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Readmission rates

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https://www.readbyqxmd.com/read/28087180/a-comparison-of-hfref-vs-hfpef-s-clinical-workload-and-cost-in-the-first-year-following-hospitalization-and-enrollment-in-a-disease-management-program
#1
T M Murphy, D F Waterhouse, S James, C Casey, E Fitzgerald, E O'Connell, C Watson, J Gallagher, M Ledwidge, K McDonald
BACKGROUND: Admission with heart failure (HF) is a milestone in the progression of the disease, often resulting in higher intensity medical care and ensuing readmissions. Whilst there is evidence supporting enrolling patients in a heart failure disease management program (HF-DMP), not all reported HF-DMPs have systematically enrolled patients with HF with preserved ejection fraction (HFpEF) and there is a scarcity of literature differentiating costs based on HF-phenotype. METHODS: 1292 consenting, consecutive patients admitted with a primary diagnosis of HF were enrolled in a hospital based HF-DMP and categorized as HFpEF (EF≥45%) or HFrEF (EF<45%)...
December 23, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28079871/the-relationship-between-the-rising-cesarean-delivery-and-postpartum-readmission-rates
#2
M A Clapp, J N Robinson, S E Little
OBJECTIVE: This study seeks to determine if the increasing rate of postpartum readmissions is related to the increasing rate of cesarean delivery. STUDY DESIGN: Readmitted patients were identified in the State Inpatient Databases of California, Florida and New York from 2004 to 2011. Relevant maternal comorbidities, pregnancy complications and intrapartum events were collected using ICD-9 diagnosis and procedure codes. The effects of cesarean delivery were first examined via univariate logistic regression to calculate the odds of readmission by year for patients who had delivered via cesarean section...
January 12, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28079778/association-of-intended-route-of-delivery-and-maternal-morbidity-in-twin-pregnancy
#3
Sarah Rae Easter, Julian N Robinson, Ellice Lieberman, Daniela Carusi
OBJECTIVE: To evaluate maternal morbidity in twin pregnancies according to intended mode of delivery. METHODS: We assembled a 7-year retrospective cohort (2007-2014) of women delivering viable, vertex-presenting twins beyond 32 weeks of gestation without contraindication to labor or uterine scar. We classified women as undergoing a trial of labor to attempt vaginal birth or choosing an elective cesarean delivery. Our primary outcome was a measure of composite maternal morbidity including death, postpartum hemorrhage, infection, major procedure, readmission for infection or reoperation, need for dilation and evacuation for hemorrhage or infection, venous thromboembolism, small bowel obstruction or ileus, or intensive care unit admission...
January 9, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28079709/meaningful-use-of-electronic-health-records-by-outpatient-physicians-and-readmissions-of-medicare-fee-for-service-beneficiaries
#4
Mark A Unruh, Hye-Young Jung, Joshua R Vest, Lawrence P Casalino, Rainu Kaushal
BACKGROUND: Nearly one-fifth of hospitalized Medicare fee-for-service beneficiaries are readmitted within 30 days. Participation in the Meaningful Use initiative among outpatient physicians may reduce readmissions. OBJECTIVE: To evaluate the impact of outpatient physicians' participation in Meaningful Use on readmissions. SUBJECTS AND RESEARCH DESIGN: The study population included 90,774 Medicare fee-for-service beneficiaries from New York State (2010-2012)...
January 10, 2017: Medical Care
https://www.readbyqxmd.com/read/28079682/comparing-short-term-complications-of-inpatient-versus-outpatient-single-level-anterior-cervical-discectomy-and-fusion-an-analysis-of-6940-patients-using-the-acs-nsqip-database
#5
Ryan Khanna, Robert B Kim, Sandi K Lam, George R Cybulski, Zachary A Smith, Nader S Dahdaleh
STUDY DESIGN: Multicenter propensity score-adjusted retrospective cohort study. OBJECTIVE: To determine baseline 30-day complication rates for anterior cervical discectomy and fusion (ACDF) and compare clinical complications for patients undergoing single-level ACDFs between inpatient and outpatient settings. SUMMARY OF BACKGROUND DATA: ACDF remains the most common procedure in the treatment of a variety of cervical disc pathologies, making it a focus of quality improvement initiatives...
