improves Patient Outcomes. (semanticscholar.org)
  • How one clinical acute care unit was able to raise HCAHPS scores consistently using the teach-back method in patient and family education is described and is one technique that may improve outcomes, particularly patient satisfaction. (semanticscholar.org)
  • Poor patient outcomes and the financial burden associated with readmissions validates the importance of addressing this clinical problem at the microsystem level. (semanticscholar.org)
  • Data on the education levels of patients and their caregivers were collected, and patient outcomes in high education level (HEL) and low education level (LEL) groups were compared. (who.int)
  • We know that an improved patient experience - and well educated patients - means that patients are more involved in their care and thus more likely to adhere to care plans, which leads to improved outcomes. (getwellnetwork.com)
  • This approach aligns with the Get Well philosophy that an engaged and educated patient has better health and safety outcomes. (getwellnetwork.com)
  • used the STS/ACC TVT Registry to evaluate the association between TR severity and TAVR outcomes in 34,576 patients who had TAVR between 2011 and 2015. (acc.org)
  • They add that future research should investigate whether these patients would have better outcomes with surgical aortic valve replacement. (acc.org)
  • Minimally invasive surgical treatment of intracranial meningiomas in elderly patients (≥ 65 years): outcomes, readmissions, and tumor control. (bepress.com)
  • 65 years versus 118 patients ≥ 65 years old, there were no significant differences in tumor location, size, or outcomes. (bepress.com)
  • CONCLUSIONS: This analysis suggests that elderly patients with meningiomas, when carefully selected, generally have excellent surgical outcomes and tumor control. (bepress.com)
  • By identifying variances in lateral versus posterior approach outcomes, the appropriate approach can be chosen for to maximize benefit to the patient. (cns.org)
  • Importance To optimize patient outcomes and preserve critical acute care access during the COVID-19 pandemic, the Los Angeles County Department of Health Services developed the SAFE @ HOME O 2 Expected Practice (expected practice), enabling ambulatory oxygen management for COVID-19. (ama-assn.org)
  • Objective To assess outcomes of patients with COVID-19 pneumonia discharged via the expected practice approach to home or quarantine housing with supplemental home oxygen. (ama-assn.org)
  • Accurate population-based data are needed on the rate, economic impact, and the long-term outcomes of readmission among patients with cirrhosis. (tropmedres.ac)
  • In addition, we demonstrated that interventions driven by real-time vital sign data may greatly aid in reducing hospital readmissions and costs while improving patient outcomes. (jmir.org)
  • Secondary outcomes were time to first psychiatric ED visit and readmission, separately. (ices.on.ca)
  • In-hospital mortality, prolonged length of stay (LOS), and 30-day readmission are common outcomes in the intensive care unit (ICU). (frontiersin.org)
  • The prognostic prediction models established in our study achieved good performance in predicting common outcomes of patients in ICU, especially in mortality prediction. (frontiersin.org)
  • In addition, readmission and prolonged length of stay (LOS) are both common clinical outcomes indicating patients' health conditions ( 2 , 3 ), critical care quality ( 4 , 5 ), and medical efficiency ( 6 ). (frontiersin.org)
  • Thus, early identification of seriously ill patients and those with prolonged LOS and readmission risk and subsequent management is exceedingly important in improving patient outcomes and providing optimal allocation of medical resources. (frontiersin.org)
  • However, traditional scoring systems, even some machine learning methods in predicting these outcomes, especially in stratifying the risk of readmission, have shown only modest results ( 7 - 10 ). (frontiersin.org)
  • AHRQ Projects funded by the Patient-Centered Outcomes Research Trust Fund. (ahrq.gov)
  • The considerable penalties levied on healthcare centers underline the need for healthcare providers to receive and provide continuing medical education (CME) to enhance their patient outcomes and reduce readmissions. (wellapp.com)
  • Outcomes included patient 30-day cardiac readmission, patient self-care , caregiver self - efficacy , caregiver perceived control, and caregiver HF knowledge . (bvsalud.org)
  • We were one of the first private healthcare providers to publish clinical performance and patient reported outcomes on our website. (spirehealthcare.com)
  • And because we want our patients and GPs to make informed choices, we were one of the first private hospitals to publish clinical performance and patient reported outcomes on our website including information on our rates of MRSA blood infection and clostridium difficile infection. (spirehealthcare.com)
  • Cincinatti, OH- Pharmacist-provided medication therapy management (MTM) optimizes therapeutic outcomes by counseling patients on medication use and adherence, according to the American Society of Consultant Pharmacists. (uspharmacist.com)
  • African Medical Journal describing its use of service claims data to patient investigation and treatment, as well as providing a framework determine standardised mortality rates, across hospital systems, for against which clinical outcomes can be measured. (who.int)
  • The nursing scope of practice, which includes patient health education, aligns standards and competencies with current healthcare philosophy, and mandates nurses to provide patient-centered care, prevent disease, and reduce acute care interventions, while improving outcomes and reducing costs (ANA, 2015). (wholehealtheducation.com)
  • The current objectives were to: 1) describe the new orbital-coronal vertical axis (ORB-CVA) line that evaluates coronal alignment from cranium to sacrum, 2) assess correlation with other radiographic variables, 3) evaluate correlations with patient-reported outcomes (PROs), and 4) compare the ORB-CVA with the standard C7-CVA. (thejns.org)
  • When patients understand their condition and treatment plan well, they are more likely to adhere to it and experience better health outcomes. (arizonadailynews.xyz)
  • Patients who receive care during a transition are also more likely to have better health outcomes. (arizonadailynews.xyz)
  • In addition to enhancing patient experience, care transitions can also improve clinical outcomes. (arizonadailynews.xyz)
  • This allows us to increase clinical outcomes across a whole population of patients while lowering the overall cost - the holy grail of healthcare. (techandfinance.com)
  • SPRI's doctors have used the outcomes of SPRI research to vastly improve the care of their patients, as well as to share their findings through publications and international conferences. (sprivail.org)
  • When a predictive model is developed, patient outcomes are linked mathematically to existing data on patient-specific variables and details about the injury and surgical procedure. (sprivail.org)
  • Later this model can be used to predict those same outcomes based on the same patient-specific details for a new patient. (sprivail.org)
  • We believe, that custom healthcare software development is the key enabler of healthcare interoperability, patient engagement, accurate diagnostics, and positive healthcare outcomes. (arihantinfosys.com)
  • With the nature of the pandemic changing, many physicians say restrictive limits may be harming patients' mental health and leading to worse outcomes. (thelowdownblog.com)
  • Now, with the nature of the pandemic changing in the U.S. and increasing vaccination rates among the general population, patients and many physicians say the more restrictive ongoing limits, like only allowing one visitor, are no longer justified and may actually be harming patients' mental health and leading to worse outcomes. (thelowdownblog.com)
  • CMS estimates that these readmissions cost $26 billion, 65% of which was attributed to avoidable readmissions. (the-hospitalist.org)
  • Public policy efforts intended to reduce hospital readmissions should target the reduction of only avoidable readmissions. (trusteemag.com)
  • Hospitals are focused intently on reducing avoidable readmissions using a number of strategies. (trusteemag.com)
  • As a result of the RARE Campaign (Reducing Avoidable Readmissions Effectively), it is estimated that patients spent 18,280 more nights sleeping comfortably in their own beds instead of the hospital. (mnhospitals.org)
  • In the most recent time period measured, the 4th quarter of 2012, hospitals achieved a roughly 17 percent reduction in avoidable readmissions compared to baseline. (mnhospitals.org)
  • Preventing avoidable readmissions requires improved patient care coordination between hospitals and community partners such as long-term care facilities, home care organizations and primary care clinics. (mnhospitals.org)
  • Jeffrey Brenner, MD , Executive Director of the Camden Coalition of Healthcare Providers , a nonprofit organization working to develop value-based care models in New Jersey, believes the establishment of readmission penalties has accelerated healthcare's transformation to value-based care as hospitals look to improve care coordination, build community partnerships, and make patients more active participants in their own health care. (darkdaily.com)
  • Partly because of the readmissions penalties, people are having discussions they have never had before … When everything is said and done, the whole health system is going to look different. (darkdaily.com)
  • The number of hospitals facing financial penalties for failing to stop patients from returning to the hospital will remain steady next year, but the potential severity of the punishments is doubling. (khn.org)
