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Timely estimation of National Admission, readmission, and observation-stay rates in medicare patients with acute myocardial infarction, heart failure, or pneumonia using near real-time claims data
- Source :
- BMC Health Services Research, Vol 20, Iss 1, Pp 1-9 (2020), BMC Health Services Research
- Publication Year :
- 2020
- Publisher :
- BMC, 2020.
-
Abstract
- Background To estimate, prior to finalization of claims, the national monthly numbers of admissions and rates of 30-day readmissions and post-discharge observation-stays for Medicare fee-for-service beneficiaries hospitalized with acute myocardial infarction (AMI), heart failure (HF), or pneumonia. Methods The centers for Medicare & Medicaid Services (CMS) Integrated Data Repository, including the Medicare beneficiary enrollment database, was accessed in June 2015, February 2017, and February 2018. We evaluated patterns of delay in Medicare claims accrual, and used incomplete, non-final claims data to develop and validate models for real-time estimation of admissions, readmissions, and observation stays. Results These real-time reporting models accurately estimate, within 2 months from admission, the monthly numbers of admissions, 30-day readmission and observation-stay rates for patients with AMI, HF, or pneumonia. Conclusions This work will allow CMS to track the impact of policy decisions in real time and enable hospitals to better monitor their performance nationally.
- Subjects :
- medicine.medical_specialty
Time Factors
Myocardial Infarction
Observation
Medicare
Prediction models
Patient Readmission
01 natural sciences
Health informatics
Health administration
Insurance Claim Review
03 medical and health sciences
Patient Admission
0302 clinical medicine
Real-time reporting
Observation stay
medicine
Humans
030212 general & internal medicine
Myocardial infarction
0101 mathematics
health care economics and organizations
Aged
Heart Failure
Estimation
business.industry
Health Policy
Nursing research
lcsh:Public aspects of medicine
010102 general mathematics
Medicare claims data
lcsh:RA1-1270
Pneumonia
Length of Stay
medicine.disease
United States
Heart failure
Emergency medicine
business
Medicaid
Readmission
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 14726963
- Volume :
- 20
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC Health Services Research
- Accession number :
- edsair.doi.dedup.....cc908a50da40bc1bfbb443f60ca172a6