Evidence map›Paper›PMID 36752354›Full record

Observational studyArthritis care & research2023

Associations of Postdischarge Follow-Up With Acute Care and Mortality in Lupus: A Medicare Cohort Study.

Maria Schletzbaum, Nadia Sweet, Brad Astor, Ang Yu, W Ryan Powell, Andrea Gilmore-Bykovskyi, Farah Kaiksow, Ann Sheehy, Amy J Kind, Christie M Bartels

Open access · bronzeAbstract readObservational Study
In one paragraph

Observational study in Arthritis care & research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 24% of its field
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

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. 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

10 authors at 1 institution in 1 country.

Maria SchletzbaumUniversity of Wisconsin, Madison.ORCID 0000-0002-9009-3620
Nadia SweetUniversity of Wisconsin, Madison.
Brad AstorUniversity of Wisconsin, Madison.ORCID 0000-0002-0876-0069
Ang YuUniversity of Wisconsin, Madison.ORCID 0000-0002-1828-0165
W Ryan PowellUniversity of Wisconsin, Madison.ORCID 0000-0001-6340-1520
Andrea Gilmore-BykovskyiUniversity of Wisconsin, Madison.ORCID 0000-0003-4930-3558
Farah KaiksowUniversity of Wisconsin, Madison.ORCID 0000-0002-1625-2187
Ann SheehyUniversity of Wisconsin, Madison.ORCID 0000-0001-6856-4687
Amy J KindUniversity of Wisconsin, Madison.ORCID 0000-0002-7183-610X
Christie M BartelsUniversity of Wisconsin, Madison.ORCID 0000-0001-6523-0374
University of Wisconsin–Madison · US

Funding

Integrated Training For Physician-ScientistsT32GM140935 · NIGMS · UNIVERSITY OF WISCONSIN-MADISON · PI Anna Huttenlocher, Jeniel E Nett · 2021 to 2026
$6.5M
Neighborhood Socioeconomic Disadvantage and Medicare's 30-Day Rehospitalization Policy: Eliminating Rehospitalization Disparities by Informing Policy Design and ImplementationR01MD010243 · NIMHD · UNIVERSITY OF WISCONSIN-MADISON · PI KIND, AMY J. · 2015 to 2019
$2.8M
Investigating the Role of Care Retention in Lupus Disease Outcomes and Disparities in Young Adult and Pediatric PatientsF30MD015211 · NIMHD · UNIVERSITY OF WISCONSIN-MADISON · PI SCHLETZBAUM BOWLER, MARIA ANNA · 2020 to 2022
$122k
NIGMS NIH HHS T32 GM140935NIMHD NIH HHS F30 MD015211NIMHD NIH HHS R01 MD010243
6 · The paper itself

Abstract

objectivePatients with systemic lupus erythematosus experience the sixth highest rate of 30-day readmissions among chronic diseases. Timely postdischarge follow-up is a marker of ambulatory care quality that can reduce readmissions in other chronic conditions. Our objective was to test the hypotheses that 1) beneficiaries from populations experiencing health disparities, including patients from disadvantaged neighborhoods, will have lower odds of completed follow-up, and that 2) follow-up will predict longer time without acute care use (readmission, observation stay, or emergency department visit) or mortality.

methodsThis observational cohort study included hospitalizations in January-November 2014 from a 20% random sample of Medicare adults. Included hospitalizations had a lupus code, discharge to home without hospice, and continuous Medicare A/B coverage for 1 year before and 1 month after hospitalization. Timely follow-up included visits with primary care or rheumatology within 30 days. Thirty-day survival outcomes were acute care use and mortality adjusted for sociodemographic information and comorbidities.

resultsOver one-third (35%) of lupus hospitalizations lacked 30-day follow-up. Younger age, living in disadvantaged neighborhoods, and rurality were associated with lower odds of follow-up. Follow-up was not associated with subsequent acute care or mortality in beneficiaries age <65 years. In contrast, follow-up was associated with a 27% higher hazard for acute care use (adjusted hazard ratio [HR] 1.27 [95% confidence interval (95% CI) 1.09-1.47]) and 65% lower mortality (adjusted HR 0.35 [95% CI 0.19-0.67]) among beneficiaries age ≥65 years.

conclusionOne-third of lupus hospitalizations lacked follow-up, with significant disparities in rural and disadvantaged neighborhoods. Follow-up was associated with increased acute care, but 65% lower mortality in older systemic lupus erythematosus patients. Further development of lupus-specific postdischarge strategies is needed.

Indexed as

AftercarePatient DischargeAdultAgedCohort StudiesHospitalizationHumansMedicarePatient ReadmissionRetrospective StudiesUnited States

Identifiers

PMID36752354
PMCPMC10406973
OpenAlexW4319461285

What OpenQuestion holds

Textmetadata
LicenceTDM
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.