  • According to analysis by Kaiser Health News , 39 hospitals will incur the maximum penalty, and hospitals collectively will pay an estimated $428 million in penalties in the current fiscal year for readmission rates deemed higher than expected by CMS formulas. (the-hospitalist.org)
  • CMS' fiscal year 2015 final rule for reimbursement under the Hospital Inpatient Prospective Payment System, first published in the Federal Register , spells out fiscal year 2015 penalties and readmissions payment adjustment factors. (the-hospitalist.org)
  • While hospital readmissions are declining, there are serious questions about how the HRRP assesses penalties that affect the fairness and long-term sustainability of the program. (trusteemag.com)
  • 2. The inclusion of readmissions unrelated to the initial admission in determining HRRP penalties. (trusteemag.com)
  • The HRRP's approach to calculating hospital penalties needs refinement to reduce readmissions without unfairly penalizing hospitals. (trusteemag.com)
  • Readmission denials and payment penalties continue to be a source of frustration for hospitals. (ahdam.org)
  • Prior to MSSP, readmission rates in SNHs were higher compared to non-SNHs, but MSSP did not have significantly different impact on hospital readmission and mortality rates for SNHs and non-SNHs. (rand.org)
  • Similar reductions in readmission rates were observed in SNHs and non-SNHs participating in MSSP, indicating persistent gaps between SNHs and non-SNHs. (rand.org)
  • This single centre pilot study aimed to determine epidemiological correlations between education level and hospital readmission and mortality rates of CHF patients in a nonwestern country population. (who.int)
  • The education levels of CHF patients and caregivers were not correlated with readmission or mortality rates. (who.int)
  • This study evaluated the epidemiological correlation of education level of patients and their caregivers and readmission and mortality rates of congestive heart failure (CHF) patients. (who.int)
  • To ascertain the rates of 30-day readmissions and emergency department presentations among pediatric patients with an index admission for functional seizures. (cureepilepsy.org)
  • Particular measures include hospital-wide 30-day readmission rates in addition to disease-specific 30-day readmission rates, including a report-out for congestive heart failure readmission rates ( CHF RSRR ). (getwellnetwork.com)
  • By focusing on making patient education at its facility both high-quality and consistently assigned, this VAMC sought to lay the groundwork for lowered readmission rates for its Veteran population. (getwellnetwork.com)
  • We also found that rates of unplanned hospital readmissions following elective hip and knee replacement procedures fell markedly among the 50- to 84-year-old population between 2009 and 2013. (aarp.org)
  • Overall, the rapid reductions in hospital readmission rates among the 65- to 84-year-old age group resulted in rates that are now much more comparable to those found in the 50- to 64-year-old age group. (aarp.org)
  • However, a recent ranking of hospitals by the Modern Healthcare Data Center indicates that influences other than inferior care-such as patient demographics-can affect 30-day readmission rates . (darkdaily.com)
  • That's because readmission rates impact a hospital's budget. (darkdaily.com)
  • Several recent studies, however, have called into question the link between suboptimal care and high readmission rates. (darkdaily.com)
  • In lumbar decompressive surgery, the impact of minimally invasive (MIS) lateral access approaches versus open posterior approaches on readmission rates remains poorly understood. (cns.org)
  • The aim of this study is to determine if MIS lateral access approaches impact 30-day hospital readmission rates compared to open posterior approaches. (cns.org)
  • Question What are the mortality and readmission rates in patients with COVID-19 pneumonia discharged according to an expected practice approach with supplemental home oxygen? (ama-assn.org)
  • Meaning In this study, a careful and systematic expected practice approach to treatment of patients with COVID-19 using home oxygen was associated with low all-cause mortality and low 30-day return admission rates. (ama-assn.org)
  • Readmission rates at Barnes-Jewish Hospital have improved, but the hospital still faces a federal penalty of more than $1 million. (khn.org)
  • Conclusions: Patients hospitalized with cirrhosis complications had high rates of unscheduled 30-day readmission. (tropmedres.ac)
  • The exact percentage will be determined by how a hospital's 30-day readmission rates for heart attack, heart failure, and pneumonia perform against expected readmission rates. (openhealthnews.com)
  • After disentangling patient-related factors, researchers find hospital factors significantly affect 30-day readmission rates, researchers report in an article published in the September 14 issue of the New England Journal of Medicine . (medscape.com)
  • The authors believe the current findings validate use of readmission rates as a measure of hospital quality and performance, and a starting point for further reducing preventable readmissions. (medscape.com)
  • These observations include significant variability in readmission rates in the different groups. (biomedcentral.com)
  • readmission rates for patients admitted to the hospital? (bartleby.com)
  • Hospital readmission rates are a way of appraising the quality and effectiveness of the care that patients receive. (wellapp.com)
  • CMS cannot continue to utilize a payment model that is nearly 20 years old and assume it accurately reflects patient costs, especially for a population with needs as acute and diverse as those receiving care at Inpatient Psychiatric Facilities (IPFs)," said Rep. Jodey Arrington (R-TX) , "Over a decade of data and outside examination have shown not only flaws in the model but high rates of expensive readmissions. (house.gov)
  • Sean May, vice president at the firm Charles River Associates, said hospital mergers are associated with improvements in clinical quality outcome measures at acquired hospitals, including a statistically significant reduction in inpatient readmission rates. (aha.org)
  • Research has shown that hospitals adhering to clinical measures through the Get With The Guidelines quality improvement initiative can often see fewer readmissions and lower mortality rates. (st-marys.org)
  • Transforming hospital communication is a cultural shift, but taking the steps to get started as well as implementing simple steps to improve doctor-patient communication right away, can play an important role in reducing your hospital's readmission rates while improving patient safety. (transonic.com)
  • In fact, a number of house-call programs across the country are finding that they can ensure continuity of care and reduce readmission rates for an increasingly aging population. (trusteemag.com)
  • Adding to the debate over the value of hospital readmission rates, a new study links the data to higher rates of adverse events in patients treated for pneumonia. (medscape.com)
  • We also know that many are not preventable and that efforts to lower readmission rates have not been highly successful overall, although there have been some positive studies," he said. (medscape.com)
  • For the new study, he said, the researchers sought to understand more about readmission rates and pneumonia. (medscape.com)
  • Both readmissions and patient safety are associated with the quality of hospital care, but it is unknown whether patients admitted to hospitals with higher risk-standardized readmission rates had a higher risk of in-hospital adverse events. (medscape.com)
  • Patients with pneumonia admitted to a hospital with a high readmission rate were more likely to suffer an adverse event while hospitalized, and hospitals with high readmission rates had higher rates of adverse events among their patients," Metersky said. (medscape.com)
  • The message of the study is that "readmission rates likely do reflect overall hospital quality, and factors that contribute to readmission rates might also contribute to patient safety/adverse event rates," he said. (medscape.com)
  • However, he added, "without further studies, I would generally be very reluctant to conclude from this that readmission rates should be used as a proxy for hospital quality or patient safety. (medscape.com)
  • The purposes of this study were to (1) describe the characteristics of the population with congestive heart failure (CHF) who were admitted to a large, southeastern, acute-care hospital and (2) determine which patients are at risk for readmissions within 6 months. (nih.gov)
  • Participants who completed the study were 90 adult patients discharged from two local hospitals with a diagnosis of congestive heart failure, chronic obstructive pulmonary disease, or pneumonia. (uspharmacist.com)
  • As access to large data set analysis becomes possible, the nature of the analytics has changed from looking at individual patients to looking at populations of patients with problems such as congestive heart failure or diabetes, for instance. (techandfinance.com)
  • The sensors are coupled with a mobile app to gather data and a brain dysfunction monitoring app, plus a proprietary algorithm which collates the data onto a clinician dashboard, and the platform allows direct, two-way communication between patient and healthcare professional. (pharmaphorum.com)
  • Reducing readmissions for heart failure is a crucial quality improvement endeavor for many healthcare systems, including the VA. In combination with other interventions, patient education has been proven to help reduce readmissions . (getwellnetwork.com)
  • Providers and other healthcare staff may have too many tasks on their metaphorical plates to cover during rounds to also add on patient education, whether at bedside or via digital assignment. (getwellnetwork.com)
  • Particularly with the staffing shortages brought on by the COVID-19 pandemic and facility turnover, many institutions find themselves short-staffed, meaning remaining healthcare staff may be strapped for time and unable to take on extra patient education. (getwellnetwork.com)
