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 ...

This is the first study reporting the characteristics of all COPD admissions to public hospital in Hong Kong. In our study, we found that there were high admission and unplanned readmission rates in Hong Kong and 8.0% of admission episodes to medical wards were COPD admissions. As medical admissions contributed to approximately half of the total admission in HA, our figure of 8.0% was comparable to the COPD annual admissions of 4% of the total admissions reported by HA in year 2008-2009 [17]. This figure was significantly higher than previously reported in UK, which was around 1% [4]. Admission and readmission to hospital are very common among COPD patients discharged from hospital after an acute exacerbation [18]. 80% of patients requiring inpatient management of a severe exacerbation are readmitted with a year [19]. Unplanned readmission has a great impact on hospital stay and healthcare expenses [20, 21] but unplanned readmission of COPD is seldom reported. In our study, the unplanned ...

The Idaho Statesman (http://bit.ly/2curtHe ) reports that the Centers for Medicare and Medicaid Services shows that just one in eight of more than 28,000 hospital admissions in Idaho resulted with patients returning for further care in 2015.. ...

Impact of structured rounding tools on time allocation during multidisciplinary rounds: an observational study. Abraham J, Kannampallil TG, Patel VL, et al. JMIR Hum Factors 2016 Dec 9;3(2):e29. Access the abstract on PubMed®.. How physician perspectives on E-prescribing evolve over time. A case study following the transition between EHRs in an outpatient clinic. Abramson EL, Patel V, Pfoh ER, et al. Appl Clin Inform 2016 Oct 26;7(4):994-1006. Access the abstract on PubMed®.. Enhancing the evidence for behavioral counseling: a perspective from the Society of Behavioral Medicine. Alcántara C, Klesges LM, Resnicow K, et al. Am J Prev Med 2015 Sep;49(3 Suppl 2):S184-93. Access the abstract on PubMed®.. Morbid obesity and use of second generation antipsychotics among adolescents in foster care: evidence from Medicaid. Allaire BT, Raghavan R, Brown DS. Child Youth Serv Rev 2016 Aug;67:27-31. Epub 2016 May 30. Access the abstract on PubMed®.. Population well-being measures help explain geographic ...

Our results indicate that derived health literacy estimates can be used as proxies for test-based measures to conduct health literacy research on a larger scale than previously feasible with direct assessments. Using derived health literacy estimates at the census block group level, our findings suggest that health literacy is a significant, independent predictor of having a readmission within 30-days of discharge from a hospital stay for AMI; it is also predictive of the number of readmissions experienced by a patient within this timeframe. To our knowledge, this is the first study investigating the association between health literacy, albeit a derived estimate, and 30-day hospital readmission on a population level.. Agreement between the derived health literacy estimates and individual, test-based measures was fair, but less than ideal. This is understandable, as the estimates are based on a neighbourhood average and not individual performance. Interestingly, the levels of agreement between ...

3 days. Univariate analysis and multivariable logistic regression were performed to assess the impact of hospital length of stay on unplanned readmission after adjusting for an array of patient factors.. Results:. A total of 91,102 patients, were included in the analysis. The median age of the study sample was 59 years with 50.5% males. Median length of stay varied by procedure: ACDF, Lumbar Discectomy: 1 day; Lumbar Laminectomy: 2 days, PLF: 3 days. Rate of unplanned readmission was 4.1% (3,678 patients) for all four spinal procedures[ACDF: 3.0% (n=525), Lumbar Discectomy: 3.7% (n=377), Lumbar Laminectomy: 4.4%(n=714), PLF: 4.5% (n=2062)]. Overall, LOS > 3 days was associated with an increased likelihood for unplanned readmission(OR: 1.26; CI: 1.14-1.38, Ref: LOS=3 days) while LOS< 3 days did not confer an increased risk(OR: 0.95; CI: 0.87-1.04, Ref: LOS=3 days). Further analyzing by each procedure, LOS>3 days was associated with higher odds of readmission following Lumbar Laminectomy(OR: 1.3; ...

