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 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
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 ...
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.
Objective to build up and validate the Drug Derived Difficulty Index (DDCI), a predictive model derived from drug prescriptions able to stratify the general population according to the risk of death, unplanned hospital admission, and readmission, and to compare the new predictive index with the Charlson Comorbidity Index (CCI). was compared to the CCI in terms of calibration, discrimination and reclassification. Setting 6 local health government bodies with 2.0 million citizens aged 40 years or above. Results One year and overall mortality rates, unplanned hospitalization rates and hospital readmission rates gradually improved with increasing ABT-737 DDCI score. In the overall human population, the model including age, gender and DDCI showed a high overall performance. DDCI expected 1-yr mortality, general mortality and unplanned hospitalization with an precision of 0.851, 0.835, and 0.584, respectively. If in comparison to CCI, DDCI demonstrated reclassification and discrimination properties ...
Using the Model for Improvement, our study demonstrated a reduction in ,48-hour readmissions to the CICU after the development and testing of a new care process practice bundle. Our study demonstrated that the bundle was sustainable in a busy tertiary paediatric cardiology setting, and that it led to a significant decrease in the frequency of these clinically important events without interfering with other quality outcome metrics, such as LOS or rapid clinical decompensation.. It is recognised that in-hospital readmission to the ICU has been associated with increased LOS, increased cost and increased mortality. Previous studies have focused primarily on identifying factors or conditions associated with increased risk of readmission to the ICU, the effect on mortality or to identify all-cause hospital readmissions.1 4 6 12 13 Despite the negative effects of in-hospital ICU readmission, reports of system modifications to prevent these events are limited. Our efforts were instead focused on ...
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 ( ) 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% ...
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 ... 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
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 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: 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.
The gains weve seen in just one month of implementation of Vivify Healths remote patient monitoring technology are extremely impressive, said Lisa White MHA, MSN, RN, Director of Home Care, Hospice and Palliative Care at Munson Healthcare Home Health. The technology is helping our patients to be healthier and happier in their homes and aiding our care professionals to drive quality patient outcomes.. Following this successful roll-out, Munson is expanding its remote patient monitoring program by doubling the number of kits from Vivify Health. Munson recently worked with Vivify Health to create a video to further tell the story of how the remote patient monitoring program is impacting patient lives. View that video here.. It is exciting to partner with organizations like Munson Home Health, whose mission aligns so closely with ours, namely allowing people to be healthier, more engaged and ultimately have better quality of life in their homes, rather than in hospitals or skilled nursing ...
While his web persona has been described as a blogvocateur, Dr. Sidorov has wide range of knowledge about the medical home, condition management, population-based health care and managed care that is only exceeded by his modesty. He has been quoted by the Wall Street Journal, Consumer Reports and NPRs All Things Considered. He has over 20 years experience in primary care, disease management and population based care coordination. He is a primary care general internist and former Medical Director at Geisinger Health Plan. He is primary care by training, managed care by experience and population-based care strategies by disposition. The contents of this blog reflect only the opinions of Sidorov and should not be interpreted to have anything to do with any current or past employers, clients, customers, friends, acquaintances or enemies, personal, professional, foreign or domestic. This is also not intended to function as medical advice. If you really need that, work with a personal physician or ...
"Impact of HbA1c measurement on hospital readmission rates: analysis of 70,000 clinical database patient records." BioMed ... "Hospital readmission of patients with diabetes". Current Diabetes Reports. 15 (4): 1-9. doi:10.1007/s11892-015-0584-7. PMID ...
Impact of Patient Safety Indicators on readmission after abdominal aortic surgery. J Vasc Nurs 2018 Dec;36(4):189-195. Epub ... National estimates of 30-day unplanned readmissions of patients on maintenance hemodialysis. Clin J Am Soc Nephrol 2017 Oct 6; ... Nationwide Readmissions Database (NRD): The NRD is designed to support various types of analyses of national readmission rates ... The NEDS captures encounters where the patient is admitted for inpatient treatment, as well as those in which the patient is ...
Area hospitals ranked well in patient readmissions, but wait times need improving. "Long-Term Care Homes - Kitchener-Waterloo- ... Region of Waterloo Paramedic Services may transport patients to either Grand River Hospital or St. Mary's General Hospital ... "Waterloo Region hospitals rank well on readmissions, but wait times need work". Waterloo Region Record. November 29, 2018. ...
"Hospital Readmission in General Medicine Patients: A Prediction Model". Journal of General Internal Medicine. 25 (3): 211-219. ... She has studied the sleep that patients get in hospital, and showed that hospitalised patients receive two hours less sleep a ... "Hospital Readmission in General Medicine Patients: A Prediction Model". Journal of General Internal Medicine. 25 (3): 211-219. ... As well as studying the sleep of patients, Arora has investigated the impact of on-duty napping on the fatigue of mental health ...
One study performed showed that patients with heart failure who received teach-back education had a 12% lower readmission rate ... For example, a patient with asthma may recognize the symptom of shortness of breath. This patient can manage the symptom by ... The patient may need to contact their healthcare team for advice. Red is the danger zone, meaning the patient's signs and ... A patient's literacy can also affect their rating of healthcare quality. A poor healthcare experience may cause a patient to ...
26 (11). Sonmez, H; Kambo, V; Taha, R; Poretsky, L (2016). "Reducing hospital readmissions in patients with diabetes: ... "The effects of a comprehensive multidisciplinary outpatient diabetes program on hospital readmission rates in patients with ... Poretsky's work helped lead to the use of insulin-sensitizing agents in patients with PCOS. Poretsky and his coworkers also ... Stolyarczyk R, Rubio S, Smolyar D, Young I, Poretsky L (June 1998). "24 hr urinary free cortisol in patients with acquired ...
Brian Dolan (January 27, 2015). "Medication adherence app reminds pharmacy's HIV patients to take meds". MobiHealth News. ... Vera Gruessner (April 17, 2015). "Mobile Health Technology Cuts Hospital Readmission Rates". mHealth Intelligence. "Pharmacist- ... as well as a provider portal which gives physicians patient health data. John Musil, a practicing pharmacist, founded Avella ... Avella Provides Guidance on Factors to Consider when Selecting a Specialty Pharmacy for Hepatitis C Patients. ...
These are the highest readmission rates for both patient categories. Notably, congestive heart failure was not among the top ... In the same year, Medicaid patients were readmitted at a rate of 30.4 per 100 admissions, and uninsured patients were ... Easy methods for identifying low-risk patients are:. *ADHERE Tree rule indicates that patients with blood urea nitrogen , 43 mg ... "Efficacy of β blockers in patients with heart failure plus atrial fibrillation: an individual-patient data meta-analysis". The ...
... decrease hospital readmission's and increase patient's ability to thrive at home after hospital discharge. Post hospitalization ... Faith community nurses also maintain the goal of patient care towards wholistic functioning. Patients have needs that are not ... to improve the patient's health and disease status. Not only does a faith community nurse improve patient outcomes but they ... It is important to note that faith community nurses are not expected to provide patient care in the church or at a patient's ...
Another study found that 39% of patients in NYHA class 4 and 31% of patients in NYHA class 3 had severely impaired kidney ... These complications led to longer hospital stay, higher mortality, and greater chance for readmission. ... However, they should be used with caution in patients with CRS and kidney failure. Although patients with kidney failure may ... It was found that an adenosine A1-receptor antagonist called KW-3902 was able to improve kidney function in CRS patients. ...
"Transition Coaches Reduce Readmissions for Medicare Patients With Complex Postdischarge Needs". Agency for Healthcare Research ... During transitions, patients with complex medical needs, primarily older patients, are at risk for poorer outcomes due to ... every patient's primary physician would be responsible for the patient through every health care process at all times, but this ... Patient responses to the survey predicts return to the emergency department and/or hospital. Dr. Eric Coleman and his team at ...
Johnson RF (October 2017). "Emergency department visits, hospitalizations, and readmissions of patients with a peritonsillar ... Treatment can also be given while a patient is under anesthesia, but this is usually reserved for children or anxious patients ... Tonsillectomy can be indicated if a patient has recurring peritonsillar abscesses or a history of tonsillitis. For patients ...
Predictors of Cause-Specific Hospital Readmissions in Patients with Congestive Heart Failure. Clinical Cardiology, 26, 411-418 ... Yazigi A, Zahr L, Armenian HK: Patient Compliance in a Well Baby Clinic. Effect of Two Modes of Intervention. Tropical and ... Familial aggregation of fainting in a case-control study of neurally mediated hypotension patients who present with unexplained ... Armenian HK, Lilienfeld AM, Diamond EL, Bross IDJ: Epidemiologic Characteristics of Patients with Prostatic Neoplasms, American ...
Area hospitals ranked well in patient readmissions, but wait times need improving. "Long-Term Care Homes - Kitchener-Waterloo- ... "Waterloo Region hospitals rank well on readmissions, but wait times need work". Waterloo Region Record. 29 November 2018. ...
The partnership is expected to help Tri-City improve patient outcomes and reduce its readmission rate. Research affiliations of ... Under the terms of this agreement, ECRMC patients have access to specialized facilities operated by UC San Diego Health in the ... In particular, clinical and translational research are important for both entities to advance the quality of patient care. UC ... the floor for which is completely pressurized and filtered allowing patients to roam freely. The Rady Pavilion for Women and ...
"Comparison of Hospital Mortality and Readmission Rates for Medicare Patients Treated by Male vs Female Physicians". JAMA ... Studies have shown that patients treated by female physicians may have better outcomes than patients treated by male physicians ... "Comparison of postoperative outcomes among patients treated by male and female surgeons: a population based matched cohort ...
"Comparison of Hospital Mortality and Readmission Rates for Medicare Patients Treated by Male vs Female Physicians". JAMA ... "Comparison of postoperative outcomes among patients treated by male and female surgeons: a population based matched cohort ...
Health information exchange makes patient care more informed and coordinated, and reduces unnecessary care and readmissions. ... and safety-net providers to explore how a formalized health information organization could enable better care for patients in ...
The available data suggests that in general, patients discharged AMA have an increased risk of hospital readmission, and ... "breakdown in the patient-doctor relationship" and an infringement of patient autonomy. Some authors have begun to question the ... lacks evidence of its utility to improve patient care, and may harm patients by reducing their likelihood of following up. ... as well as the patient's understanding, should be documented in the patient's chart. Many physicians incorrectly believe that ...
Plans for a $250 million expansion project were announced in 2007 that will include room for 90 new patient beds, new operating ... "Innovation Information Technology-Powered Population Health Care Management Improves Outcomes and Reduces Hospital Readmissions ... The health care system developed CareVio, a patient centered and clinician-led information technology enhanced care ... and Emergency Department Visits". The Joint Commission Journal on Quality and Patient Safety. 43 (7): 330-337. doi:10.1016/j. ...
"Comparison of Hospital Mortality and Readmission Rates for Medicare Patients Treated by Male vs Female Physicians". JAMA ... Students would act both as the doctor and the patient, allowing each student to understand the procedure and create a more ... A sharp increase of women in the medical field led to developments in doctor-patient relationships, changes in terminology and ... Women healers treated most patients, not limiting themselves to treating solely women.[citation needed] The names of 24 women ...
The Health Management Unit is set up to assist patients who need help to manage their long-term conditions. These patients ... It also aimed to reduce unnecessary re-admissions to the hospital. The Transitional Care team comprised doctors, nurses, ... Andrew's Community Hospital's Home Care Service attended to the nursing needs of patients residing in the east. These patients ... Patient Safety and Quality: An Evidence-Based Handbook for Nurses, Advances in Patient Safety, Rockville (MD): Agency for ...
Here he drafted his first publication, a brief case report on a young patient with filariasis. In January 1911, Howard took an ... In any case, he was not permitted readmission to the army. Nevertheless, he did find success in another branch of the ... In October 1911, Knox attempted to rejoin the army and applied to the office of the surgeon general for readmission. His ... he had validated the patient which contributed to his improvement. ...
The oldest patient was the 62-year-old nun. The youngest patient was the 22-month-old baby girl. Two patients-Eugene Le Bar, ... However, during the time between Acosta's discharge from and readmission to Willard Parker, he had returned to work at Bellevue ... However, both patients, one a 22-month-old baby girl who had been treated for croup, and the other, Ishmael Acosta, a 27-year- ... Two patients on the same floor at Willard Parker Hospital with Le Bar were discharged soon after Le Bar's death. ...
Due to improved patient outcomes, in the last two decades, laparoscopic surgery has been adopted by various surgical sub- ... "Adhesion-related readmissions following gynaecological laparoscopy or laparotomy in Scotland: an epidemiological study of 24 ... The risk of such injuries is increased in patients who have a low body mass index or have a history of prior abdominal surgery ... About 20% of patients undergo hypothermia during surgery and peritoneal trauma due to increased exposure to cold, dry gases ...
... or abdomen Shock patients with a systolic blood pressure < 90 mmHg Patients with isolated traumatic brain injury (TBI) Elderly ... "Surgical Intensive Care Unit Admission Variables Predict Subsequent Readmission". The American Surgeon. 79 (6): 583-588. PMID ... Eligible patients also must have emergency department or hospital dispositions available. Patients are excluded from the ... Patients in the third cohort had a blunt single-system injury with an AIS score ≥ 3 in only one AIS body region, with the ...
open access) Sorra, J.S. and Nieva, V.F. (2004). Hospital survey on patient safety culture (Publication No. 04-0041). Rockville ... Examples of Research Issues: Team performance, medication reconciliation, discharge for prevention of early readmission, ... Steering Council members represent a variety of backgrounds and contribute knowledge and guidance in areas such as patient ... and patient outcomes. The ISRN infrastructure supports virtual collaboration in the conduct of network studies through direct ...
... which benefits patients, but some of the worst hospitals have high re-admission rates which is bad for patients but is ... and that these individuals were in the 10th decile for patient cost, with annual per patient expenses ranging from $51,000 to $ ... "Patient ratings of health care are easy to obtain and report, but do not accurately measure the technical quality of medical ... "Rand study finds patients' ratings of their medical care do not reflect the technical quality of their care" (Press release). ...
... asymptomatic immunocompromised patients (such as cancer patients), health workers who work with immunocompromised patients, and ... This will also include testing of long-term care and personal care residents upon admission and readmission. On May 14, the SHA ... On July 7, the SHA began to lift restrictions on visitation, allowing residents of acute and long-term care patients to have ... On April 28, the SHA announced that it would expand its testing to include more involving asymptomatic patients. ...
Craig JA (2012). Ferri's netter patient advisor (2nd ed.). Saunders. p. 913. ISBN 9781455728268. . Traditionally, two types of ... If pulmonary rehabilitation improves mortality rates or hospital readmission rates is unclear.[109] Pulmonary rehabilitation ... Torres M, Moayedi S (May 2007). "Evaluation of the acutely dyspneic elderly patient". Clinics in Geriatric Medicine. 23 (2): ... March 2020). "Pharmacologic Therapies in Patients With Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic ...
patients with primary or posttraumatic osteoarthritis with relatively low functional demand;. *patients with severe ankle ... Ankle replacements have a 30-day readmission rate of 2.2%, which is similar to that of knee replacement but lower than that of ... 6.6% of patients undergoing primary TAR require a reoperation within 12 months of the index procedure. Early revision rates are ... This procedure is becoming the treatment of choice for patients, replacing the conventional use of arthrodesis, i.e. fusion of ...
"Julius Center for General Practice and Patient Oriented Research / Univ. Department of Neurology, University Medical Center ... Predictors of Hospital Readmission After Stroke. *Consent of thrombolysis IV in Acute stroke ... "Autopsy prevalence of intracranial atherosclerosis in patients with fatal stroke". Assistance Publique-Hôpitaux de Paris; ... "Heart and vessel pathology underlying brain infarction in 142 stroke patients". Department of Pathology, National ...
... patient readmission rate, inpatient mortality rate, and case mix index.[34]. Modern hospitals are in part defined by their ... a b Hospitals in New Orleans see surge in uninsured patients but not public funds - USA Today, Wednesday 26 April 2006 ... but a hospital might keep a patient under observation which is only covered under Medicare Part B, and subjects the patient to ... ensuring that there is a clear disincentive to admit such patients. In the United States, laws exist to ensure patients receive ...
Rubin LG, Schaffner W (July 2014). "Clinical Practice: Care of the asplenic patient". The New England Journal of Medicine. 371 ... sepsis was the second most common principal reason for readmission within 30 days.[100] ... A meta-analysis of individual patient data from randomized trials". American Journal of Respiratory and Critical Care Medicine ... Scottish Intercollegiate Guidelines Network (SIGN) (May 2014). Care of Deteriorating Patients (PDF). Guideline 139. Edinburgh: ...
Patients also can present with elevated serum cholesterol, and often complain of severe itching or "pruritus" because of the ... "An osteopathic approach to reduction of readmissions for neonatal jaundice". Osteopathic Family Physician. 5 (1): 17-23. doi: ... Most patients presenting with jaundice will have various predictable patterns of liver panel abnormalities, though significant ... Roche, SP; Kobos, R (15 January 2004). "Jaundice in the adult patient". American Family Physician. 69 (2): 299-304. PMID ...
... Network, an internet-based peer support service for newly diagnosed cancer patients, cancer survivors and their ... "Effectiveness of peer support at reducing readmissions of persons with multiple psychiatric hospitalizations". Psychiatric ... "The Role of Peer Support in Diabetes Care and Self-Management, The Patient: Patient-Centered Outcomes Research". Adis. 2 (1): ... analysis of seven randomized trials that compared a peer support intervention to group cognitive-behavioral therapy in patients ...
