ArticleAnnals of surgery2016
Impact of Risk Adjustment for Socioeconomic Status on Risk-adjusted Surgical Readmission Rates.
Article in Annals of surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 1 of them a synthesis that pooled it.
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Who cites it
42 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Social Risk Adjustment In The Hospital Readmissions Reduction Program: A Systematic Review And Implications For Policy.Health affairs (Project Hope) · 2022Pooled it
- Hospital readmission disparity measure for evaluating hospital performance and penalties.Archives of public health = Archives belges de sante publique · 2025Article
- The effect of intraoperative goal-directed fluid therapy in patients under anesthesia for gastrointestinal surgery.World journal of gastrointestinal surgery · 2024Article
- Sociocultural and Demographic Factors Predict Readmissions for General Surgery Patients.World journal of surgery · 2023Article
- Association of Cumulative Colorectal Surgery Hospital Costs, Readmissions, and Emergency Department/Observation Stays with Insurance Type.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
- Article
- Association of Insurance Type with Inpatient Surgical 30-day Readmissions, Emergency Department Visits/Observation Stays, and Costs.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2023Article
- Social risk adjustment in the hospital readmission reduction program: Pitfalls of peer grouping, measurement challenges, and potential solutions.Health services research · 2023Article
- Association of Insurance Type With Inpatient Surgery 30-Day Complications and Costs.The Journal of surgical research · 2023Article
- Association of Insurance Type With Colorectal Surgery Outcomes and Costs at a Safety-Net Hospital: A Retrospective Observational Study.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2022Article
- Adjusting for Social Risk Factors in Pediatric Quality Measures: Adding to the Evidence Base.Academic pediatrics · 2022Article
- Evaluating How Safety-Net Hospitals Are Identified: Systematic Review and Recommendations.Health equity · 2022Review
- Socio-demographic and -economic factors associated with 30-day readmission for conditions targeted by the hospital readmissions reduction program: a population-based study.BMC public health · 2021Article
- Association of Socioeconomic Area Deprivation Index with Hospital Readmissions After Colon and Rectal Surgery.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- Evaluation of Changes in Veterans Affairs Medical Centers' Mortality Rates After Risk Adjustment for Socioeconomic Status.JAMA network open · 2020Observational
- Association of Medicaid Eligibility With Surgical Readmission Among Medicare Beneficiaries.JAMA network open · 2020Article
- Impact of Hospital Readmissions Reduction Program Penalties on Hip and Knee Replacement Readmissions: Comparison of Hospitals at Risk of Varying Penalty Amounts.The Journal of bone and joint surgery. American volume · 2020Article
- Social Determinant of Health Documentation Trends and Their Association with Emergency Department Admissions.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2020Article
- Evidence of the Linkage Between Hospital-based Care Coordination Strategies and Hospital Overall (Star) Ratings.Medical care · 2020Article
- Assessing the impact of social determinants of health on predictive models for potentially avoidable 30-day readmission or death.PloS one · 2020Article
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Authors and funding
6 authors.
Funding
Abstract
objectiveTo assess whether differences in readmission rates between safety-net hospitals (SNH) and non-SNHs are due to differences in hospital quality, and to compare the results of hospital profiling with and without SES adjustment.
backgroundIn response to concerns that quality measures unfairly penalizes SNH, NQF recently recommended that performance measures adjust for socioeconomic status (SES) when SES is a risk factor for poor patient outcomes.
methodsMultivariate regression was used to examine the association between SNH status and 30-day readmission after major surgery. The results of hospital profiling with and without SES adjustment were compared using the CMS Hospital Compare and the Hospital Readmissions Reduction Program (HRRP) methodologies.
resultsAdjusting for patient risk and SES, patients admitted to SNHs were not more likely to be readmitted compared with patients in in non-SNHs (AOR 1.08; 95% CI:0.95-1.23; P = 0.23). The results of hospital profiling based on Hospital Compare were nearly identical with and without SES adjustment (ICC 0.99, κ 0.96). Using the HRRP threshold approach, 61% of SNHs were assigned to the penalty group versus 50% of non-SNHs. After adjusting for SES, 51% of SNHs were assigned to the penalty group.
conclusionsDifferences in surgery readmissions between SNHs and non-SNHs are due to differences in the patient case mix of low-SES patients, and not due to differences in quality. Adjusting readmission measures for SES leads to changes in hospital ranking using the HRRP threshold approach, but not using the CMS Hospital Compare methodology. CMS should consider either adjusting for the effects of SES when calculating readmission thresholds for HRRP, or replace it with the approach used in Hospital Compare.
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