Background. Patients hospitalized for heart failure (HF) are at high risk of readmission. Chronic obstructive pulmonary disease (COPD) is one of the most prevalent comorbidities in this population. However, few data and only small studies describe the impact of COPD on the risk of readmission.. Methods and results. Hospitalizations for HF were identified in the 2012 National Readmissions Database. We compared clinical characteristics and the risk of all-cause, cardiovascular (CV) and respiratory-related readmission for patients with and without COPD. We included 225,160 patients hospitalized for HF among whom 54,953 had comorbid COPD. Patients with COPD were younger (median age 76 years COPD versus 77 years without COPD; p , 0.001), had a higher burden of comorbidity and were more frequently male (53% versus 49%, p , 0.001). Thirty-day all-cause readmission risk was two-fold greater in patients with COPD compared to those without COPD (adjusted HR 2.02, 95%CI 1.97-2.08). Most readmissions were ...

TY - JOUR. T1 - Risk factors for hospital readmission of patients with heart failure. T2 - A cohort study. AU - Sadeq, Adel. AU - Sadeq, Ahmed. AU - Sadeq, Asil. AU - Alkhidir, Israa. AU - Aburuz, Salahedin. AU - Mellal, Abdullah. AU - Al Najjar, Munther. AU - Elnour, Asim. PY - 2020/7/1. Y1 - 2020/7/1. N2 - Aim: The aim of this study was to develop a risk factor model for hospital readmission in patients with heart failure. Background: Identification of risk factors and predictors of readmission to hospital in patients with heart failure is very crucial for improved clinical outcomes. Objective: The objective of the current study was to investigate and delineate the risk factors that may be implicated in putting a patient at greater risk of readmission due to uncontrolled heart failure. Materials and Methods: This is a prospective follow-up cohort study of 170 patients with heart failure at a tertiary hospital in Al Ain city in the United Arab Emirates. We have developed a risk factor model ...

Hospital admission for congestive heart failure is extremely common and quite expensive, although it is frequently preventable. New drugs and therapies have been reported to reduce admissions, decrease morbidity and mortality, and improve the quality of life for these patients. Patients with an ejection fraction less than 40 percent (decreased systolic function) should be treated with medication to improve symptoms and prevent progression of heart failure. Angiotensin-converting enzyme (ACE) inhibitors are a mainstay of treatment in patients who can tolerate them; in patients who cannot take these drugs, angiotensin II receptor blocking agents offer an alternative. Patients with New York Heart Association class II or III heart failure should also receive a beta blocker (metoprolol, carvedilol or bisoprolol). Recent research has shown that treatment with spironolactone improves mortality and hospital readmission rates. An exercise program should also be recommended for all patients with heart failure

Background: Patients, providers, and health systems are focused on reducing readmissions for patients with acute decompensated heart failure (ADHF). Readmission after hospitalization is common and often secondary to HF decompensation, but it remains challenging to identify patients at-risk. Bioimpedance is a validated marker of thoracic fluid accumulation. We examined whether transthoracic bioimpedance, measured using a Fluid Accumulation Vest (FAV), predicted HF decompensation in advance of a clinical event in patients discharged after ADHF.. Methods: Participants included 42 patients hospitalized for ADHF. Participants were trained on the use of a FAV-smartphone dyad to obtain and transmit a 5-minute bioimpedance measurement once daily for 45-days after discharge. Readmission and diuretic dosing adjustments were identified using participant report and causes adjudicated using medical records. Daily bioimpedance was analyzed using the HF detection strategy shown in Figure. Receiver operating ...