In a very large study (29,790 participants) published in British medical journal The Lancet, 35% of patients who underwent open ... of all readmissions occurred in the first year after the initial surgery.[13] Adhesion-related complexity at reoperation adds ... "Adhesion-related hospital readmissions after abdominal and pelvic surgery: A retrospective cohort study". The Lancet. 353 (9163 ... "Five Things Physicians and Patients Should Question", Choosing Wisely: an initiative of the ABIM Foundation, American Academy ...
೨೦೦೭). "The utility of gestures in patients with chest discomfort". Am. J. Med. ೧೨೦ (೧): ೮೩-೯. doi:೧೦.೧೦೧೬/j.amjmed.೨೦೦೬.೦೫.೦೪೫ ... "Patterns of hospital performance in acute myocardial infarction and heart failure - 30-day mortality and readmission" ... 2003). "Effects of aspirin dose when used alone or in combination with clopidogrel in patients with acute coronary syndromes: ... Bosch X, Theroux P. (2005). "Left ventricular ejection fraction to predict early mortality in patients with non-ST-segment ...
... transfer or readmission from another hospital or ICU).. When possible, data about the interval time between the patient's ... APACHE II score can be used to describe the morbidity of a patient when comparing the outcome with other patients. ... It is applied within 24 hours of admission of a patient to an intensive care unit (ICU): an integer score from 0 to 71 is ... APACHE II was designed to measure the severity of disease for adult patients admitted to intensive care units. It has not been ...
Since patients often do not know how severe their conditions are, nurses were originally supposed to review a patient's chart ... and hospital readmissions.[6][7][8] Of interest, increasing levels of CPS were associated with significantly lower 90-day ... Patients who are more seriously ill tend to require more hospital resources than patients who are less seriously ill, even ... At the same time the number of chronic diseases varies from 2.8 in young patients and 6.4 among older patients.[56] ...
The risk of such injuries is increased in patients who have a low body mass index[26] or have a history of prior abdominal ... "Adhesion-related readmissions following gynaecological laparoscopy or laparotomy in Scotland: an epidemiological study of 24 ... Many patients with existing pulmonary disorders may not tolerate pneumoperitoneum (gas in the abdominal cavity), resulting in a ... Due to improved patient outcomes, in the last two decades, laparoscopic surgery has been adopted by various surgical sub- ...
... analyzing electronic medical records in order to use predictive modeling to help identify patients at high risk of readmission ... The model was trained on a large dataset (10,293 patients) and validated on a separated dataset (1818 patients). It achieved an ... Initially the hospital focused on patients with congestive heart failure, but the program has expanded to include patients with ... al.[9] proposed a deep learning model-Probabilistic Prognostic Estimates of Survival in Metastatic Cancer Patients (PPES-Met)- ...
2017). An evaluation of involving family caregivers in the self-care of heart failure patients on hospital readmission: ... enhancement of patient-provider communication, better prioritization of patient concerns, and emotional support for the patient ... Using the device at the end of life can cause pain to the patient and distress to anyone who sees the patient experience this.[ ... there may be no treatment of the disease which can prolong the life of the patient or improve the patient's quality of life. In ...
Care of the asplenic patient»։ The New England Journal of Medicine 371 (4): 349-56։ July 2014։ PMID 25054718։ doi:10.1056/ ... 91,0 91,1 Sutton J. P., Friedman B. (September 2013)։ «Trends in Septicemia Hospitalizations and Readmissions in Selected HCUP ... 83,0 83,1 «Human recombinant protein C for severe sepsis and septic shock in adult and paediatric patients»։ The Cochrane ... A Meta-analysis of Individual Patient Data from Randomized Trials»։ American Journal of Respiratory and Critical Care Medicine ...
... in-patient/out-patient) and the individual patient.[2]:2757 Pain management is classified into either pre-emptive or on-demand ... readmission). There is usually overlap in the contributing factors that lead to morbidity and mortality between the health of ... Suffix added for patients undergoing emergency procedure One part of the risk assessment is based on the patients' health. The ... A trained, vigilant anesthesia provider should continually care for the patient. The same minimum standards for patient safety ...
Opioid pain relievers may be used for patients with severe pain. Antiemetics may be administered if the patient is vomiting. ... "Readmissions to U.S. Hospitals by Procedure" (PDF). Agency for Healthcare Research and Quality. April 2013. Archived (PDF) from ... The patient is examined several times a day, and X-ray images are made to ensure he or she is not getting clinically worse.[22] ... Most patients improve with conservative care in 2-5 days. When the obstruction is cancer, surgery is the only treatment. Those ...
Care of the asplenic patient". The New England Journal of Medicine. 371 (4): 349-56. doi:10.1056/NEJMcp1314291. PMID 25054718. ... sepsis was the second most common principal reason for readmission within 30 days.[93] ... A Meta-analysis of Individual Patient Data from Randomized Trials". American Journal of Respiratory and Critical Care Medicine ... Scottish Intercollegiate Guidelines Network (SIGN) (May 2014). Guideline 139: care of deteriorating patients. Edinburgh: SIGN. ...
... of elderly patients in nursing homes and is also present in approximately 30% of depressed patients on selective serotonin ... and also have a higher likelihood of requiring readmission. This is particularly the case in men and in the elderly.[36] ... The incidence of hyponatremia depends largely on the patient population. A hospital incidence of 15-20% is common, while only 3 ... Filippatos, TD; Liamis, G; Christopoulou, F; Elisaf, MS (April 2016). "Ten common pitfalls in the evaluation of patients with ...
Assessment of older patients before elective surgeries can accurately predict the patients' recovery trajectories.[6] One ... assist with the transition from hospital to home and prevent unplanned hospital readmissions. Customized interventions include ... rather than how old the patient's face looks-can help older patients make fully informed choices about their options. ... June 2010). "Frailty as a predictor of surgical outcomes in older patients". J. Am. Coll. Surg. 210 (6): 901-8. doi:10.1016/j. ...
"An osteopathic approach to reduction of readmissions for neonatal jaundice". Osteopathic Family Physician. 5 (1): 17-23. doi ... Patient UK: Neonatal jaundice. *Neonatal Hyperbilirubinemia Management and Learning Tool for Healthcare Providers ...
... both the Patient-Centered Research into Outcomes Stroke Patients Prefer and Effectiveness Research (PROSPER) study and the ... not previously on statins at the time of admission have a lower risk of major cardiac adverse events and hospital readmission ... April 2017). "2017 Taiwan lipid guidelines for high risk patients". Journal of the Formosan Medical Association = Taiwan Yi Zhi ... Cardiologist Steven Nissen at Cleveland Clinic commented "We are losing the battle for the hearts and minds of our patients to ...
... patient readmission rate, inpatient mortality rate, and case mix index.[47]. In the United States, the number of ... a b Hospitals in New Orleans see surge in uninsured patients but not public funds - USA Today, Wednesday 26 April 2006 ... but a hospital might keep a patient under observation which is only covered under Medicare Part B, and subjects the patient to ... They are a particularly important provider of healthcare to uninsured patients and patients with Medi-Cal (which is ...
Goroll, Allan H. (2009). Primary care medicine : office evaluation and management of the adult patient (6th ed.). Philadelphia ... "An osteopathic approach to reduction of readmissions for neonatal jaundice". Osteopathic Family Physician. 5 (1): 17-23. doi: ... Patients also can present with elevated serum cholesterol, and often complain of severe itching or "pruritus" because of the ... Roche, SP; Kobos, R (15 January 2004). "Jaundice in the adult patient". American Family Physician. 69 (2): 299-304. PMID ...
... (ED) waiting times have a serious impact on patient mortality, morbidity with readmission in less than 30 ... A patient's chance of survival is greatly improved if the patient receives definitive treatment (i.e. surgery or reperfusion) ... 73% were afraid of patients as a result of violence, almost half, 49%, hid their identities from patients, 74% had reduced job ... Medications appropriate to manage the patient's condition will also be given. Depending on underlying causes of the patient's ...
Goroll, Allan H. (২০০৯)। Primary care medicine : office evaluation and management of the adult patient (6th সংস্করণ)। ... "An osteopathic approach to reduction of readmissions for neonatal jaundice"। Osteopathic Family Physician। 5 (1): 17-23। ডিওআই: ...
Congestive heart failure is a leading cause of hospital readmissions in the U.S. In a study of 18 States, Medicare patients ... These are the highest readmission rates for both patient categories. Notably, congestive heart failure was not among the top ... In the same year, Medicaid patients were readmitted at a rate of 30.4 per 100 admissions, and uninsured patients were ... of patients seek re-admission within 6 months after treatment and the average duration of hospital stay is 6 days. ...
Report of the Committee of Inquiry into Allegations of Ill - Treatment of Patients and other irregularities at the Ely Hospital ... and reducing both admissions and readmission rates. The second focuses on reforming psychiatric care to reduce (or avoid ... Goffman, Erving (1961). Asylums: essays on the social situation of mental patients and other inmates. Anchor Books.. ... A key text in the development of deinstitutionalisation was Asylums: Essays on the Social Situation of Mental Patients and ...
But high readmission rates have been linked to spiraling-and unnecessary-health care costs. ... hospitals havent followed their patients progress after theyve been discharged. ... Hospitals Help Their Patients-at Home. To reduce readmission rates, hospitals help discharged patients with rides to the doctor ... Many readmissions, he points out, can be prevented with a bit of "damage control." About half of the patients in his study who ...
Nearly a quarter of hospitalized patients with sickle cell disease needed readmission within two weeks after discharge, ... Nearly a quarter of hospitalized patients with sickle cell disease needed readmission within two weeks after discharge, ... Some 29% of patients overall had no acute-care encounters and another 25% had fewer than one per year. But 17% had three or ... Explain to interested patients that sickle cell disease results from a genetic defect in the gene for hemoglobin, leading to ...
Cloud to enable collaboration and communication across the entire care team for one holistic and up-to-date view of the patient ... 360-Degree Patient Views. With integrated data from EHRs and a 360-degree view of the patient in Health Cloud, the care ... 360-Degree Patient Views. With integrated data from EHRs and a 360-degree view of the patient in Health Cloud, the care ... With the shift to value-based care, its more important than ever to reduce readmissions and improve patient outcomes - all ...
Factors affecting early unplanned readmission of elderly patients to hospital. British Medical Journal 1988; 297 :784 ... Factors affecting early unplanned readmission of elderly patients to hospital.. British Medical Journal 1988; 297 doi: https:// ...
A large study of an intervention to reduce the hospital readmission of older adults discharged from the emergency department ... Cite this: Best Practice for Older Patients Fails to Curb Readmissions - Medscape - May 22, 2017. ... The readmission rates were similar in the intervention and control groups. When Dr Biese showed a graph of the data, he quipped ... Similar patients, who served as the control group, got a call from the nurse asking how they felt about their care. ...
... characteristics that appear to raise the risk of elderly surgical patients having an unplanned hospital readmission within a ... Preventing readmissions "These study findings give surgeons more information to help elderly patients prepare better for an ... Readmission risk increases for elderly patients with geriatric-specific characteristics Journal of the American College of ... More than one in 10 of the elderly patients in the new study had an unexpected readmission, according to study authors. " ...
... hospitals across Illinois are facing penalties from Medicare for having too many patients return within a month of discharge. ... HIGH READMISSIONS, HIGH FINES. More than 100 hospitals in Illinois are being penalized for having too many patients return ... In a statement, the hospital said it is committed to reducing preventable readmissions and improving the health of patients. ... The fines are based on readmissions between July 2011 and June 2014 and include Medicare patients who were originally ...
... , according to research published today in ESC ... Pupil size predicts death and hospital readmission in patients with heart failure. *Download PDF Copy ... Our results suggest that pupil area is a novel way to identify heart patients at elevated risk of death or hospital readmission ... Pupil size predicts death and hospital readmission in patients with heart failure, according to research published today in ESC ...
The ACA program that penalizes hospitals with higher-than-average readmission rates did not increase mortality risk for ... patients between 2008 and 2016, according to a study published Jan. 15 in The British Medical Journal. ... ACA hospital readmission program did not increase patients mortality risk. Gabrielle Masson - Wednesday, January 15th, 2020. ... but the increase began before the readmission policy was announced. Almost half of the heart patients who died after leaving ...
... the new risk prediction tool can help identify which patients are likely to be readmitted to the surgical intensive care unit ( ... Additionally, ICU readmissions are costly for both patients and hospitals. The Centers for Medicare and Medicaid Services ... A surgeon or other health care provider in the SICU might use the nomogram results to try to reduce a patients readmission ... Because the study patients were "a fairly diverse spectrum of surgical patients" who went to the SICU postoperatively, Dr. ...
PATient Navigator to rEduce Readmissions (PArTNER). The safety and scientific validity of this study is the responsibility of ... A Patient Navigator will provide social support, literacy appropriate education, and act as a conduit between the patient and ... Patient Navigator) and a peer-led telephone support line to improve patient experience during hospital to home transition. ... and acts as a conduit between the patient and the patients medical team ...
Study results indicate intra-operative identification of annular defect size may allow spine surgeons to risk-stratify patients ... Patient Risk for Recurrent Herniation and Readmission by Annular Defect Size. International Society for the Advancement of ... For Professionals › News And Research › Patient Risk for Recurrent Herniation and Readmission by Ann... ... A total of 49,331 patients were included in these manuscripts.. Study Results. A total of 13 of the 278 patients in Group B ...
This report describes risk factors for readmission after discharge from an initial COVID-19 hospitalization. ... This report describes risk factors for readmission after discharge from an initial COVID-19 hospitalization. ... Multiple readmissions occurred in 1.6% of patients. Risk factors for readmission included age ≥65 years, presence of certain ... More than a single readmission occurred among 1.6% of patients discharged after the index hospitalization. Readmissions ...
University Hospitals cardiothoracic surgery department demonstrated a very significant reduction in hospital readmissions ... The 30-day readmission rate for patients receiving the typical care after this surgery was 11.54 percent, while those receiving ... This greatly prevented adverse consequences including readmission with added cost savings.. "We found that patients sometimes ... In Follow Your Heart, a cardiac surgery NP, who helped care for the patient in the hospital, visited the patient at home twice ...
The data suggest further that the greater attention to diabetes reflected in HbA1c determination may improve patient outcomes ... Multivariable logistic regression was used to fit the relationship between the measurement of HbA1c and early readmission while ... This analysis of a large clinical database (74 million unique encounters corresponding to 17 million unique patients) was ... The statistical model suggests that the relationship between the probability of readmission and the HbA1c measurement depends ...
In the sample, 69,294 patients (21.8%) experienced at least 1 readmission within 365 days of a prior admission. Within a 365- ... Shown are the numbers of patients hospitalized in 2003 with different readmission experiences during the follow-up period. ... Hospital utilization and characteristics of patients experiencing recurrent readmissions within childrens hospitals.. Berry JG ... DESIGN, SETTING, AND PATIENTS: Retrospective cohort analysis of 317,643 patients (n = 579,504 admissions) admitted to 37 US ...
New Study: Medicares Readmission Penalties May Be Killing Patients. Jan 8, 2019. • 8 ... removed patients discharged to a hospice from the 8 million patients in their sample, they got the same results. This is not ... The percent of patients discharged to hospices is small. Among CHF patients, for example, the discharge rate to hospices was ... 1] In my December 7 article, I cited a study by Sabbini and Wright that found that readmission rates as "readmission" is almost ...
Hospital readmissions that Medicare penalizes under the Affordable Care Act are largely driven by patient characteristics such ... Hospital readmissions that Medicare penalizes under the Affordable Care Act are largely driven by patient characteristics such ... Hospital readmissions that Medicare penalizes under the Affordable Care Act are largely driven by patient characteristics such ... Medicares Hospital Readmissions Reduction Program adjusts its 30-day readmission measures for age, sex, discharge diagnosis ...
Marijuana use disorder does not appear to be associated with shorter times until readmission. ... SSD patients with recent other drug use disorder had an increased risk for a second to fifth readmission (HR = 1.13, 95% CI [ ... We found that AUD and other drug use disorder increase readmission risk in patients with SSD after a first hospitalization, ... Using Claims Data to Examine Hospital Readmission Risk in Patients With Schizophrenia and Comorbid Marijuana Use Disorders. ...
A multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart failure.. Rich MW1, ... Survival for 90 days without readmission, the primary outcome measure, was achieved in 91 of the 142 patients in the treatment ... 29, P not significant). In the control group, 23 patients (16.4 percent) had more than one readmission, as compared with 9 ... In a subgroup of 126 patients, quality-of-life scores at 90 days improved more from base line for patients in the treatment ...
Readmission rates after complex cancer operations tend to be higher in hospitals that are considered to be vulnerable because ... Patient Readmissions to Vulnerable Hospitals after Complex Cancer Operations Vary with the Type of Institution and Its Patient ... Postoperative Wound Monitoring App Can Reduce Readmissions and Improve Patient Care * Patient Education Brochure Provides Low- ... Patient Readmissions after Complex Cancer Operations Vary with Institution Type and Patient Cohort ...
Abstract: The U.S. Patient Protection and Affordable Care Act (ACA) mandates that COPD patient readmissions to a hospital that ... 4. Patient training. Use of the "teach-back" method, in which the patient "teaches" the clinician, enables the patient to self- ... COPD Patient 30-Day Hospital Readmission Reduction Program. COPD Homecare Hospital and Clinic Pulse Oximetry ... PRINCIPLES OF A PATIENT-CENTERED, CROSS-CONTINUUM, DISEASE-MANAGEMENT APPROACH TO REDUCING COPD 30-DAY READMISSIONS. ...
... readmission in a diverse patient population and derive and validate a simple model for identifying patients at high readmission ... Hospital Readmission in General Medicine Patients: A Prediction Model. Journal of General Internal Medicine 25(3): 211-219. ... Measurements: We identified readmissions from administrative data and 30-day post-discharge telephone follow-up. Patient-level ... Among patients in the derivation cohort, seven factors emerged as significant predictors of early readmission: insurance status ...