  • In a December 2015 article, Modern Healthcare noted the steps taken by Roper St. Francis Healthcare in response to CMS' various quality-based incentive programs, including establishing the Care Transition Program , in which elderly patients are provided assistance in managing their medications. (darkdaily.com)
  • As part of the monitoring program, Todd Shuman, MD , Chief Physician Officer, at the Charleston, SC-based healthcare system, told Modern Healthcare that pharmacy technicians are conducting medication reconciliations with patients as well as making calls to local pharmacies to determine when patients last filled their prescriptions. (darkdaily.com)
  • There's been a lot of uncertainty about the degree to which readmission is about hospital environment, including policy and staff, and to what extent we're powerless as healthcare providers because in the end it's all about the patient," lead author Harlan M. Krumholz, MD, from the cardiovascular medicine section at Yale University School of Medicine in New Haven, Connecticut, told Medscape Medical News . (medscape.com)
  • In an effort to reduce hospital readmissions, OSF HealthCare implemented a BOOST-based navigator inside of EPIC. (osfhealthcare.org)
  • Healthcare Analytics built a 30 Day Readmission Risk Model that helps clinicians identify patients most at risk for readmissions, driving work processes and helping better align patients with existing interventions such as case management. (osfhealthcare.org)
  • Like many hospital systems around the U.S., OSF HealthCare is continually working to reduce its hospital readmission rate. (osfhealthcare.org)
  • The Healthcare Analytics team came up with a more efficient way to proactively identify patients in need of risk mitigation. (osfhealthcare.org)
  • After the Institute of Medicine released its sentinel report, To Err is Human: Building a Safer Health System , the Agency for Healthcare Research and Quality (AHRQ), in conjunction with its Federal partners and non-Federal stakeholders and at the direction of Congress, started the process of building the foundation to better understand patient safety challenges and how effective solutions could be rapidly implemented. (ahrq.gov)
  • At the direction of Congress, the Agency for Healthcare Research and Quality (AHRQ), in conjunction with its Federal partners and non-Federal stakeholders, started the process of building the foundation to better understand patient safety challenges and how effective solutions could be rapidly implemented. (ahrq.gov)
  • The Agency's official designation as the Federal lead in patient safety began when the Healthcare Research and Quality Act of 1999 was signed into law. (ahrq.gov)
  • Savvy healthcare providers have noticed that patient education has changed dramatically over the past few decades. (wellapp.com)
  • The biggest change is the shift from providers deciding what healthcare consumers want to a practice of patient enablement where treatment decisions entail cooperation between providers and consumers. (wellapp.com)
  • Additionally, data collected through the program helps identify actionable improvements to bring patients back into care in the comunity, such as scheduling a PCP follow-up visit or connecting patients to other healthcare resources. (cipherhealth.com)
  • The Center for Healthcare Engineering and Patient Safety (CHEPS) brings together multi-disciplinary teams to improve healthcare delivery and patient experiences. (umich.edu)
  • This means healthcare providers need to revamp their current patient care model to include prevention through incorporating patient health education, a cornerstone of patient centered care. (wholehealtheducation.com)
  • Now that the healthcare industry has started to embrace the bigger picture of how to deliver patient-driven health care, while reducing costs, the demand and utilization of therapeutic approaches that support this model are rapidly growing. (wholehealtheducation.com)
  • Recently, the government instituted a system of tying hospital (and provider) reimbursement for services to patient satisfaction scores delivered via Hospital Consumer Assessment of Healthcare Providers and Systems. (kevinmd.com)
  • Public healthcare institutions (PHIs) in Singapore have a range of policies and guidelines for the management of patients presenting to the emergency department (ED). (annals.edu.sg)
  • Healthcare providers at HUM involved in the care of patients with heart failure (i.e. internal medicine physicians, inpatient hospital nurses, outpatient clinic physicians, outpatient clinic nurses, etc. (who.int)
  • Our healthcare consulting expertise is built on a detailed understanding of each player across the value chain, from doctors and patients to payers, drug developers, and manufacturers. (arihantinfosys.com)
  • We oversee faultless performance, usability, and security of our delivered solutions, which guarantees both flawless operation and positive user experience for healthcare providers as well as their patients, partners, and vendors. (arihantinfosys.com)
  • We create solutions that comb through scattered healthcare data and arrange the information for healthcare professionals to predict optimal treatment for particular individuals or groups of patients, as well as elaborate strategies for preventing specific diseases. (arihantinfosys.com)
  • The telehealth implementation industry is supporting the revolutionary transformation of the healthcare background as well as improving the patient experience from virtual visits and online patient portals to remote monitoring, wearable gadgets, cloud-based medical data as well as special health applications. (namasteui.com)
  • For healthcare providers, it is a vital strategy to supervise the health of their patients from a high volume, not expensive perspective. (namasteui.com)
  • If you are a patient, please refer your questions to your healthcare provider. (cdc.gov)
  • Commencing as one of the innovators in Chronic Care Management, it is presently the industry frontrunner, helping patients thrive and healthcare providers boost profits. (gotohealthxl.com)
  • HealthXL ® 's solutions reduce patient visits to hospitals, ED's and doctor's offices in Virginia and all over the U.S. while also reducing healthcare costs and improving patient care. (gotohealthxl.com)
  • In 2014, HealthEast Care System decided to apply the compassion and problem-solving skills of paramedics to a different type of work - helping mental health patients readjust to their home environment, manage their medications and get follow-up care after they are discharged from St. Joseph's Hospital's inpatient mental health unit. (mnhospitals.org)
  • This service provides a reduction in readmissions for hospitals and surgery centers. (pegbenefits.com)
  • The digital therapeutic (DTx) - called CirrhoCare - has been shown in pilot testing to allow early diagnosis of new complications (decompensation events), with fewer and shorter hospital readmissions compared to a control group with standard follow-up over a three-month period. (pharmaphorum.com)
  • While the rate of 30 day readmissions did not significantly vary, there were significantly fewer complications with lateral approaches (13% vs 19%, p=0.02). (cns.org)
  • Additionally, lateral access surgeries led to significantly fewer reoperations, thereby reducing risk to the patient and cost to the hospital. (cns.org)
  • Physicians wrote significantly fewer prescriptions for painkillers and other medications for elderly and disabled patients who had legal access to medical marijuana, a new study finds. (the-hospitalist.org)
  • Over the course of a year, this resulted in about 425 fewer readmissions than expected in our medium-high and high-risk patients. (osfhealthcare.org)
  • Patients provided MTM services from pharmacists had notably fewer hospital readmissions than similar patients receiving usual postdischarge care, according to the study led by University of Cincinnati researchers. (uspharmacist.com)
  • Patients who received MTM services from the pharmacist experienced significantly fewer readmissions than patients who received usual care. (uspharmacist.com)
  • By increasing care coordination, patients can receive the best possible care and experience fewer delays or gaps in their treatment. (arizonadailynews.xyz)
  • Fewer readmissions to the hospital. (naturallybetter.tv)
  • They demonstrate the potential to reduce re-hospitalisations, whilst enabling management of these patients at-home, with a data-driven, physician-assistance tool, that enables prompt intervention to clinical alerts, thereby reducing the morbidity in these patients. (pharmaphorum.com)
  • We speculate that this may be due to differences in patient clinical characteristics as well as the comprehensiveness of the diagnostic evaluation and management in the EMU compared to the general neurology service. (cureepilepsy.org)
  • Cancer patients who report significant symptoms of depression before undergoing a complex abdominal surgery are at increased risk of postoperative complications and unplanned hospital readmissions, according to a UPCI study published recently in the Journal of Clinical Oncology . (upmc.edu)
  • We believe these findings validate our commercial focus on the use of galectin-3 testing to combat unplanned hospital readmissions, and will help us drive further clinical adoption of galectin-3 testing as a routine part of heart failure management," Eric Bouvier, the company's president and CEO, said in a statement at the end of last month. (genomeweb.com)
  • The first study , published online in Circulation Heart Failure looked at almost 2,000 patients enrolled in two larger clinical studies, CORONA, and COACH. (genomeweb.com)
  • We identified clinical and social factors as well as remote monitoring usage trends that identify targetable patient populations that could benefit most from integration of daily remote monitoring. (jmir.org)
