Evidence map›Paper›PMID 30897056›Full record

ArticleJournal of hospital medicine2019

Do Hospitals Participating in Accountable Care Organizations Discharge Patients to Higher Quality Nursing Homes?

Alexander M Bain, Rachel M Werner, Yihao Yuan, Amol S Navathe

Abstract read
In one paragraph

Article in Journal of hospital medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
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

4 authors.

Alexander M BainPerelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Rachel M WernerPerelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Yihao YuanPerelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Amol S NavathePerelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.

Funding

Midcareer Mentoring Award for Patient-Oriented Research in AgingK24AG047908 · NIA · UNIVERSITY OF PENNSYLVANIA · PI WERNER, RACHEL M · 2014 to 2024
$2.0M
AHRQ HHS R01 HS024266NIA NIH HHS K24 AG047908
6 · The paper itself

Abstract

We examined whether hospitals participating in Medicare's Shared Saving Program increased the use of highly rated skilled nursing facilities (SNFs) or decreased the use of low-rated SNFs hospital-wide after initiation of their accountable care organization (ACO) contracts compared with non-ACO hospitals. Using a difference-in-differences design, we estimated the change in the probability of discharge to 5-star and 1-star SNFs among all beneficiaries discharged from ACO-participating hospitals after the hospital initiated ACO participation. After joining an ACO, the percentage of hospital discharges going to a high-quality SNF increased by 3.4 percentage points on a base of 15.4% (95% confidence interval [CI] 1.3-5.5, P = .002) compared with non-ACO-participating hospitals. The probability of discharge from an ACO-participating hospital to low-quality SNFs did not change significantly compared with non-ACO-participating hospitals. Our findings indicate that ACO-participating hospitals were more likely to discharge patients to highly rated SNFs after they began their ACO contract but did not change the likelihood of discharge to lower rated SNFs in comparison with non-ACO hospitals.

Indexed as

Accountable Care OrganizationsSkilled Nursing FacilitiesAged, 80 and overFemaleHospitalsHumansMaleMedicarePatient DischargePatient ReadmissionQuality of Health CareUnited States

Identifiers

PMID30897056
PMCPMC7172035

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.