A January 22, 2017 JAMA article examined the readmission rate and costs of patients discharged with a diagnosis of sepsis. The study examined the 30-day readmission rates. Currently, CMS tracks readmissions following index hospitalizations for acute myocardial infarction (AMI), heart failure, chronic obstructive pulmonary disease (COPD), and pneumonia Although previously unstudied, the authors hypothesized that… Read More
A Perspective article from The New England Journal of Medicine — Days Spent at Home — A Patient-Centered Goal and Outcome This study suggests we should consider days at home as a quality measure rather then readmissions. Post measures of the quality of health care delivery focus on what health care providers do, not what… Read More
This November 4, 2016 New York Times Article talks about how Community paramedicine programs are expanding and are increasingly tending to older patients in their homes, solving problems there and eliminating costly ambulance trips. In 2009, when Medstar Mobile Healthcare began enrolling patients in Fort Worth, it was one of four emergency services in the… Read More
This JAMA article discusses the problems of routinely hospitalizing elderly patients which may hasten their disability, independence, and demise In older patients, acute medical illness that requires hospitalization is a sentinel event that often precipitates disability. This results in the subsequent inability to live independently and complete basic activities of daily living (ADLs). This hospitalization-associated… Read More
This is a troubling study that finds an inverse relationship between readmissions and mortality. It states that if you include increased mortality as a quality measure almost 1/3 of hospitals with a favorable readmission rate would be penalized This study attempts to determine how readmission penalties for hospitals in the United States would change if… Read More
A study in Journal of Hospital Medicine, hospitalist Daniel J. Brotman, MD, and his colleagues examined nearly 4,500 acute-care hospitals’ hospital-wide readmission rates and compared them with those hospitals’ mortality rates in six areas used by the Centers for Medicare & Medicaid Services: heart attack, pneumonia, heart failure, stroke, chronic obstructive pulmonary disease, and coronary… Read More
The bipartisan legislation put forward this week would also allow off-campus hospital outpatient departments currently under construction to continue receiving higher rates than similar facilities that aren’t owned by hospitals. Bipartisan legislation introduced this week would tweak Medicare’s readmissions program to adjust for socio-economic status of patients. It would also allow off-campus hospital outpatient departments… Read More
Over the past decade hospitals have increasingly decided to employ physicians. In 2003, hospitals employed about 29% of physicians and that has dramatically increased to 42% of hospitals in 2012. Hospitals argued that this would increase productivity and was needed to coordinate care and improve quality. A study in the September 20, 2016 issue of… Read More
An article by Padma Gulur et al. in Pain Research and Treatment Volume 2015 (2015), Article ID 482081 looked at morphine and hydromorphone use. Hydromorphone (Dilaudid) is up to 7.5 times as potent as morphine and its use has dramatically increased in the past decade. This study has some great background information and resources which… Read More