TY - JOUR. T1 - Predictors of 30-day readmission after subarachnoid hemorrhage. AU - Singh, Mandeep. AU - Guth, James C.. AU - Liotta, Eric. AU - Kosteva, Adam R.. AU - Bauer, Rebecca M.. AU - Prabhakaran, Shyam. AU - Rosenberg, Neil. AU - Bendok, Bernard R.. AU - Maas, Matthew B.. AU - Naidech, Andrew M.. PY - 2013/12/1. Y1 - 2013/12/1. N2 - Background: Readmission within 30 days is increasingly evaluated as a measure of quality of care. There are few data on the rates of readmission after subarachnoid hemorrhage (SAH). Objective: We sought to determine the predictors of 30-day readmission in patients with SAH. Methods: We prospectively identified 283 patients with SAH admitted between 2006 and 2012. Readmission was determined by means of an automated query with confirmation in the electronic medical record. Results: Overall, 21 (8 %) patients were readmitted for infection (n = 8), headache (n = 5), hydrocephalus (n = 4), cardiovascular causes (n = 2), medication-related complications (n = 1), ...

In a study population comprising 7 diverse hospitals and 39,604 adults of all ages hospitalized for a broad range of medical reasons, an electronic model utilizing EMR data routinely available within 24 h of admission identified patients at high risk of post-discharge death or readmission events early in their hospitalization.. Adding information available on discharge (e.g. length of stay and other comorbidities) to the electronic model had a small incremental benefit in predicting the risk of readmission and death, but no significant impact on predicting the risk of readmission alone. This suggests that meaningful patient-level risk stratification of readmission risk can occur early in the hospital stay without waiting for further information at time of discharge. The electronic model does not require manual computation by staff and was constructed such that it can be calculated directly from the commonly used commercial EMR employed by this diverse group of 7 hospitals. With wide-spread ...

Surgical site infection (SSI) is the third most common healthcare-associated infection, yet is the most costly in terms of resources. Objective: To improve patient care experience, develop better links between acute and community care and reduce readmissions for SSI. Methods: To reduce cardiac SSI, a photo of the surgical wound was taken on the day of hospital discharge (Photo at Discharge = PaD), accompanied by individualised information for patients and carers. Patient feedback was sought via a postal questionnaire (85% return rate) and telephone follow-up. A prospective surveillance service monitored SSI rates on readmission. Results: Observational audit and SSI surveillance data collected over a 21-month period suggest PaD is associated with four times lower readmission rates for incisional SSI (p=0.0344). The potential savings are estimated at £15,000 per deep incisional SSI prevented. Discussion: PaD is associated with improved patient experience, a reduction in incisional SSI readmission rates

Results 18 PEG procedures, out of a total of 812, resulted in a readmission within 8 days (2.2%). These included both push (33.3%) and pull (66.6%) techniques. The table below displays the indication and complication of each readmission. 4 readmissions were deemed innocent patient concerns that could be attributed to trivial post-PEG symptoms.. 3 peritonitis cases were identified (0.3%), all of which were to facilitate head and neck cancer treatment. Case 1 had a BMI of 40, underwent push PEG and was found to have suture dislodgement at laparotomy. Case 2 underwent pull PEG, had peritoneal leakage and was found to have a PEG sited through colonic mesentery into posterior stomach at laparotomy requiring repair. Case 3 underwent push PEG and experienced severe pain post-procedure resulting in early suture removal and subsequent presentation with PEG malposition in peritoneal space. No adverse factors concerning PEG insertion technique were identified. ...

Background: Electroconvulsive therapy, ECT, is an effective acute treatment for severe depression. Today ECT is usually discontinued when the patients depressive symptoms abate, although relapse is common. Some studies suggest that continuation ECT (cECT) may prevent relapse of depression, but there are few studies available. Aims: The aim of this study was to describe the need for inpatient care before, during and after cECT. Methods: A retrospective chart. review was conducted of all patients (n=27) treated with cECT between 2005 and 2007 at Orebro University Hospital, Sweden. All patients were severely depressed at the initiation of index ECT. The DSM-IV diagnoses were major depression (n=19), bipolar depression (n=5) or schizoaffective depression (n=3). Results: The hospital day quotient was lower (HDQ=15) during cECT (mean duration+/-standard deviation=104+/-74 days) than during the 3 years prior to cECT (HDQ=26). The rehospitalization rate was 43% within 6 months and 58% within 2 years ...

