PMID- 26916487
OWN - NLM
STAT- MEDLINE
DCOM- 20160714
LR  - 20160226
IS  - 1558-3597 (Electronic)
IS  - 0735-1097 (Linking)
VI  - 67
IP  - 8
DP  - 2016 Mar 1
TI  - Has Public Reporting of Hospital Readmission Rates Affected Patient Outcomes?:
      Analysis of Medicare Claims Data.
PG  - 963-72
LID - 10.1016/j.jacc.2015.12.037 [doi]
LID - S0735-1097(16)00055-3 [pii]
AB  - BACKGROUND: In 2009, the Centers for Medicare & Medicaid Services (CMS) began
      publicly reporting 30-day hospital readmission rates for patients discharged with
      acute myocardial infarction (MI), heart failure (HF), or pneumonia. OBJECTIVES:
      This study assessed trends of 30-day readmission rates and post-discharge care
      since the implementation of CMS public reporting. METHODS: We analyzed Medicare
      claims data from 2006 to 2012 for patients discharged after a hospitalization for
      MI, HF, or pneumonia. For each diagnosis, we estimated trends in 30-day all-cause
      readmissions and post-discharge care (emergency department visits and observation
      stays) by using hospitalization-level regression models. We modeled adjusted
      trends before and after the implementation of public reporting. To assess for a
      change in trend, we tested the difference between the slope before implementation
      and the slope after implementation. RESULTS: We analyzed 37,829 hospitalizations 
      for MI, 100,189 for HF, and 79,076 for pneumonia from >4,100 hospitals. When
      considering only recent trends (i.e., since 2009), we found improvements in
      adjusted readmission rates for MI (-2.3%), HF (-1.8%), and pneumonia (-2.0%), but
      when comparing the trend before public reporting with the trend after reporting, 
      there was no difference for MI (p = 0.72), HF (p = 0.19), or pneumonia (p =
      0.21). There were no changes in trends for 30-day post-discharge care for MI or
      pneumonia; however, the trend decreased for HF emergency department visits from
      2.3% to -0.8% (p = 0.007) and for observation stays from 15.1% to 4.1% (p =
      0.04). CONCLUSIONS: The release of the CMS public reporting of hospital
      readmission rates was not associated with any measurable change in 30-day
      readmission trends for MI, HF, or pneumonia, but it was associated with less
      hospital-based acute care for HF.
CI  - Copyright (c) 2016 American College of Cardiology Foundation. Published by
      Elsevier Inc. All rights reserved.
FAU - DeVore, Adam D
AU  - DeVore AD
AD  - Duke Clinical Research Institute, Durham, North Carolina; Department of Medicine,
      Duke University School of Medicine, Durham, North Carolina. Electronic address:
      adam.devore@duke.edu.
FAU - Hammill, Bradley G
AU  - Hammill BG
AD  - Duke Clinical Research Institute, Durham, North Carolina.
FAU - Hardy, N Chantelle
AU  - Hardy NC
AD  - Duke Clinical Research Institute, Durham, North Carolina.
FAU - Eapen, Zubin J
AU  - Eapen ZJ
AD  - Duke Clinical Research Institute, Durham, North Carolina; Department of Medicine,
      Duke University School of Medicine, Durham, North Carolina.
FAU - Peterson, Eric D
AU  - Peterson ED
AD  - Duke Clinical Research Institute, Durham, North Carolina; Department of Medicine,
      Duke University School of Medicine, Durham, North Carolina.
FAU - Hernandez, Adrian F
AU  - Hernandez AF
AD  - Duke Clinical Research Institute, Durham, North Carolina; Department of Medicine,
      Duke University School of Medicine, Durham, North Carolina.
LA  - eng
GR  - U19HS021092/HS/AHRQ HHS/United States
PT  - Journal Article
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
SB  - AIM
SB  - IM
CIN - J Am Coll Cardiol. 2016 Mar 1;67(8):973-5. PMID: 26916488
MH  - Cause of Death/trends
MH  - Follow-Up Studies
MH  - Heart Failure/epidemiology/*therapy
MH  - Hospitals/*standards
MH  - Humans
MH  - Incidence
MH  - Insurance Claim Reporting/*statistics & numerical data
MH  - Medicare/*statistics & numerical data
MH  - Myocardial Infarction/epidemiology/*therapy
MH  - Patient Readmission/*statistics & numerical data
MH  - Pneumonia/epidemiology/*therapy
MH  - Quality Indicators, Health Care
MH  - Retrospective Studies
MH  - Survival Rate/trends
MH  - United States/epidemiology
OTO - NOTNLM
OT  - Centers for Medicare & Medicaid Services
OT  - heart failure
OT  - myocardial infarction
OT  - quality
EDAT- 2016/02/27 06:00
MHDA- 2016/07/15 06:00
CRDT- 2016/02/27 06:00
PHST- 2015/06/16 00:00 [received]
PHST- 2015/11/04 00:00 [revised]
PHST- 2015/12/01 00:00 [accepted]
PHST- 2016/02/27 06:00 [entrez]
PHST- 2016/02/27 06:00 [pubmed]
PHST- 2016/07/15 06:00 [medline]
AID - S0735-1097(16)00055-3 [pii]
AID - 10.1016/j.jacc.2015.12.037 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2016 Mar 1;67(8):963-72. doi: 10.1016/j.jacc.2015.12.037.