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https://www.readbyqxmd.com/read/29772725/attention-based-recurrent-temporal-restricted-boltzmann-machine-for-radar-high-resolution-range-profile-sequence-recognition
#1
Yifan Zhang, Xunzhang Gao, Xuan Peng, Jiaqi Ye, Xiang Li
The High Resolution Range Profile (HRRP) recognition has attracted great concern in the field of Radar Automatic Target Recognition (RATR). However, traditional HRRP recognition methods failed to model high dimensional sequential data efficiently and have a poor anti-noise ability. To deal with these problems, a novel stochastic neural network model named Attention-based Recurrent Temporal Restricted Boltzmann Machine (ARTRBM) is proposed in this paper. RTRBM is utilized to extract discriminative features and the attention mechanism is adopted to select major features...
May 16, 2018: Sensors
https://www.readbyqxmd.com/read/29749269/cms-hospital-readmission-reduction-program-and-anticoagulants-received-following-a-tha-tka-discharge
#2
François Laliberté, Craig I Coleman, Brahim Bookhart, Jeff Schein, Silas Martin, Willy Wynant, Yongling Xiao, Patrick Lefebvre, Scott Kaatz
OBJECTIVES: To assess association between 30-day readmission rate and treatment received after total hip and knee arthroplasty (THA/TKA) discharge (rivaroxaban vs. warfarin or non-anticoagulant). To subsequently model impact of increasing rivaroxaban use on the Hospital Readmission Reduction Program (HRRP) penalty, which was imposed on hospitals with excess 30-day readmissions after hospitalizations for selected conditions, including THA/TKA. METHODS: The US Truven Health MarketScan Medicare Supplemental database from 07/01/2010 to 04/30/2015 was used...
May 11, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29740816/the-impact-of-the-hospital-readmissions-reduction-program-across-insurance-types-in-california
#3
David S Zingmond, Li-Jung Liang, Punam Parikh, José J Escarce
OBJECTIVE: Examine 30-day readmission rates for indicator conditions before and after adoption of the Hospital Readmissions Reduction Program (HRRP). DATA: California hospital discharge data, 2005 to 2014. STUDY DESIGN: Estimated difference between pre-HRRP trends and post-HRRP rates of hospital readmissions after hospitalization for indicator conditions targeted by the HRRP (heart attack, heart failure, and pneumonia) by payer among insured adults...
May 8, 2018: Health Services Research
https://www.readbyqxmd.com/read/29611719/early-hospital-readmissions-following-an-acute-exacerbation-of-copd-in-the-nationwide-readmissions-database
#4
David M Jacobs, Katia Noyes, Jiwei Zhao, Walter Gibson, Timothy F Murphy, Sanjay Sethi, Heather M Ochs-Balcom
RATIONALE: Understanding the causes and factors related to readmission for an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) within a nationwide database including all payers and ages can provide valuable input for the development of generalizable readmission reduction strategies. OBJECTIVES: To determine the rates, causes, and predictors for early (3-, 7-, and 30-day) readmission in patients hospitalized with AECOPD in the United States utilizing the Nationwide Readmission Database (NRD) following the initiation of the Hospital Readmissions Reduction Program (HRRP) but prior to its expansion to COPD...
April 3, 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29579442/will-hospital-peer-grouping-by-patient-socioeconomic-status-fix-the-medicare-hospital-readmission-reduction-program-or-create-new-problems
#5
Richard L Fuller, John S Hughes, Norbert I Goldfield, Richard F Averill
BACKGROUND: In 2016 the U.S. Congress directed the Centers for Medicare & Medicaid Services (CMS) to implement the 21st Century Cures Act to fix a flaw in the Hospital Readmissions Reduction Program (HRRP). One section of the Act is intended to remove bias in calculating penalties for hospitals treating large percentages of low socioeconomic status (SES) patients. A study was conducted to analyze the effect of the introduction of SES hospital peer groups on the number and distribution of the hospitals being penalized...