  • Nevertheless, the likelihood of patients being readmitted to the hospital is affected not only by the steps hospitals take to improve care, but also by a variety of clinical and nonclinical factors beyond providers' control. (trusteemag.com)
  • In health care today, there is increasing emphasis on the value of care patients receive and rewarding providers for delivering high quality care as efficiently as possible," said Sanne Magnan, president and CEO, Institute for Clinical Systems Improvement. (mnhospitals.org)
  • This hospital has been recognized regionally and nationally for clinical excellence and patient safety. (bartleby.com)
  • Clinical and laboratory data over time for a heart-lung transplant patient in France who had cytolytic hepatitis caused by HCirV-1 develop. (cdc.gov)
  • Was the death specific clinical conditions (i.e. acute myocardial infarction, coronary of this patient expected? (who.int)
  • It requires a proactive clinical focus, in which patients at high risk for disease progression are identified for early intervention, patient education services are expanded, care is coordinated across sites and specialties, and redundant, non-evidence-based treatments are eliminated-all with three key objectives: making patients healthier, providing high-quality care, and reducing the total cost of care. (wholehealtheducation.com)
  • A case of MDR-TB was defined as a positive culture for M. tuberculosis in any patient at the hospital from January 1, 1988, through January 31, 1990, whose clinical course was consistent with TB and whose isolate was resistant to at least isoniazid (INH) and rifampin. (cdc.gov)
  • Patient frailty was assessed using the Johns Hopkins Adjusted Clinical Groups (ACG) System. (caltech.edu)
  • Knowledge gained from these models may help neurosurgeons identify high-risk patients who require additional clinical attention or resource utilization prior to surgical planning. (caltech.edu)
  • Intensive Care Units (ICU) are specialized spaces inside hospitals for the treatment of patients whose survival is threatened by diseases or clinical conditions that cause instability or dysfunction of one or more physiological systems. (bvsalud.org)
  • ABSTRACT Objectives: to identify the presence of compulsive overeating disorder in patients with cardiovascular diseases and to verify its relation with sociodemographic, clinical variables and the presence of anxiety and depressive symptoms. (bvsalud.org)
  • Consequently, all patients should be evaluated for entry into well-designed clinical trials. (medscape.com)
  • If a clinical trial is not available, the patient can be treated with standard therapy. (medscape.com)
  • With a legacy of putting patients first, Weill Cornell Medicine is committed to providing exemplary and individualized clinical care, making groundbreaking biomedical discoveries, and educating generations of exceptional doctors and scientists. (cornell.edu)
  • A multinational randomized trial concluded that empagliflozin in patients hospitalized for acute HF is well tolerated and leads to significant clinical benefit in the 90 days after treatment initiation. (medscape.com)
  • This required nurses to assess patients on multiple criteria in an effort to identify which are at the highest risk of readmission. (osfhealthcare.org)
  • Through HRS, hospitals give patients with the highest risk of readmission a tablet preloaded with educational videos and information about what they need to do to stay out of the hospital. (blogspot.com)
  • The authors note that "there was a significant interaction between left ventricle ejection fraction (LVEF) and TR in that severe TR was independently associated with risk-adjusted increased mortality and heart failure readmission for patients with LVEF greater than 30 percent. (acc.org)
  • Acutely decompensated heart failure readmission at 1-year in patients with acute coronary syndrome. (escardio.org)
  • Larger values (higher respiratory rate, higher blood glucose level, and so on) indicated a greater risk for readmission. (medindia.net)
  • There were no significant differences in the mortality (3 vs 2%) or readmission rate (18 vs 19%) between the LEL and HEL patients, and 29.6% of LEL patients had caregivers with an LEL. (who.int)
  • A wide variety of traditional nursing home approaches to care need to be reexamined if short-stay patients are to be properly prepared for return home," writes columnist Jeffrey Nichols, M.D., in the March 2013 Caring for the Ages in response to a question from a nursing home whose main referral hospital was dissatisfied with its readmission rate. (ecri.org)
  • Overall in-hospital mortality was 4.5 percent, with the lowest rate in patients with mild TR (3.9 percent) and the highest rate in patients with severe TR (7.6 percent). (acc.org)
  • In addition, patients with severe TR had the highest mortality rate at 30 days (11.3 percent), six months (26.8 percent) and one year (34.2 percent). (acc.org)
  • Previous studies have shown that there is a low rate of statin prescribing and a lack of adherence to treatment by patients with CHD. (bmj.com)
  • The primary outcome investigated in this study was 30-day readmission rate, compared between approaches through univariate analysis. (cns.org)
  • The investigators calculated the risk-standardized rate for unplanned readmissions for all hospitals, classifying them into performance quartiles, with the lowest readmission rate (quartile 1) indicating the best performance. (medscape.com)
  • Overall, the mean risk-standardized readmission rate was 15.6% (±0.6). (medscape.com)
  • Medicare's overall readmission rate in 2013 was 18%, which was down slightly from previous years but still amounted to two million patients. (the-hospitalist.org)
  • The goal of our program, named the Heart Health Program, was to examine the feasibility of using digital health monitoring in real-world home settings, ascertain patient adoption, and evaluate impact on 30-day readmission rate. (jmir.org)
  • Within a month, the readmission rate was 1.5 % in 2010 and 6.5 % in 2011. (biomedcentral.com)
  • To reduce the hospital readmissions rate, we have implemented quality-of-care initiatives. (biomedcentral.com)
  • The lower the readmission rate, the higher the perceived quality of care, and vice versa. (wellapp.com)
  • Here's an easy-to-use, integrated solution with a 98% patient deliverability rate. (beckershospitalreview.com)
  • Is my rate of heart failure readmissions artery bypass graft (CABG) surgery, pneumonia and acute stroke). (who.int)
  • Background: Readmission rate can provide an importantindicator of the global functioning of the health system such as,the articulation between inpatient treatment and communityinterventions. (who.int)
  • however, they have a significantly higher rate of recurrence requiring readmission or operation within 5 years. (nih.gov)
  • This study supplements that knowledge and more specifically links readmission rate, which has been criticized as a measure of quality, with patient safety," said pulmonologist Mark Metersky, MD, of UConn Health, in an interview. (medscape.com)
  • The median hospital-specific risk-standardized readmission rate was 17.0% (95% CI, 16.3%-17.7%), the occurrence rate of adverse events was 2.6% (95% CI, 2.54%-2.65%), and the number of adverse events per 1000 discharges was 157.3 (95% CI, 152.3-162.5)," the researchers reported. (medscape.com)
  • Study objective --To examine the rate and characteristics of ED visits of rarely used as an outcome of prior patients recently discharged from any hospital. (cdc.gov)
  • The readmissions program evaluates patients initially hospitalized for heart attack, heart failure, pneumonia chronic obstructive pulmonary disease, and total hip and total knee replacements. (darkdaily.com)
  • Design, Setting, and Participants This retrospective cohort study included 621 adult patients with COVID-19 pneumonia who were discharged from 2 large urban public hospitals caring primarily for patients receiving Medicaid from March 20 to August 19, 2020. (ama-assn.org)
  • Results A total of 621 patients with COVID-19 pneumonia (404 male [65.1%] and 217 female [34.9%]) were discharged with home oxygen. (ama-assn.org)
  • 3. An unplanned readmission unrelated to the initial admission, such as a fracture from a car accident following an initial stay for pneumonia. (trusteemag.com)
  • Predicting 30-day pneumonia readmissions using electronic health record data. (the-hospitalist.org)
  • Although the 13% increase of adverse events at the patient level may not seem like much, "when considered on a hospital level (several hundred pneumonia admissions per year for larger hospitals) or at the national level (over 1.5 million admissions per year pre-COVID), a 13% increase in the number of adverse events becomes very large," he said. (medscape.com)
  • In the end we still have work to do to improve readmissions," Dr Krumholz said. (medscape.com)
  • Methods: The study was performed in King Abdullah Medical City, Makkah, Saudi Arabia from February 2015 to February 2016, and included 167 consecutive patients enrolled in a CHF management registry. (who.int)
  • CDAD patients were signifi cantly more likely than controls to Methods be discharged to a long-term-care facility or outside hospital. (cdc.gov)
  • Methods: Data were analyzed from all consecutive adult patients admitted to internal medicine services at 7 large hospitals belonging to 3 health systems in Dallas/Fort Worth between November 2009 and October 2010 and split randomly into derivation and validation cohorts. (elsevier.com)
  • The challenges in monitoring and preventing patient safety incidents for people with intellectual disabilities in NHS acute hospitals: evidence from a mixed-methods study. (ahrq.gov)
  • Methods: The Nationwide Readmissions Database was used to identify patients who underwent pituitary tumor operations (n = 19,653) in 2016-2017. (caltech.edu)
  • It will help to prevent relapse andreadmissions in psychiatric patients and to the nurses inproviding psychoeducation to the patient and family.Materials and Methods: The study was conducted 100psychiatric patients who were re-admitted in 2 selectedinpatient mental health setups in Pune, Maharashtra. (who.int)