... and hospital readmissions among older adults with heart failure. The problem addressed the heart failure patients lack of ... Higher numbers of hospital readmissions were significantly related to more difficulty with management of heart failure and a ... for development of safe and effective holistic intervention strategies to decrease costly hospital readmissions for patients ...
... found that hospitals serving children may face financial penalties for patient readmissions due to factors beyond the control ... Readmission Rates at Childrens Hospitals Influenced by Patients Characteristics. February 15, 2016 ... Studies like ours show that patients who are poorer or are minorities are readmitted at higher rates than other patients, which ... found that hospitals serving children may face financial penalties for patient readmissions due to factors beyond the control ...
Table 2: Values of the primary diagnosis in the final dataset. In the analysis, groups that covered less than 3.5% of encounters were grouped into "other" category ...
Notably, seven (7%) readmissions occurred in the initial 100 patients and five (2%) in the remaining 243 patients (p= 0.04). ... Readmission rates following laparoscopic sleeve gastrectomy: Detailed analysis of 343 consecutive patients.. Amani Jambhekar, ... Patients readmitted within 30 days were compared to the remaining patients using Student t-tests for continuous variables and ... the causes for readmission after LSG and to identify patterns of complications and causes for readmissions in LSG patients that ...
"Finding a reduced 30-day cardiac readmission rate in PAP-adherent patients is important for improving both patient care and ... In contrast, hospital readmission or emergency department visits occurred in 30 percent of cardiac patients with sleep apnea ... According to the authors, reducing hospital readmission rates for cardiac patients is essential for the provision of cost- ... Thirty-day hospital readmission was defined as a hospitalization or visit to the emergency department for a cardiac cause more ...
Black patients with diabetes may have a significantly higher risk of readmission to hospitals than other ethnic and racial ... Black patients with diabetes may have a significantly higher risk of readmission to hospitals than other ethnic and racial ... Black patients with diabetes may have a significantly higher risk of readmission to hospitals than other ethnic and racial ... The study aimed to investigate the racial/ethnic differences in all-cause readmission among patients with diabetes in the ...
This finding suggests that patient-centered information can have an important role in the evaluation and ma … ... Higher overall patient satisfaction and satisfaction with discharge planning are associated with lower 30-day risk-standardized ... hospital readmission rates after adjusting for clinical quality. ... Study design: Among patients 18 years or older, an ... Relationship between patient satisfaction with inpatient care and hospital readmission within 30 days Am J Manag Care. 2011 Jan ...
  • Rush, though, began its own program two years ago because its staff had long suspected that the detailed discharge plans they sent home with patients-covering follow-up doctors' appointments, prescriptions and health services offered in their communities-were often ignored. (
  • Explain that almost a quarter of patients hospitalized for sickle cell in this study required rehospitalization within two weeks after discharge, suggesting that their initial care was inadequate. (
  • Nearly a quarter of hospitalized patients with sickle cell disease needed readmission within two weeks after discharge, suggesting that their initial care was inadequate, researchers said. (
  • Once at home, the patient and family members can take advantage of digital tools - from looking up discharge instructions, to setting reminders - that help them adhere to the care plan, while reducing the chance of a costly readmission. (
  • Secondary outcomes were whether patients had trouble getting medications or follow-up appointments in the 30 days after discharge. (
  • In our current paradigm of care, whether we admit patients to the hospital or discharge them to the community, they are at high risk," Dr Biese added. (
  • The four geriatric risk factors for readmission after general surgical procedures are cognitive impairment requiring another person to sign the patient's consent form for the operation (called "incompetent at admission"), use of a mobility aid, risk of falling at discharge from the hospital, and need for skilled home health care after going home. (
  • For the fourth year in a row, hospitals across Illinois and the nation are being penalized by Medicare for having what the agency defines as too many patients return within a month of discharge. (
  • Researchers noted a national trend toward increased mortality risk in heart failure patients' post-discharge period, but the increase began before the readmission policy was announced. (
  • From among 3,109 SICU admissions, the investigators found that 141 patients were readmitted to the SICU within 72 hours of discharge. (
  • 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. (
  • 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. (
  • Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge. (
  • After discharge from an initial COVID-19 hospitalization, 9% of patients were readmitted to the same hospital within 2 months of discharge. (
  • 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. (
  • 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. (
  • Few studies have investigated discharge patterns and hospital readmissions among large groups of patients after an initial COVID-19 hospitalization ( 4 - 7 ). (
  • 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). (
  • Among the 106,543 (85%) surviving patients, 9% (9,504) were readmitted to the same hospital within 2 months of discharge through August 2020. (
  • 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. (
  • 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. (
  • 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. (
  • In Follow Your Heart, a cardiac surgery NP, who helped care for the patient in the hospital, visited the patient at home twice within the first 14 days after discharge. (
  • All patients have specific needs that need to be individualized after discharge. (
  • The HRRP punishes hospitals if their rate of readmissions within 30 days following discharge exceeds the national average. (
  • In its June 2018 report, MedPAC had claimed the HRRP has reduced the rate at which patients targeted by the HRRP were readmitted within 30 days after discharge without increasing mortality. (
  • reported that the mortality rate within 30 days of discharge for both CHF and pneumonia patients rose in 2010, the year the HRRP was announced (that is, the year it was authorized by the ACA), and again in 2012, the year the HRRP was implemented. (
  • not only declined to make that baffling mistake, they refined their post-discharge data even further: They examined 30-day mortality rates among patients who were readmitted within the 30-day window separately from mortality among those who were not. (
  • They found that the increase in mortality within the 30-day-post-discharge period was driven primarily by deaths among patients who were not readmitted within the 30-day window. (
  • The authors, and an accompanying editorial by Dr. Gregg Fonarow, noted that this evidence suggested causality - that the HRRP was killing CHF and pneumonia patients by encouraging hospitals to put off readmitting patients until after the 30-day post-discharge period. (
  • Medicare's Hospital Readmissions Reduction Program adjusts its 30-day readmission measures for age, sex, discharge diagnosis and recent diagnoses. (
  • We conducted a prospective, randomized trial of the effect of a nurse-directed, multidisciplinary intervention on rates of readmission within 90 days of hospital discharge, quality of life, and costs of care for high-risk patients 70 years of age or older who were hospitalized with congestive heart failure. (
  • The intervention consisted of comprehensive education of the patient and family, a prescribed diet, social-service consultation and planning for an early discharge, a review of medications, and intensive follow-up. (
  • The U.S. Patient Protection and Affordable Care Act (ACA) mandates that COPD patient readmissions to a hospital that exceed a predetermined threshold in less than 30 days from discharge will result in financial penalties to the involved institution. (
  • Measurements: We identified readmissions from administrative data and 30-day post-discharge telephone follow-up. (
  • We performed logistic regression analysis to identify significant predictors of unplanned readmission within 30 days of discharge and developed a scoring system for estimating readmission risk. (
  • Results show that none of the cardiac patients with sleep apnea who had adequate adherence to PAP therapy were readmitted to the hospital or visited the emergency department for a heart problem within 30 days from discharge. (
  • Thirty-day hospital readmission was defined as a hospitalization or visit to the emergency department for a cardiac cause more than 48 hours after discharge. (
  • Furthermore, the Centers for Medicare and Medicaid Services (CMS) withholds hospital reimbursement for the care of patients readmitted within 30 days after hospital discharge. (
  • To determine whether hospitals where patients report higher overall satisfaction with their interactions among the hospital and staff and specifically their experience with the discharge process are more likely to have lower 30-day readmission rates after adjustment for hospital clinical performance. (
  • A hospital-level multivariable logistic regression analysis was performed for each of 3 clinical conditions to determine the relationship between patient-reported measures of their satisfaction with the hospital stay and staff and the discharge process and 30-day readmission rates, while controlling for clinical performance. (
  • Higher overall patient satisfaction and satisfaction with discharge planning are associated with lower 30-day risk-standardized hospital readmission rates after adjusting for clinical quality. (
  • Efforts to reduce readmissions must look beyond the current focus on a single hospital discharge and transition period. (
  • Main outcome measures Survival to discharge from hospital after discharge from critical care and readmission to critical care. (
  • Conclusions The activity of the critical care outreach team seems to improve patient survival to discharge from hospital and may reduce the number of readmissions to critical care. (
  • Perhaps the most important of these recommendations was the development of patient at risk teams and follow up services to complement critical care while improving the speed and quality of patient recovery to discharge from hospital. (
  • We aimed to determine the effectiveness of follow up services during the period between discharge from critical care to discharge from hospital and on readmission to critical care. (
  • All-cause first readmissions were determined within 30 days and 180 days after discharge. (
  • 4 ) showed that rehospitalizations within 30 days of discharge occurred in 20% of patients with diabetes, which is more than the 5-14% estimated for all hospital discharges. (
  • Failure to acknowledge diabetes at discharge is associated with increased 30-day readmissions, suggesting that suboptimal diabetes management may be an important factor for successful transitions in care ( 4 ). (
  • One-fifth of patients deemed well enough to go home after being treated with newer technologies like CAT scans, MRIs and critical care teams end up being re-admitted within 30 days of their discharge, Chen wrote. (
  • Research being presented at the American College of Cardiology's 62nd Annual Scientific Session 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. (
  • 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 higher adherence to core measures considered medical "best practices" in heart failure care and lower hospital readmissions. (
  • As part of the Affordable Care Act's effort to improve quality while also saving taxpayers dollars, Medicare has recently started fining hospitals that have too many patients readmitted within 30 days of their discharge a widely accepted marker of sub-optimal care. (
  • The electronic discharge tool, first piloted in 2010, was designed to cover all aspects of the discharge process and includes integrated decision-support tools and safeguards to guide clinicians through the recommended steps for heart failure patients. (
  • Adherence to the heart failure core measures was evaluated on three inpatient quality measures including provision of discharge instructions to patients, appropriate assessment of heart pumping ability and the prescription of evidence-based medications or documentation of contraindication. (
  • The observed readmission rate among patients discharged with and without theelectronic discharge orders tool was 15.5 and 18 percent, respectively. (
  • Dr. Benuzillo adds that in addition to improving patient care, electronic discharge tools like these couldhelp hospitals financially by reducing reimbursement penalties for readmission of patients within 30 daysfollowing discharge from their initial hospitalization. (
  • In a study reported online by the American Journal of Cardiology, Henry J. Michtalik, M.D., M.P.H., and his colleagues tested heart failure patients on admission and discharge for levels of a protein that's considered a marker for heart stress. (
  • Though the patients' NT-proBNP levels were tested again at discharge, the decision for or against discharge was determined by clinical judgment alone and the treating physicians were not aware of the protein's level at discharge. (
  • Patients might leave the hospital with discharge instructions to ensure they stay on the mend, but there's plenty that could go wrong once they get home. (
  • According to the reduction program, a readmission occurs when a Medicare patient is readmitted to the same or another acute-care hospital within 30 days of discharge, with certain exceptions such as transfers to another hospital and planned readmissions for chemotherapy, rehabilitation or other treatment. (
  • They partially attribute the disparity in mortality and readmission rates to the Hospital Readmission Reduction Program, which incentivized hospitals to improve patient care even following discharge but may have led to some hospitals taking shortcuts around financial penalties, leading to increased mortality rates for things like heart failure and pneumonia. (
  • There was a significant association between readiness for discharge and subsequent early readmission: for each 10% decrease in the proportion of fulfilled criteria, the odds of readmission increased by 14% (95% confidence interval [CI] 1. (
  • CONCLUSIONS: Among patients with heart failure, early unplanned readmissions were not associated with suboptimal admission work-up or evaluation and treatment but were weakly associated with readiness for discharge. (
  • Records of patients admitted to the authors' institution from October 2007 through June 2014 were analyzed for several data points, including initial LOS, readmission occurrence, admitting and secondary diagnoses, and discharge disposition. (
  • The aim of this study was to investigate the effect of telemedicine consultations between respiratory nurses at the hospital and COPD patients in their homes after a discharge from the hospital, which was caused by an exacerbation. (
  • In brief, FPAS holds discharge diagnoses on all in-patient contacts in Funen County since 1973 and out-patient secondary care contacts since 1989. (
  • BRIDGE (Bridging the Discharge Gap Effectively) is an NP-led transitional care program for cardiac patients within 14 days of discharge. (
  • Does Diuretic Dose at Discharge Influence Readmission Rate in ADHF Patients? (
  • Increasing loop diuretic dosages at discharge may reduce the rate of 30-day readmission for patients with acute decompensated heart failure (ADHF) with a low ejection fraction and evidence of fluid overload, a new study has found. (
  • The median furosemide equivalent dose on preadmission was 40mg (IQR=20-60), and for the 50 patients with increased dosages on discharge the median furosemide equivalent dose was 80mg (IQR=80-160). (
  • In the increased-dose group, many of the patients were switched from furosemide prior to admission to bumetanide at discharge, however this was not tied to all-cause reduction in 30-day readmission. (
  • Philadelphia-area hospitals participating in a patient readmission study saw a 7% drop in 30-day, same-facility readmissions if they provided a patient discharge summary complete with data pulled from an electronic health record (EHR) system. (
  • In this mode of health information exchange, hospitals could more readily share a patient discharge summary with physicians, nursing homes, home health agencies and insurers. (
  • However, there was one thing that issuing a patient discharge summary could not encourage - patient use of personal health record (PHR) systems. (
  • In fact, PHR adoption is so low that participating hospitals have opted instead to prepare a paper booklet to give to heart failure patients upon discharge. (
  • RT: SearchHealthIT: Issuing patient discharge summary shown to reduce hospital #readmission odds via #Healthcare Imp. (
  • We studied all admissions for patients with CHF during 2011 using a statewide discharge data set from Pennsylvania. (
  • The primary outcome was readmission to any Pennsylvania hospital within 30 days of discharge. (
  • The Centers for Medicare & Medicaid Services (CMS) reports that 18 percent of Medicare patients are readmitted within 30 days of discharge, and the agency believes that many of these readmissions are avoidable and/or unnecessary. (
  • A growing number of programs across the country have demonstrated improvements in the discharge and aftercare process, also known as care transitions, and such improvements can result in a significant reduction in readmissions, reducing overall healthcare costs and improving care quality. (
  • The study noted that half of those readmitted within 30 days lacked evidence of a physician office visit occurring between discharge and readmission. (
  • The main emphasis of Medicare's readmission reduction initiatives, including the QIO-led Care Transitions pilot programs in 14 communities across the U.S., has been on identifying the key components of improved discharge and aftercare that contribute to readmission reduction. (
  • Many programs have centered their efforts on heart failure patients, with successful reductions following redesign of their discharge process and improvements in medication reconciliation. (
  • These included age at index admission, gender, ethnicity, admission/discharge date, length of stay, treatment specialty, admission type and source, discharge destination, comorbidities, number of accident and emergency (A&E) visits in the 6 months before the index admission and whether a patient was readmitted within 30 days of index discharge. (
  • Over 20% of HF patients are readmitted within 30 days of discharge from the hospital. (
  • However, it appears that more frequent home visits early after hospital discharge may be the best combination to decrease hospital readmissions. (
  • Patients are at discharge from the psychiatric hospitals randomized, separately according to psychiatric diagnosis (thus, the RADMIS trial consists of two separate trials according to diagnosis, bipolar disorder or unipolar disorder), to: 1) a smartphone-based monitoring system including a) an integrated feedback loop between patients and clinicians and b) context-aware CBT modules (intervention group) or 2) treatment-as-usual (control group) for a 6-months trial period. (
  • The analysis found that asthmatics with allergic rhinitis were 4.4 times more likely to face hospital readmission within 30 days of discharge compared to asthmatics without allergic rhinitis. (
  • Main outcome measures Primary readmission diagnoses of readmissions within 30 days of discharge and potentially avoidable 30 day readmissions to the index hospital or two other hospitals in its network. (
  • Post-discharge care should focus attention not just on the primary index admission diagnosis but also on the comorbidities patients have. (
  • The project uses a team approach to assess patients' risk for re-hospitalization and plan-and-execute risk-specific discharge planning activities. (
  • CHICAGO (October 11, 2018) - Despite a common belief that weekend and holiday discharge after major heart surgery may impact hospital readmissions, research published online today in The Annals of Thoracic Surgery showed that day of discharge does not affect readmissions. (
  • Hospital discharge is an intricate and dynamic process requiring choreography of patients, physicians, ancillary staff, and outpatient caregivers," said Peyman Benharash, MD, from the University of California, Los Angeles (UCLA). (
  • Most recently, cardiac surgery patients who have been discharged home received discharge kits equipped with wireless enabled blood pressure monitors, oximeters, weight scales, and miniaturized electrocardiogram sensors synced to a mobile tablet device. (
  • We encourage patients to be engaged in the discharge process early on and to understand that returning home on a weekend does not mean you will have a higher chance of rehospitalization. (
  • Sanaiha Y, Ou R, Ramos G, Juo Y, Shemin RJ, and Benharash P. Day of Discharge Does Not Impact Hospital Readmission After Major Cardiac Surgery. (
  • The day of discharge does not impact readmission rates and patient outcomes for heart surgery patients. (
  • Experts say that high rates of readmission - when patients are readmitted within 30 days of discharge - indicate that the nation's hospitals are not adequately addressing patient health issues. (
