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Assessment of Variability in Hospita...

Karichu, James K.

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Assessment of Variability in Hospital Readmissions Among Medicare Beneficiaries in the United States.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Assessment of Variability in Hospital Readmissions Among Medicare Beneficiaries in the United States./
作者:	Karichu, James K.
出版者:	Ann Arbor : ProQuest Dissertations & Theses, : 2017,
面頁冊數:	209 p.
附註:	Source: Dissertation Abstracts International, Volume: 78-09(E), Section: B.
Contained By:	Dissertation Abstracts International78-09B(E).
標題:	Public health. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=10592410
ISBN:	9781369733839

Assessment of Variability in Hospital Readmissions Among Medicare Beneficiaries in the United States.
Karichu, James K.

Assessment of Variability in Hospital Readmissions Among Medicare Beneficiaries in the United States. - Ann Arbor : ProQuest Dissertations & Theses, 2017 - 209 p.

Source: Dissertation Abstracts International, Volume: 78-09(E), Section: B.

Thesis (Ph.D.)--Kent State University, 2017.

Background: Medicare risk standardized hospital readmission rates (RSRRs) vary substantially among hospitals in the United States (U.S.). The Centers for Medicare and Medicaid Services (CMS) has indicated that variation in RSRRs suggests quality of care differences between hospitals. However, other factors beyond quality of care have been implicated in this variability. The purpose of this study was to assess the amount of variation in 30-day RSRRs attributable to the county of hospital location among fee-for service (FFS) Medicare beneficiaries with a principal discharge diagnosis of heart failure (HF), acute myocardial infarction (AMI), and pneumonia (PN) in the U.S.

ISBN: 9781369733839Subjects--Topical Terms:

534748
Public health.

Assessment of Variability in Hospital Readmissions Among Medicare Beneficiaries in the United States.
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245 1 0 $a Assessment of Variability in Hospital Readmissions Among Medicare Beneficiaries in the United States.
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520 $a Background: Medicare risk standardized hospital readmission rates (RSRRs) vary substantially among hospitals in the United States (U.S.). The Centers for Medicare and Medicaid Services (CMS) has indicated that variation in RSRRs suggests quality of care differences between hospitals. However, other factors beyond quality of care have been implicated in this variability. The purpose of this study was to assess the amount of variation in 30-day RSRRs attributable to the county of hospital location among fee-for service (FFS) Medicare beneficiaries with a principal discharge diagnosis of heart failure (HF), acute myocardial infarction (AMI), and pneumonia (PN) in the U.S.
520 $a Methods: Data for the study were obtained from CMS, American Hospital Association (AHA), Area Health Resources Files (AHRF), County Health Rankings files, and U.S. Census Bureau data sets. Following data mergers, hierarchical linear modeling (HLM), with randomly varying intercepts, was conducted in SAS proc Glimmix. Results: For AMI, HF and PN 13.9, 37.3 and 26.5 percent respectively of variability in hospital-level RSRRs was attributable to the county of hospital location. Second, county-level per capita number of PCPs, percentage black-only resident population, the number of skilled nursing facilities per capita, and smoking rate were found to be statistically and independently associated with re-hospitalization across all three disease categories.
520 $a Conclusions: Findings from this study indicate that county-level factors explain a notable amount of variability in hospital RSRRs, but the size of explained variability varies by medical condition. These findings underscore the importance of neighborhood factors in explaining variability in hospital-level RSRRs.
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