  • Materials And Methods: A cross-sectional descriptive study was conducted on HIV/AIDS patients on ART attending Bombo Hospital in Tanga from July to October 2019. (bvsalud.org)
  • METHODS: Multicenter prospective study evaluated patients who underwent anterior cervical spine surgery for degenerative pathologies, studying surgical, anesthesia, base disease, and radiological variables (preoperatively, 24 hours, 1 and 3 weeks, and 6 months after surgery), with control group matched. (bvsalud.org)
  • However, no large-scale study has examined the feasibility and acceptability of these methods in spine surgery patients. (bvsalud.org)
  • These results support recent analyses that found chronic conditions to be significantly associated with hospital readmission ( 6 , 7 ) and could be explained by the complications of underlying conditions in the presence of COVID-19 ( 8 ), COVID-19 sequelae ( 3 ), or indirect effects of the COVID-19 pandemic ( 9 ). (cdc.gov)
  • In this study it was demonstrated that levetiracetam (LEV) had a significantly better effectiveness (i.e. less often ASM treatment failure for any reason or due to adverse effects) compared to enzyme-inducing anti-seizure medications (EIASMs), supporting the current neuro-oncology guideline recommendations to avoid EIASMs in glioma patients. (cureepilepsy.org)
  • Average cost at index admission for those with a 30-day readmission were significantly higher than those readmitted beyond 30 days or not readmitted. (tropmedres.ac)
  • Looking at patients' percentage change in galectin-3 levels, the group found that those whose levels increased over time by 15 percent or more had significantly more subsequent hospitalizations and higher mortality compared to those who's levels were stable, or decreased over time. (genomeweb.com)
  • The authors demonstrated that patients who experienced increases in galectin-3 were at significantly increased risk of subsequent unplanned hospital admissions for heart failure. (genomeweb.com)
  • According to Bouvier, this additional use would significantly expand the market for the test from around 20 million to roughly 200 million patients in the US and Europe. (genomeweb.com)
  • On the other hand, the overall mean patient satisfaction with the TOC process was not significantly different between patients who received pharmacist care and those who did not. (uspharmacist.com)
  • A descriptive correlational design, using variables maintained in a computerized data bank on patients with CHF (N = 557, 39% were black) who were admitted between October 2000 and March 2002, was used to describe the adult population with CHF and identify variables associated with a likelihood of readmission. (nih.gov)
  • The univariate analysis indicated that cognitive impairment and autism were associated with a lower likelihood of readmission, while a neurology referral and being started on an anti-seizure medication were associated with a greater likelihood of readmission. (cureepilepsy.org)
  • Our data suggest that patients admitted to the epilepsy monitoring unit (Emu) service have a lower likelihood of readmission. (cureepilepsy.org)
  • By proactively reaching out to patients with CipherOutreach, Choptank reduces the likelihood of adverse events and keeps patients from revisiting the hospital or emergency room. (cipherhealth.com)
  • Being retired, single or depressed increases the likelihood of readmissions for men, survey finds. (hhnmag.com)
  • A retrospective case-control study of 276 family medicine inpatients was conducted to determine the factors associated with 30-day readmission. (jabfm.org)
  • We used statistical analyses to determine risk factors associated with 30-day all-cause readmission. (jmir.org)
  • We analyzed the factors associated with 30-day unplanned readmission (30dUR) following head and neck cancer resections that included free tissue reconstruction (FTR). (utmb.edu)
  • Thirty-Day Readmission and Cost Analysis in Patients With Cirrhosis: A Nationwide Population-Based Data. (tropmedres.ac)
  • The study examined the relationship between preoperative symptoms of depression and 30-day complications and readmissions, as well as overall survival for patients undergoing hyperthermic intraperitoneal chemotherapy with cytoreductive surgery (HIPEC+CS), a complex surgical procedure during which abdominal tumors are removed and the area is "washed" with high doses of heated chemotherapy. (upmc.edu)
  • Aurora is using the data to look at effects of length of stay, complications and readmissions. (techandfinance.com)
  • BG medicine is hopeful that data from two studies published earlier this year will help shore up the scientific foundation for the company's new strategy of marketing its galectin-3 test to hospitals as a tool for reducing unplanned readmissions. (genomeweb.com)
  • Despite the heightened focus on reducing preventable hospital readmission for over a decade now, there remains a high number of these incidences. (amalgamatedbenefits.com)
  • Reducing readmissions is a complex undertaking because not all readmissions can or should be prevented. (trusteemag.com)
  • Reducing readmissions is an important way to improve quality and lower health care spending, and hospitals are making significant progress. (trusteemag.com)
  • Reducing hospital readmissions can be achieved via a variety of interventions including arranging timely outpatient appointments and ensuring medication reconciliation. (wellapp.com)
  • Recent studies show that leveraging automated messaging technology within patient education protocols greatly helps in reducing hospital readmissions. (wellapp.com)
  • Therefore, reducing hospital readmissions with enhanced patient education implies adopting efficient patient communication hubs that elevate patient education. (wellapp.com)
  • Traditionally, reducing hospital readmissions relied upon written materials around self-care guidelines, medical management, medication, and disease processes. (wellapp.com)
  • One of the primary ways care transitions can enhance patient experience is by reducing the number of hospital readmissions. (arizonadailynews.xyz)
  • These measures include evaluation of the proper use of medications and other stroke treatments aligned with the most up-to-date, evidence-based guidelines with the goal of speeding recovery and reducing death and disability for stroke patients. (st-marys.org)
  • The implementation of the change will involve conducting a study on the effectiveness of medication assessment at reducing readmissions among psychiatric patients. (topnursingessay.com)
  • The key outcome that will determine the success of the intervention is a significant consensus among psychiatric nurses regarding the viability of using medication assessment in routine practice as a means of enhancing adherence and reducing readmissions. (topnursingessay.com)
  • La información en esta página debería ser considerada como ejemplos de información de antecedentes para la temporada de influenza 2021-2022 para la práctica médica respecto del uso de medicamentos antivirales contra la influenza. (cdc.gov)
  • Hospital readmissions are when a patient is discharged from the hospital and then readmitted within 30 days. (arizonadailynews.xyz)
  • Objective: Although pituitary adenomas (PAs) are common intracranial tumors, literature evaluating the utility of comorbidity indices for predicting postoperative complications in patients undergoing pituitary surgery remains limited, thereby hindering the development of complex models that aim to identify high-risk patient populations. (caltech.edu)
  • While many hospital readmissions are unavoidable, experts believe hospitals can reduce readmissions for certain conditions. (aarp.org)
  • Are Some Readmissions Unavoidable? (darkdaily.com)
  • Becker's Hospital Review reported on a study published online June 15, 2016, in JAMA Surgery that concluded many readmissions were unavoidable. (darkdaily.com)
  • However, many readmissions may be unavoidable due to the natural progression of disease, accepted treatment protocol or a patient's preferences. (trusteemag.com)
  • Some readmissions are, of course, unavoidable and occur as a result of unanticipated medical complications. (wellapp.com)
  • A surgeon or other health care provider in the SICU might use the nomogram results to try to reduce a patient's readmission risk, according to Dr. Martin. (medindia.net)
  • These preliminary results […] reaffirm that CirrhoCare is feasible for community management of decompensated cirrhosis patients," said lead investigator Prof Raj Mookerjee, a consultant hepatologist at University College London. (pharmaphorum.com)
  • These results were primarily driven by substantial reductions in readmissions among the 65- to 84-year-old population. (aarp.org)
  • The reason why we are excited [about the results] is that they show that galectin-3 levels do change over time in a proportion of patients and that change does appear to reflect disease progression in terms of the underlying pathophysiology," he said. (genomeweb.com)
  • Therefore, a study was conducted to describe the type of psychiatric diagnosis among the Results admittedpatientsinthepsychiatricwardof Socio-demographic characteristics of JDWNRHandtodeterminetherelationshipof patients psychiatricdisorderswithsocio-demographic Therewere1336admissionsinthepsychiatry characteristicsofthepatients. (who.int)
  • The results suggest that interventions targeting caregiver HF education could be effective in improving HF patients ' 30-day cardiac readmissions, patient self-care , and caregiver perceived control. (bvsalud.org)
  • Despite the contrary results of a long-term study, at least some patients are paying more. (hhnmag.com)
  • Results indicate that 20% of patients in the usual care group were admitted to the hospital within 30 days compared with 6.9% of patients in the intervention group. (uspharmacist.com)