This meta-analysis reviewing 44 publications dealing with over 1.5 million patients undergoing LC identified that, on average one in thirty patients are readmitted within 30 days. This reflects the findings of Tang et al. [75], in their meta-analysis comparing day case and inpatient LC, which reported a mean post discharge readmission rate of 2.4%, and an in-patient admission rate of 13.1%. Readmission rates were not found to be statistically significantly different between large studies and small studies (Figures 3 and 4), nor whether the surgery was undertaken in Europe [31, 50] or North America [8, 33]. Readmission has become a quality indicator in the delivery of medical care [70, 75]. This relates to both the inconvenience to patients, the cost, resource utilisation and the associated morbidity and potential mortality. Cholecystectomy itself is one of the commonest procedures undertaken with over one million cholecystectomys performed in the US annually [1, 2]. A readmission rate of 3% ...

Abstract, originally published in Epilepsia. Objective: To assess whether epilepsy is associated with increased odds of 30-day readmission due to psychiatric illness during the postpartum period.. Methods: The 2014 Nationwide Readmissions Database and the International Classification of Disease, Ninth Revision, Clinical Modification codes were used to identify postpartum women up to 50 years old in the United States, including the subgroup with epilepsy. The primary outcome was 30-day readmission and was categorized as (1) readmission due to psychiatric illness, (2) readmission due to all other causes, or (3) no readmission. Secondary outcome was diagnosis at readmission. The association of the primary outcome and presence of epilepsy was examined using multinomial logistic regression.. Results: Of 1 558 875 women with admissions for delivery identified, 6745 (.45%) had epilepsy. Thirteen of every 10 000 women had 30?day psychiatric readmissions in the epilepsy group compared to one of every 10 ...

Boockvar, K. S., Halm, E. A., Litke, A., Silberzweig, S. B., McLaughlin, M., Penrod, J. D., Magaziner, J., Koval, K., Strauss, E. and Siu, A. L. (2003), Hospital Readmissions After Hospital Discharge for Hip Fracture: Surgical and Nonsurgical Causes and Effect on Outcomes. Journal of the American Geriatrics Society, 51: 399-403. doi: 10.1046/j.1532-5415.2003.51115.x ...

All medical discharges: All medical DRGs. All surgical discharges: All surgical DRGs. Acute myocardial infarction (CMS definition (excluded one-day stay): principal diagnosis code (ICD-9) 410.00, 410.01, 410.10, 410.11, 410.20, 410.21, 410.30, 410.31, 410.40, 410.41, 410.50, 410.51, 410.60, 410.61, 410.70, 410.71, 410.80, 410.81, 410.90, and 410.91. Congestive heart failure (CMS definition): principal diagnosis code (ICD-9) 402.01, 402.11, 402.91, 404.01, 404.03, 404.11, 404.13, 404.91, 404.93, 428.0, 428.1, 428.20, 428.21, 428.22, 428.23, 428.30, 428.31, 428.32, 428.33, 428.40, 428.41, 428.42, 428.43, and 428.9. Pneumonia (CMS definition): principal diagnosis code (ICD-9) 480.0, 480.1, 480.2, 480.3, 480.8, 480.9, 481, 482.0, 482.1, 482.2, 482.30, 482.31, 482.32, 482.39, 482.40, 482.41, 482.42, 482.49, 482.81, 482.82, 482.83, 482.84, 482.89, 482.9, 483.0, 483.1, 483.8, 485, 486, 487.0, and 488.11. Hip fracture (Dartmouth Atlas definition): principal diagnosis code (ICD-9) 820xx ...