  • Exclusion criteria were inability to comply with the intervention, acute myocardial infarction, comorbidity likely to lead to death or readmission in the near future, planned discharge to long-term residential care, or residence outside of the hospital catchment area. (
  • Margo Brooks Carthon , PhD, RN, FAAN, Assistant Professor of Nursing and a member of the University of Pennsylvania School of Nursing's Center for Health Outcomes & Policy Research (CHOPR), undertook a qualitative descriptive study to investigate the nursing care experienced by older blacks at high risk for readmission following a recent hospital discharge, as reported by those patients. (
  • Controlling for demographic, clinical, and hospital characteristics, patients receiving transitional care (n = 1,104) were as much as 30% less likely to experience a readmission during the year following discharge compared to patients receiving usual care (n = 613). (
  • Evidence suggests that care coordination at hospital discharge is critical for patients with psychiatric illnesses [ 5 - 7 ]. (
  • A stratified random sample of patients with unplanned readmission within 30 days after discharge was selected for medical record reviews. (
  • Avoidable readmissions were due to: clinician factor (42.3%) including low threshold for admission and premature discharge etc. (
  • patient factor (including medical and health factor) (41.9%) such as relapse or progress of previous complaint, and compliance problems etc., followed by system factor (14.6%) including inadequate discharge planning, inadequate palliative care/terminal care, etc., and social factor (1.2%) such as carer system, lack of support and community services. (
  • After adjusting for patients' age, gender, principal diagnosis at previous discharge and readmission hospitals, the risk factors for avoidable readmissions in the total population i.e. all acute care admissions irrespective of whether there was a readmission or not, included patients with a longer length of stay, and with higher number of hospitalizations and attendance in public outpatient clinics and Accident and Emergency departments in the past 12 months. (
  • In the analysis of only unplanned readmissions, it was found that the concordance of the principal diagnosis for admission and readmission, and shorter time period between discharge and readmission were associated with avoidable readmissions. (
  • These readmissions could be prevented by a system of ongoing clinical review to examine the clinical practice/decision for discharge, and improving clinical care and enhancing patient knowledge of the early warning signs for relapse. (
  • Our findings thus provide important insights into the development of an effective discharge planning system which should place patients and carers as the primacy focus of care by engaging them along with the healthcare professionals in the whole discharge planning process. (
  • However, there have been studies which reported that readmissions to hospitals after discharge within a short duration are in fact often avoidable. (
  • Readmitted patients, their carers, and treating professionals were surveyed during readmission to assess the discharge process and the predictability and preventability of the readmission. (
  • Acute admission and number of days since previous hospital discharge were factors strongly associated with readmission. (
  • Patients were considered readmitted if they returned to the hospital within 30-days post-discharge. (
  • Patients are at greatest risk of an unplanned readmission within seven days of discharge, with the majority of readmissions occurring within 30 days, researchers noted. (
  • Researchers used the U.S. Nationwide Readmission Database to identify patients undergoing PCI between 2010 and 2014 and analyze the rate, causes, predictors, and cost of unplanned readmissions up to 180 days after discharge. (
  • Patients with ESRD requiring hemodialysis (HD) are twice (35% versus 16%) as likely to be readmitted within 30 days of discharge compared with general patients on Medicare ( 1 ). (
  • For the majority of patients on HD, the first medical encounter after an inpatient discharge is at the outpatient HD unit. (
  • The SRR compares the observed number with the expected number of readmissions on the basis of multivariable adjustment for patient demographics, patient socioeconomic factors, and discharge hospital characteristics ( 4 ). (
  • ABSTRACT Readmission of diabetic patients after discharge from hospital has potential value as a quality of care indicator. (
  • This retrospective cohort and case-control study aimed to determine the readmission rate for diabetic patients within 28 days after discharge and the association between quality of inpatient care and unplanned readmission. (
  • Comparison of data from readmitted patients (n = 62) and a sample of nonreadmitted patients (n = 62) showed that adherence by health care providers to American Diabetes Association guidelines for admission work-up (OR 0.91, 95% CI: 0.85-0.99) and readiness for discharge criteria (OR 0.89, 95% CI: 0.84-0.95) were significantly more likely to decrease the risk of readmission within 28 days. (
  • Patients were followed from hospital discharge until death, emigration, or completion of 30 days follow-up. (
  • Of 409 patients with an initial Z03* diagnosis at the AMAU, 55% (n = 226) received a more specific discharge diagnosis after transferral to other departments. (
  • Patients diagnosed with Z03* at hospital discharge have a substantially lower 30-day mortality, but a higher readmission-rate, compared to patients who obtain a specific diagnosis during the entire hospital stay. (
  • Timely home visits following patients' discharge from the hospital offer patients tools and support that promote self-management and reduce the likelihood of readmission to the hospital. (
  • Post-Discharge Home Visits: 5 Pillars to Reduce Readmissions and Engage High-Risk Patients , Danielle Amrine, transitional care business manager at the Council on Aging (COA) Southwestern Ohio, describes her organization's home visit intervention, which is designed to encourage and empower patients of any age and their caregivers to assert a more active role during their care transition and avoid breakdowns in post-discharge care. (
  • Cognizant that poorly executed care transitions lead to poor clinical outcomes, dissatisfaction among patients, and the inappropriate use of hospital emergency and post-acute services, COA developed the home visits intervention, in which field coaches conduct post-discharge visits to patients at home and/or within skilled nursing facilities (SNFs). (
  • What is the effectiveness of a discharge-planning and home follow-up protocol implemented by advanced practice nurses (APNs) for hospitalized patients? (
  • All patients had ≥ 1 risk factors for poor discharge outcomes (age ≥ 80 years, inadequate support system, multiple chronic health problems, history of depression, moderate to severe functional impairment, multiple hospitalizations during previous 6 mo, hospitalization in past 30 d, fair or poor self-rated health, or history of nonadherence, 72% completed the study. (
  • 177 patients were allocated to the APN intervention, which extended from admission to 4 weeks after discharge. (
  • 186 patients allocated to the control group received routine discharge planning, including standard home care if referred. (
  • Outcomes included readmissions (cumulative hospital days, mean length of stay), time to first readmission, and estimated cost of health services after discharge (based on standardized Medicare reimbursements). (
  • Among elderly inpatients at risk for hospital readmission, discharge planning and home follow-up by an advanced practice gerontologic nurse reduced hospital readmissions and increased length of time from discharge to readmission. (
  • The often-intricate care set up by discharge planners for homebound elderly patients may fall through without adequate follow-up after discharge ( 1 ). (
  • Noncompliance with medication, which occurs in nearly half of elderly patients after discharge ( 2 ), may be missed without pill counts or direct assessment of the patient's understanding and tolerance of the medications. (
  • Risk scores using nurse interpretation of nonmedical workers' observations show that patients in the high-risk category had significantly higher readmission rates than patients in the baseline-risk and mild-risk categories at 30, 60, 90, and 120 days after discharge. (
  • The medication review programme led by a clinical pharmacist resulted in a substantial reduction in the use of inappropriate medications among hospitalised elderly patients and all-cause unscheduled readmissions at 1 month after hospital discharge. (
  • This white paper draws upon the experiences of an expert panel, as well as conclusions from clinical trials that have addressed the 30-day readmission problem and associated behavioral issues related to the need for pulmonary rehabilitation. (
  • Conclusions: Select patient characteristics easily available shortly after admission can be used to identify a subset of patients at elevated risk of early readmission. (
  • Conclusions: Readmission rates following LSG remain in a similar range as described previously for other laparoscopic bariatric procedures. (
  • Conclusions Although LACE shows good discriminatory power in statistical terms, it may have little added value over and above clinical judgement in predicting a patient's risk of hospital readmission. (
  • Conclusions: The five most common primary diagnoses of potentially avoidable readmissions were usually possible complications of an underlying comorbidity. (
  • Conclusions Recent biologic or tsDMARD use was not associated with a greater risk of mortality or readmission after hip fracture, abdominopelvic or cardiac surgery compared with methotrexate. (
  • CONCLUSIONS: Multimorbid patients with ACS are at a greater risk for worse outcomes than their nonmultimorbid counterparts. (
  • CONCLUSIONS Regardless of the reason for hospitalization, patients with chronic medical and psychiatric conditions may benefit from transitional care support that addresses both conditions. (
  • Conclusions Several patient characteristics were associated with first AECOPD admission in a primary care cohort of people with COPD but fewer were associated with readmission. (
  • Conclusions The current study suggests that early intervention with statins in septic pneumonia patients may improve patient outcomes. (
  • Conclusions In patients with ESRD on hemodialysis, nearly one quarter of admissions were followed by a 30-day unplanned readmission. (
  • The researchers compared readmission rates for 311 non-vulnerable hospitals, 13 safety net hospitals, 31 high Medicaid institutions, and five hospitals that were both safety net and high Medicaid institutions. (
  • To reduce readmission rates, hospitals help discharged patients with rides to the doctor and home-delivered meals. (
  • Traditionally, hospitals haven't followed their patients' progress after they've been discharged. (
  • But high readmission rates have been linked to spiraling-and unnecessary-health care costs, prompting hospitals like Rush to start pilot programs to give patients the help they may need when they first return home. (
  • Readmission rates have become such a concern that both President Barack Obama's budget proposal and the health care reform bills in Congress call for changes in how hospitals are paid. (
  • The data covered all patients treated at acute-care, nonfederal hospitals whose records indicated presence of sickle cell disease. (
  • It is not clear that hospitals are using geriatric variables in evaluating patients. (
  • Our results support screening for use of a mobility aid or having a surrogate sign consent when hospitals admit geriatric patients for surgical care. (
  • Readmissions are stressful and expensive and Medicare reduces payments to hospitals with excess readmissions," said R. Scott Jones, MD, MS, FACS, a study coauthor and emeritus professor and chair of the University of Virginia's surgery department. (
  • In Chicago, 25 hospitals are being fined for high readmissions, even though most have improved from last year. (
  • Thousands of hospitals were automatically exempted because they specialize in certain types of patients, like veterans or children, or because they were designated 'critical access' hospitals. (
  • Many hospitals say they are working hard to reduce readmissions but are fighting an uphill battle. (
  • The hospital's readmission penalty climbed 1.22 percentage points from a year earlier, the highest jump among Illinois hospitals. (
  • Some hospitals see the penalties as being unfair because they can lose money even if they had fewer readmissions than they did in previous years. (
  • In fact, more than 70 Illinois hospitals facing penalties had drops in readmission rates last year. (
  • Researchers analyzed 2008-16 Medicare claims for patients 65 or older admitted to hospitals with heart failure, acute myocardial infarction or pneumonia. (
  • Additionally, ICU readmissions are costly for both patients and hospitals. (
  • The Centers for Medicare and Medicaid Services reduces reimbursements to hospitals that have excess 30-day readmission rates, including ICU readmissions. (
  • Their interests converge with those of hospitals now that high 30-day readmission rates for some conditions place hospitals at risk for financial penalties from the Centers for Medicare and Medicaid Services. (
  • Hospital utilization and characteristics of patients experiencing recurrent readmissions within children's hospitals. (
  • To describe the inpatient resource utilization, clinical characteristics, and admission reasons of patients recurrently readmitted to children's hospitals. (
  • Retrospective cohort analysis of 317,643 patients (n = 579,504 admissions) admitted to 37 US children's hospitals in 2003 with follow-up through 2008. (
  • Among a group of pediatric hospitals, 18.8% of admissions and 23.2% of inpatient charges were accounted for by the 2.9% of patients with frequent recurrent admissions. (
  • This finding suggests that Medicare is penalizing hospitals to a large extent based on the patients they serve," the authors conclude. (
  • Their findings come as the CMS and healthcare quality experts wrestle with how to refine Medicare's readmissions measures without letting hospitals off the hook if they serve more challenging patient populations. (
  • CHICAGO (May 31, 2016): Readmission rates after complex cancer operations tend to be higher in hospitals that are considered to be vulnerable because they serve as safety nets in their communities or have a high number of Medicaid patients. (
  • Payment programs that penalize hospitals for high readmission rates without understanding these issues could stress already financially threatened institutions, according to authors of a new study published online in the Journal of the American College of Surgeons in advance of print publication. (
  • Findings such as these led to creation of the Medicare Hospital Readmissions Reduction Program (HRRP) in the Affordable Care Act, which penalizes hospitals that have higher than expected readmission rates. (
  • In the present study, researchers found that patient factors were primary drivers of higher readmission rates to vulnerable hospitals after cancer operations. (
  • These results further support the need for incorporating socioeconomic variables into the determination of HRRP payments especially for hospitals that already serve a disproportionate number of disadvantaged patients. (
  • Patient conditions and hospital infrastructure make vulnerable hospitals prone to higher readmissions from the outset. (
  • Policymakers need to be aware of the drivers that lead to higher readmissions at these hospitals so payment penalties do not push financially strained hospitals into further hardship," said Young Hong, MD, lead study investigator, MedStar-Georgetown Surgical Outcomes Research Center and Georgetown University Medical Center, Washington, D.C. (
  • The researchers evaluated the care of 110,857 adult patients who had one of seven major or complex cancer procedures between January 1, 2004, and September 30, 2011, in one of 355 hospitals in the state of California. (
  • The 30-day readmission rates were 14 percent for safety net hospitals, 13 percent for high Medicaid hospitals, and 14 percent for safety net and high Medicaid institutions. (
  • Ninety-day readmission rates were 20 percent for safety net hospitals, 22 percent for high Medicaid hospitals, and 21 percent for high Medicaid and safety net hospitals. (
  • In contrast, the readmission rates for non-vulnerable hospitals were 11 percent at 30 days and 17 percent at 90 days. (
  • Patients having cancer operations at vulnerable hospitals were more likely to live in low income areas (28 percent vs. 17 percent), have Medicaid (27 percent vs. 5 percent), and be admitted via the emergency department for their index procedure (15 percent vs 9 percent) than those who had their operations at non-vulnerable hospitals. (
  • A team of researchers from children's hospitals across the country, including a University of Colorado School of Medicine faculty member, found that hospitals serving children may face financial penalties for patient readmissions due to factors beyond the control of the hospital. (
  • In the most comprehensive study to date of state Medicaid readmission pay-for-performance policies and social determinants of health, the researchers found that pay-for-performance measures may disproportionately penalize hospitals that serve children who are poor, ethnic or racial minorities or publicly insured. (
  • The results of the study are reported in an article, 'Association of Social Determinants with Children's Hospitals' Preventable Readmissions Performance,' published online on Feb. 15, by JAMA Pediatrics. (
  • Studies like ours show that patients who are poorer or are minorities are readmitted at higher rates than other patients, which raises concern that the readmissions penalties punish hospitals for the type of patients that they serve, rather than purely for the quality of care they provide,' Sills says. (
  • They conclude that without adjusting for social determinants of health, 'hospitals that care for more vulnerable patients may receive penalties in part related to patient factors beyond the control of the hospital and unrelated to the quality of hospital care. (
  • Yet even with evidence that some children's hospitals could be unfairly penalized in a shift to pay for performance, policymakers have recommended further study before adopting risk adjustment factors that would reduce penalties for hospitals that care for more patients with social determinants of health risk factors. (
  • In their analysis, the researchers used 15-day and 30-day readmission rates to measure the hospitals. (
  • In baseline studies, 22 hospitals were penalized when patients were readmitted within the 15-day window and 23 were penalized for readmissions within the 30-day window. (
  • Black patients with diabetes may have a significantly higher risk of readmission to hospitals than other ethnic and racial minorities due to the high burden and complications of the disease, according to research published in JAMA Network Open. (
  • When compared with white individuals, black and Hispanic patients had the highest observed-to-expected (OE) readmission rate ratio when their income was low and when they were hospitalized in nonprofit hospitals, academic hospitals, or large hospitals. (
  • Hospitals and healthcare systems need to recognize that many post-care facilities aren't equipped to deal with these patients and plan accordingly to provide the most efficient and high-quality care possible, they argue. (
  • Testing for NT-proBNP at the beginning and end of hospitalization, Michtalik says, could help doctors and hospitals make better decisions about which patients are truly ready to be released and which ones are at higher risk for relapse, readmission or worse. (
  • The program, which began in fiscal year 2013, incentivizes hospitals across the nation to reduce preventable readmissions by cutting Medicare payments for those with rates deemed unacceptably high. (
  • This October, reducing readmissions will become an even more urgent objective for hospitals as the potential reimbursement reductions get bigger and the list of conditions CMS scrutinizes gets longer. (
  • During the first year , CMS cut Medicare reimbursement by up to 1 percent for 2,213 hospitals with high readmission rates for heart attack, heart failure and pneumonia. (
  • CMS penalizes hospitals for readmissions exceeding a hospital's expected readmission rate, which is the national mean readmission rate risk-adjusted for demographic characteristics and the severity of illness of a particular provider's patients, according to Health Affairs . (
  • Right now, a lot of hospitals are barely included in the program because they just don't have very many patients that are included in one of the three conditions," Dr. Joynt says. (
  • Richard Juknavorian, senior director of performance technologies at The Advisory Board Company, sees the program's upcoming expansion as part of a larger transition to a healthcare industry where hospitals won't get paid for readmissions at all. (
  • Soon, he says Medicare and commercial payers alike won't reimburse providers for preventable readmissions, and hospitals that display "ostrich syndrome" will suffer. (
  • The readmission rates of top performing facilities were similar to, and in some cases greater than, the rates posted by unranked hospitals. (
  • Cardiology patients have better survival rates at hospitals atop the U.S. News and World Report rankings, but the risk of readmission is more or less the same -- and with 30-day readmissions tied to reimbursement , that could pose an issue for providers at all points on the spectrum. (
  • Despite the good news on the mortality front, to-ranked hospitals fared no better, at least statistically, when it came to 30-day readmission rates. (
