Reductions in Readmission Rates Are Associated With Modest Improvements in Patient-reported Health Gains Following Hip and Knee Replacement in England

Friebel, Rocco; Dharmarajan, Kumar; Krumholz, Harlan M.; Steventon, Adam

doi:10.1097/mlr.0000000000000779

Cited by 12 publications

(12 citation statements)

References 30 publications

(31 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Unplanned readmissions following joint replacement are determined, in part, by the quality and safety of the initial hospital stay, transitional care services and post discharge support (Friebel et al, 2017). Widespread belief that readmissions are indicative of poor quality treatment is reflected in the fact that financial penalties for excess readmissions (including for hip replacements) have been imposed on hospitals in both the US and the UK since 2012 (Joynt and Jha, 2012).…”

Section: Quality Measuresmentioning

confidence: 99%

Does price deregulation in a competitive hospital market damage quality?

Roos

O’Donnell

Schut³

et al. 2020

Journal of Health Economics

View full text Add to dashboard Cite

Regulators may be hesitant to permit price competition in healthcare markets because of its potential to damage quality. We assess whether this fear is well founded by examining a reform that permitted Dutch health insurers to freely negotiate prices with hospitals. Unlike previous research on hospital competition that has relied on quality indicators for urgent treatments, we take advantage of a plausible absence of selection bias to identify the effect on the quality of elective procedures that should be more price responsive. Using data on all admissions for hip replacements to Dutch hospitals and a difference-indifferences comparison between more and less concentrated markets, we find no evidence that price deregulation in a competitive environment reduces quality measured by hip replacement readmission rates.

show abstract

Section: Quality Measuresmentioning

confidence: 99%

Does price deregulation in a competitive hospital market damage quality?

Roos

O’Donnell

Schut³

et al. 2020

Journal of Health Economics

View full text Add to dashboard Cite

show abstract

“…However, HES data are generally considered of high quality, as they are derived from data used for hospital reimbursement and have been used in the study of adverse drug reactions, 24 and policy evaluations linked to other patient groups. 25 , 26 The focus on hospital inpatients may have missed some patients treated in the Accident and Emergency Departments who did not get admitted as an inpatient, therefore providing conservative estimates of the true burden to the National Health Service.…”

Section: Discussionmentioning

confidence: 99%

Trends and characteristics of hospitalisations from the harmful use of opioids in England between 2008 and 2018: Population-based retrospective cohort study

Friebel

Maynou

2022

J R Soc Med

Self Cite

View full text Add to dashboard Cite

Summary Objective To examine the trends and characteristics of opioid-related hospital admissions in England over 10 years, and its burden for the National Health Service and public finances. Design Patient-level data from the Hospital Episode Statistics database to examine all opioid-related hospitalisations from 2008 to 2018, stratified by type of opioid admission and patient demographics. Setting All National Health Service hospitals in England. Participants Patients hospitalised from the harmful use of opioids. Main outcome measures The number of opioid-related hospitalisations, length of stay, in-hospital mortality, 30-day readmission rate and treatment costs. Results Opioid-related hospitalisations increased by 48.9%, from 10,805 admissions in 2008 to 16,091 admissions in 2018, with total treatment costs of £137 million. The growth in opioid-related hospitalisations was 21% above the corresponding rate for all other emergency admissions in England. Relative changes showed that hospitalisations increased most for individuals older than 55 years (160%), those living in the most affluent areas of England (93.8%), and suffering from four co-morbidities (627.6%) or more. Hospitals reduced mean patient length of stay from 2.8 days to 1.1 days over 10 years. Mean in-hospital mortality was 0.4% and mean 30-day readmission risk was 16.6%. Conclusion Opioid use is an increasing public health concern in England, though hospitalisation and mortality rates are less pronounced than in other countries. There are concerns about significant rises in hospitalisations from older, less deprived and sicker population groups. Our findings should prompt policymakers to go beyond monitoring mortality statistics when assessing the impacts of harmful use of opioids.

show abstract

“…Due to data limitations related to linking hospitalizations for individual patients across the study period, we were unable to assess patient outcomes such as hospital readmission rates 45 and instead focused on in‐hospital mortality and length of stay. While both measures are widely used for the assessment of quality of care, 46,47 it is possible that adverse events resulted in significant deterioration of patient health with exacerbation of the posthospital syndrome, 48 which could cause death or impact on patient‐reported outcomes 49 following patient discharge not captured in our data. Moreover, length of stay may be considered endogenous, given previous findings, but is also commonly used as a proxy for resource use and to reflect on severity 50 .…”

Section: Discussionmentioning

confidence: 99%