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This study demonstrates elevated readmission rates for ischemic and hemorrhagic stroke in the intermediate 30‐, 60‐, and 90‐day risk periods following common cardiac procedures relative to noncardiac procedures and common medical admissions. Ischemic stroke risk was highest following TAVR and LVAD, and hemorrhagic stroke risk was highest following LVAD, SAVR, and LAA closure. Aside from LAA closure, all cardiac procedures were associated with a higher readmission risk for stroke than noncardiac procedures. The ischemic stroke readmission rates following SAVR, cardiac catheterization, permanent pacemaker placement, and implantable cardioverter defibrillator placement were all higher than rates following admission with UTI, pneumonia, and COPD. Ischemic stroke readmission rates following LVAD and TAVR were higher than rates following admission with CHF. These results suggest that the cardiac procedures and postoperative management confer additional vulnerability to patients who have many ...

Results-There were 2305 SAH and 8708 ICH discharges from JC-PSC-certified hospitals and 3892 SAH and 22 564 ICH discharges from noncertified hospitals. Unadjusted in-hospital mortality (SAH: 27.5% versus 33.2%, P,0.0001; ICH: 27.9% versus 29.6%, P=0.003) and 30-day mortality (SAH: 35.1% versus 44.0%, P,0.0001; ICH: 39.8% versus 42.4%, P,0.0001) were lower in JC-PSC hospitals, but 30-day readmission rates were similar (SAH: 17.0% versus 17.0%, P=0.97; ICH: 16.0% versus 15.5%, P=0.29). Risk-adjusted 30-day mortality was 34% lower (odds ratio, 0.66; 95% confidence interval, 0.58-0.76) after SAH and 14% lower (odds ratio, 0.86; 95% confidence interval, 0.80-0.92) after ICH for patients discharged from JC-PSC-certified hospitals. There was no difference in 30-day risk-adjusted readmission rates for SAH or ICH based on JC-PSC status.. ...

Understanding that a deferred complication is not equal to an avoided complication, we queried hospital databases to determine the number of patients readmitted (to the emergency department [ED] or the orthopedics floor) within 1 week after same-day discharge. Over 4 yr, 30 were readmitted; 24 of these were due to bleeding, infection, swelling, or wound-related complications. Of the remaining six patients, one was readmitted for PONV, another for spinal headache. The remaining four were readmitted for surgical site pain, two of which were discharged from the emergency room. One patient had a diagnostic knee arthroscopy with meniscal repair under spinal anesthesia. The other patient had ACL reconstruction under epidural with femoral nerve block. Both of these patients presented 6 days after surgery. Of the two patients requiring hospital readmission, one patient had ACL reconstruction under lumbar plexus and sciatic nerve blocks, presented the day after surgery (presumably after the effects of ...

Boston University School of Medicine researchers have found that providing health insurance coverage to previously uninsured people does not result in reducing 30-day readmission rates.

For the second time in 6 months, Medicare has erred in calculating hospital readmission penalties for more than 1,000 of the nations hospitals, says a Kaiser Health News article. As a result, Medicare has slightly lessened its readmissions penalties for 1,246 hospitals as part of its Hospital Readmissions Reduction Program. The penalty imposed on St Claire Regional Medical Center in Morehead, Kentucky, will drop the most, from 0.93% to 0.72% of every payment Medicare makes for a patient during the fiscal year that ends in September. Medicare also modestly increased the penalties for 226 hospitals. LaSalle General Hospital in Jena, Louisiana, will see its penalty grow by the greatest percentage. LaSalle will lose 0.84% of each Medicare payment per patient, instead of the 0.65% reduction Medicare previously announced.. The payment changes for most hospitals were small, averaging .03% of each reimbursement. Overall, hospitals will pay $10 million less in penalties than previously calculated, for a ...