April 2018: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/29552431/editorial-transitional-care-clinics-to-reduce-30-day-readmissions-in-heart-failure-patients
#6
EDITORIAL
Katherine Smith, Jeffrey P Fleming, Bernard Gros
Heart failure (HF) is one of the most prevalent chronic diseases in the United States (U.S.), with an estimated prevalence of five million patients in the U.S. and an annual healthcare cost of greater than 30 billion dollars. Readmission rates for HF patients are astronomically high, with up to 25% of hospitalized patients with HF requiring readmission within 30 days of discharge. The Hospital Readmissions Reduction Program (HRRP) of the Patient Protection and Affordable Care Act aims to address these concerns by financially penalizing institutions with unacceptably high risk-adjusted 30-day readmission rates for HF patients...
January 15, 2018: Curēus
https://www.readbyqxmd.com/read/29443931/robust-automatic-target-recognition-via-hrrp-sequence-based-on-scatterer-matching
#7
Yuan Jiang, Yang Li, Jinjian Cai, Yanhua Wang, Jia Xu
High resolution range profile (HRRP) plays an important role in wideband radar automatic target recognition (ATR). In order to alleviate the sensitivity to clutter and target aspect, employing a sequence of HRRP is a promising approach to enhance the ATR performance. In this paper, a novel HRRP sequence-matching method based on singular value decomposition (SVD) is proposed. First, the HRRP sequence is decoupled into the angle space and the range space via SVD, which correspond to the span of the left and the right singular vectors, respectively...
February 14, 2018: Sensors
https://www.readbyqxmd.com/read/29417574/medicare-payment-penalties-and-safety-net-hospital-profitability-minimal-impact-on-these-vulnerable-hospitals
#8
Gloria J Bazzoli, Michael P Thompson, Teresa M Waters
OBJECTIVE: To examine relationships between penalties assessed by Medicare's Hospital Readmission Reduction Program and Value-Based Purchasing Program and hospital financial condition. DATA SOURCES/STUDY SETTING: Centers for Medicare and Medicaid Services, American Hospital Association, and Area Health Resource File data for 4,824 hospital-year observations. STUDY DESIGN: Bivariate and multivariate analysis of pooled cross-sectional data. PRINCIPAL FINDINGS: Safety net hospitals have significantly higher HRRP/VBP penalties, but, unlike nonsafety net hospitals, increases in their penalty rate did not significantly affect their total margins...
February 8, 2018: Health Services Research
https://www.readbyqxmd.com/read/29351776/readmission-rates-in-not-for-profit-vs-proprietary-hospitals-before-and-after-the-hospital-readmission-reduction-program-implementation
#9
Lauren E Birmingham, Willie H Oglesby
BACKGROUND: The Patient Protection and Affordable Care Act established the Hospital Readmission Reduction Program (HRRP) to penalize hospitals with excessive 30-day hospital readmissions of Medicare enrollees for specific conditions. This policy was aimed at increasing the quality of care delivered to patients and decreasing the amount of money paid for potentially preventable hospital readmissions. While it has been established that the number of 30-day hospital readmissions decreased after program implementation, it is unknown whether this effect occurred equally between not-for-profit and proprietary hospitals...
January 19, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29320453/radar-hrrp-target-recognition-based-on-stacked-autoencoder-and-extreme-learning-machine
#10
Feixiang Zhao, Yongxiang Liu, Kai Huo, Shuanghui Zhang, Zhongshuai Zhang
A novel radar high-resolution range profile (HRRP) target recognition method based on a stacked autoencoder (SAE) and extreme learning machine (ELM) is presented in this paper. As a key component of deep structure, the SAE does not only learn features by making use of data, it also obtains feature expressions at different levels of data. However, with the deep structure, it is hard to achieve good generalization performance with a fast learning speed. ELM, as a new learning algorithm for single hidden layer feedforward neural networks (SLFNs), has attracted great interest from various fields for its fast learning speed and good generalization performance...