  • Increased staffing, in addition to sophisticated analytic tools, will accelerate the process of getting research results to doctors and their patients. (sprivail.org)
  • And part of shaping a better patient experience means offering top-notch, accessible patient education - digestible information that explains a patient's condition, lets them know about symptoms to look out for, and informs them about different courses of treatment that may be offered. (getwellnetwork.com)
  • While Adourian said that "physicians and hospitals will have to see how to fold this [information] into their own readmission reduction programs," the studies have demonstrated how this sort of serial measurement could be used to ascertain a patient's real risk profile for the type of disease progression that leads to an unplanned trip back to the hospital. (genomeweb.com)
  • Preventing hospital readmissions should be prioritized upon a patient's admission. (amalgamatedbenefits.com)
  • Also critical are effective communications between the patient and patient's family and all members of the treating medical team. (amalgamatedbenefits.com)
  • It is also important that patients and their family members/caregivers understand that they too have a responsibility to the patient's well-being by following recommended PCP and specialty provider visits, the prescribed treatment plan, asking questions when a medical directive is unclear, and communicating openly what they are experiencing (i.e., symptoms) in terms of their medical condition. (amalgamatedbenefits.com)
  • After the claim for the readmission was denied, the hospital appealed, arguing it was not preventable because of the patient's history of noncompliance, Wilson said. (ahdam.org)
  • Since the patient is receiving skilled care, the days during the sanction period are counted as benefit days and are deducted from the patient's 100 skilled days. (palmettogba.com)
  • Nomogram, the new risk prediction tool can help identify which patients are likely to be readmitted to the surgical intensive care unit (SICU). (medindia.net)
  • Intensive Care Unit Acquired Weakness (ICUAW) affects critically ill patients on prolonged ICU stay, which is associated with significant morbidity and mortality. (medindia.net)
  • Nomogram - the new risk prediction tool is a quick and easy way to determine if a patient is ready to leave the surgical intensive care unit. (medindia.net)
  • There are several benefits to evaluating the possibility of early unplanned readmission to the SICU, which Dr. Martin called an established measure of postoperative care quality. (medindia.net)
  • The project focused on the association between inadequate care transitions in patients with heart failure and subsequent costly readmissions. (semanticscholar.org)
  • Discharging patients from the emergency department with a relatively simple and feasible teach-back method can contribute to safer and better transitional care from the ED to home. (semanticscholar.org)
  • One recent study described a gradient of patient capability or willingness for self-care and the extent of caregiver contribution. (who.int)
  • 1 Unplanned readmissions may be a marker of poor-quality inpatient care 2 ⇓ - 4 or ineffective hospital-to-home transitions. (jabfm.org)
  • 13 ⇓ ⇓ ⇓ ⇓ ⇓ ⇓ ⇓ - 21 There are relatively few studies examining the risk factors for readmission among all primary care patients, and many of these were performed outside the United States or in hospitalist practices. (jabfm.org)
  • It is well known that a small proportion of patients account for a disproportionate number of hospital admissions and health care costs. (jabfm.org)
  • 26 ⇓ - 28 Identifying these patients is important for quality of care and economic reasons. (jabfm.org)
  • it is not enough to hand the patient a list of medications and equipment and contact information for a home care agency. (ecri.org)
  • Patients who adhere to their care plans also see a reduction in harm. (getwellnetwork.com)
  • This care management minimizes progression of the disease process, and the patient can contact their primary care provider before they are so sick they need to be admitted again. (getwellnetwork.com)
  • Patients with heart failure who are admitted to the VA may receive education from their primary care team or from the nursing staff. (getwellnetwork.com)
  • This article provides information on the patterns of one-year readmissions (for any reason) to acute care hospitals in Canada among patients with mental illness as the most responsible diagnosis in their index admission during 2002-2003. (longwoods.com)
  • In 2003-2004, 37.0% of patients with mental illness discharged from acute care hospitals were readmitted within a period of one year, compared with 27.3% of patients discharged with a non-mental illness (CIHI 2006). (longwoods.com)
  • Under the Affordable Care Act , hospitals are penalized for excessive readmissions related to select conditions. (darkdaily.com)
  • A large number of readmissions were not caused by suboptimal medical care or deterioration of medical conditions, but by confounding issues of substance abuse or homelessness," the authors stated. (darkdaily.com)
  • No patients died in the ambulatory setting or in transit when returning to acute care setting. (ama-assn.org)
  • Patients were included in the analysis cohort if they received emergency or inpatient care for COVID-19 and were discharged with home oxygen. (ama-assn.org)
  • Readmission was captured from hospitals at all health care levels across the country within the Universal Coverage Scheme. (tropmedres.ac)
  • A digital medicine software platform developed at Mount Sinai Health System, called RxUniverse, was used to prescribe a digital care pathway including the HealthPROMISE digital therapeutic and iHealth mobile apps to patients' personal smartphones. (jmir.org)
  • Care teams were alerted via a Web-based dashboard of abnormal patient BP and weight change readings, and further action was taken at the clinicians' discretion. (jmir.org)
  • Background: Unplanned readmissions have become a metric for measuring quality of care. (utmb.edu)
  • Clearly, hospitals need to develop better strategies including those focused on high quality patient transitions of care. (amalgamatedbenefits.com)
  • This helps ensure that all of the vital patient supports are in place well in advance to promote a safe transition of care. (amalgamatedbenefits.com)
  • These measures are reports of different things that affect patient care. (medlineplus.gov)
  • These staff time reductions translate to a little more than $2 million per year that we can put back into direct patient care. (osfhealthcare.org)
  • The predictive model uses many variables from data within the electronic health record (EHR) to assign a risk level to each patient so that OSF clinicians can take proactive steps to improve care coordination instead of spending time trying to identify which patients may be at high risk for a readmission. (osfhealthcare.org)
  • Providers may be able to prevent certain readmissions if they ensure that their patients receive the right care at the right time, both in the hospital and in subsequent care settings. (trusteemag.com)
  • Planned readmissions are typically part of clinically appropriate care. (trusteemag.com)
  • However, these readmissions are currently included in the HRRP penalty calculation, even though they are not associated with care delivered by the hospital. (trusteemag.com)
  • Search our extensive library of COPD care and readmissions reduction resources, including best practices, research articles, educational materials and toolkits. (copdfoundation.org)
  • A broad-based coalition of hospitals and care providers working across the continuum of care has prevented 4,570 avoidable hospital readmissions between Jan. 1, 2011 and Dec. 31, 2012. (mnhospitals.org)
  • For example, Swift County-Benson Hospital has achieved success through a combination of interventions including a focus on patient education, increased communication with primary care providers and improved patient transfer communication and collaboration with the area nursing home, assisted living and assisted living plus facilities, and home care agencies. (mnhospitals.org)
  • The value of the RARE Campaign is that, rather than individual medical associations or hospitals tackling readmissions separately, partners from various health care settings are working together. (mnhospitals.org)
  • In the audit team included the G.P. physician, home health care team, the patient and their relatives and the A-24 Acute Ward. (biomedcentral.com)
  • Even in a nonoutbreak setting, CDAD had a statistically sig- tal (BJH), a 1,250-bed, tertiary-care academic hospital in nifi cant negative impact on patient illness and death, and the St. Louis, Missouri. (cdc.gov)
  • Due to the spread of infection in hospitals, it has contributed to an overuse of antibiotics leading to antibiotic resistance and an increase in deaths among patients, consequentially decreasing the effectiveness of health care in America. (bartleby.com)
  • LGH offers patients some of the most advanced health care technology available. (bartleby.com)
  • A retrospective cohort study was conducted on 40,083 patients in ICU from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. (frontiersin.org)
  • Patients in the intensive care unit (ICU) are usually critically ill, presenting a high mortality risk compared with other departments in the hospital ( 1 ). (frontiersin.org)
  • Researchers studied the best ways to identify and report on these factors and examined the impact that working conditions, health care information technology, and enhanced provider expertise could have on addressing patient safety challenges. (ahrq.gov)
  • This report, which reflected energy and commitment to improving care, detailed more than 100 actions Federal entities could take to address threats to patient safety. (ahrq.gov)
  • Some of these are necessary, however, it is estimated that a whopping 75 percent of these readmissions are avoidable with better care. (wellapp.com)
