Evidence map›Paper›PMID 28319580›Full record

ArticleMedical care2017

Hospital Characteristics Associated With Risk-standardized Readmission Rates.

Leora I Horwitz, Susannah M Bernheim, Joseph S Ross, Jeph Herrin, Jacqueline N Grady, Harlan M Krumholz, Elizabeth E Drye, Zhenqiu Lin

Abstract read
In one paragraph

Article in Medical care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed.

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  19. Factors Associated With Multiple Psychiatric Readmissions for Youth With Mood Disorders.Journal of the American Academy of Child and Adolescent Psychiatry · 2020
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Leora I Horwitz*Department of Population Health, Division of Healthcare Delivery Science, New York University School of Medicine †Center for Healthcare Innovation and Delivery Science, New York University Langone Medical Center ‡Department of Medicine, Division of General Internal Medicine and Clinical Innovation, New York University School of Medicine, New York, NY §Center for Outcomes Research and Evaluation, Yale New Haven Health ∥Department of Internal Medicine, Section of General Internal Medicine, Yale School of Medicine ¶Department of Medicine, Robert Wood Johnson Foundation Clinical Scholars Program, Yale School of Medicine #Department of Health Policy and Management, Yale School of Public Health **Department of Medicine, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT ††Health Research and Educational Trust, Chicago, IL ‡‡Department of Pediatrics, Yale School of Medicine, New Haven, CT.
Susannah M Bernheim
Joseph S Ross
Jeph Herrin
Jacqueline N Grady
Harlan M Krumholz
Elizabeth E Drye
Zhenqiu Lin

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Institutional Career Development CoreKL2TR001862 · NCATS · YALE UNIVERSITY · PI CANTLEY, LLOYD G, EDELMAN, E. JENNIFER · 2016 to 2025
$12.2M
Center for Cardiovascular Outcomes Research at Yale UniversityU01HL105270 · NHLBI · YALE UNIVERSITY · PI CURTIS, JEPTHA PELHAM, KRUMHOLZ, HARLAN MARC · 2010 to 2013
$5.8M
Understanding hospital value: provider, hospital and community effectsR01HS022882 · AHRQ · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI HORWITZ, LEORA · 2014 to 2023
$2.9M
Impact of Publicity Reporting Hospital Outcome Measures for Older AdultsK08AG032886 · NIA · YALE UNIVERSITY · PI ROSS, JOSEPH SOLOMON · 2008 to 2012
$738k
Heart Failure Readmissions in Older Adults: A Systems PerspectiveK08AG038336 · NIA · YALE UNIVERSITY · PI HORWITZ, LEORA · 2010 to 2013
$648k
AHRQ HHS R01 HS022882NCATS NIH HHS KL2 TR001862NCATS NIH HHS UL1 TR001863NHLBI NIH HHS U01 HL105270NIA NIH HHS K08 AG032886NIA NIH HHS K08 AG038336
6 · The paper itself

Abstract

backgroundSafety-net and teaching hospitals are somewhat more likely to be penalized for excess readmissions, but the association of other hospital characteristics with readmission rates is uncertain and may have relevance for hospital-centered interventions.

objectiveTo examine the independent association of 8 hospital characteristics with hospital-wide 30-day risk-standardized readmission rate (RSRR).

designThis is a retrospective cross-sectional multivariable analysis. SUBJECTS: US hospitals. MEASURES: Centers for Medicare and Medicaid Services specification of hospital-wide RSRR from July 1, 2013 through June 30, 2014 with race and Medicaid dual-eligibility added.

resultsWe included 6,789,839 admissions to 4474 hospitals of Medicare fee-for-service beneficiaries aged over 64 years. In multivariable analyses, there was regional variation: hospitals in the mid-Atlantic region had the highest RSRRs [0.98 percentage points higher than hospitals in the Mountain region; 95% confidence interval (CI), 0.84-1.12]. For-profit hospitals had an average RSRR 0.38 percentage points (95% CI, 0.24-0.53) higher than public hospitals. Both urban and rural hospitals had higher RSRRs than those in medium metropolitan areas. Hospitals without advanced cardiac surgery capability had an average RSRR 0.27 percentage points (95% CI, 0.18-0.36) higher than those with. The ratio of registered nurses per hospital bed was not associated with RSRR. Variability in RSRRs among hospitals of similar type was much larger than aggregate differences between types of hospitals.

conclusionsOverall, larger, urban, academic facilities had modestly higher RSRRs than smaller, suburban, community hospitals, although there was a wide range of performance. The strong regional effect suggests that local practice patterns are an important influence. Disproportionately high readmission rates at for-profit hospitals may highlight the role of financial incentives favoring utilization.

Indexed as

MedicaidAgedAged, 80 and overCross-Sectional StudiesFee-for-Service PlansFemaleHospitals, High-VolumeHospitals, Low-VolumeHumansMalePatient ReadmissionRegional Medical ProgramsRetrospective StudiesRural PopulationUnited StatesUrban Population

Identifiers

PMID28319580
PMCPMC5426655

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.