ArticleCirculation2022
Ninety-Day Risk-Standardized Home Time as a Performance Metric for Cardiac Surgery Hospitals in the United States.
Article in Circulation, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 13 citations in OpenAlex.
- Early outpatient follow-up, hospital-free survival, and health-related quality of life in older adults after hospitalization for acute myocardial infarction.Journal of hospital medicine · 2026Article
- Healing at Home: Receipt of Home Health Care and Patient-Centered Outcomes Among Older Adults After Acute Myocardial Infarction.Journal of the American Medical Directors Association · 2026Article
- Comparing Hospital-Free Days by Frailty Status for Patients Undergoing Surgical Intervention for Cardiovascular Disease.Journal of the American College of Surgeons · 2025Article
- Days at home after surgery as a perioperative outcome: scoping review and recommendations for use in health services research.The British journal of surgery · 2024Article
- Remote monitoring following adult cardiac surgery: A paradigm shift?JTCVS open · 2023Article
- Patient-, Clinician-, and Institution-level Variation in Inotrope Use for Cardiac Surgery: A Multicenter Observational Analysis.Anesthesiology · 2023Observational
- Frailty and Time at Home After Post-Acute Care in Skilled Nursing Facilities.Journal of the American Medical Directors Association · 2023Article
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Corrections and comments
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Authors and funding
16 authors at 8 institutions in 1 country.
Funding
Abstract
backgroundAssessing hospital performance for cardiac surgery necessitates consistent and valid care quality metrics. The association of hospital-level risk-standardized home time for cardiac surgeries with other performance metrics such as mortality rate, readmission rate, and annual surgical volume has not been evaluated previously.
methodsThe study included Medicare beneficiaries who underwent isolated or concomitant coronary artery bypass graft, aortic valve, or mitral valve surgery from January 1, 2013, to October 1, 2019. Hospital-level performance metrics of annual surgical volume, 90-day risk-standardized mortality rate, 90-day risk-standardized readmission rate, and 90-day risk-standardized home time were estimated starting from the day of surgery using generalized linear mixed models with a random intercept for the hospital. Correlations between the performance metrics were assessed using the Pearson correlation coefficient. Patient-level clinical outcomes were also compared across hospital quartiles by 90-day risk-standardized home time. Last, the temporal stability of performance metrics for each hospital during the study years was also assessed.
resultsOverall, 919 698 patients (age 74.2±5.8 years, 32% women) were included from 1179 hospitals. Median 90-day risk-standardized home time was 71.2 days (25th-75th percentile, 66.5-75.6), 90-day risk-standardized readmission rate was 26.0% (19.5%-35.7%), and 90-day risk-standardized mortality rate was 6.0% (4.0%-8.8%). Across 90-day home time quartiles, a graded decline was observed in the rates of in-hospital, 90-day, and 1-year mortality, and 90-day and 1-year readmission. Ninety-day home time had a significant positive correlation with annual surgical volume (
conclusionsNinety-day risk-standardized home time is a feasible, comprehensive, patient-centered metric to assess hospital-level performance in cardiac surgery with greater temporal stability than mortality and readmission measures.
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