Analysis of Hospital-Level Readmission Rates and Variation in Adverse Events Among Patients With Pneumonia in the United States

Wang, Yun; Eldridge, Noel; Metersky, Mark L.; Rodrick, David; Faniel, Constance; Eckenrode, Sheila; Mathew, Jasie; Galusha, Deron; Tasimi, Anila; Ng, Beng Koon; Jaser, Lisa; Peterson, A.; Normand, Sharon‐Lise T.; Krumholz, Harlan M.

doi:10.1001/jamanetworkopen.2022.14586

Cited by 3 publications

(4 citation statements)

References 18 publications

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“…It provides evidence of room for improvement for hospitals with high rates for both 30-day all-cause mortality and readmissions. The findings extend previous studies 7 , 16 , 17 that focused on the hypothesis that patients with adverse events are at high risk for 30-day all-cause mortality and readmissions. Nevertheless, this study suggests that not only are patients who experience adverse events more likely to experience mortality and readmission, but patients treated at a hospital with high 30-day all-cause mortality and readmission rates may also be at a greater risk of developing adverse events.…”

Section: Discussionsupporting

confidence: 87%

“…We have previously reported the association between hospital performance and adverse events for myocardial infarction and pneumonia. 6 , 7 For this study, we focused on research questions at the individual and hospital levels: (1) do patients with HF who receive care at hospitals that have high risks of 30-day all-cause mortality and readmission experience a higher risk for hospital adverse events and (2) do hospitals that perform poorly for 30-day all-cause mortality and readmission also have high rates of in-hospital adverse events.…”

mentioning

confidence: 99%

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Relationship Between In-Hospital Adverse Events and Hospital Performance on 30-Day All-cause Mortality and Readmission for Patients With Heart Failure

Wang

Eldridge

Metersky

et al. 2023

Circ: Cardiovascular Quality and Outcomes

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BACKGROUND: Hospitals with high mortality and readmission rates for patients with heart failure (HF) might also perform poorly in other quality concepts. We sought to evaluate the association between hospital performance on mortality and readmission with hospital performance rates of safety adverse events. METHODS: This cross-sectional study linked the 2009 to 2019 patient-level adverse events data from the Medicare Patient Safety Monitoring System, a randomly selected medical records-abstracted patient safety database, to the 2005 to 2016 hospital-level HF-specific 30-day all-cause mortality and readmissions data from the United States Centers for Medicare & Medicaid Services. Hospitals were classified to one of 3 performance categories based on their risk-standardized 30-day all-cause mortality and readmission rates: better (both in <25th percentile), worse (both >75th percentile), and average (otherwise). Our main outcome was the occurrence (yes/no) of one or more adverse events during hospitalization. A mixed-effect model was fit to assess the relationship between a patient's risk of having adverse events and hospital performance categories, adjusted for patient and hospital characteristics. RESULTS: The study included 39 597 patients with HF from 3108 hospitals, of which 252 hospitals (8.1%) and 215 (6.9%) were in the better and worse categories, respectively. The rate of patients with one or more adverse events during a hospitalization was 12.5% (95% CI, 12.1–12.8). Compared with patients admitted to better hospitals, patients admitted to worse hospitals had a higher risk of one or more hospital-acquired adverse events (adjusted risk ratio, 1.24 [95% CI, 1.06–1.44]). CONCLUSIONS: Patients admitted with HF to hospitals with high 30-day all-cause mortality and readmission rates had a higher risk of in-hospital adverse events. There may be common quality issues among these 3 measure concepts in these hospitals that produce poor performance for patients with HF.

