Although reducing readmissions appears desirable because it may improve older adults' health and reduce costs, how will we know if the Hospital Readmissions Reduction Program (HRRP) policy has, in fact, been successful?
This paper compares the classification of hospital statistical outlier status as better or worse performance than expected for postoperative complications using Medicare claims versus clinical registry data.
This study aims to describe the magnitude of hospital costs among patients undergoing abdominal surgery, and determine whether hospital costs estimates are consistent with clinical expectations of hospital resource use.
RAND Europe is conducting a rapid review of the evidence of the effectiveness and efficiency of initiatives for reducing length of stay in hospital. The project will also examine the impact of these initiatives on the quality of care and patient experiences.
This study sought to (i) describe the nature of interventions that have been used to reduce length of stay in acute care hospitals; (ii) identify the factors that are known to influence length of stay; and (iii) assess the impact of interventions on patient outcomes, service outcomes and costs.
In a RAND study about the landscape of patient safety in Massachusetts, researchers interviewed expert observers (patients, health care leaders, and others) about progress to date and future opportunities to produce safer patient care.
Malpractice reform has been advocated by many experts as a key to reining in health care costs. Three states raised the standard for malpractice in the emergency room to gross negligence, but that did not translate into less-expensive care.
RAND researchers designed and field tested an Emergency Department Patient Experience of Care Survey for the Centers for Medicare & Medicaid Services for use with adult patients who have visited the emergency department.
It's not unusual for a demonstration to fall short of its original objectives. Learning from such cases is part of the innovation process. This is especially worthwhile for bundled payment, which has many potential benefits for patients, providers, and payers.
In many countries, the nature of hospital activity is changing. Different forms of hospital cooperation, such as hospital groups, networks, or systems, may have different impacts on hospital performance. Consolidation may lead to quality improvements, but there are also risks.
A pilot program intended to implement and test a cost-saving strategy for orthopedic procedures at hospitals in California failed to meet its goals, succumbing to recruitment challenges, regulatory uncertainty, administrative burden and concerns about financial risk.
Despite widespread interest in bundled payments as a strategy to control health care costs, implementation efforts continue to disappoint. A pilot program in California failed to meet its goals, succumbing to recruitment challenges, regulatory uncertainty, administrative burden, and concerns about financial risk.
Older adults are frequently hospitalized from the emergency department (ED) after an episode of unexplained syncope. We hypothesize that an emergency department observation syncope protocol will reduce resource use without adversely affecting patient-oriented outcomes.
Our finding that the rate of major obstetrical complications varies markedly across US hospitals should prompt clinicians and policy makers to develop comprehensive quality metrics for obstetrical care and focus on improving obstetrical outcomes.
The long-term effects of reform are important to consider because adherence to duty hour restrictions was limited in the first few years after the transition, and oversight of residents since the transition may have changed.