January 10, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28073753/migraine-and-risk-of-perioperative-ischemic-stroke-and-hospital-readmission-hospital-based-registry-study
#6
Fanny P Timm, Timothy T Houle, Stephanie D Grabitz, Anne-Louise Lihn, Janne B Stokholm, Katharina Eikermann-Haerter, Ala Nozari, Tobias Kurth, Matthias Eikermann
OBJECTIVE:  To evaluate whether patients with migraine are at increased risk of perioperative ischemic stroke and whether this may lead to an increased hospital readmission rate. DESIGN:  Prospective hospital registry study. SETTING:  Massachusetts General Hospital and two satellite campuses between January 2007 and August 2014. PARTICIPANTS:  124 558 surgical patients (mean age 52.6 years; 54.5% women). MAIN OUTCOME MEASURES:  The primary outcome was perioperative ischemic stroke occurring within 30 days after surgery in patients with and without migraine and migraine aura...
January 10, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28073594/analysis-of-readmission-rates-to-the-intensive-care-unit-after-implementation-of-a-rapid-response-team-in-a-university-hospital
#7
R Bergamasco E Paula, M T Tanita, J Festti, L T Queiroz Cardoso, C M Carvalho Grion
OBJECTIVES: To compare readmission rates to the intensive care unit (ICU) before and after the implementation of a rapid response team (RRT), and to identify risk factors for readmission. DESIGN: A quasi-experimental before-after study was carried out. SETTING: A University Hospital. PATIENTS: All patients discharged from the ICU from January to December 2008 (control group) and from January 2010 to December 2012 (intervention group)...
January 7, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28069851/less-intense-postacute-care-better-outcomes-for-enrollees-in-medicare-advantage-than-those-in-fee-for-service
#8
Peter J Huckfeldt, José J Escarce, Brendan Rabideau, Pinar Karaca-Mandic, Neeraj Sood
Traditional fee-for-service (FFS) Medicare's prospective payment systems for postacute care provide little incentive to coordinate care or control costs. In contrast, Medicare Advantage plans pay for postacute care out of monthly capitated payments and thus have stronger incentives to use it efficiently. We compared the use of postacute care in skilled nursing and inpatient rehabilitation facilities by enrollees in Medicare Advantage and FFS Medicare after hospital discharge for three high-volume conditions: lower extremity joint replacement, stroke, and heart failure...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069848/aco-affiliated-hospitals-reduced-rehospitalizations-from-skilled-nursing-facilities-faster-than-other-hospitals
#9
Ulrika Winblad, Vincent Mor, John P McHugh, Momotazur Rahman
Medicare's more than 420 accountable care organizations (ACOs) provide care for a considerable percentage of the elderly in the United States. One goal of ACOs is to improve care coordination and thereby decrease rates of rehospitalization. We examined whether ACO-affiliated hospitals were more effective than other hospitals in reducing rehospitalizations from skilled nursing facilities. We found a general reduction in rehospitalizations from 2007 to 2013, which suggests that all hospitals made efforts to reduce rehospitalizations...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069529/outcomes-in-older-patients-with-grade-iii-cholecystitis-and-cholecystostomy-tube-placement-a-propensity-score-analysis
#10
Francesca M Dimou, Deepak Adhikari, Hemalkumar B Mehta, Taylor S Riall
BACKGROUND: The Tokyo guidelines recommend initial cholecystostomy tube drainage, antibiotics, and delayed cholecystectomy in patients with grade III cholecystitis. STUDY DESIGN: We used Medicare data (1996-2010) to identify patients ≥66 years admitted with grade III acute cholecystitis. We evaluated adherence to the Tokyo guidelines and compared mortality, readmission, and complication rates with and without cholecystostomy tube placement in a propensity-matched (1:3) cohort of patients with grade III cholecystitis...
