ArticleThe Journal of thoracic and cardiovascular surgery2022
Interhospital variability in health care-associated infections and payments after durable ventricular assist device implant among Medicare beneficiaries.
Article in The Journal of thoracic and cardiovascular surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Developing a Toolkit to Reduce Infections Following Durable LVAD Implantation in the United States Using a Multistage Mixed Methods Design.Circulation. Cardiovascular quality and outcomes · 2025Guideline
- Interhospital variation in Medicare spending for infections after coronary artery bypass grafting and surgical aortic valve replacement.JTCVS open · 2026Article
- Interhospital variability in 180-day infections following cardiac surgery.The Journal of thoracic and cardiovascular surgery · 2025Article
- Association Between Left Ventricular Assist Device Infections and Number of Shared Patients Among Care Providers: A Network Analysis.The Annals of thoracic surgery · 2025Article
- Enhancing Qualitative and Quantitative Data Linkages in Complex Mixed Methods Designs: Illustrations from a Multi-Phase Healthcare Delivery Study.Journal of mixed methods research · 2024Article
- Infections following left ventricular assist device implantation and 1-year health-related quality of life.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2023Article
- Mortality following durable left ventricular assist device implantation by timing and type of first infection.The Journal of thoracic and cardiovascular surgery · 2023Article
- Comparison of Evaluations for Heart Transplant Before Durable Left Ventricular Assist Device and Subsequent Receipt of Transplant at Transplant vs Nontransplant Centers.JAMA network open · 2022Article
- Incompleteness of health-related quality of life assessments before left ventricular assist device implant: A novel quality metric.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2022Article
- Association Between Care Fragmentation and Total Spending After Durable Left Ventricular Device Implant: A Mediation Analysis of Health Care-Associated Infections Within a National Medicare-Society of Thoracic Surgeons Intermacs Linked Dataset.Circulation. Cardiovascular quality and outcomes · 2022Article
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Authors and funding
10 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveThe objective of this study was to investigate variations across hospitals in infection rates and associated costs, the latter reflected in 90-day Medicare payments. Despite high rates and expenditures of health care--associated infections associated with durable ventricular assist device implantation, few studies have examined interhospital variation and associated costs.
methodsClinical data on 8688 patients who received primary durable ventricular assist devices from July 2008 to July 2017 from the Society of Thoracic Surgeons Interagency Registry for Mechanically Assisted Circulatory Support (Intermacs) hospitals (n = 120) were merged with postimplantation 90-day Medicare claims. Terciles of hospital-specific, risk-adjusted infection rates per 100 patient-months were estimated using Intermacs and associated with Medicare payments (among 5440 Medicare beneficiaries). Primary outcomes included infections within 90 days of implantation and Medicare payments.
resultsThere were 3982 infections identified among 27.8% (2417/8688) of patients developing an infection. The median (25th, 75th percentile) adjusted incidence of infections (per 100 patient-months) across hospitals was 14.3 (9.3, 19.5) and varied according to hospital (range, 0.0-35.6). Total Medicare payments from implantation to 90 days were 9.0% (absolute difference: $13,652) greater in high versus low infection tercile hospitals (P < .0001). The period between implantation to discharge accounted for 73.1% of the difference in payments during the implantation to 90-day period across terciles.
conclusionsHealth care--associated infection rates post durable ventricular assist device implantation varied according to hospital and were associated with increased 90-day Medicare expenditures. Interventions targeting preventing infections could improve the value of durable ventricular assist device support from the societal and hospital perspectives.
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