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Section: Discussionsupporting

confidence: 87%

mentioning

confidence: 99%

Relationship Between In-Hospital Adverse Events and Hospital Performance on 30-Day All-cause Mortality and Readmission for Patients With Heart Failure

Wang

Eldridge

Metersky

et al. 2023

Circ: Cardiovascular Quality and Outcomes

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“…Not only as risk factors, comorbidity, malnutrition, and immunization status were significantly predictive factors for recovery in pneumonia patients. 21 The average duration of hospitalization in this study was 4.38 days. This result is similar to Toomey et al in 2016, 26 who mentioned that the research readmission rate for the hospital was 6.5%, and Rozenbaum et al in 2015, 27 with an average LoS of 6.7 days (3.6-7.7 days).…”

Section: Discussionmentioning

confidence: 75%

“…20 The importance of identifying risk factors associated with readmission events of pneumonia and the duration of hospitalization are necessary for the evaluation and management of patients with pneumonia, as well as for measuring healthcare quality and reducing cost. 19,21,22 Readmissions are a sign of poor disease management during the initial visit. 22 How to reduce cost expenses while achieving maximum outcomes is a challenge in the current world, particularly when it comes to funding at the Healthcare and Social Security Agency (BPJS).…”

Section: Original Articlementioning

confidence: 99%

Duration of Hospitalization and Risk Factors of Readmission of Community-Acquired Pneumonia Incidence in Hospitalized Toddlers

Lisa,

Arini

2024

J Respirol Indones

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Background: The Indonesia Health Profile Report 2020 stated that pneumonia is one of the causes of high infant and toddler mortality in Indonesia. Length of stay and readmission are crucial indicators of service quality for hospitalized pneumonia patients. This study aims to determine the duration of hospitalization and identify risk factors for readmission among toddlers hospitalized with CAP.Methods: This cross-sectional study was conducted with subjects of pneumonia toddlers hospitalized in Sarila Husada Hospital Sragen from November 2021 to Januari 2023Results: A total of 357 toddlers were hospitalized with CAP (median age = 17 months; IQR 7–24); the majority were under 36 months old (309 subjects; 86%); male (54%) predominated than female (46%). Median duration of hospitalization for CAP=2 days with IQR=3.0-5.0. Readmission events were only 5, higher among toddlers aged 2-36 months but not statistically significant. Factors associated with readmission in CAP toddlers were the history of previous hospitalizations during the past year due to infection (P=0.012; adjusted odds ratio [aOR]=13.6; confidence interval [CI]=1.49–12.34).Conclusion: The readmission rate was very low in our study. Toddlers 2–36 months of age and those with previous hospitalizations with infections are at higher risk of readmission in CAP.

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Qualidade assistencial em hospitais e equilíbrio financeiro: contribuições para o desenvolvimento local

Carmo Filho,

Borges

2024

R. G. Secr.

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O artigo explora a interação entre qualidade assistencial hospitalar e gestão financeira, buscando avaliar a consonância com os atributos definidores da qualidade assistencial, como eficácia, segurança, cultura de excelência e obtenção de resultados desejados. O objetivo é compreender a contribuição dos principais pesquisadores nesse campo e sua relação com o desenvolvimento local. A metodologia incluiu mineração de texto e exame bibliométrico da base de dados PubMed, de 2004 a 2023, para identificar os cinco pesquisadores mais profícuos. Os resultados foram avaliados sob a perspectiva quantitativa e, por conseguinte, os estudos dos cinco principais pesquisadores foram examinados. Os achados revelam que a gestão financeira hospitalar voltada para a qualidade é uma estratégia inteligente para otimizar a eficiência operacional e alcançar melhores resultados clínicos e financeiros. Nesse contexto, os hospitais desempenham um papel crucial como agentes de desenvolvimento local, contribuindo para o crescimento econômico e o bem-estar das comunidades locais.

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Analysis of Hospital-Level Readmission Rates and Variation in Adverse Events Among Patients With Pneumonia in the United States

Cited by 3 publications

References 18 publications

Relationship Between In-Hospital Adverse Events and Hospital Performance on 30-Day All-cause Mortality and Readmission for Patients With Heart Failure

Relationship Between In-Hospital Adverse Events and Hospital Performance on 30-Day All-cause Mortality and Readmission for Patients With Heart Failure

Duration of Hospitalization and Risk Factors of Readmission of Community-Acquired Pneumonia Incidence in Hospitalized Toddlers

Qualidade assistencial em hospitais e equilíbrio financeiro: contribuições para o desenvolvimento local

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