January 10, 2018: Sensors
https://www.readbyqxmd.com/read/29199504/hospital-readmissions-reduction-program-intended-and-unintended-effects
#11
Min Chen, David C Grabowski
This study examines whether the Hospital Readmissions Reduction Program (HRRP), which penalizes hospitals with excess readmissions for certain conditions, has reduced hospital readmissions and led to unintended consequences. Our analyses of Florida hospital administrative data between 2008 and 2014 find that the HRRP resulted in a reduction in the likelihood of readmissions by 1% to 2% for traditional Medicare (TM) beneficiaries with heart failure, pneumonia, or chronic obstructive pulmonary disease. Readmission rates for Medicare Advantage (MA) beneficiaries and privately insured patients with heart attack and heart failure decreased even more than TM patients with the same target condition (e...
December 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29179718/what-is-the-impact-of-a-clinically-related-readmission-measure-on-the-assessment-of-hospital-performance
#12
Roger K Khouri, Hechuan Hou, Apoorv Dhir, Juan J Andino, James M Dupree, David C Miller, Chad Ellimoottil
BACKGROUND: The Hospital Readmission Reduction Program (HRRP) penalizes hospitals for high all-cause unplanned readmission rates. Many have expressed concern that hospitals serving patient populations with more comorbidities, lower incomes, and worse self-reported health status may be disproportionately penalized by readmissions that are not clinically related to the index admission. The impact of including clinically unrelated readmissions on hospital performance is largely unknown. We sought to determine if a clinically related readmission measure would significantly alter the assessment of hospital performance...
November 28, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29167870/association-of-the-hospital-readmissions-reduction-program-with-surgical-readmissions
#13
(no author information available yet)
No abstract text is available yet for this article.
March 1, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29148921/a-predictive-model-for-readmissions-among-medicare-patients-in-a-california-hospital
#14
Ian Duncan, Nhan Huynh
Predictive models for hospital readmission rates are in high demand because of the Centers for Medicare & Medicaid Services (CMS) Hospital Readmission Reduction Program (HRRP). The LACE index is one of the most popular predictive tools among hospitals in the United States. The LACE index is a simple tool with 4 parameters: Length of stay, Acuity of admission, Comorbidity, and Emergency visits in the previous 6 months. The authors applied logistic regression to develop a predictive model for a medium-sized not-for-profit community hospital in California using patient-level data with more specific patient information (including 13 explanatory variables)...
November 17, 2017: Population Health Management
https://www.readbyqxmd.com/read/29128869/association-of-the-hospital-readmissions-reduction-program-implementation-with-readmission-and-mortality-outcomes-in-heart-failure
#15
Ankur Gupta, Larry A Allen, Deepak L Bhatt, Margueritte Cox, Adam D DeVore, Paul A Heidenreich, Adrian F Hernandez, Eric D Peterson, Roland A Matsouaka, Clyde W Yancy, Gregg C Fonarow
Importance: Public reporting of hospitals' 30-day risk-standardized readmission rates following heart failure hospitalization and the financial penalization of hospitals with higher rates have been associated with a reduction in 30-day readmissions but have raised concerns regarding the potential for unintended consequences. Objective: To examine the association of the Hospital Readmissions Reduction Program (HRRP) with readmission and mortality outcomes among patients hospitalized with heart failure within a prospective clinical registry that allows for detailed risk adjustment...
January 1, 2018: JAMA Cardiology
https://www.readbyqxmd.com/read/29028756/financial-performance-of-hospitals-in-the-mississippi-delta-region-under-the-hospital-readmissions-reduction-program-and-hospital-value-based-purchasing-program
#16
Hsueh-Fen Chen, Saleema Karim, Fei Wan, Adrienne Nevola, Michael E Morris, T Mac Bird, J Mick Tilford
BACKGROUND: Previous studies showed that the Hospital Readmissions Reduction Program (HRRP) and the Hospital Value-based Purchasing Program (HVBP) disproportionately penalized hospitals caring for the poor. The Mississippi Delta Region (Delta Region) is among the most socioeconomically disadvantaged areas in the United States. The financial performance of hospitals in the Delta Region under both HRRP and HVBP remains unclear. OBJECTIVE: To compare the differences in financial performance under both HRRP and HVBP between hospitals in the Delta Region (Delta hospitals) and others in the nation (non-Delta hospitals)...
