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Unplanned Readmissions after Hospital Discharge among Heart Failure Patients At Risk for 30-Day Readmission Using an Administrative Dataset and “Off the Shelf” Readmission Models
| Content Provider | Semantic Scholar |
|---|---|
| Author | Reed, James Farr Bokovoy, Jonna L. Doram, Keith |
| Copyright Year | 2014 |
| Abstract | Background: Readmission of patients who were recently discharged after hospitalization with heart failure (HF) represents an important, expensive, and often preventable adverse outcome. The risk of readmission may be modified by the quality and type of care provided to these patients. Improving readmission rates is the joint responsibility of hospitals and clinicians. Measuring readmission will create incentives to invest in interventions to improve hospital care, better assess the readiness of patients for discharge and facilitate transitions to outpatient status. This measure is also responsive to the recent call by Medicare Payment Advisory Commission to develop readmission measures, with HF as a priority condition. Objective: Unplanned hospital readmission has emerged as a major CMS focus of quality improvement and payment reform. Coupled with national initiatives, Adventist Health West chose unplanned readmissions following an index hospitalization for HF for a major system-wide initiative for CY 2013. Methods: Given competitive heart failure readmission models, our strategy became one of using the best of three – LACE, Hansan and PARR – as the basic building blocks to find a better predictive readmissions model. Results: The ROC curve and C-statistics for the five models using the combined data from Adventist Hospitals were computed for the combined hospitals and individually for each entity. Overall, the Hasan, PARR, and AH Models (C-statistics of 0.802, 0.821 and 0.846, respectively) were superior to either the CMS or LACE prediction model (C-statistic of 0.749 and 0.547, respectively). Conclusion: Using “Off the Shelf” readmission HF models as a guide, a useful readmission model may be derived which, in this case, is slightly superior than competing readmission models. |
| File Format | PDF HTM / HTML |
| Volume Number | 9 |
| Alternate Webpage(s) | https://print.ispub.com/api/0/ispub-article/14837 |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
