ArticleMedical care2016
Hospital Use of Observation Stays: Cross-sectional Study of the Impact on Readmission Rates.
Article in Medical care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Association of Diagnosed Dementia with Post-discharge Mortality and Readmission Among Hospitalized Medicare Beneficiaries.Journal of general internal medicine · 2022Article
- Thirty-Day Re-observation, Chronic Re-observation, and Neighborhood Disadvantage.Mayo Clinic proceedings · 2020Article
- The Accuracy of Interqual Criteria in Determining the Observation versus Inpatient Status in Older Adults with Syncope.The Journal of emergency medicine · 2020Article
- What Is an Observation Stay? Evaluating the Use of Hospital Observation Stays in Medicare.Journal of the American Geriatrics Society · 2020Observational
- Assessment of Hospital Readmissions From the Emergency Department After Implementation of Medicare's Hospital Readmissions Reduction Program.JAMA network open · 2020Article
- Multiyear Rehospitalization Rates and Hospital Outcomes in an Integrated Health Care System.JAMA network open · 2019Article
- Hospital revisits within 30 days after discharge for medical conditions targeted by the Hospital Readmissions Reduction Program in the United States: national retrospective analysis.BMJ (Clinical research ed.) · 2019Article
- Identifying Observation Stays In Medicare Data: Policy Implications of a Definition.Journal of hospital medicine · 2019Article
- Hospital Characteristics Associated With Postdischarge Hospital Readmission, Observation, and Emergency Department Utilization.Medical care · 2018Article
- Association of the Hospital Readmissions Reduction Program With Surgical Readmissions.JAMA surgery · 2018Article
- Outcomes after observation stays among older adult Medicare beneficiaries in the USA: retrospective cohort study.BMJ (Clinical research ed.) · 2017Article
- Many Neurology Readmissions Are Nonpreventable.The Neurohospitalist · 2017Article
- Hospitalization Risk Associated With Emergency Department Reasons for Visit and Patient Age: A Retrospective Evaluation of National Emergency Department Survey Data to Help Identify Potentially Avoidable Emergency Department Visits.Health services research and managerial epidemiologyArticle
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundThe Centers for Medicare and Medicaid Services publicly reports hospital risk-standardized readmission rates (RSRRs) as a measure of quality and performance; mischaracterizations may occur because observation stays are not captured by current measures.
objectivesTo describe variation in hospital use of observation stays, the relationship between hospitals observation stay use and RSRRs. MATERIALS AND
methodsCross-sectional analysis of Medicare fee-for-service beneficiaries discharged after acute myocardial infarction (AMI), heart failure, or pneumonia between July 2011 and June 2012. We calculated 3 hospital-specific 30-day outcomes: (1) observation rate, the proportion of all discharges followed by an observation stay without a readmission; (2) observation proportion, the proportion of observation stays among all patients with an observation stay or readmission; and (3) RSRR.
resultsFor all 3 conditions, hospitals' observation rates were <2.5% and observation proportions were <12%, although there was variation across hospitals, including 28% of hospital with no observation stay use for AMI, 31% for heart failure, and 43% for pneumonia. There were statistically significant, but minimal, correlations between hospital observation rates and RSRRs: AMI (r=-0.02), heart failure (r=-0.11), and pneumonia (r=-0.02) (P<0.001). There were modest inverse correlations between hospital observation proportion and RSRR: AMI (r=-0.34), heart failure (r=-0.26), and pneumonia (r=-0.21) (P<0.001). If observation stays were included in readmission measures, <4% of top performing hospitals would be recategorized as having average performance.
conclusionsHospitals' observation stay use in the postdischarge period is low, but varies widely. Despite modest correlation between the observation proportion and RSRR, counting observation stays in readmission measures would minimally impact public reporting of performance.
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