TY - JOUR. T1 - Effect of hospital follow-up appointment on clinical event outcomes and mortality. AU - Grafft, Carrie A.. AU - McDonald, Furman S.. AU - Ruud, Kari L.. AU - Liesinger, Juliette T.. AU - Johnson, Matthew G.. AU - Naessens, James M.. PY - 2010/6/14. Y1 - 2010/6/14. N2 - Background: Decreasing hospital readmission and patient mortality after hospital dismissal is important when providing quality health care. Interventions recently proposed by the Centers for Medicare and Medicaid Services to reduce avoidable hospital readmissions include providing patients with clear discharge instructions and appointments for timely follow-up visits. Although research has demonstrated a correlation between follow-up arrangements and reduced hospital readmission in specific patient populations, the effect of hospital follow-up in general medicine patients has not been assessed. Methods: For this study, we reviewed hospital dismissal instructions for general medicine patients dismissed in 2006 from ...

A similar pattern was seen for the 1-year risk-adjusted readmission and mortality rates, with a decline in the readmission rate from 57.2 to 56.3% (hazard ratio, 0.92) and an increase in the mortality rate from 31.3 to 36.3%.

Exploratory descriptive study, developed in a governmental hospital of tertiary care in Minas Gerais (Brazil), from January 2008 to December 2009. Medical records and reports of control infection practitioner of 98 patients readmitted with SSI were reviewed and the data were analyzed in relation to gender, age, co morbidities, length of staying, surgery, specialty, type of procedures, wound class, duration of surgery, SSI and micro-organisms. ...

Heart failure (HF) is a growing healthcare burden and one of the leading causes of hospitalizations and readmission. to more effectively prevent readmissions remain areas for continued improvement. Keywords: Heart failure Readmission Prevention Process measures Approximately 5.7 million American adults are living with heart failure (HF) and the projections are that the prevalence of HF will increase 46% from 2012 to 2030 with greater than 8 million adults living with the chronic condition. HF is one of the leading primary diagnoses for hospitalization with an estimated 1 million patients discharged in 2010 2010. The total cost of HF for 2012 was $30.7 billion. According to Medicare from 2009 to 2012 the median risk-standardized 30 day readmission rate for BG45 HF was 23.0%.1 Readmissions receive particular attention from researchers and policy makers as they are perceived as a correctable source of poor quality of care and excessive medical spending. The Affordable Care Act instituted BG45 a ...

Data Synthesis:. 43 articles were identified, and a taxonomy was developed to categorize interventions into 3 domains that encompassed 12 distinct activities. Predischarge interventions included patient education, medication reconciliation, discharge planning, and scheduling of a follow-up appointment before discharge. Postdischarge interventions included follow-up telephone calls, patient-activated hotlines, timely communication with ambulatory providers, timely ambulatory provider follow-up, and postdischarge home visits. Bridging interventions included transition coaches, physician continuity across the inpatient and outpatient setting, and patient-centered discharge instruction. ...

On multivariable lineal regression analyses, the study period (pre-IMCU-CS/post-IMCU-CS) remained significantly independently associated with a shorter ICU (standardized beta value -0077; 95% confidence interval, -0.259 to -0.038; P=.008) and in-hospital mean LoS (standardized beta value -0.066; 95% confidence interval, -0.135 to -0.016; P=.01). Likewise, the study period (pre-IMCU-CS/post-IMCU-CS) did not remain significantly independently associated with in-hospital mortality or 30-day readmission. The main cause of cardiac ICU readmission during hospitalization was respiratory failure; there was no difference in the incidence of cardiac ICU readmission between the study groups (P=.93, Table 4). The mean LoS in the IMCU-CS was 3.5±2.6 days. An analysis of clinical outcomes showed no significant differences in in-hospital mortality (4.9% vs 3.5%, P=.28) or 30-day readmission rate (4.3% vs 4.2%; P=.89) for pre-IMCU-CS compared with post-IMCU-CS, respectively.. In the pre-IMCU-CS period, only ...