  • Patients who clearly comprehend their after-hospital care instructions have over 30 percent less chance of readmission compared to others. (wellapp.com)
  • Improvement in Heart Failure Self-Care and Patient Readmissions with Caregiver Education: A Randomized Controlled Trial. (bvsalud.org)
  • The purpose of this study was to evaluate the effectiveness of a caregiver -only educational intervention aimed at improving caregiver self - efficacy , perceived control, and HF knowledge , as well as patient self-care and 30-day cardiac readmission. (bvsalud.org)
  • Self-care maintenance (p = 0.002), self-care management (p = 0.005), 30-day cardiac readmission (p = 0.003), and caregiver perceived control (p (bvsalud.org)
  • By directly integrating with Maryland's State Health Information Exchange (HIE), CRISP, CipherHealth identifies patients needing follow up during their care transitions after a hospital visit anywhere within the state. (cipherhealth.com)
  • Recently discharged Choptank patients receive automated calls asking about their care transition and status. (cipherhealth.com)
  • Should a patient indicate an issue, Choptank care coordinators are notified and help to resolve the concern. (cipherhealth.com)
  • Patient data are essential to providing coordinator care, but more data also creates heightened risks. (pharmacytimes.com)
  • With malware and ransomware attacks on the rise, being aware of dangers and proactively creating a plan to manage problems is essential to protecting patient data, according to a session at the Asembia 2022 Specialty Pharmacy Summit titled "Drugs, Data, and Defense: Protecting Patient Data While Providing Safer Care. (pharmacytimes.com)
  • Developing and regularly testing a business continuity plan is also an essential step to ensure that patients still receive necessary care if the data are compromised, or the systems go offline. (pharmacytimes.com)
  • For example, Griffin said the 21st Century Cares Act includes a requirement for interoperability because the data are owned by the patient, so it cannot be kept exclusively by a single health care provider. (pharmacytimes.com)
  • When considering data security overall, Griffin said the ultimate goal is to have a more complete picture of the patient in order to provide better care. (pharmacytimes.com)
  • Members of the Massachusetts Nurses Association at Boston-based Brigham and Women's Hospital plan to hold an informational picket Feb. 1 to highlight their concerns related to patient care and working conditions at the facility. (beckershospitalreview.com)
  • Experts on an IHI panel say that it is time to "change the conversation" and clue patients in to the total cost of care options. (hhnmag.com)
  • We're all well aware of the need to exercise caution when providing care, washing your hands to prevent the spread of infections and ticking other items off the checklist to avoid physically harming the patient. (hhnmag.com)
  • Nurses are on the front lines and spend the most time interacting with patients, noted September Wallingford, R.N., director of nursing advocacy at Costs of Care, and a practicing nurse at Brigham and Women's Hospital, in Boston. (hhnmag.com)
  • Michele Rhee, director of strategic initiatives at both Costs of Care and the National Brain Tumor Society, recalled one instance when she, as a cancer patient, needed to be transported to a facility across the street after surgery. (hhnmag.com)
  • The research team sought to determine if a community pharmacy-based transition of care (TOC) program, including the full scope of MTM services-provided by TransitionRx in this case-could decrease hospital readmissions, resolve medication-related problems, and increase patient satisfaction. (uspharmacist.com)
  • A similar group of patients received usual care. (uspharmacist.com)
  • Entries are still being accepted for the 32nd annual MHA awards program celebrating the outstanding work your hospitals and caregivers do to deliver patient care and serve your communities. (mnhospitals.org)
  • MHA award categories recognize excellence including community health, best workplace and patient care. (mnhospitals.org)
  • found that, due to ongoing antibiotic treatment, the majority of their patients in intensive care units had dominance of their gut microbiome by potential pathogens. (cdc.gov)
  • And final y, it allows patients to The publication sought to transparently examine variations in care make informed decisions about possible treatment options. (who.int)
  • What these three programs have in common is they all involve patient centered care. (wholehealtheducation.com)
  • This is forcing health care to move beyond the acute care, symptom-based approach to include both disease prevention and patient empowerment through patient education for self-care. (wholehealtheducation.com)
  • Patient health education is at the core of the patient-centered care model, and no other clinically trained health professional is better poised to fill this role than the nurse - and more specifically, the holistic nurse. (wholehealtheducation.com)
  • Ways and Means Republican Members introduced a package of mental health bills to close gaps in mental health care, improve our current system to work better for patients, reduce physician burnout, protect consumers, and bring more openness into the system. (house.gov)
  • The I.P.F. Improvement Act represents our fiduciary responsibility to both taxpayers and patients receiving care in these facilities. (house.gov)
  • To ensure patients can access the treatment options that are most appropriate for their care needs, we add more treatment options between traditional outpatient therapy and full inpatient care. (house.gov)
  • While most mobile health tools used today are reference apps for health care providers and patients, there are ways in which other types of mobile technologies can be immediately useful. (kevinmd.com)
  • While there is significant debate over the correlation of patient satisfaction to quality of care, this system is here to stay at least for a while. (kevinmd.com)
  • Lack of adequate access to care (as illustrated in a Merritt Hawkins survey on physician appointment wait times ), impact of in-person visits on caregivers, logistical problems for rural patients, and lack of available inexpensive care after hours are all factors which make this technology attractive. (kevinmd.com)
  • There is no doubt that remote patient monitoring will play a large role in the health care continuum. (kevinmd.com)
  • Once the patient goes home, they use the tablet to record -- and transmit to their care team -- the medication they take, their weight, their activities and any side effects they experience. (blogspot.com)
  • Making the care transition from one setting to another is often difficult for patients. (arizonadailynews.xyz)
  • Below are four ways to enhance care transitions to improve the patient experience. (arizonadailynews.xyz)
  • Additionally, care transitions can provide follow-up phone calls or home visits to ensure that patients understand their education and follow them correctly. (arizonadailynews.xyz)
  • Another way care transitions can help reduce hospital readmissions is by connecting patients with community resources. (arizonadailynews.xyz)
  • Care transitions can help connect patients with these resources to transition back to their community successfully. (arizonadailynews.xyz)
  • Another way care transitions can enhance patient experience is by improving communication between care providers. (arizonadailynews.xyz)
  • In addition to improving communication, care transitions can help reduce the hospital readmission risk. (arizonadailynews.xyz)
  • When patients are discharged from the hospital, they are often given a list of follow-up appointments and instructions on how to care for themselves at home. (arizonadailynews.xyz)
  • Care transitions can also help to increase the coordination of care for patients. (arizonadailynews.xyz)
  • Transitions in care can also help to improve communication between patients and their care providers. (arizonadailynews.xyz)
  • Good communication can also help build trust between patients and their care providers, leading to better long-term relationships. (arizonadailynews.xyz)
  • Care transitions have also been shown to improve patient satisfaction. (arizonadailynews.xyz)
  • Patient satisfaction measures how happy or satisfied patients are with their overall experience with a health care provider or facility. (arizonadailynews.xyz)
  • Studies have shown that patients who receive care during a transition are more likely to be satisfied with their overall experience than those who do not receive transition-related care. (arizonadailynews.xyz)
  • One study found that patients who received care during a transition were more likely to report higher satisfaction with their care providers and the care they received. (arizonadailynews.xyz)
  • The study also found that patients who did not receive care during a transition were more likely to report lower satisfaction levels. (arizonadailynews.xyz)
  • From January through April 1990, tuberculin skin-test conversions* occurred among eight health-care workers (HCWs) on a specialized ward for human immuno deficiency virus (HIV)-infected patients at a large urban hospital in Florida. (cdc.gov)
  • How satisfied are patients and surgeons with telemedicine in orthopaedic care during the COVID-19 pandemic? (ahrq.gov)
  • Using these kind of approaches with our 1.2 million Aurora patient population has enabled us to achieve savings of 42 percent versus the Segal [a national health care cost survey] trend over the past 10 years. (techandfinance.com)
  • With the help ofpsychoeducational module, the staff nurses, student nursescan provide psychoeducation to the patients and caregiversabout the comprehensive care of psychiatric patients at thehome including the psychosocial rehabilitation. (who.int)