  • Top-ranked hospitals did garner better HCAHPS rankings for patient satisfaction, averaging 3.9 out of 5 stars, compared to 3.3 stars among non-ranked hospitals. (
  • Hospitals in various states have been slammed by readmission penalties , including 215 of 292 hospitals in California. (
  • Once-failing hospitals say accountability, transparency key to surviving fallout from failing patient safety grades When Leapfrog released their Spring 2016 patient safety grades recently, 15 hospitals got slapped with a very public 'F' grade casting a spotlight on them that no institution wants. (
  • Hospital readmission rate has become a major indicator of quality of care, with penalties given to hospitals with high rates of readmission. (
  • One of the less known policies of the Affordable Care Act, the Hospitals Readmission Reduction Program, requires that hospitals with higher than national average readmission rates for certain medical conditions and surgical procedures be penalized. (
  • For many hospitals, the readmission penalties result in millions of dollars in profit lost. (
  • According to an October 2014 article from Kaiser Health News , "Medicare is fining a record number of hospitals - 2,610 - for having too many patients return within a month for additional treatments, federal records released {recently} show. (
  • Even though the nation's readmission rate is dropping, Medicare's average fines will be higher, with 39 hospitals receiving the largest penalty allowed. (
  • The remote monitoring technology and implementation drives revenue issues beyond the CMS readmission penalties," said John Kirsner, Partner, Jones Day, an expert on the implications of the ACA on hospitals. (
  • The result for UVA has been a dramatic decrease in joint readmission rates, and a ready for prime time remote monitoring/care coordination program that can be put into place at hospitals across the country. (
  • Since 2013, Medicare has been financially penalizing hospitals with above-average 30-day readmission rates for heart failure patients. (
  • Currently, Medicare is penalizing hospitals for what it considers excessive readmission rates. (
  • Last month, Medicare said it will access $227 million in fines against hospitals in 49 states as part of an initiative to reduce the number of patients readmitted within a month. (
  • The results will interest hospitals, who under the Affordable Care Act, are penalized by the Centers for Medicare and Medicaid Services (CMS) if they have higher 30-day readmission rates than the national average. (
  • For the 18 participating hospitals, this amounted to 400 unnecessary readmissions and $4 million in savings in the third quarter of 2011. (
  • Reducing avoidable readmissions rapidly is becoming one of the biggest hot-button issues for hospitals, and it's a matter that involves both medical necessity compliance and patient care concerns. (
  • At the same time, CMS noted that hospitals were being rewarded for readmissions via additional DRG reimbursement. (
  • Due to a wide range of illnesses that can lead to readmission, it can be challenging for hospitals to determine where to focus their limited resources. (
  • In fact, nearly one in five Medicare patients discharged from Minnesota hospitals is readmitted within 30 days. (
  • The goal of this program is to improve patient safety by standardizing and improving communication during transitions of care between hospitals and across all settings of care, including other hospitals, skilled nursing facilities, long-term care, assisted living, home health and primary care. (
  • MHA partners with Stratis Health, the Minnesota QIN-QIO, in the Coordination of Care Initiative that supports hospitals and organizations across the continuum of care as they provide high-quality transitions for patients. (
  • Patients with unipolar or bipolar disorder discharged from psychiatric hospitals in The Capital Region of Denmark are invited to participate. (
  • In 2013, the federal government began penalizing hospitals with higher than expected readmission rates. (
  • The results are in after a three-year campaign to prevent harm and reduce readmissions for hospital patients across the nation, and participating Indiana hospitals such as Good Samaritan are showing significant progress. (
  • From 2012-2014, 116 Indiana hospitals partnered with the Indiana Hospital Association (IHA) in the Centers for Medicare and Medicaid Services' (CMS) Partnership for Patients campaign. (
  • Participating hospitals worked to improve care in 11 core patient safety areas of focus, such as early elective deliveries and pressure ulcers. (
  • When it comes to patient safety, Indiana hospitals don't compete with one another - they collaborate to share best practices, address regional needs and work together on quality improvements for the sake of their patients and the communities they serve," said Doug Leonard, president of IHA. (
  • We are extremely proud of the results achieved during the Partnership for Patients campaign that highlight the tremendous accomplishments of our hospitals and reflect leadership commitment to quality and patient safety. (
  • In the study, researchers assessed whether adding a standard measure for indicating the socioeconomic status of heart failure patients could alter the expected 30-day heart failure hospital risk standardized readmission rate (RSRR) among New York City hospitals. (
  • The study examined data of heart failure patient hospitalizations at 48 New York City hospitals for 17,767 Medicare patients aged 65 years and older who had a combined 25,962 hospitalizations between 2006 and 2009. (
  • As a result, hospitals with excessive, or more than expected readmission rates, have begun to lose a percentage of their Medicare reimbursements. (
  • More than 2,200 hospitals were fined for avoidable readmissions in 2013, for a total of $280 million in reduced Medicare payments. (
  • We test this model using a unique dataset that tracks both patient demographic and clinical data for individual patients across 72 hospitals in North Texas. (
  • The researchers tested their model using a unique data set that tracked patient demographic, clinical and administrative data across 67 hospitals in North Texas during a four-year period. (
  • In 2012, the U.S. Centers for Medicare and Medicaid Services imposed penalties on hospitals for preventable readmissions related to chronic conditions, such as heart failure. (
  • Hospitals should consider the use of innovative information technologies, including electronic health records and patient portals, to improve communication between patients and clinicians in order to improve the quality of care delivery to patients with chronic diseases such as congestive heart failure," Bardhan said. (
  • Hospitals are more focused on taking better care of these patients once they are readmitted, Bardhan said. (
  • Hospitals that implement cardiology and administrative information systems are more likely to exhibit lower readmission rates compared to hospitals that have not implemented these systems. (
  • Hospitals can use the approach that we have developed to not only identify and stratify patients based on their readmission risk propensity, but also reduce their frequency of future readmissions by delivering appropriate treatment and providing more efficient post-acute care," Bardhan said. (
  • Those results may indicate that the HRRP may have incentivized hospitals to cut readmissions in a way that jeopardized the health and survival of heart failure patients. (
  • The research team found that 63% of the readmission reductions could be simply attributed to the way patients' diagnoses were coded, or "how hospitals document the severity of admitted patients. (
  • The number of secondary diagnoses, such as obesity or hypertension in heart attack patients, increased by 39% at hospitals participating in HRRP. (
  • It is possible that hospitals exposed to the HRRP undercoded severity prior to the HRRP, rather than overcoding severity after the program," said researcher Andrew Ryan, Ph.D. "Nonetheless, there is a long history of healthcare providers and health plans increasing the coded severity of patients when it is to their advantage to do so. (
  • Patients were enrolled in Community Care of North Carolina's medical home program and were discharged from 100 different hospitals throughout the state from July 1, 2010 through June 30, 2011. (
  • Readmission did not predict and was not a valid indicator of the quality of care for patients with heart failure admitted to three Swiss university hospitals. (
  • In an optimally functioning health care system, patients discharged from hospitals would obtain the needed and appropriate care in the community. (
  • The Partnership for Patients, a federal initiative, is focused on reducing preventable readmissions to hospitals by 20 percent and reducing preventable hospital-acquired conditions by 40 percent over a three-year period. (
  • The efforts of the MHA Keystone HEN, comprised of 70 Michigan hospitals, have resulted in an expansion of MHA Keystone Center activities to address the reduction of harm across all areas of the hospital setting and improve patient and family engagement. (
  • Numbers of readmissions per patient differ substantially between the six hospitals, up to a factor of 2. (
  • Comparing frequently admitted patients to non-frequently admitted patients commits the constant risk fallacy and potentially lowers HSMRs of hospitals treating many frequently admitted patients and increases HSMRs of hospitals treating many non-frequently admitted patients. (
  • Hospitals can dramatically increase heart attack survival rates in patients suffering cardiogenic shock by providing rapid hemodynamic support. (
  • 1, 2 More than 34 million patients are discharged from hospitals or emergency rooms each year, and interventions that improve care transitions from one healthcare setting to another have been shown to reduce readmissions. (
  • Brousseau and colleagues noted that there was no correlation between the initial duration of hospitalization and the risk of readmission. (
  • A total of 21,112 of patients with sickle cell disease in these states had at least one emergency department visit or hospitalization during that period. (
  • Among 126,137 unique patients with an index COVID-19 admission during March-July 2020, 15% died during the index hospitalization. (
  • More than a single readmission occurred among 1.6% of patients discharged after the index hospitalization. (
  • Percentages shown were attributable to children categorized by their maximum recurrent readmission frequency (0 to ≥4) during a 365-day interval following an index hospitalization. (
  • We found that having marijuana use disorder or AUD alone within 90 days of initial hospitalization was associated with longer times until first readmission. (
  • We found that AUD and other drug use disorder increase readmission risk in patients with SSD after a first hospitalization, whereas marijuana use disorder does not appear to be associated with an increased risk for readmission. (
  • Moreover, the researchers suggested that this significant risk among black patients could not be explained by demographic factors, comorbidities, income, reason for index hospitalization, or place of hospitalization. (
  • The majority of early (before BC) readmissions following an index hospitalization for ACS patients referred to BRIDGE were unavoidable and unrelated to ACS. (
  • The modified, APN led palliative care program, utilizing more frequent home visits after a hospitalization, significantly reduced hospital readmission rates in this sample. (
  • Aronow W, Shamliyan T. Comparative Effectiveness of Disease Management With Information Communication Technology for Preventing Hospitalization and Readmission in Adults With Chronic Congestive Heart Failure. (
  • Patients in this study experienced 980 readmissions over the course of 1 year, with 20% of readmissions for a different reason than the primary hospitalization, and 36% of readmissions occurring at a different hospital. (
  • The primary reasons for initial hospitalization and subsequent 30-day readmission were discordant in 80% of admissions. (
  • Most readmissions were for primary diagnoses that were different from initial hospitalization. (
  • We analyzed the Slovenian data on mortality and readmissions after first HF hospitalization in patients aged 65 years or over. (
  • In this observational epidemiological study, the Slovenian national hospitalization database was searched for HF patients aged ≥65 years with first HF hospitalization between 2008 and 2012. (
  • Age is an independent predictor of mortality but not readmissions in elderly patients with first HF hospitalization. (
  • A study published in the April New England Journal of Medicine reports that, currently, about one in five Medicare patients returns to a hospital within 30 days of being discharged. (
  • At Rush, for example, the typical hospital stay for a Medicare patient is six days at a cost of $18,000 to Medicare. (
  • Nationally, readmissions cost Medicare $17.4 billion in 2004. (
  • That means helping patients avoid return trips to the hospital will benefit not only the patient, but the nation's health care system as well, says Mark Williams, M.D., of Northwestern University's Feinberg School of Medicine and coauthor of the Medicare study. (
  • Those with a large number of patients who are "frequent fliers" would have their Medicare payments cut. (
  • How frequently patients return to the hospital after treatment for heart attacks, heart failure and pneumonia is an indicator of how well the hospital did the first time around, according to the Centers for Medicare & Medicaid Services (CMS). (
  • Readmissions are still too high, the federal government says, and Presence will pay a hefty penalty - likely worth millions of dollars - after Medicare reduces reimbursements to the hospital by 2.79 percent, the highest in the Chicago metropolitan area. (
  • Medicare has determined that their readmission rates are still too high. (
  • For each hospital, Medicare determined what it thought the appropriate number of readmissions should be based on the mix of patients and how the hospital industry performed overall. (
  • If the number of readmissions was above that projection, Medicare fined the hospital. (
  • The fines are based on readmissions between July 2011 and June 2014 and include Medicare patients who were originally hospitalized for one of five conditions: heart attack, heart failure, pneumonia, chronic lung problems or elective hip or knee replacements, according to Kaiser Health News. (
  • Even so, readmissions at Illinois Valley are still climbing, and now Medicare is socking the hospital with a 1.77 percent cut. (
  • It said it has seen improvements in its readmission data since the Medicare figures were collected more than a year ago. (
  • The op-ed criticized the Hospital Readmissions Reduction Program (HRRP), one of dozens of "value-based payment" programs imposed on the Medicare fee-for-service program by the Affordable Care Act. (
  • Hospital readmissions that Medicare penalizes under the Affordable Care Act are largely driven by patient characteristics such as income and education rather than the quality of care they receive, according to a new study. (
  • Clinical quality improvement efforts as well as federal payment policies have sought to reduce hospital readmissions to improve the quality of patient care and decrease Medicare program spending. (
  • A review of Medicare claims by the Medicare Payment Advisory Commission (MedPAC) in 2005 found that 5 to 79 percent of readmissions could potentially have been prevented and saved $12 billion in Medicare spending. (
  • In the final 180-day model, no IDE, African American race, Medicaid or Medicare insurance, longer stay, and lower HbA 1c were independently associated with increased hospital readmission. (
  • In addition, the Medicare Payment Advisory Commission has reduced reimbursement rates for patients who have early rehospitalizations for certain conditions such as congestive heart failure (CHF) ( 2 ). (
  • Because of scenarios like that, between July 2011 and June 2012, Swedish had an overall 30-day Medicare patient readmission rate higher than the national average of 16 percent. (
  • Aside from the desire to improve outcomes for patients, Ms. Donofrio says the hospital was motivated by the threat of penalties for high readmission rates under the Medicare Hospital Readmissions Reduction Program. (
  • Are you, or is someone you love, an MS patient on Medicare in need of financial assistance? (
  • For instance, over a year and half ago, Broad Axe Care Coordination and University of Virginia Health System (UVA) partnered to design and execute a comprehensive platform combining services and technology to reduce readmissions for key conditions where Medicare was imposing penalties, including heart attack, heart failure, pneumonia and COPD. (
  • Because heart failure has one of the highest readmission rates of all conditions that have been studied in Medicare and Medicaid populations, we decided to focus on it and try to identify predictors for early readmission. (
  • Comorbidities, sociodemographic factors including male sex, age, black race and Medicare coverage, and prolonged length of stay are associated with increased risk of readmission in patients with CHF. (
  • For several years CMS has indicated that rising numbers of readmissions, and especially readmissions clinically related to an initial hospital stay, were responsible for a large portion of Medicare costs. (
  • A landmark New England Journal of Medicine article published in 2009 identified a 19.6 percent rate of readmission within 30 days, increasing to 34 percent at 90 days, for Medicare fee-for-service beneficiaries. (
  • Medicare Quality Improvement Organizations (QIOs) long had been responsible for monitoring readmissions by performing occasional audits, however this was not effective in reducing overall readmission rates. (
  • A 2009 study by the New England Journal of Medicine shows that 20 percent of Medicare patients are back in the hospital a mere 30 days after release. (
  • Heart failure (HF) is the most common cause of hospital admissions among Medicare recipients, and readmission rates are disproportionately higher than in other chronic conditions. (
  • the study linked data on 388,078 PCI patients (≥65 years), who were treated at a hospital participating in ACC's CathPCI Registry , to Medicare fee-for-service claims made between January 2007 and December 2009. (
  • Congestive heart failure is the most common cause of hospital readmission in the United States for patients age 65 years or older and in the Medicare program. (
  • The results of the study indicated several important determinants of patient readmission risk, including patient demographics, hospital characteristics and payer type (Medicare, Medicaid, self-pay, private insurance, etc. (
  • While Medicare patients are more likely to be readmitted, their frequency of future readmissions is lower after their first readmission. (
  • The results of the Centers for Medicare & Medicaid Services' program to reduce hospital readmissions are being called into question by two new studies - with one suggesting the initiative may have the "unintended consequence" of raising patient mortality rates. (
  • Dennis Wagner & Paul McGann, MD Co-Directors, Partnership for Patients US Department of Health & Human Services and Centers for Medicare & Medicaid Services AHRQ Annual Conference September 10, 2012. (
  • Rehospitalizations among patients in the medicare fee-for-service program. (
  • Thirty-day readmission rates for Medicare beneficiaries by race and site of care. (
  • Arbaje AI, Wolff JL, Qilu Y, Powe NR, Anderson GF, Boult C. Postdischarge Environmental and Socioeconomic Factors and the Likelihood of Early Hospital Readmission Among Community-Dwelling Medicare Beneficiaries. (
  • Although national epidemiology of unplanned readmissions has been described in other diseases, there are limited data on patients with ESRD on HD, especially those with non-Medicare insurance ( 2 , 3 ). (
  • As of 2017, outpatient dialysis units will be indirectly penalized by the Centers for Medicare and Medicaid (CMS) for excessive readmissions as the standardized readmissions ratio (SRR) becomes part of the ESRD Quality Incentive Program. (
  • Concerned about escalating hospital readmissions from skilled nursing facilities (SNFs) and the accompanying pinch of Medicare readmissions penalties, three Michigan healthcare organizations decided to set competition aside to collaborate and reduce rehospitalizations from SNFs. (
  • Jencks SF, Williams MV, Coleman EA (2009) Rehospitalizations among patients in the Medicare fee-for-service program. (
  • In a statement, the hospital said it is 'committed to reducing preventable readmissions' and improving the health of patients. (
  • Readmissions for ACS are common, costly, and potentially preventable. (
  • A 2007 MedPAC report declared 76% of 30-day readmissions preventable. (
  • A clear discrepancy is seen between the 76% preventable readmissions in the MedPAC report and the 19% preventable readmissions in this study. (
  • Mitigating preventable readmissions, where patients are readmitted for the same primary diagnosis within thirty days, is a significant challenge in delivery of high quality healthcare. (
  • It is essential to profile the prevalence of avoidable readmissions and understand its drivers so as to develop possible interventions for reducing readmissions that are preventable. (
  • The MHA Keystone HEN aims to reduce the number of preventable adverse drug events, catheter-associated urinary tract infections (CAUTIs), central-line-associated bloodstream infections, injuries from falls and immobility, obstetrical adverse events, pressure ulcers, surgical-site infections, venous thromboembolisms, ventilator-associated events (VAEs) and preventable readmissions. (
  • Objectives Because of fundamental differences in healthcare systems, US readmission data cannot be extrapolated to the European setting: To investigate the opinions of readmitted patients, their carers, nurses and physicians on predictability and preventability of readmissions and using majority consensus to determine contributing factors that could potentially foresee (preventable) readmissions. (