Infants born very prematurely can require supplementary oxygen for many months. Rehospitalisation is common in the first 2 years after birth and the majority of admissions are for respiratory disorders. Rehospitalisation is particularly increased in infants with bronchopulmonary dysplasia (BPD) who require supplementary oxygen for more than 28 days after birth, and in infants who have a respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) (see chapter 16). Respiratory symptoms continue to be common in schoolchildren who were born prematurely, and the most severely affected remain symptomatic in adulthood; an adverse outcome that may be more common in females. Prematurely born infants, particularly those who wheeze at follow-up, have evidence of airway obstruction (raised airway resistance and gas trapping) in the first 2 years after birth. Their lung function improves with increasing age, but even in adolescence there is evidence of airflow limitation in those who had had ...

Background. Admissions to hospitals for childhood asthma seem to be increasing, even though admissions for other childhood conditions are decreasing. We studied admissions and readmissions for childhood asthma in Ontario in an attempt to uncover factors relating to the admission patterns.. Methods. Using the hospital discharge data from the Canadian Institute for Health Information, 28 646 children with diagnoses of asthma were identified from April 1, 1989, to March 31, 1992.. Results. The admission rates for asthma among children in Ontario showed a 14.8% decrease from 1987 to 1992. This decline was observed primarily in 5- to 17-year-olds. Younger children had a fourfold risk of hospital admission for asthma. In the 4 years studied, 10 427 children (36.4%) were readmitted at least once, representing 22 114 readmissions, 16 196 (73.2%) of which were for asthma. The 6-month probabilities of readmission for asthma were 20.0% (0- to 4-year-olds) and 11.7% (5- to 17-year-olds). The estimated ...

Capsules.kaiserhealthnews.org: By Diane Webber - AUGUST 17TH, 2012, 8:53 AM.. This week, a KHN analysis of Medicare data showed that 2,211 hospitals will face penalties in October for having too many patients readmitted for care within 30 days of discharge.. Hospital executives around the country have had something to say about those penalties and the new policy. Heres a round-up of how the story played as it was picked up and localized by some of our reporting partners at NPR member stations around the country.. Pennsylvania & Delaware. Taunya English, covering the story at WHYY in Philadelphia, reported on resistance to the policy coming from the regional hospital association.. [Medicare] needs to remember that people are not cars, Curt Schroder, head of the Delaware Valley Healthcare Council, told English. They seem to be treating hospitals like auto repair shops. In other words, You should be able to change the tire, send them on their way and not see them for another 5,000 miles. ...

If patients could recognise themselves, or anyone else could recognise a patient from your description, please obtain the patients written consent to publication and send them to the editorial office before submitting your response [Patient consent forms] ...

JAMA Internal Medicine published a study about patients favoring women as their doctors. The study is centered on readmission and mortality rate among the elderly. The authors selected random data, in which a third of the physician sample were female. For the study, researchers examined hospital readmissions and mortality data for a random sample of traditional Medicare beneficiaries 65 or older who ended up in acute-care hospitals from Jan. 1, 2011, through Dec. 31, 2014. Those data consisted of slightly more than 1.5 million hospitalizations, in which patients were seen by 58,344 physicians. About a third of those physicians were women.. The researchers adjusted the data to account for different characteristics of hospitals and patients, as well as physician characteristics that were not based on sex, such as experience level. These types of adjustments ensure that the studys findings do not simply reflect a situation where male physicians are seeing sicker patients, for instance.. The female ...

Objective:To evaluate causes and predictors of readmission after new ileostomy creation.Background:New ileostomates have been reported to have higher readmission rates compared with other surgical patients, but data on predictors are limited.Methods:A total of 1114 records at 2 associated hospitals

Columbus Community Hospital - Columbus, NE Interdisciplinary Teams Reduce Readmissions Through building relationships among providers across the care continuum and implementing standardized processes, Columbus Community Hospital reduced all-cause 30-day readmissions by 42%, saving $819,797 in hospital care. Download the full case study below.

