Hospital readmission rates in Medicare

Erdem, Erkan; Fout, Betty; Korda, Holly; Abolude, Abisola

doi:10.5430/jha.v3n4p109

Cited by 4 publications

(4 citation statements)

References 15 publications

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“…The results of this study also show that higher occupancy rate is associated with higher readmission rates for AMI, CHF, and pneumonia. These results are similar to those of Erdem et al, 66 who found that readmission rates increased with hospitals’ occupancy rate. This increase may result from the premature discharge of patients from hospitals to free up the beds for additional patients.…”

Section: Discussionsupporting

confidence: 91%

Reduction in Hospitals’ Readmission Rates: Role of Hospital-Based Skilled Nursing Facilities

Gupta

Zengul

Davlyatov

et al. 2019

INQUIRY

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Hospital readmission within 30 days of discharge is an important quality measure given that it represents a potentially preventable adverse outcome. Approximately, 20% of Medicare beneficiaries are readmitted within 30 days of discharge. Many strategies such as the hospital readmission reduction program have been proposed and implemented to reduce readmission rates. Prior research has shown that coordination of care could play a significant role in lowering readmissions. Although having a hospital-based skilled nursing facility (HBSNF) in a hospital could help in improving care for patients needing short-term skilled nursing or rehabilitation services, little is known about HBSNFs’ association with hospitals’ readmission rates. This study seeks to examine the association between HBSNFs and hospitals’ readmission rates. Data sources included 2007-2012 American Hospital Association Annual Survey, Area Health Resources Files, the Centers for Medicare and Medicaid Services (CMS) Medicare cost reports, and CMS Hospital Compare. The dependent variables were 30-day risk-adjusted readmission rates for acute myocardial infarction (AMI), congestive heart failure, and pneumonia. The independent variable was the presence of HBSNF in a hospital (1 = yes, 0 = no). Control variables included organizational and market factors that could affect hospitals’ readmission rates. Data were analyzed using generalized estimating equation (GEE) models with state and year fixed effects and standard errors corrected for clustering of hospitals over time. Propensity score weights were used to control for potential selection bias of hospitals having a skilled nursing facility (SNF). GEE models showed that the presence of HBSNFs was associated with lower readmission rates for AMI and pneumonia. Moreover, higher SNFs to hospitals ratio in the county were associated with lower readmission rates. These findings can inform policy makers and hospital administrators in evaluating HBSNFs as a potential strategy to lower hospitals’ readmission rates.

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Section: Discussionsupporting

confidence: 91%

Reduction in Hospitals’ Readmission Rates: Role of Hospital-Based Skilled Nursing Facilities

Gupta

Zengul

Davlyatov

et al. 2019

INQUIRY

View full text Add to dashboard Cite

show abstract

“…LOS, hospital costs, or discharge destination are outcomes associated with healthcare utilization or medical service use in a broad sense and are related to a series of potential cost-saving factors for healthcare [65]. For example, a reduction of LOS can decrease inpatient hospital costs and increase hospital bed availability, increasing the overall cost-efficiency of hospitals [66].…”

Section: Discussionmentioning

confidence: 99%

Early inpatient rehabilitation for acutely hospitalized older patients: a systematic review of outcome measures

et al. 2019

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Background Selecting appropriate outcome measures for vulnerable, multimorbid, older patients with acute and chronic impairments poses specific challenges, which may have caused inconsistent findings of previous intervention trials on early inpatient rehabilitation in acutely hospitalized older patients. The aim of this review was to describe primary outcome measures that have been used in randomized controlled trials (RCTs) on early rehabilitation in acutely hospitalized older patients, to analyze their matching, and to evaluate the effects of matching on the main findings of these RCTs. Methods A systematic literature search was conducted in PubMed, Cochrane CENTRAL, CINAHL, and PEDro databases. Additional studies were identified through reference and citation tracking. Inclusion criteria were: RCT, patients aged ≥65 years, admission to an acute hospital medical ward (but not to an intensive medical care unit), physical exercise intervention (also as part of multidisciplinary programs), and primary outcome measure during hospitalization. Two independent reviewers extracted the data, assessed the methodological quality, and analyzed the matching of primary outcome measures to the intervention, study sample, and setting. Main study findings were related to the results of the matching procedure. Results Twenty-eight articles reporting on 24 studies were included. A total of 33 different primary outcome measures were identified, which were grouped into six categories: functional status, mobility status, hospital outcomes, adverse clinical events, psychological status, and cognitive functioning. Outcome measures differed considerably within each category and showed a large heterogeneity in their matching to the intervention, study sample, and setting. Outcome measures that specifically matched the intervention contents were more likely to document intervention-induced benefits. Mobility instruments seemed to be the most sensitive outcome measures to reveal such benefits. Conclusions This review highlights that the selection of outcome measures has to be highly specific to the intervention contents as this is a key factor to reveal benefits attributable to early rehabilitation in acutely hospitalized older patients. Inappropriate selection of outcome measures may represent a major cause of inconsistent findings reported on the effectiveness of early rehabilitation in this setting. Trial registration PROSPERO CRD42017063978 . Electronic supplementary material The online version of this article (10.1186/s12877-019-1201-4) contains supplementary material, which is available to authorized users.

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“…All patients in our study had a complex social situation not suitable for ED practices. Erdem et al [31] suggests, in a study on readmission rates in medical care at a large hospital in the US, that a large hospital may serve sicker or more complex cases which makes care coordination more difficult. Since the hospital where the study was performed is the largest hospital in the area that might also be true for this hospital.…”

Section: Discussionmentioning

confidence: 99%

A New Model for Dealing with Patients Who Frequently Arrive Spontaneously at Hospital Emergency Departments Requiring Health Care: A Pilot Study

Persson¹

2014

Int J Nurs Clin Pract

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Background: Patients who repeatedly seek care directly at hospital based somatic emergency departments take up a large proportion of health care resources, at the same time they appear to experience low satisfaction with the care they receive. The purposes of this pilot study were to describe: I) the development of a team model for taking care of frequent visitors to a somatic hospital based ED; II) Eventual changes, over six months, in costs and patients' health care utilization related to pilot testing the model and III), the team's experiences of implementing the model. Methods: A mixed method convergent parallel design was used. Results:The development of the model began as a top-down process and later on into a bottom-up approach once the inter-professional team became involved. The new model functioned as a support for all 12 patients included in the study and collectively their visits decreased by a total of 73 visits (55%). Conclusion:The inference quality description is that a management induced project may be accepted and actively applied when those involved experience freedom to structure the project. Increased communication between different professionals within the hospital and between different caregivers such as ED, primary health care and community social-and health-care, increases the possibility for the patients to be cared for in a sustainable and non-fragmented way.

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Hospital readmission rates in Medicare

Cited by 4 publications

References 15 publications

Reduction in Hospitals’ Readmission Rates: Role of Hospital-Based Skilled Nursing Facilities

Reduction in Hospitals’ Readmission Rates: Role of Hospital-Based Skilled Nursing Facilities

Early inpatient rehabilitation for acutely hospitalized older patients: a systematic review of outcome measures

A New Model for Dealing with Patients Who Frequently Arrive Spontaneously at Hospital Emergency Departments Requiring Health Care: A Pilot Study

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