  • Cohen's Kappa measured pairwise agreement of considering readmission as predictable/preventable by patients, carers and professionals. (
  • 2) Factors distinguishing predictable from non-predictable and preventable from non-preventable readmissions. (
  • Results The majority deemed 27.8% readmissions potentially predictable and 14.4% potentially preventable. (
  • Patients readmitted within 30 days were compared to the remaining patients using Student t-tests for continuous variables and Chi-square tests for categorical variables. (
  • For patients who had an index sepsis admission, 17.5% were readmitted within 30 days. (
  • Close to 30 percent of congestive heart failure patients were readmitted within 30 days from 2006 to 2010 in the Dallas-Fort Worth region," Zheng said. (
  • Of 1055 eligible patients discharged alive, 139 (13.2%) were readmitted within 30 days. (
  • Among patients discharged to home with a Z03*-diagnosis, 30% were readmitted within 30 days, while the corresponding figure was 23% for patients receiving a specific diagnosis (p = 0.06). (
  • After adjusting for other factors that could affect prognosis such as body mass index (BMI) and kidney function, patients with a small pupil area had an 28% lower risk of all-cause mortality and an 18% reduced risk of readmission due to heart failure compared to patients with a large pupil area. (
  • 2020) Prognostic value of pupil area for all‐cause mortality in patients with heart failure. (
  • The study did not find evidence of increased mortality rates linked to the U.S. Hospital Readmissions Reduction Program, especially not among emergency department or observation patients. (
  • Management of hyperglycemia in hospitalized patients has a significant bearing on outcome, in terms of both morbidity and mortality. (
  • It is increasingly recognized that the management of hyperglycemia in the hospitalized patient has a significant bearing on outcome, in terms of both morbidity and mortality [ 1 , 2 ]. (
  • on the other hand, found that for one group of targeted patients - those with congestive heart failure (CHF) - mortality went up as 30-day readmissions went down. (
  • Dr. Strobeck reported the results of a propensity score matched-controlled retrospective analysis of mortality and readmission outcomes in a mixed community cohort of 245 consecutive heart failure patient admissions over the course of four years for whom at least one year of follow-up or mortality data were available. (
  • Outcomes for each member of this cohort were statistically compared to the 30-day mortality and readmissions and 365-day mortality rates of ten controls derived from CMS data and matched for demographics, comorbidities, and time of treatment. (
  • 10 mg/day (mortality aOR 1.64 (1.02 to 2.64), readmission aOR 1.60 (1.15 to 2.24)) versus no glucocorticoids, although results varied when stratifying by surgery category. (
  • Multimorbidity in Patients With Acute Coronary Syndrome Is Associated With Greater Mortality, Higher Readmission Rates, and Increased Length of Stay: A Systematic Review. (
  • Can a specialist-nurse intervention reduce mortality and morbidity in patients hospitalized with chronic heart failure? (
  • The 30-day risk-adjusted mortality rate of patients in the program was shown to increase, from 7.2% before implementation to 8.6% after it. (
  • One-year readmission and mortality rates followed a similar pattern, researchers said. (
  • Mochari-Greenberger H, Cohen LP, Liao M, Mosca L (2015) Racial and Ethnic Differences in 30-Day Readmission and 1-Year Mortality among Patients Hospitalized for Heart Failure. (
  • This study evaluated the association between race/ethnicity, 30-day readmission, and 1-year mortality among a diverse cohort of hospitalized HF patients overall and by age group. (
  • Secondary outcomes included neutrophil migration, safety and tolerability, length of stay, readmissions and mortality. (
  • An editorial cautioned against legislation that financially penalizes institutions when they fail to meet an "arbitrary benchmark" for readmissions, which may cause unintended consequences, citing the example of the Hospital Readmissions Reduction Program, where a reduction of heart failure admissions was associated with an increase in mortality. (
  • The researchers found that combined health coaching and remote monitoring did not reduce all-cause 180-day hospital readmissions among heart failure patients, and did not have significant effects on 30-day hospital readmissions, 30-day mortality, or 180-day mortality. (
  • 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. (
  • 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. (
  • The education levels of CHF patients and caregivers were not correlated with readmission or mortality rates. (
  • 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. (
  • Predictive factors of early readmission and mortality in patients with heart failure hospitalized in the Department of Internal Medicine of the San Carlos University Hospital, Spain]. (
  • Readmission and mortality in patients discharged with a diagnosis of medical observation and evaluation (Z03*-codes) from an acute admission unit in Denmark: a prospective cohort study. (
  • We assessed the 30-day risk of readmission and mortality among patients receiving an International Classification of Diseases 10th edition diagnosis of medical observation and evaluation (Z03*) following admission to an acute medical admission unit (AMAU), stratified on any further specification of diagnosis during hospital stay. (
  • In contrast, corresponding figures for 30-day mortality were 3% for Z03*-diagnosed patients and 10% for those who obtained a specific diagnosis (p = 0.003). (
  • We have studied the impact of readmissions by linking admissions of the same patient, and as a result were able to compare hospital mortality among frequently, as opposed to, non-frequently readmitted patients. (
  • We also formulated a method to adjust for readmission for the calculation of hospital standardised mortality ratios (HSMRs). (
  • All-cause mortality and readmissions were compared in young-olds (65-74 years), middle-olds (75-84 years), and old-olds (≥85 years) using cumulative probability plots and log rank test. (
  • The prognostic value of comorbidities on mortality and readmissions for age groups were assessed using multiple Cox proportional hazards models. (
  • Importance of comorbidities as a predictor for mortality faded with increasing age while only small decrease in hazard ratios for readmissions were seen. (
  • Comorbidities are important predictors for mortality and readmissions in elderly. (
  • Gabet A, Juillière Y, Lamarche-Vadel A, Vernay M, Olié V. National trends in rate of patients hospitalized for heart failure and heart failure mortality in France, 2000-2012. (
  • Geriatric conditions and subsequent mortality in older patients with heart failure. (
  • Reduce readmissions on the path to healthier outcomes. (
  • With the shift to value-based care, it's more important than ever to reduce readmissions and improve patient outcomes - all while driving down costs. (
  • This solution combines relevant patient data from different systems into a single view, so care coordinators can easily engage with care teams and patients to drive healthier post-acute outcomes. (
  • The University of Virginia was among 25 participating centers in the Geriatric Surgery Pilot study, which the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP®) created in 2014 to collect risk factors and outcomes in surgical patients 65 and older. (
  • At the 17th Annual Meeting of the International Society for the Advance of Spine Surgery, Ali Araghi, DO, an orthopaedic spine surgeon at The CORE Institute in Phoenix, AZ cited current literature reporting that recurrent herniation and early readmission rates (within 90 days post-operatively) are predominant causes of negative outcomes in these patients. (
  • Intra-operative risk stratification could ideally lower hospital costs (of up to nearly $40,000/case) and prevent negative patient outcomes. (
  • The data suggest further that the greater attention to diabetes reflected in HbA1c determination may improve patient outcomes and lower cost of inpatient care. (
  • These findings in readmission rates and outcomes are concerning, particularly as they likely underestimate the true impact of racial/ethnic differences in the United States, as our study comprised privately insured individuals with access to care,' the authors said, noting that about10% of black residents are uninsured compared with 6% of whites. (
  • Appearing in Circulation: Cardiovascular Quality and Outcomes, the study describes the first risk model for hospital readmission specifically developed for older heart attack patients . (
  • New York, NY, March 14, 2018 (GLOBE NEWSWIRE) -- Daxor Corporation (NYSE MKT: DXR) , an investment company with medical instrumentation and biotechnology operations, announces the presentation of new research highlighting the significant benefits to patient outcomes through individualization of care guided by blood volume analysis (BVA). (
  • The authors conclude by acknowledging the need for further studies to assess the links between patient outcomes and loop diuretics. (
  • Various types of palliative care delivery programs have demonstrated positive outcomes for HF patients by decreasing emergency department visits, hospital days, physician visits, and medical costs. (
  • The employment of this risk score in the clinical setting may translate to improved patient outcomes, proper quality assessment, and guided resource management, specifically for those patients at highest risk of readmissions," write the authors. (
  • It is widely recognised that the management of patients with acute respiratory failure in the Emergency Department (ED) is a pivotal point that may influence outcomes at later stages in patient care pathways. (
  • In particular, the decision to submit patients to invasive mechanical ventilation (IMV) and the mode of ventilator settings utilised are of relevance in determining patient outcomes. (
  • We feel that this short period is unlikely to have contributed any meaningful effect on overall patient outcomes. (
  • Moreover, it would have been of great interest to discuss any changes in ventilator parameters between ED and ICU, and if the initial choice of ventilator settings could have influenced patient outcomes, i. (
  • As Good Samaritan strives to be the regional center of excellence for health and wellness, nothing is more important than our focus on high quality patient outcomes and world class patient safety," stated Rob McLin, President and CEO. (
  • A new report by Icahn School of Medicine at Mount Sinai, published in the journal Circulation: Cardiovascular Quality and Outcomes , shows the socioeconomic status of congestive heart failure patients does not influence hospital rankings for heart failure readmissions. (
  • We were surprised to find that patients discharged on weekends and holidays had similar readmission rates and outcomes as patients who were cleared on weekdays," said Dr. Benharash. (
  • No individual component will significantly alter patient outcomes," he said. (
  • Healthx now offers a new remote patient-monitoring platform to improve outcomes for chronically ill members with diabetes, hypertension, congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), coronary artery disease (CAD) and multiple co-morbidities. (
  • Objectives The impact of immunosuppression on postoperative outcomes has primarily been studied in patients undergoing joint replacement surgery. (
  • The intensity of the dysregulated host response varies from patient to patient and has a negative impact on survival and other outcomes. (
  • Secondary outcomes included combined death or readmission for any reason, death, readmission for worsening chronic heart failure, and readmission for any reason. (
  • Understanding the experiences of older black patients and exploring if nursing care addresses their needs and prepares them for successful transition back into community settings offers important perspectives about the relationship between nursing care quality and outcomes," explains Brooks-Carthon. (
  • 6, 10, 11 These doubts about the use of readmission to measure the quality of care for patients with HF has led the American Heart Association/American College of Cardiology (AHA/ACC) Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke to publish recommendations about the evaluation of the quality of care in patients with HF. (
  • You will learn strategies to educate treat and motivate patients to achieve optimal health and outcomes. (
  • Objective: Contemporary outcomes data among heart failure (HF) patients younger than age 65 are limited, especially among Hispanics. (
  • 2 Adjuvant statin therapy in severely critically ill patients has failed to improve outcomes and may be associated with increased morbidity, 4,5 however our ASEPSIS study suggested that early intervention with statins may reduce the progression of sepsis in a ward-based cohort of milder sepsis patients. (
  • 6 In light of this, we investigated whether oral treatment with simvastatin improved neutrophil function and clinical outcomes in elderly patients with septic pneumonia. (
  • 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. (
  • 15, 16 Nonmedical workers are involved in 8 out of 10 hours of paid services provided to the elderly and people with disabilities, and growing evidence shows that they can improve patient experience and outcomes. (
  • The hospital's rates of readmission for heart attack and pneumonia patients, at about 20 percent, are in line with the national average, according to CMS data. (
  • Compared to the large pupil area group, patients in the small pupil area group had a significantly poorer survival rate and significantly higher rate of readmission for heart failure. (
  • 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 ). (
  • Higher numbers of hospital readmissions were significantly related to more difficulty with management of heart failure and a poor sense of life purpose. (
  • These patients differed significantly from those who had fewer hospitalizations with respect to age, race/ethnicity, gender, English proficiency, and insurance type. (
  • 2 - 5 The same year a report published by the Scottish Executive concluded that outreach teams and follow up would not significantly optimise patient care or affect the workload of intensive care units. (
  • Attending Physicians - Some physicians or specialties may have significantly higher rates of readmissions than others. (
  • The problem grows significantly for those Medicaid patients who are older and are shuttled between general and intensive care facilities. (
  • however, several non-cardiac risk factors significantly contribute to readmission risk. (
  • Repeat care delivery at the same hospital reduces the risk of future readmissions significantly. (
  • The addition of laboratory features significantly improved the prediction ability of the model, which suggests that laboratory data may be useful in identifying patients at risk of readmission. (
  • The researchers found that intervention patients reported significantly improved quality of life at 180-days when compared to usual care patients based on the Minnesota Living with Heart Failure questionnaire, a well validated instrument for measuring quality of life among heart failure patients. (
  • Observed deaths for frequently admitted patients were significantly lower than HSMR-predicted deaths, which could be explained by uncorrected factors surrounding readmissions. (
  • A systematic pharmacist-led medication review programme significantly reduced the number of inappropriate medications and unplanned hospital readmissions among geriatric in-patients. (
  • Up to 45% of patients admitted to hospital with heart failure die within one year of admission and the majority die within five years of admission. (
  • Multivariable logistic regression was used to fit the relationship between the measurement of HbA1c and early readmission while controlling for covariates such as demographics, severity and type of the disease, and type of admission. (
  • In the sample, 69,294 patients (21.8%) experienced at least 1 readmission within 365 days of a prior admission. (
  • He has been treating COPD patients for more than 40 years, and his program has a 4% admission rate for COPD exacerbations.5 He holds over 15 patents associated with respiratory care. (
  • Participants Patients discharged from the critical care unit after their first or only admission for two study periods, 26 February 2000 to 25 February 2001 and 26 February 2001 to 25 February 2002. (
  • Typically, he adds, patients are already tested for this heart failure marker upon admission. (
  • There was no significant association between early unplanned readmissions and the scores for quality of the admission work-up or evaluation and treatment during the stay. (
  • Univariate analysis indicated a higher readmission rate with more diagnoses upon admission (P (
  • Patients received at least one BVA test at or near admission with follow-up as needed. (
  • Avoidable readmission was defined as being the result of a patient or provider issue that if managed may have prevented the admission. (
  • The severity of congestive heart failure, however, was not a factor in either admission or readmission rates. (
  • Our results agree with several recent studies in finding an adverse impact of depression on admission and readmission rates," Ketterer says. (
  • Admission Source - Transfers from skilled and long-term care facilities may have higher readmission rates than most other patients. (
  • No prior trial has investigated whether the use of a smartphone-based system can prevent re-admission among patients discharged from hospital. (
  • BACKGROUND Patients with chronic medical and mental health comorbidities are at increased risk of hospital admission, but little is known about their hospital utilization patterns or whether nurse-directed transitional care interventions have any appreciable impact on future hospitalizations. (
  • We hypothesize that reasons for admission and readmission may vary greatly among patients with complex needs and that there may be multiple hospital systems involved. (
  • Objectives To investigate patient characteristics of an unselected primary care population associated with risk of first hospital admission and readmission for acute exacerbation of chronic obstructive pulmonary disease (AECOPD). (
  • 794 (11%) had at least 1 readmission and the risk of readmission increased with each admission. (
  • More severe COPD and COPD admission prior to primary care diagnosis were associated with increased risk of AECOPD readmission in an adjusted Prentice-Williams-Peterson model. (
  • High BMI was associated with a lower risk of first AECOPD admission and readmission. (
  • Prompt diagnosis in primary care may reduce the risk of AECOPD admission and readmission. (
  • We included patient-level variables and admission-level variables. (
  • Patients at risk of future readmission suffered from comorbidity, consumed more drugs, and were frequent users of in- and outpatient health care services in the year prior to the index admission. (
  • Factors related to index admission were only weakly associated with readmission. (
  • Event-free survival in the subgroups of the programme and control groups consisting of A patients whose original admission was due in part to failure to adhere to their therapeutic regimen, and B the others. (
  • Causes of readmission depend on when they are assessed, and noncardiovascular causes are more common farther out from the initial admission, the authors noted. (
  • Using a national all-payer administrative database, we describe the epidemiology of 30-day unplanned readmissions in patients on hemodialysis, determine concordance of reasons for initial admission and readmission, and identify predictors for readmission. (
  • The Clinical Classification Software was used to categorize admission diagnosis into mutually exclusive clinically meaningful categories and determine concordance of reasons for admission on index hospitalizations and readmissions. (
  • Patients admitted more frequently show lower risks of dying on average per admission. (
  • This was attributed to patient comorbidities. (
  • In the study, multivariate hazard models adjusted for relevant patient comorbidities, compared 30-day asthma- and COPD-related readmissions of patients with allergic and non-allergic rhinitis with those patients without that diagnosis, says Singh. (
  • When patients have asthma or COPD we tend to focus on treating the lower respiratory, but we also need to focus on comorbidities to help improve management of their illness," says Bernstein, an expert in allergies and also a UC Health physician. (
  • Objective To evaluate the primary diagnoses and patterns of 30 day readmissions and potentially avoidable readmissions in medical patients with each of the most common comorbidities. (
  • Patients with neoplasm, heart failure, and chronic kidney disease had a higher risk of potentially avoidable readmissions than did those without those comorbidities. (
  • Functional status is a frequently overlooked risk factor for readmissions and is a more valuable predictor of readmission risk than medical comorbidities in the medically complex inpatient rehabilitation population. (
  • This study of over 12,000 medically complex patients in the Uniform Data System for Medical Rehabilitation admitted to inpatient rehabilitation facilities compared functional status to medical comorbidities as predictors of acute care readmissions. (
  • The study found that functional status - as measured by FIM, or functional independence measure - was a better predictor of acute care readmissions than medical comorbidities were, and lower functional status was correlated with a higher risk of readmission. (
