Evidence map›Paper›PMID 38770653›Full record

ArticleCirculation. Cardiovascular quality and outcomes2024

Home Health Care Use and Outcomes After Coronary Artery Bypass Grafting Among Medicare Beneficiaries.

Michael P Thompson, Hechuan Hou, Donald S Likosky, Francis D Pagani, Jason R Falvey, Kathryn H Bowles, Rishi K Wadhera, Madeline R Sterling

Abstract read
In one paragraph

Article in Circulation. Cardiovascular quality and outcomes, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. 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

8 authors.

Michael P ThompsonDepartment of Cardiac Surgery (M.P.T., H.H., D.S.L., F.D.P.), University of Michigan, Ann Arbor.
Hechuan HouDepartment of Cardiac Surgery (M.P.T., H.H., D.S.L., F.D.P.), University of Michigan, Ann Arbor.ORCID 0000-0002-0890-0746
Donald S LikoskyDepartment of Cardiac Surgery (M.P.T., H.H., D.S.L., F.D.P.), University of Michigan, Ann Arbor.ORCID 0000-0003-0416-9359
Francis D PaganiDepartment of Cardiac Surgery (M.P.T., H.H., D.S.L., F.D.P.), University of Michigan, Ann Arbor.ORCID 0000-0003-4430-9969
Jason R FalveyDepartment of Physical Therapy and Rehabilitation Science and Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore (J.F.).
Kathryn H BowlesDepartment of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia (K.H.B.).ORCID 0000-0001-7740-5725
Rishi K WadheraRichard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Boston, MA (R.K.W.).ORCID 0000-0003-1089-3896
Madeline R SterlingDepartment of Medicine, Weill Cornell Medicine, New York, NY (M.R.S.).ORCID 0000-0002-9928-4407

Funding

University of Maryland Claude D. Pepper Older Americans Independence Center (UM-OAIC)P30AG028747 · NIA · UNIVERSITY OF MARYLAND BALTIMORE · PI ALICE S. RYAN · 2006 to 2026
$28.9M
Cardiovascular Health of Low-Income Working-Age Adults in the US: Health Care Access, Policy, and the PandemicR01HL164561 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI Rishi Kumar Wadhera · 2022 to 2026
$3.7M
Novel Assessments of Technical and Non-Technical Cardiac Surgery QualityR01HL146619 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI LIKOSKY, DONALD S, PAGANI, FRANCIS D · 2020 to 2024
$3.4M
I-TRANSFER-HF: Improving TRansitions ANd OutcomeS for Heart FailurE Patients in Home Health CaRe: A Type 1 Hybrid Effectiveness Implementation TrialR01HL169312 · NHLBI · WEILL MEDICAL COLL OF CORNELL UNIV · PI Madeline R Sterling · 2023 to 2026
$3.1M
Understanding and Addressing Variation in Healthcare-Associated Infections After Durable Ventricular Assist Device TherapyR01HS026003 · AHRQ · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI LIKOSKY, DONALD S · 2018 to 2022
$2.3M
The ENRICH Study: Engaging Community and Municipal Services to Promote High Quality Aging in Place After Hip FractureK76AG074926 · NIA · UNIVERSITY OF MARYLAND BALTIMORE · PI FALVEY, JASON RAYMOND · 2021 to 2025
$1.4M
Leveraging Home Health Aides to Improve Outcomes in Heart FailureK23HL150160 · NHLBI · WEILL MEDICAL COLL OF CORNELL UNIV · PI STERLING, MADELINE R · 2020 to 2024
$921k
Explaining Rising Heart Failure Mortality in MedicareK23HL148525 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI WADHERA, RISHI KUMAR · 2019 to 2023
$863k
Determinants, Outcomes, and Financial Incentives Associated with Cardiac Rehabilitation Enrollment After Cardiac SurgeryK01HS027830 · AHRQ · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI THOMPSON, MICHAEL PATRICK · 2021 to 2025
$711k
AHRQ HHS K01 HS027830AHRQ HHS R01 HS026003NHLBI NIH HHS K23 HL148525NHLBI NIH HHS K23 HL150160NHLBI NIH HHS R01 HL146619NHLBI NIH HHS R01 HL164561NHLBI NIH HHS R01 HL169312NIA NIH HHS K76 AG074926NIA NIH HHS P30 AG028747
6 · The paper itself

Abstract

backgroundHome health care (HHC) has been increasingly used to improve care transitions and avoid poor outcomes, but there is limited data on its use and efficacy following coronary artery bypass grafting. The purpose of this study was to describe HHC use and its association with outcomes among Medicare beneficiaries undergoing coronary artery bypass grafting.

methodsRetrospective analysis of 100% of Medicare fee-for-service files identified 77 331 beneficiaries undergoing coronary artery bypass grafting and discharged to home between July 2016 and December 2018. The primary exposure of HHC use was defined as the presence of paid HHC claims within 30 days of discharge. Hierarchical logistic regression identified predictors of HHC use and the percentage of variation in HHC use attributed to the hospital. Propensity-matched logistic regression compared mortality, readmissions, emergency department visits, and cardiac rehabilitation enrollment at 30 and 90 days after discharge between HHC users and nonusers.

resultsA total of 26 751 (34.6%) of beneficiaries used HHC within 30 days of discharge, which was more common among beneficiaries who were older (72.9 versus 72.5 years), male (79.4% versus 77.4%), White (90.2% versus 89.2%), and not Medicare-Medicaid dual eligible (6.7% versus 8.8%). The median hospital-level rate of HHC use was 31.0% (interquartile range, 13.7%-54.5%) and ranged from 0% to 94.2%. Nearly 30% of the interhospital variation in HHC use was attributed to the discharging hospital (intraclass correlation coefficient, 0.296 [95% CI, 0.275-0.318]). Compared with non-HHC users, those using HHC were less likely to have a readmission or emergency department visit, were more likely to enroll in cardiac rehabilitation, and had modestly higher mortality within 30 or 90 days of discharge.

conclusionsA third of Medicare beneficiaries undergoing coronary artery bypass grafting used HHC within 30 days of discharge, with wide interhospital variation in use and mixed associations with clinical outcomes and health care utilization.

Indexed as

Coronary Artery BypassHome Care ServicesMedicarePatient ReadmissionAgedAged, 80 and overCardiac RehabilitationCoronary Artery DiseaseDatabases, FactualEmergency Service, HospitalFee-for-Service PlansFemaleHumansInsurance BenefitsMalePatient Dischargecoronary artery bypasshome care servicesMedicareoutcome assessment

Identifiers

PMID38770653
PMCPMC11251853

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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.