January 6, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28069329/chronic-kidney-disease-is-an-independent-risk-factor-for-transfusion-cardiovascular-complication-and-thirty-day-readmission-in-minimally-invasive-total-knee-arthroplasty
#11
Feng-Chih Kuo, Po-Chun Lin, Yu-Der Lu, Mel S Lee, Jun-Wen Wang
BACKGROUND: Little is known about the relationship between chronic kidney disease (CKD) and minimally invasive total knee arthroplasty (MIS-TKA). We hypothesized that CKD was an independent risk factor for postoperative complications and increased blood transfusion in patients following MIS-TKA. METHODS: A retrospective review of a prospective database was conducted on patients who underwent MIS-TKAs at an academic medical center between 2009 and 2012. Glomerular filtration rates (GFRs) were calculated for each patient at the time of surgery and a CKD group of 205 patients (GFR < 60 mL/min) were matched at a ratio of 1:2 with 410 patients showing a GFR ≥ 60 mL/min (control group)...
December 14, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28069285/dialysis-modality-and-readmission-following-hospital-discharge-a-population-based-cohort-study
#12
Jeffrey Perl, Eric McArthur, Chaim Bell, Amit X Garg, Joanne M Bargman, Christopher T Chan, Shai Harel, Lihua Li, Arsh K Jain, Danielle M Nash, Ziv Harel
BACKGROUND: Readmissions following hospital discharge among maintenance dialysis patients are common, potentially modifiable, and costly. Compared with patients receiving in-center hemodialysis (HD), patients receiving peritoneal dialysis (PD) have fewer routine dialysis clinic encounters and as a result may be more susceptible to a hospital readmission following discharge. STUDY DESIGN: Population-based retrospective-cohort observational study. SETTINGS & PARTICIPANTS: Patients treated with maintenance dialysis who were discharged following an acute-care hospitalization during January 1, 2003, to December 31, 2013, across 164 acute-care hospitals in Ontario, Canada...
January 6, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28068972/an-underlying-diagnosis-of-osteonecrosis-of-bone-is-associated-with-worse-outcomes-than-osteoarthritis-after-total-hip-arthroplasty
#13
Jasvinder A Singh, Jason Chen, Maria C S Inacio, Robert S Namba, Elizabeth W Paxton
BACKGROUND: Well-designed studies of complications and readmission rates in patients undergoing total hip arthroplasty (THA) with osteonecrosis are lacking. Our objective was to examine if a diagnosis of osteonecrosis was associated with complications, mortality and readmission rates after THA. METHODS: We analyzed prospectively collected data from an integrated healthcare system's Total Joint Replacement Registry of adults with osteonecrosis vs. osteoarthritis (OA) undergoing unilateral primary THA during 2001-2012, in an observational cohort study...
January 9, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28068783/clinical-pharmacist-management-of-bacteremia-in-a-community-hospital-emergency-department
#14
C Dustin Waters, Bryce J Bitton, Annie Torosyan, Kevin P Myers
BACKGROUND: Bacteremia is a serious condition that leads to high morbidity and mortality. Data describing pharmacist involvement in the management of bacteremia in the emergency department are lacking. OBJECTIVE: To determine if pharmacist involvement in the management of bacteremia in the emergency department (ED) led to an increase in appropriate treatment of bacteremia as well as improvements in patient outcomes. METHODS: The primary outcome of this retrospective cohort study was the rate of appropriate treatment of bacteremia...
January 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28068364/meta-analysis-of-stenting-versus-non-stenting-for-the-treatment-of-ureteral-stones
#15
Hai Wang, Libo Man, Guizhong Li, Guanglin Huang, Ning Liu, Jianwei Wang
BACKGROUND AND AIM: Ureteroscopic lithotripsy (URL) and extracorporeal shock wave lithotripsy (ESWL) are two widely used methods for the treatment of ureteral stones. The need for ureteral stenting during these procedures is controversial. In this meta-analysis, we evaluated the benefits and disadvantages of ureteral stents for the treatment of ureteral stones. METHODS: Databases including PubMed, Embase and Cochrane library were selected for systematic review of randomized controlled trials (RCTs) comparing outcomes with or without stenting during URL and ESWL...