  • The C statistic of a logistic model designed to predict hospital readmissions was .69 using just functional status as compared to .57 using just comorbidities. (
  • These data highlight an opportunity to better assess and treat non-cardiac comorbidities in order to reduce readmissions in this high-risk population. (
  • Patients with psychiatric comorbidities have extremely complex treatment needs, are at increased risk for avoidable hospital admissions and readmissions [ 1 , 2 ], and contribute disproportionately to overall health care costs. (
  • The enrollment procedures had very few exclusion criteria in order to mirror potential actual use by health systems, so that patients with a wide range of socioeconomic backgrounds and health comorbidities were enrolled in the study. (
  • another 14 formed the first cohort early in 2011 and found this framework to be a template for smooth, safe transitions, which is one component of reducing readmissions. (
  • No single approach has been repeatedly effective in reducing readmissions for older black patients. (
  • A second HRRP-related study, published Monday in JAMA Internal Medicine by University of Michigan researchers, indicated the program may have overstated its success in reducing readmissions. (
  • IMPACT: The use of remote monitoring technology is not yet ready for widespread adoption for the purposes of reducing readmissions. (
  • 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. (
  • MANHASSET, NY - A study from North Shore University Hospital's (NSUH) cardiothoracic surgery department demonstrated a very significant reduction in hospital readmissions after coronary artery bypass graft (CABG) surgery. (
  • We hypothesize that measurement of HbA1c is associated with a reduction in readmission rates in individuals admitted to the hospital. (
  • Because of the reduction in hospital admissions, the overall cost of care was $460 less per patient in the treatment group. (
  • The readmissions reduction program, which was established by the Patient Protection and Affordable Care Act, took effect in fiscal year 2013. (
  • A recent Wall Street Journal article shines a light on remote patient monitoring and post-acute care coordination, a service that is experiencing rapid growth and focusing on readmission rate reduction. (
  • 0.001), implying a 56% relative reduction in the risk of 30-day readmissions compared with conventionally managed patients. (
  • The annual estimated cost of sepsis readmissions is about half the annual cost of all four of the conditions in Medicare's Hospital Readmissions Reduction Program, recent research shows. (
  • Policymakers have incorporated financial disincentives in the Inpatient Prospective Payment System (IPPS) to take effect in FY 2013 to encourage further reduction in the rate of related, avoidable readmissions in several key diagnostic categories, including heart failure, acute MI and pneumonia. (
  • QIO support for readmission reduction has been expanded under the Integrate Care for Populations and Communities (ICPC) initiative, which builds on the successes of the Care Transitions projects during the last three years. (
  • In 2010, UCLA launched a Readmission Reduction Program. (
  • The results demonstrate how predictive analytics is an important component of the Hospital Readmissions Reduction Program , as established by the Affordable Care Act to improve the quality of health care delivery, Bardhan said. (
  • Search our extensive library of COPD care and readmissions reduction resources, including best practices, research articles, educational materials and toolkits. (
  • The demonstration by Naylor and colleagues of a reduction in the 24-week readmission rate of hospitalized elderly patients who were followed by APNs highlights critical problem areas affecting the successful management of older transitional-care patients. (
  • These patients accounted for 18.8% (109,155 admissions) of all admissions and 23.2% ($3.4 billion) of total inpatient charges for the study cohort during the entire follow-up period. (
  • Results: Approximately 17.5% of patients were readmitted in each cohort. (
  • A cumulative risk score of ≥25 points identified 5% of patients with a readmission risk of approximately 30% in each cohort. (
  • The study involved a cohort of 272,758 adult patients with diabetes who had been discharged from the hospital between January 1, 2009 and December 31, 2014. (
  • By analyzing a cohort of patients admitted to Buffalo Medical Center and Millard Fillmore Gates Hospital in 2012, researchers were able to identify 131 ADHF patients. (
  • Results The training cohort included data on 91 922 patient episodes. (
  • The researchers randomly assigned patients to either a development cohort (n = 194,179) or a validation cohort (n = 193,899) and found similar mean 30-day unplanned readmission rates for both cohorts (11.35 percent vs. 11.36 percent respectively). (
  • Meng Y, Speier W, Shufelt C, Joung S, E Van Eyk J, Bairey Merz C, Lopez M, Spiegel B, Arnold C. A Machine Learning Approach to Classifying Self-Reported Health Status in a Cohort of Patients With Heart Disease Using Activity Tracker Data. (
  • Exploring and identifying patterns of risk factors for acute, all-cause 30-day readmission in a Danish cohort of patients aged 65+. (
  • Design, setting, participants, & measurements This is a retrospective cohort study using the Nationwide Readmission Database from the year 2013 to identify index admissions and readmission in patients with ESRD on hemodialysis. (
  • Elderly individuals--those age 65 years or older--make up 43 percent of Americans undergoing an inpatient operation* and are more likely than younger patients to have postoperative complications, results of multiple studies show. (
  • And preventing ICU readmission avoids transitions to and from the SICU and the general inpatient ward. (
  • OBJECTIVE To explore the relationship between inpatient diabetes education (IDE) and hospital readmissions in patients with poorly controlled diabetes. (
  • 5 ) showed that 30% of these patients were hospitalized more than once within 1 year, and these patients accounted for a majority of the inpatient costs for patients with diabetes. (
  • There were 2,409 inpatient hospitalizations that were eligible to measure readmission (also called indexadmissions) and adhered to at least one core measure. (
  • These challenges are perhaps most salient when patients are transitioning from an acute inpatient setting to an outpatient service setting. (
  • Is readmission a valid indicator of the quality of inpatient psychiatric care? (
  • The randomized controlled trial had the power to detect a 5% absolute decrease in 30-day readmission rates, which was the primary outcome of the study. (
  • Survival for 90 days without readmission, the primary outcome measure, was achieved in 91 of the 142 patients in the treatment group, as compared with 75 of the 140 patients in the control group, who received conventional care (P = 0.09). (
  • The primary outcome was readmission of discharged heart failure patients to the hospital within 30 days from any cause. (
  • Although it may be necessary to readmit some patients, the striking rate of readmission demands efforts to further clarify the determinants of readmission and develop strategies in terms of quality of care and care transitions to prevent this adverse outcome,' the research team wrote. (
  • Outcome measures Clinical and patient characteristics of readmission versus non-readmission episodes, proportion of readmission episodes at each LACE score, regression modelling of variables associated with readmission to assess the effectiveness of LACE and other variable combinations to predict 30-day readmission. (
  • Combined outcome of death or readmission for heart failure (emergency or elective). (
  • At 1 year, fewer patients in the specialist-nurse group than in the usual-care group had the combined outcome of death or readmission for heart failure, and fewer were readmitted for heart failure (Table). (
  • Outcome measures such as readmissions have often been proposed as indicators of the quality of care. (
  • Given the current limitations of available outcome measures, particularly the lack of appropriate risk adjustment methods, the group does not recommend the use of readmission for comparing healthcare providers for patients with HF. (
  • Hospital readmission is considered an adverse health outcome in older people, adding additional pressure on clinical resources within health care services. (
  • Outcome was acute, all-cause 30-day readmission. (
  • The primary outcome measure was the 1-year cumulative incidence of readmission or death. (
  • Studies investigating outcome in elderly patients from large datasets are lacking, particularly in central and eastern European countries. (
  • Although previous studies have examined healthcare utilization by sickle cell patients, none was so broadly based, Brousseau and colleagues asserted. (
  • We felt that if healthcare systems on a wide-scale basis were going to implement a follow-up phone-call intervention, they were likely to do something similar to this - get their callback center to call patients using a scripted survey - he explained here at the American Geriatrics Society (AGS) 2017 Annual Scientific Meeting. (
  • The current healthcare delivery model treats patients with COPD primarily when they present in an acute phase of the illness, but very few patients receive active management for the chronic component. (
  • Patient-level factors were grouped into four categories: sociodemographic factors, social support, health condition, and healthcare utilization. (
  • Until we begin making different decisions regarding how we allocate our resources, [hospital-dependent patients'] presence will be a constant reminder of which medical research and healthcare we consider worthy and which we do not,' Chen wrote. (
  • Healthcare IoT has the potential to greatly improve patient care - but it's not without its challenges. (
  • Demographics, readmission rates, healthcare system follow-up and weight loss were compared between cohorts, with and without a DSM-IV Axis-I psychiatric diagnosis. (
  • It is also acknowledged that early hospital readmission following an episode of acute critical illness is a major problem not only for patients' quality of life but also healthcare systems in general. (
  • According to researchers, better measures may be needed to assess the true impact of socioeconomic risk factors on hospital profiling based on 30-day congestive heart failure readmissions, and to fully explore the impact of CMS's new healthcare reform policies on hospital profiling. (
  • Healthcare reform has put a strong focus on avoidable hospital readmissions, penalizing institutions that have higher-than-expected readmissions rates. (
  • We see a great need for remote patient monitoring in the healthcare payer market," said Greg Bell, president of Healthx. (
  • Readmissions like these result in increased healthcare costs, functional decline and greater need for skilled nursing when transitioning back to community settings. (
  • Hospital readmissions are a large source of wasteful healthcare spending, and current care transition models are too expensive to be sustainable. (
  • Approximately $355 billion in healthcare spending is wasted each year in the United States as a result of failures of care delivery, poor care coordination, and overtreatment, including up to $44 billion attributable to unplanned hospital readmissions. (
  • Overall, the greatest odds of readmission were with the occurrence of any 30-day postoperative complication (odds ratio 5.1) and the need for a reoperation (odds ratio 2.8)--both NSQIP risk factors. (
  • Through the ACA, CMS has introduced 30-day readmission reimbursement penalties. (
  • Explain to interested patients that sickle cell disease results from a genetic defect in the gene for hemoglobin, leading to vaso-occlusive complications with severe pain. (
  • Our results suggest that pupil area is a novel way to identify heart patients at elevated risk of death or hospital readmission,' said study author Dr. Kohei Nozaki of Kitasato University Hospital, Kanagawa, Japan. (
  • 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. (
  • Results show that 78 percent of the cardiac patients had sleep apnea (81/104). (
  • The results revealed that the rates of 30-day all-cause readmission were 10.2% among white individuals, 12.2% among black individuals, 10.9% among Hispanics, and 9.9% among Asian individuals. (
  • RESULTS In all, 2,265 patients were included in the 30-day analysis and 2,069 patients were included in the 180-day analysis. (
  • Roughly 5.7 million people in the United States have heart failure, which kills about 300,000 each year, and results in repeat hospitalizations for many patients. (
  • DETROIT Heart patients' mental state and thinking abilities may help predict whether costly and potentially dangerous early hospital readmission will follow their release after treatment, according to the results of a significant new study by Henry Ford Hospital researchers. (
  • Results showed that the patients who had their dosage increased had a 20% 30-day readmission rate compared to 38.3% for those with the same or decreased dose ( P= 0.0285). (
  • Results: Among 10 731 discharges, 2398 (22.3%) were followed by a 30 day readmission, of which 858 (8.0%) were identified as potentially avoidable. (
  • While research results show heart failure patients with a higher socioeconomic status were less likely to be readmitted, the overall impact of socioeconomic status on heart failure readmission rates was very minimal. (
  • Our study results were unexpected and show our accounting for possible social risks of congestive heart failure patients does not alter the hospital rankings for heart failure readmission rates," says Alex Blum, MD, MPH, lead study author from the Department of Health Evidence and Policy at Icahn School of Medicine at Mount Sinai and the National Institutes of Health. (
  • These results add to the growing body of evidence that functional status is an important predictor of readmissions. (
  • The results indicate that patient profiles derived from our model can serve as the building block for clinical decision support system to identify patients with high CHF readmission risk. (
  • Results have significant implications for future initiatives to address the needs of black patients at risk for gaps in transitions and avoidable readmissions. (
  • A drug approved for use in controlling hallucinations and delusions in Parkinson's patients showed mix results in a trial among Alzheimer's sufferers. (
  • RESULTS A total of 1,717 patients were included in the final analysis. (
  • Results: The 30-day readmission rate was 10% (n=41). (
  • Results 61 patients were recruited acute admissions unit at the Queen Elizabeth Hospital Birmingham between 2013 and 2015, with 31 patients randomised to simvastatin and 30 to placebo. (
  • Results During 2013, there were 87,302 (22%) index admissions with at least one 30-day unplanned readmission. (
  • A Collaborative Blueprint for Reducing SNF Readmissions: Driving Results with Quality Reporting and Performance Metrics examines the evolution of the Tri-County SNF Collaborative, as well as the set of clinical and quality targets and metrics with which it operates. (
  • Readmission results were based on all allocated patients. (
  • Among patients 18 years or older, an observational analysis was conducted using Hospital Compare data on clinical performance, patient satisfaction, and 30-day risk-standardized readmission rates for acute myocardial infarction, heart failure, and pneumonia for the period July 2005 through June 2008. (
  • Other common cardiac causes of readmission were acute myocardial infarction between 0 and 7 days (27.6% of cardiac readmissions) and heart failure during all subsequent time periods (22.2% to 23.7% of cardiac readmissions). (
  • These penalties are geared to begin the process of moving from a "fee-for service" model in which transitions between acute and chronic disease states can be disconnected, to a patient centric, disease management system in which care is coordinated across the acute and chronic phases. (
  • 3, 4 However, a major barrier to the sustainability of traditional nurse-staffed transitional care interventions is their high cost relative to the readmission penalties they are designed to prevent. (
  • About half of the patients in his study who were readmitted to the hospital, for example, never saw a doctor after they were discharged. (
  • The federal agency is sponsoring 14 projects nationwide to study how transitional care can reduce readmissions. (
  • In a population-based study of more than 16,000 sickle cell patients hospitalized in eight states, the 30-day rehospitalization rate was 33.4% (95% CI 33.0% to 33.8%), of which two-thirds were readmitted within 14 days, according to David C. Brousseau, MD, of the Medical College of Wisconsin in Milwaukee, and colleagues. (
  • The higher utilization in our study may be explained by the inclusion of many patients who do not benefit from the type of comprehensive care that was provided" in that study, Brousseau and colleagues wrote. (
  • SAN ANTONIO - Having a nurse phone older adults discharged from the emergency department to help with medication use and appointment scheduling had no effect on readmission rates or on whether the patient followed up with a physician, according to a study of 2000 patients. (
  • The fact that Dr Biese and his team were able to study 2000 patients in a short period of time shows it was powered well, she added. (
  • More than one in 10 of the elderly patients in the new study had an unexpected readmission, according to study authors. (
  • Using the first three years of data from that pilot study, Dr. Turrentine's research team tested 13 geriatric characteristics and 26 NSQIP risk factors for complications in 6,039 elderly general surgery patients from the NSQIP database. (
  • This study examined whether pupil area could predict prognosis in patients with heart failure. (
  • The study was conducted in 870 patients hospitalised for acute heart failure in 2012 to 2017. (
  • Our study indicates that it could be used in daily clinical practice to predict prognosis in patients with heart failure, including those who also have atrial fibrillation. (
  • This study focuses on developing and testing a program that combines a community health worker (lay patient advocate, acting as a 'Patient Navigator') and a peer-led telephone support line to improve patient experience during hospital to home transition. (
  • One study reported that patients with large annular defects had a 21% rate of reoperation, compared to a 1% rate among patients with small or slit-type defects. (
  • A second study reported an 18% recurrent herniation rate in patients with large annular defects. (
  • Noting that nearly 1 in 5 patients in the studies had a large annular defect, Dr. Araghi and colleagues undertook a study to evaluate annular defect size and its effect on early reherniation and subsequent readmission in lumbar discectomy patients. (
  • A total of 13 of the 278 patients in Group B underwent reoperation (5.0%) at the index level within 90-days of initial surgery, compared to a 2.1% weighted average rate in Group A. Comparing the two groups, this study found that patients with large annular defects have more than twice the risk of early hospital readmission compared to the general discectomy population. (
  • The CABG patients who did not receive home health care through the Follow Your Heart program were three times more likely to either be readmitted to the hospital or pass away, the study found. (
  • A total of 401 patients participated in the study with 169 receiving cardiac surgery nurse practitioner (NP) home visits and 232 receiving usual care following CABG. (
  • To address this gap, this study examines time to readmission by indicators for recent marijuana use disorder in the presence of alcohol use disorder (AUD) and other drug use disorder. (
  • The overall purpose of this study was to explore individual perceptions of life purpose, health-related quality of life, and hospital readmissions among older adults with heart failure. (
  • To date, one previous study has reported a 1.7% readmission rate for 529 Laparoscopic Sleeve Gastrectomies (LSG). (
  • This study is a clarion call to detect, diagnose, and especially to treat sleep apnea in patients who are hospitalized for heart problems. (
  • The study involved 104 consecutive patients who reported symptoms of sleep apnea while being hospitalized for a cardiac condition such as heart failure, arrhythmias or myocardial infarction. (
  • The study aimed to investigate the racial/ethnic differences in all-cause readmission among patients with diabetes in the United States. (
  • A study in the October issue of the Journal of Clinical sleep medicine is the first to show that 30-day hospital readmission rates and emergency department visits are reduced in heart disease patients with sleep apnea who are treated with positive airway pressure therapy. (
  • SUBJECT AND METHODS: We performed a case-control study among patients discharged with a principal diagnosis of heart failure. (
  • Another Swiss heart failure readmissions study by Luthi, et al . (
  • Performance on a simple mobility test is the best predictor of whether an elderly heart attack patient will be readmitted, a Yale-led study reports. (
  • In this study, mobility was assessed using the Timed Up and Go (TUG) test, which involves timing patients as they stand up from a seated position and then walk 10 feet. (
  • The study by John E. Strobeck, MD, PhD and Wayne L. Miller, MD, PhD, of the Mayo Clinic appeared during the session entitled "Cardiotoxity, Cardiomyophathies and Heart Failure Readmissions" at the American College of Cardiology 2018 Scientific Session (1105-104). (
  • In this study, 81% (n=17) of early readmissions were deemed unavoidable and most (n=14, 66.7%) were attributed to non-ACS issues or disease progression. (
