4 results
Search Results
2. Further Evidence on the System-Wide Effects of the Hospital Readmissions Reduction Program.
- Author
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Demiralp, Berna, He, Fang, and Koenig, Lane
- Subjects
PATIENT readmissions ,PATIENT Protection & Affordable Care Act ,MEDICAL care costs ,CHRONIC diseases ,HOSPITAL care ,INSURANCE statistics ,HEALTH insurance statistics ,CLINICAL medicine ,HEART failure ,MEDICARE ,MYOCARDIAL infarction ,PNEUMONIA ,TIME series analysis ,LOGISTIC regression analysis ,KEY performance indicators (Management) - Abstract
Objective: To investigate the potential spillover effects of the Hospital Readmissions Reduction Program (HRRP) on readmissions for nontargeted conditions and patient populations. We examine HRRP effects on nontargeted conditions separately and on non-Medicare populations in Florida and California.Data Sources: From 2007-2013, 100 percent Medicare inpatient claims data, 2007-2013 State Inpatient Database (SID) for Florida, and 2007-2011 SID for California.Study Design: We conducted an interrupted time series analysis to estimate the change in 30-day all-cause unplanned readmission trends after the start of HRRP using logistic regression.Principal Findings: Hospitals with the largest reductions in targeted Medicare readmissions experienced higher reductions in nontargeted Medicare readmissions. Among nontargeted conditions, reductions were higher for neurology and surgery conditions than for the cardiovascular and cardiorespiratory conditions, which are clinically similar to the targeted conditions. For non-Medicare patients, readmission trends for targeted conditions in Florida and California did not change after HRRP.Conclusions: Our findings are consistent with positive spillover benefits associated with HRRP. The extent of these benefits, however, varies across condition and patient groups. The observed patterns suggest a complex response, including a role of nonfinancial factors, in driving lower readmissions. [ABSTRACT FROM AUTHOR]- Published
- 2018
- Full Text
- View/download PDF
3. Using Bayesian Imputation to Assess Racial and Ethnic Disparities in Pediatric Performance Measures.
- Author
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Brown, David P., Knapp, Caprice, Baker, Kimberly, and Kaufmann, Meggen
- Subjects
PEDIATRICS ,MEDICAL care ,BAYESIAN analysis ,STATISTICAL matching ,MULTIPLE imputation (Statistics) ,INSURANCE statistics ,BENCHMARKING (Management) ,CLINICAL medicine ,ETHNIC groups ,GEOGRAPHIC information systems ,HEALTH services accessibility ,HEALTH status indicators ,MEDICAL quality control ,POPULATION ,PROBABILITY theory ,KEY performance indicators (Management) - Abstract
Objective: To analyze health care disparities in pediatric quality of care measures and determine the impact of data imputation.Data Sources: Five HEDIS measures are calculated based on 2012 administrative data for 145,652 children in two public insurance programs in Florida.Methods: The Bayesian Improved Surname and Geocoding (BISG) imputation method is used to impute missing race and ethnicity data for 42 percent of the sample (61,954 children). Models are estimated with and without the imputed race and ethnicity data.Principal Findings: Dropping individuals with missing race and ethnicity data biases quality of care measures for minorities downward relative to nonminority children for several measures.Conclusions: These results provide further support for the importance of appropriately accounting for missing race and ethnicity data through imputation methods. [ABSTRACT FROM AUTHOR]- Published
- 2016
- Full Text
- View/download PDF
4. Slow motion.
- Author
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Bryant, Rebecca
- Subjects
THERAPEUTICS ,CANCER treatment ,MELANOMA treatment ,CLINICAL medicine - Abstract
The article focuses on the application of "Slow-Mohs" technique in treating rare melanomas in Delray Beach, Florida. Physician John Strasswimmer considers this technique as the best option for difficult-to-demarcate melanomas. Strasswimmer notes that it is performed in the office entailing small margins across nonmelanoma cancers. He suggests that the patients should be managed in a multidisciplinary fashion.
- Published
- 2009
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