2017: PloS One
https://www.readbyqxmd.com/read/28067747/readmission-and-reoperation-after-surgery-for-pelvic-organ-prolapse
#16
Erik D Hokenstad, Amy E Glasgow, Elizabeth B Habermann, John A Occhino
OBJECTIVES: We aimed to determine the rates of readmission and reoperation for patients undergoing surgery for pelvic organ prolapse (POP). METHODS: The American College of Surgeons National Surgical Quality Improvement Program Participant User File was used to select all surgeries performed for POP from 2012 through 2014. The cohort was then reviewed for unplanned readmissions and unplanned reoperations within 30 days of POP surgery. Patient and procedural factors associated with readmission or reoperation were compared using χ analyses and Student t test...
January 6, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28065771/risk-factors-for-30-day-readmission-in-adults-with-sickle-cell-disease
#17
Max A Brodsky, Mark Rodeghier, Maureen Sanger, Jeannie Byrd, Brandi McClain, Brittany Covert, Dionna O Roberts, Karina Wilkerson, Michael R DeBaun, Adetola A Kassim
BACKGROUND: Readmission to the hospital within 30-days is a measure of quality care; however, only few modifiable risk factors for 30-day readmission in adults with sickle cell disease are known. METHODS: We performed a retrospective review of the medical records of adults with sickle cell disease at a tertiary care center, to identify potentially modifiable risk factors for 30-day re-admission due to vaso-occulsive pain episodes. A total of 88 patients > 18 years of age were followed for 3...
January 5, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28065660/time-trends-in-incidence-and-outcomes-of-hospitalizations-for-aspiration-pneumonia-among-elderly-people-in-spain-2003-2013
#18
Domingo Palacios-Ceña, Valentín Hernández-Barrera, Ana López-de-Andrés, César Fernández-de-Las-Peñas, María Palacios-Ceña, Javier de Miguel-Díez, Pilar Carrasco-Garrido, Rodrigo Jiménez-García
BACKGROUND: Aspiration pneumonia (AP) is an infectious process causing high rates of mortality. The purpose of this study was: 1, to describe the incidence from 2003 to 2013 of AP hospitalizations; 2, to assess time trends in hospital outcomes variables, and; 3, to identify the factors independently associated with in-hospital mortality (IHM). METHODS: A retrospective observational study using the Spanish National Hospital Database, with patients discharged between January 2003 and December 2013 was conducted...
January 5, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28065624/outcome-of-unicondylar-knee-arthroplasty-vs-total-knee-arthroplasty-for-early-medial-compartment-arthritis-a-randomized-study
#19
Vikas Kulshrestha, Barun Datta, Santhosh Kumar, Gaurav Mittal
BACKGROUND: With increasing number of patients with early osteoarthritis of knee opting for total knee arthroplasty (TKA), there has been increase in patients dissatisfied with surgical outcomes. It is being presumed that offering unicondylar knee arthroplasty (UKA) to them would improve outcomes. METHODS: Primary objective of our study was to look for any difference in patient-reported outcome and function at 2-year follow-up in patients undergoing UKA as compared to TKA...
December 23, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28063837/leveraging-lean-principles-in-creating-a-comprehensive-quality-program-the-ucla-health-readmission-reduction-initiative
#20
Nasim Afsar-Manesh, Sarah Lonowski, Aram A Namavar
INTRODUCTION: UCLA Health embarked to transform care by integrating lean methodology in a key clinical project, Readmission Reduction Initiative (RRI). METHODS: The first step focused on assembling a leadership team to articulate system-wide priorities for quality improvement. The lean principle of creating a culture of change and accountability was established by: 1) engaging stakeholders, 2) managing the process with performance accountability, and, 3) delivering patient-centered care...
January 4, 2017: Healthcare
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