  • In our study, the estimated annual cost of sepsis readmissions amounted to more than $3.5 billion within the United States. (
  • Study: Memory problems, emotional stress result in early readmissions of hear. (
  • In the study, the researchers chose 84 patients who were admitted to Henry Ford Hospital for treatment of acute congestive heart failure. (
  • Educating patients about their mental illness, as well as involving live-in family members in helping with the patient's medications, and keeping medical appointments may also help reduce hospital readmissions, the study concluded. (
  • This study assessed the characteristics associated with 30-day hospital readmission in a large hospital Trust in the West Midlands. (
  • The purpose of this retrospective comparison study was to evaluate the difference in hospital readmissions between HF patients enrolled in a non-modified home palliative care program and a modified home palliative care program. (
  • A simple risk score model could help identify the risk of 30-day readmission in patients undergoing PCI, according to a recent study published in Catheterization and Cardiovascular Interventions . (
  • Upon applying the risk model to the study population, the researchers found that 15 percent of PCI patients scored ≥13 and 42 percent scored ≤6. (
  • This study may garner some attention because of its focus on 30-day hospital readmission rates which is one of the biggest economic markers of success for hospital systems," says Bernstein. (
  • The study also concludes that inclusion of a socioeconomic measure does not impact a hospital's RSRR profiling based on 30-day readmission. (
  • For their study, Dr. Benharash and colleagues reviewed data from The Society of Thoracic Surgeons Adult Cardiac Surgery Database for all patients who underwent non-emergency heart operations between 2008 and 2016 at Ronald Reagan UCLA Medical Center. (
  • This study develops a patient profiling model that can predict the propensity of readmission for a patient as well as the timing of future readmissions. (
  • The study answers three key questions: whether a readmission will occur, how often readmissions will occur and when a readmission will occur. (
  • Our study highlights the role of predictive analytics not only to identify high-risk patients, but also to reduce the costs associated with future readmissions of patients who suffer from chronic diseases," Bardhan said. (
  • This new study uses data from the Dallas-Fort Worth Hospital Council Research Foundation, which allowed the researchers to track patient readmissions across 18 counties in North Texas. (
  • Vollbrecht H, Arora V, Otero S, Carey K, Meltzer D, Press V. Evaluating the Need to Address Digital Literacy Among Hospitalized Patients: Cross-Sectional Observational Study. (
  • Speier W, Dzubur E, Zide M, Shufelt C, Joung S, Van Eyk J, Bairey Merz C, Lopez M, Spiegel B, Arnold C. Evaluating utility and compliance in a patient-based eHealth study using continuous-time heart rate and activity trackers. (
  • Two decades ago, a landmark study by the National Academy of Medicine (NAM) highlighted the prevalence of medical errors and called for a national commitment to reduce patient harm. (
  • LIMITATIONS This descriptive study reports on a nonrandomized intervention and its impact on service utilization for Medicaid patients with complex illnesses in North Carolina. (
  • A study was undertaken to measure the validity and predictive ability of readmission in this context. (
  • An evaluation study was performed in patients discharged alive with heart failure from three Swiss academic medical centres. (
  • The aim of this study is to identify the magnitude of avoidable readmissions, its contributing factors and costs in Hong Kong. (
  • Our study found that almost half of the readmissions could have been prevented. (
  • Chronic obstructive pulmonary disease (COPD) is largely managed in primary care and our study uses high-quality routine primary care data for all patients with COPD diagnosed in primary care in participating general practices, and therefore reflects the characteristics of patients in the population with COPD. (
  • Simvastatin to modify neutrophil function in older patients with septic pneumonia (SNOOPI): study protocol for a randomised placebo-controlled trial. (
  • Approximately one in four patients who underwent percutaneous coronary interventions (PCI) had an unplanned readmission within six months, a study found. (
  • 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. (
  • One recent study described a gradient of patient capability or willingness for self-care and the extent of caregiver contribution. (
  • Efficacy and safety of upadacitinib in Japanese patients with rheumatoid arthritis (SELECT-SUNRISE): a placebo-controlled phase IIb/III study. (
  • The objective of this study is to show how mobile technology can use the observations of nonmedical workers to stratify patients on the basis of their hospital readmission risk. (
  • This study aimed to determine whether a pharmacist-led medication review programme could reduce inappropriate medications and hospital readmissions among geriatric in-patients in Hong Kong. (
  • This is the first prospective controlled study of the effect of a pharmacist-led medication review programme on medication use and health services utilisation among hospitalised Chinese elderly patients in Hong Kong. (
  • In one hospital study, 44% of patients were prescribed at least one unnecessary drug, with the most common reason being lack of indication. (
  • In this study, our primary aim was to explore the association between 30-day hospital readmission for patients aged ≥65 years and socioeconomic characteristics of the studied population. (
  • However, in our study, elderly 30-day readmission was associated with low neighbourhood socioeconomic status. (
  • High 30-day rehospitalization rates are usually chalked up to inadequate outpatient care, the researchers suggested in the April 7 Journal of the American Medical Association -- the first population-based analysis of acute care utilization among sickle cell patients. (
  • The purpose of this white paper is to describe the causes of unacceptably high 30-day readmission rates and to identify the principles and components of a methodology to prevent COPD patient readmissions. (
  • Background and objectives Patients on hemodialysis have high 30-day unplanned readmission rates. (
  • When the researchers looked at geriatric risk factors by procedure type, they discovered that use of a mobility aid had the highest readmission odds for the thyroid/esophagus group (odds ratio 11). (
  • The investigators evaluated statistically significant predictors of readmission within 30 days following the operation, both overall and for each of five surgical procedure groups. (
  • Other strong predictors of readmission within 30 days were prior chronic lung disease, arrhythmias, and acute kidney injuries. (
  • Within 24 hours after the patient was discharged the telemedicine equipment was installed at the patient's home by a technician, who also collected and cleaned the equipment after use. (
  • Using a standard measure for a patients' socioeconomic status , did not impact hospital-level rankings and 30-day congestive heart failure patient's readmission. (
  • Prior work in readmission risk prediction has under-utilized laboratory data, which may provide valuable information about a patient's condition. (
  • Its readmission rate for heart patients, at 27.8 percent, is slightly higher than the national average of 24.5 percent. (
  • Larger values (higher respiratory rate, higher blood glucose level, and so on) indicated a greater risk for readmission. (
  • At the same time, it would follow that patients with defects smaller than 6 mm would have an even lower rate of recurrent herniation than the cited 2.1% rate. (
  • The 30-day readmission rate for patients receiving the typical care after this surgery was 11.54 percent, while those receiving home health care had a readmission rate of 3.85 percent. (
  • Such a "disconnect" may be related to the U.S. national average 30-day readmission rate of 23% for patients who are hospitalized with a COPD exacerbation. (
  • Finding a reduced 30-day cardiac readmission rate in PAP-adherent patients is important for improving both patient care and hospital finances," said principal investigator and senior author Dr. Richard J. Schwab, Professor in the Department of Medicine and co-director of the Penn Sleep Center at the University of Pennsylvania Medical Center in Philadelphia. (
  • During the first 10 months of 2013, the safety-net provider's readmission rate dropped to 14.25 percent. (
  • A decreasing LOS over time has been associated with an increasing readmission rate at the population level. (
  • However, this increasing readmission rate may represent many factors including patients' overall health status. (
  • Thus, the rate of readmission may represent a burden of illness rather than a valid metric for quality of care. (
  • We've seen a great impact on the readmission rate. (
  • Patients with a psychiatric diagnosis undergoing bariatric surgery have a low early readmission rate, a high rate of postoperative follow up, and similar postoperative weight loss compared to patients without a concurrent psychiatric diagnosis. (
  • COPD patients with allergic rhinitis may be readmitted 2.4 times the rate within 30 days of discharges compared to COPD patients without allergic rhinitis, says Singh. (
  • Conclusion: Among patients hospitalized for HF, older, but not younger, Hispanics had a higher 30-day readmission rate versus others. (
  • The median time to readmission was 35 days (interquartile range, 14 to 79 days), and peak readmission rate occurred at seven days. (
  • The risk score derived from the nonmedical workers' observations had a significant association with 30-day readmission rate with an odds ratio (OR) of 1.12 (95 percent confidence interval [CI], 1.09-1.15) compared to an OR of 1.25 (95 percent CI, 1.19-1.32) for the risk score using nurse observations. (
  • Factors affecting early unplanned readmission of elderly patients to hospital. (
  • 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. (
  • PURPOSE: To determine if early unplanned readmissions of patients hospitalized for heart failure are associated with suboptimal in-hospital care or with the clinical and demographic characteristics of the patient. (
  • A nurse who worked at the hospital's callback center was trained to phone patients 65 years and older who were discharged from the emergency department in the previous 1 to 3 days. (
  • Future research is needed to identify intervention strategies to reduce readmission rates, as well as identify the broader nonclinical factors that may be related to risk of 30-day readmission, such as access to and coordination of care, social support, and hospital culture and organizational behavior. (
  • A multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart failure. (
  • A nurse-directed, multidisciplinary intervention can improve quality of life and reduce hospital use and medical costs for elderly patients with congestive heart failure. (
  • An inexpensive, routine blood test could hold the key to why some patients with congestive heart failure do well after being discharged from the hospital and why others risk relapse, costly readmission or death within a year, new Johns Hopkins research suggests. (
  • In addition, substance abuse and chronic kidney disease may also adversely impact these rates in congestive heart failure patients. (
  • Risk of readmission is elevated in patients congestive heart failure (CHF), and clinical decision makers need to better understand risk factors for 30-day readmissions. (
  • Experts have estimated that $12 billion of the annual costs of caring for congestive heart failure could be prevented through prevention of readmissions. (
  • Researchers at The University of Texas at Dallas developed a predictive analytics model that can identify congestive heart failure patients with high readmission risk and potentially help stymie those costs. (
  • 363 patients ≥ 65 years of age (mean age 75 y, 50% men, 55% white) who were admitted from home with 1 of the following: congestive heart failure, angina, myocardial infarction, respiratory tract infection, coronary artery bypass graft, cardiac valve replacement, major bowel procedure, or lower-extremity orthopedic procedures. (
  • Health related quality of life in patients with congestive heart failure: comparison with other chronic diseases and relation to functional variables. (
  • However, the researchers noted their ability to predict readmission risk improved with the added geriatric-specific risk factors. (
  • 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. (
  • Both suggest a possible way to predict readmission and avoid it," Ketterer says. (
  • The goal was to provide a foundation for development of safe and effective holistic intervention strategies to decrease costly hospital readmissions for patients with heart failure. (
  • Increasing surgeon experience may result in further decrease of readmission rates following LSG. (
  • Michtalik says a good next step would be a prospective randomized trial that examines whether hospitalized heart failure patients do better when their doctors work intensively to decrease the heart failure marker over the course of their hospital stays. (
  • Almost half of the heart patients who died after leaving the hospital were discharged directly to hospice, Rohan Khera, MD, lead author and clinical fellow at University of Texas Southwestern Medical Center in Dallas, said in the news release. (
  • This analysis of a large clinical database (74 million unique encounters corresponding to 17 million unique patients) was undertaken to provide such an assessment and to find future directions which might lead to improvements in patient safety. (
  • The present analysis of a large clinical database was undertaken to examine historical patterns of diabetes care in patients with diabetes admitted to a US hospital and to inform future directions which might lead to improvements in patient safety. (
  • COE clinical pathways were followed consistently for all patients. (
  • all resolved their presenting clinical problems with conservative management during readmission hospital stays of 1 - 7 days (mean = 3.5). (
  • The monthly, peer-reviewed Journal of Clinical Sleep Medicine is the official publication of the American Academy of Sleep Medicine, a professional membership society that improves sleep health and promotes high quality patient centered care through advocacy, education, strategic research, and practice standards ( ). (
  • Our research suggests that maybe clinical judgment isn't enough to decide whether a heart failure patient is ready to be discharged," he says. (
  • However, they were strongly associated with the patients' clinical and demographic characteristics. (
  • During the TVC the nurse made clinical observations (i.e. dyspnoea, general condition, physical activity, anxiety), measured saturation and lung function and informed the patients how to prevent exacerbations and how to use the medication. (
  • Clinicians have often relied on their 'clinical intuition' to incorporate patients' functional impairments into prognosis," said Sarwat Chaudhry , M.D., principal investigator and associate professor of medicine at Yale. (
  • Objective To assess how well the LACE index and its constituent elements predict 30-day hospital readmission, and to determine whether other combinations of clinical or sociodemographic variables may enhance prognostic capability. (
  • One of every three readmissions was avoided for their highest-risk patients with complex clinical presentations. (
  • They had been mainly due to clinician and patient factors, in particular, both of which were intimately related to clinical management and patient care. (
  • This randomized controlled clinical trial involved 279 HF patients who were discharged from a tertiary-care hospital between February 2001 and June 2002. (
  • 3 It has been shown that implementation of a clinical pharmacist service has a positive effect on medication use and health care service utilisation among hospitalised patients. (
  • In a subgroup of 126 patients, quality-of-life scores at 90 days improved more from base line for patients in the treatment group (P = 0.001). (
  • In October 2013, the COPD Foundation convened a multi-stakeholder National COPD Readmissions Summit to summarize their understanding of how to reduce hospital readmissions in patients hospitalized for COPD exacerbations. (
  • The statistical model suggests that the relationship between the probability of readmission and the HbA1c measurement depends on the primary diagnosis. (
  • Our sample consisted of 4,349 patients with a primary diagnosis of schizophrenia spectrum disorder (SSD) in 2005 in individually linked California Health Care Cost and Utilization Project (CA HCUP) data. (
  • Dr. Tiep is the Director of Pulmonary Rehabilitation at City of Hope Medical Center in Duarte, CA and Medical Director of the Respiratory Disease Management Institute in Monrovia, CA. He has published articles on pulmonary rehabilitation disease management, and co-authored the American Thoracic Society/European Respiratory Society 2004 Standards for the Diagnosis and Treatment of Patients with COPD. (
  • It is not difficult to look for readmissions with the same DRG or ICD-9 diagnosis codes, however this approach fails to identify readmissions that involve complications or worsening of an initial illness, medication intolerance, or other events that may be clinically linked to the initial stay. (
  • Our objective was to determine whether a DSM-IV Axis-I diagnosis impacts early postoperative readmission rates, follow-up rates, and weight loss after bariatric surgery. (
  • A DSM-IV Axis-I psychiatric diagnosis was present in 143 (57.4%) of the patients at the time of surgery (PD group), while 106 (42.6%) of the patients had no psychiatric diagnosis (NPD group). (
  • The majority of patients at this Veterans Affairs medical center had a DSM IV Axis-I psychiatric diagnosis at the time of bariatric surgery. (
  • In patients with a comorbidity of heart failure, diabetes, ischemic heart disease, atrial fibrillation, or chronic kidney disease, the most common diagnosis of potentially avoidable readmission was acute heart failure. (
  • Methods We identified 54,953 patients hospitalised for HF with a comorbid diagnosis of COPD in the National Readmissions Database in the United States, in 2012. (
  • Depending on the diagnosis, 5-29% of adults are readmitted to the same hospital within 1 month, 5 and readmission rates have been shown to approach 50% within 6 months for patients discharged with heart failure (HF). (
  • Participants Data from 7002 patients from 72 general practices with a COPD diagnosis date between 2000 and 2008 recorded in their primary care record. (
  • We used Central Denmark's (Midt)-Electronic Patient Journal to identify patients with a Z03*-diagnosis among patients admitted to the AMAU, Aarhus University Hospital Nørrebrogade from April 2012 to March 2013, and noted any specification of diagnosis. (
  • Methods 'SNOOPI' was a phase-4, randomised controlled trial comparing 7-days of 80mg simvastatin with placebo in patients aged 55 years or over admitted to hospital with septic pneumonia. (
  • MHA also participated in the Reducing Avoidable Readmissions Effectively (RARE) campaign, which aimed to prevent 4,000 avoidable hospital readmissions between July 1, 2011, and Dec. 31, 2013. (
  • These states account for an estimated 33% of all U.S. patients with sickle cell disease, the researchers said. (
  • CHICAGO: Researchers have examined new geriatric-specific characteristics that appear to raise the risk of elderly surgical patients having an unplanned hospital readmission within a month of initially leaving the hospital. (
  • To validate the accuracy of their predictive nomogram, the researchers tested it using data from 577 additional SICU patients, who were not among the admissions data used to develop the model. (
  • After adjusting for length of stay, age, sex and severity of illness, researchers found that the likelihood of readmission was even lower among patients discharged with the electronic tool. (
  • The researchers found that patients whose protein levels dropped by less than 50 percent over the course of their hospital stay were 57 percent more likely to be readmitted or die within a year than those whose levels dropped by a greater percentage. (
  • Hospital readmissions are costly and detrimental to patient health, so an applicable risk model can support efforts to avert early readmissions, say the researchers. (
  • CINCINNATI--Patients hospitalized for either asthma or chronic obstructive pulmonary disease (COPD) have a higher risk of being readmitted for a hospital stay within 30 days of release if they also suffer from chronic rhinitis, according to a trio of researchers at the University of Cincinnati (UC). (
  • For each patient a standard socioeconomic index score was used by the researchers based on his or her zip codes average income and educational level. (
  • However, according to researchers the current CMS model only accounts for patient age, gender, and co-morbid health conditions and lacks measures of socioeconomic or social status. (
  • The researchers identified 4,877 patients, of whom nearly 20% of were discharged on a weekend or holiday. (
  • The model also allowed the researchers to examine the association between hospital usage of health information technologies (IT) and readmission risk. (
  • If confirmed by further research, health officials may need to reconsider the participation of heart failure patients in the program, researchers said. (
  • More than 225 individuals participated in the Summit, including patients, clinicians, health service researchers, policy makers and representatives of academic health care centers, industry and payers. (
  • The researchers sought to determine if these devices could be useful in preventing 180-day all-cause hospital readmissions for heart failure patients. (