November 2017: Medical Care
https://www.readbyqxmd.com/read/28991951/an-opportunity-to-improve-medicare-s-planned-readmissions-measure
#17
Chad Ellimoottil, Roger K Khouri, Apoorv Dhir, Hechuan Hou, David C Miller, James M Dupree
In the Hospital Readmission Reduction Program (HRRP), the Centers for Medicare & Medicaid Services (CMS) utilizes a planned/unplanned algorithm to prevent hospitals from being penalized for scheduled rehospitalizations. We evaluated version 3.0 of the CMS planned readmission algorithm and hypothesized that some readmissions categorized as planned by the HRRP algorithm may actually be unplanned. We identified 143,054 index admissions and 16,116 thirty- day readmissions for 131 hospitals. Only 1252 readmissions were considered planned according to Medicare's readmission algorithm...
October 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28726751/an-adaptive-feature-learning-model-for-sequential-radar-high-resolution-range-profile-recognition
#18
Xuan Peng, Xunzhang Gao, Yifan Zhang, Xiang Li
This paper proposes a new feature learning method for the recognition of radar high resolution range profile (HRRP) sequences. HRRPs from a period of continuous changing aspect angles are jointly modeled and discriminated by a single model named the discriminative infinite restricted Boltzmann machine (Dis-iRBM). Compared with the commonly used hidden Markov model (HMM)-based recognition method for HRRP sequences, which requires efficient preprocessing of the HRRP signal, the proposed method is an end-to-end method of which the input is the raw HRRP sequence, and the output is the label of the target...
July 20, 2017: Sensors
https://www.readbyqxmd.com/read/28717900/elements-of-program-design-in-medicare-s-value-based-and-alternative-payment-models-a-narrative-review
#19
Karen E Joynt Maddox, Aditi P Sen, Lok Wong Samson, Rachael B Zuckerman, Nancy DeLew, Arnold M Epstein
Increasing emphasis on value in health care has spurred the development of value-based and alternative payment models. Inherent in these models are choices around program scope (broad vs. narrow); selecting absolute or relative performance targets; rewarding improvement, achievement, or both; and offering penalties, rewards, or both. We examined and classified current Medicare payment models-the Hospital Readmissions Reduction Program (HRRP), Hospital Value-Based Purchasing Program (HVBP), Hospital-Acquired Conditions Reduction Program (HACRP), Medicare Advantage Quality Star Rating program, Physician Value-Based Payment Modifier (VM) and its successor, the Merit-Based Incentive Payment System (MIPS), and the Medicare Shared Savings Program (MSSP) on these elements of program design and reviewed the literature to place findings in context...
November 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28710221/trends-in-readmission-rates-for-safety-net-hospitals-and-non-safety-net-hospitals-in-the-era-of-the-us-hospital-readmission-reduction-program-a-retrospective-time-series-analysis-using-medicare-administrative-claims-data-from-2008-to-2015
#20
Amy M Salerno, Leora I Horwitz, Ji Young Kwon, Jeph Herrin, Jacqueline N Grady, Zhenqiu Lin, Joseph S Ross, Susannah M Bernheim
OBJECTIVE: To compare trends in readmission rates among safety net and non-safety net hospitals under the US Hospital Readmission Reduction Program (HRRP). DESIGN: A retrospective time series analysis using Medicare administrative claims data from January 2008 to June 2015. SETTING: We examined 3254 US hospitals eligible for penalties under the HRRP, categorised as safety net or non-safety net hospitals based on the hospital's proportion of patients with low socioeconomic status...
July 13, 2017: BMJ Open
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