TBI-related inpatient stays and treat-and-release emergency department (ED) visits are examined for 2017. Patient and injury-related characteristics of TBI-related stays and visits are presented. Outcomes of inpatient stays with a principal diagnosis of TBI are provided, including length of stay, average cost per stay, and rates of in-hospital mortality and all-cause 30-day readmissions.

Objective: Hospitals are increasingly responsible for the longitudinal care of patients discharged from their institution. We report preliminary results from an IT-enabled care management program for patients following coronary revascularization at a large regional medical center.. Methods: The program consisted of patient education, telephonic management, and integration with community providers. The intensity of the intervention was tailored to patient risk of subsequent utilization. We used hierarchical logistic regression to compare severity-adjusted all-cause non-elective 30-day readmissions to our institution for all patients discharged in the first year (April 2013 - April 2014) with the baseline period (January 2010 - March 2013). We used mixed effects models to compare patient responses to the Care Transitions Measure-3 (CTM-3), a CMS-endorsed measure of transition quality, and the Seattle Angina Questionnaire-7 (SAQ-7) following discharge, both of which were collected as part of ...

RESEARCH DESIGN AND METHODS We evaluated 13,621 patient discharges with a primary diagnosis of PE from 185 acute care hospitals in Pennsylvania (from January 2000 to November 2002). Admission glucose levels were analyzed as a categorical variable (≤110, ,110-140, ,140-170, ,170-240, and ,240 mg/dL). The outcomes were 30-day all-cause mortality and hospital readmission. We used random-intercept logistic regression to assess the independent association between admission glucose levels and mortality and hospital readmission, adjusting for patient (age, sex, race, insurance, comorbid conditions, severity of illness, laboratory parameters, and thrombolysis) and hospital (region, size, and teaching status) factors. ...

The studies differ significantly in their objectives and methods, so direct numerical comparisons may not be valid. Oddie et al looked at over 11 000 births in the Northern NHS region of the UK in 1998, excluding infants less than 35 weeks gestation.1 They concentrated on factors associated with early neonatal discharge, and then looked at what influenced readmission to hospital within 28 days. Escobar et al studied a population of over 33 000 using the Kaiser Permanente Medical Care Program (KPMCP) in California and Colorado, for which good data are available, in 1998-2000;2 they included all gestations and did not look at early discharge at all, but analysed in some detail factors associated with readmission within two weeks. The KPMCP, although not government run, is a managed healthcare system which has been described as being in many ways similar to the British National Health Service.3 Its membership is not restricted to the more prosperous sections of society, as may be inferred from the ...

We will be having another session with the same group of hospitals focusing specifically on their CHF readmission reduction initiatives, and we are eager to see how these hospitals have designed processes to combat these root causes.. With many hospitals still remaining on the CHF readmission reduction workgroup waiting list (email Daniel Thomas to join!), the list of root causes and best practices will be updated as we hear from more hospitals, so stay tuned to the blog for more updates!. ...

HCUP Methods Series Overview of Key Readmission Measures and Methods Report # 2012-04 Contact Information: Healthcare Cost and Utilization Project (HCUP) Agency for Healthcare Research and Quality 540 Gaither Road Rockville, MD 20850 http://www.hcup-us.ahrq.gov For Technical Assistance with HCUP Products: Email: [email protected] or Phone: 1-866-290-HCUP Recommended Citation: Barrett M, Raetzman S, Andrews R. Overview of Key Readmission Measures and Methods. 2012. HCUP Methods Series Report #2012-04. ONLINE December 20, 2012. U.S. Agency for Healthcare Research and Quality. Available: http://www.hcupus.ahrq.gov/reports/methods/methods.jsp. TABLE OF CONTENTS OVERVIEW ............................................................................................................................... 1 MEASURE CHARACTERISTICS ............................................................................................... 2 Primary Purpose ...

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 ...

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.