کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2959061 1178311 2015 4 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Heart Failure Is a Major Contributor to Hospital Readmission Penalties
ترجمه فارسی عنوان
نارسایی قلب یکی از مهمترین اعمال مجازات مجدد بیمارستان است
کلمات کلیدی
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
چکیده انگلیسی


• Hospitals are under financial incentives to reduce readmissions.
• The contribution of heart failure to readmissions relative to acute myocardial infarction and pneumonia is not known.
• Of 2,228 hospitals with ≥25 cases per disease, 1,636 (73.4%) received a penalty.
• The number of cases was not related to the penalty or its magnitude.
• Heart failure cases had the strongest relationship to penalty magnitude.

BackgroundThe Hospital Readmissions Reduction Program provides incentives to hospitals to reduce early readmissions for heart failure (HF), acute myocardial infarction (AMI), and pneumonia (PNE).Methods and ResultsTo examine the contribution of each diagnosis to readmissions penalty size, data were obtained from the Center for Medicare and Medicaid Services, American Hospital Association, and United States Census Bureau including number of cases; readmissions payment adjustment factor (values <1 indicate a penalty for excess readmissions), excess readmission ratio (ERR, or ratio of adjusted predicted readmission based on comorbidities, frailty, and individual patient demographics to expected probability of readmission at an average hospital) for each diagnosis, hospital teaching status, bed number, and zip code socioeconomic status. Of 2,228 hospitals with ≥25 cases per diagnosis, 1,636 received a penalty. Univariate correlation coefficients between penalty and ERR were −0.66, −0.61, and −0.43 for HF, PNE, and AMI, respectively (all P < .001). Correlation between ERRs was greatest for PNE and HF (0.30; P < .001) and weakest for PNE and AMI (0.12; P < .001). In regression analyses, the HF ERR explained the most variance in the penalty (R2 range 0.21–0.44).ConclusionHF ERR, not the number of cases, was related to penalty magnitude. These findings have implications for the design of hospital-based quality initiatives regarding readmissions.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Cardiac Failure - Volume 21, Issue 2, February 2015, Pages 134–137
نویسندگان
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