  • This study was set to determine the magnitude of OIs and associated factors among HIV/AIDS patients on Anti-Retroviral Therapy (ART) attending care and treatment clinic at Bombo Regional Referral hospital, Tanga region. (bvsalud.org)
  • This way, not only does a patient have a reference, they can bring the document to their primary care doctor for follow-up. (transonic.com)
  • SPRI is planning to add a second biostatistician to its staff, which will be another step in bringing predictive modeling to the forefront of patient care. (sprivail.org)
  • Provider organizations] need to get ready because this is really better care for patients, ideally at less cost, and this is what patients want. (trusteemag.com)
  • Subsequent admissions of a patient to a hospital or other health care institution for treatment. (bvsalud.org)
  • Descriptive and cross-sectional research with a quantitative approach, using documentary analysis of adult patients' electronic histories, who were hospitalized at a tertiary care service in the city of Rio de Janeiro between November 2014 and November 2015. (bvsalud.org)
  • Ten percent (n= 44) of patients with relative death risk (p=0.001) were readmitted to the intensive care unit. (bvsalud.org)
  • The variables female sex, age over 60 years, hospitalized at the intensive care unit for more than 30 days and readmission to the unit are risk factors for death. (bvsalud.org)
  • To deliver proper care to these patients, besides qualified staff, technological monitoring resources, vital function support, use of invasive devices and knowledge of patients' needs are necessary(1). (bvsalud.org)
  • The global population's life expectancy is growing with a steady increase in the proportion of older patients admitted to the intensive care unit (ICU).1. (annals.edu.sg)
  • In the modern world, the telehealth strategy has been essential for each hospital to respond to the varying demands of patients as well as prospects around care. (namasteui.com)
  • The doctors can offer care remotely to patients which is very essential for some of them who are unable to access or facing issues accessing a medical service for various reasons. (namasteui.com)
  • Additionally, telehealth permits patients to stay with their doctor when they shift and access care when they belong to rural areas with poor medical facilities. (namasteui.com)
  • The facility of Video chats takes very less time for the conversation with the patient and permits providers to offer medical care quicker as well as more professionally. (namasteui.com)
  • Nowadays the number of patients is increasing patient at the clinic of physicians and specialists day by day so telehealth facility is supporting people to receive the proper care according to their need. (namasteui.com)
  • In rural communities, patients stay too far away from doctors and specialists therefore sometimes they could not receive proper care in an emergency. (namasteui.com)
  • Similarly, What are the vital components of exemplary patient care quizlet? (naturallybetter.tv)
  • Patients who recover from coronavirus disease (COVID-19) infection are at risk of long-term health disorders and may require prolonged health care. (who.int)
  • The coronavirus disease (COVID-19) pandemic Patients with mild disease from COVID-19 infection continues to have significant negative impacts who then experienced long-term symptoms 5,6 are also of on health-care services worldwide as a result of concern. (who.int)
  • Given the stress of caring for Covid patients, hospitals and doctors are now saying that family members screened for Covid (and who may soon be subject to vaccination mandates) can help provide care and be effective advocates for patients. (thelowdownblog.com)
  • One recent study described a gradient of patient minority status and income level are major social capability or willingness for self-care and the extent of determinants that correlate with individual and overall caregiver contribution. (who.int)
  • HealthXL ® is a Chronic Care Management and Remote Patient Monitoring company satisfying Virginia and all 50 states in the US. (gotohealthxl.com)
  • HealthXL ® 's easily-implemented professional services improve patient care, reduce unwarranted hospital visits and boost practice income without requiring added costs. (gotohealthxl.com)
  • Its structured solutions revolutionize how your patients receive care and your practice operates. (gotohealthxl.com)
  • HealthXL ® 's Chronic Care Management Solutions in Virginia help patients obtain an ongoing care pathway for complex chronic health problems. (gotohealthxl.com)
  • HealthXL ® suit all patients with an accomplished care coordinator who strengthens care quality by making things simple. (gotohealthxl.com)
  • As part of HealthXL ® 's Chronic Care Management solutions for patients in Virginia, patients get a call every month from their care coordinator. (gotohealthxl.com)
  • Patients in Virginia also have access to their comprehensive care plan through a 24/7 provider portal. (gotohealthxl.com)
  • Structured and accelerated patient enrollment is one of the significant successes of HealthXL ® 's Chronic Care Management for health care providers solutions in Virginia. (gotohealthxl.com)
  • By securely accessing your Electronic Medical Records (EMR) and taking care of contacting eligible patients, HealthXL ® minimizes education time for practices and increases sign-ups. (gotohealthxl.com)
  • The risk prediction model has a moderately good ability to predict readmission to the surgical ICU and takes only about a minute to calculate for each patient," Dr. Martin said. (medindia.net)
  • Methodology: This was a retrospective study using the medical records of patients who were registered for TB treatment over a five-year period between 2016 to 2020. (bvsalud.org)
  • Hospital receives higher reimbursements and avoids costly readmissions (no reimbursement). (pegbenefits.com)
  • Patients who engaged with the follow-up calls were 37% less likely to experience a 30-day inpatient readmission and 38% less likely to experience a 7-day return after an emergency visit. (cipherhealth.com)
  • In this case, a 34-year-old patient was discharged March 8, 2022, from an inpatient hospital stay with a diagnosis of osteomyelitis and dry gangrene of the left foot that had caused the amputation of his fourth toe. (ahdam.org)
  • According to the 2022 AHA/ACC/HFSA Heart Failure Guidelines , SGLT2 inhibitors have a Class 2a recommendation for the pharmacologic treatment of patients with HFpEF. (medscape.com)
  • Angiotensin receptor/neprilysin inhibitors (ARNIs) have a Class 2b recommendation in the 2022 AHA/ACC/HFSA Heart Failure Guidelines because they may be considered to decrease hospitalizations in patients with HFpEF, but not mortality. (medscape.com)
  • From those patients, the team identified 37,508 patients who had two or more admissions for similar diagnoses within a year and who were treated at more than one of the 4272 hospitals. (medscape.com)
  • Six patients had symptoms of post-COVID condition, but none met the criteria for diagnosis or had alternative diagnoses. (who.int)
  • A total of 33 variables for 40,083 patients were enrolled for mortality and prolonged LOS prediction and 36,180 for readmission prediction. (frontiersin.org)
  • Mortality prediction models, prolonged LOS prediction models, and readmission prediction models achieved AUCs of 0.870 ± 0.001, 0.765 ± 0.003, and 0.635 ± 0.018, respectively. (frontiersin.org)
  • Prediction of unplanned 30-day readmission for ICU patients with heart failure. (cdc.gov)
  • When designing a risk prediction model, patient-proximate variables with a sound theoretical or proven association with the outcome of interest should be used. (who.int)
  • The more accurately the current state of a patient can be described, seeks to contribute towards improving the methodology, reporting the more accurate prediction becomes. (who.int)
  • ABSTRACT Objective: Evaluate the impact of anxiety and depression on morbidity and mortality of patients with acute coronary syndrome. (bvsalud.org)
  • The morbidity and mortality (readmission, myocardial revascularization, and. (bvsalud.org)
  • The primary outcome was time to first psychiatric ED visit or readmission. (ices.on.ca)
  • Group 1: The psychiatric patients with addiction problems. (biomedcentral.com)
  • Kulkarni Shreenath K., Garud Minakshi M., Kulkarni Mukta S.. Relationships Between Causes of Psychiatric Readmission and To Validate Psychoeducational Module. (who.int)
  • The present study highlights the causes ofreadmissions for psychiatric patients with a view to preparepsychoeducational module. (who.int)
  • The psychiatric nurses will be given educational material on medication assessment and evaluated on their perspectives on the utility of medication assessment as a strategy for lowering readmissions. (topnursingessay.com)
  • A total of 40 points (the minimum that an ill SICU patient would likely have, Dr. Martin explained) to 79 points represented a 1 to 5 percent chance, or low risk, for SICU readmission, according to the study abstract. (medindia.net)
  • And preventing ICU readmission avoids transitions to and from the SICU and the general inpatient ward. (medindia.net)
  • The study found a high prevalence of TR among patients undergoing TAVR, with more than 80 percent having at least mild TR and more than 24 percent having at least moderate TR. (acc.org)
  • Incorporating these updated recommendations into the management of patients with EVALI may minimize risk of rehospitalization and avert further mortality among patients hospitalized for EVALI. (cdc.gov)
  • The first sample consisted of 3,455,171 discharges and 2,741,289 patients at 4738 hospitals and was used to calculate hospital readmission performance. (medscape.com)
  • Premature and non-coordinated discharges are a common prequel to readmission. (transonic.com)
  • In addition to the findings about adverse events in patients, the researchers linked each interquartile range increase to 5.0 more adverse events per 1000 discharges at the hospital level (95% CI, 2.8-7.2). (medscape.com)