Journal Article
Geographic Variation and Disparities in Total Joint Replacement Use for Medicare Beneficiaries: 2009 to 2017
The study objectives are to determine whether Black Medicare beneficiaries undergo fewer hip and knee replacements across regions, and whether disparities affected all or mainly affected socioeconomically disadvantaged Black beneficiaries.
Jan 29, 2021
Journal Article
Medicare Shared Savings Program and Readmission Rate Among Patients with Ischemic Stroke
Our aim was to determine if the Medicare Shared Savings Program is associated with changes in readmissions and mortality for patients hospitalized with ischemic stroke, and whether it has a different impact on safety net hospitals and non-SNHs.
Jan 29, 2021
Journal Article
National Quality Forum Guidelines for Evaluating the Scientific Acceptability of Risk-adjusted Clinical Outcome Measures: A Report From the National Quality Forum Scientific Methods Panel
Our goal is to promote the transparency of NQF evaluations, improve the quality of performance measurements, and engage surgeons and all other stakeholders to work together to advance the science of performance measurement.
Jan 29, 2021
Journal Article
Impact of Hospital Readmissions Reduction Program Penalties on Hip and Knee Replacement Readmissions: Comparison of Hospitals at Risk of Varying Penalty Amounts
We examined whether hospitals at risk of relatively large penalties from this expansion experienced greater declines in joint replacement readmissions compared with hospitals at risk of smaller penalties.
Jan 28, 2021
Journal Article
Impact of Risk Adjustment for Socioeconomic Status on Risk-adjusted Surgical Readmission Rates
This article assesses whether differences in readmission rates between safety-net hospitals (SNH) and non-SNHs are due to differences in hospital quality, and compares the results of hospital profiling with and without adjusting for socioeconomic status.
Jan 28, 2021
Journal Article
A Trauma Mortality Prediction Model Based on the ICD-10-CM Lexicon: TMPM-ICD10
The authors constructed an outcome prediction model using only ICD-10-CM acute injury codes and compared its performance with that of the injury severity score.
Jan 28, 2021
Journal Article
Survival Rates in Trauma Patients Following Health Care Reform in Massachusetts
This article examines the effect of Massachusetts health care reform on survival rates of injured patients.
Jan 28, 2021
Journal Article
Ranking Trauma Center Quality: Can Past Performance Predict Future Performance?
This article explores whether trauma center quality metrics based on historical data can reliably predict future trauma center performance.
Jan 28, 2021
Journal Article
Trauma Care Does Not Discriminate: The Association of Race and Health Insurance with Mortality Following Traumatic Injury
Using data from a sample of patients admitted to hospitals for traumatic injury, this article examines the effects of race and insurance coverage on mortality using two logistic regression models, for patients younger and older than 65 years.
Jan 28, 2021
Journal Article
The Adult Cardiac Anesthesiology Section of STS Adult Cardiac Surgery Database: 2020 Update on Quality and Outcomes
In this first update report on quality and outcomes of the Adult Cardiac Anesthesiology Section, we present an overview of the clinically significant anesthesia and surgical variables submitted between 2015 and 2018.
Jan 28, 2021
Journal Article
A Comparison of the Injury Severity Score and the Trauma Mortality Prediction Model
We compared the performance of the Trauma Mortality Prediction Model with the Injury Severity Score and other measures of injury severity in a single cohort of patients.
Jan 28, 2021
Journal Article
Considerations for Reduction of Risk of Perioperative Stroke in Adult Patients Undergoing Cardiac and Thoracic Aortic Operations: A Scientific Statement From the American Heart Association
We herein provide suggestions on preoperative, intraoperative, and postoperative strategies aimed at reducing the risk of perioperative stroke and at improving the outcomes of patients who experience a perioperative stroke.
Jan 28, 2021
Journal Article
Improving The Accuracy Of Hospital Quality Ratings By Focusing On The Association Between Volume And Outcome
The goal of this exploratory analysis was to examine the changes in hospital star rankings for aortic valve replacement when shrinkage targets based on hospital case volume are used instead of the standard CMS approach.
Jan 28, 2021
Journal Article
Impact of Obesity on Mortality and Complications in Trauma Patients
This article examines the association between obesity and outcomes in injured patients.
Jan 27, 2021
Journal Article
Penalties and Rewards for Safety Net Vs Non-Safety Net Hospitals in the First 2 Years of the Comprehensive Care for Joint Replacement Model
We assessed whether safety net hospitals, which serve vulnerable patients, were more likely to be penalized and less likely to receive rewards compared with non-safety net hospitals that serve few vulnerable patients.
Jan 22, 2021
Journal Article
Population-Based Analysis of Firearm Injuries Among Young Children in the United States, 2010–2015
This study compares the survival of children younger than five years to children and adolescents of age 5–19 years who presented to an ED for gunshot wounds, to test the hypothesis of higher GSW mortality in very young children.
Jan 22, 2021
Journal Article
Measuring Childbirth Outcomes Using Administrative and Birth Certificate Data
The aim of this study was to develop a risk-adjusted composite measure of severe maternal morbidity and severe newborn morbidity based on administrative and birth certificate data.
Jan 22, 2021
Journal Article
Impact of Medicare's Nonpayment Program on Venous Thromboembolism Following Hip and Knee Replacements
This article determines whether Medicare's Nonpayment Program was associated with decline in venous thromboembolism following hip and knee replacements, and whether the decline was greater among hospitals at risk of larger financial losses from the Program.
Jan 21, 2021
Journal Article
Injury Scoring: Then, Now, and Into the 21st Century
In this essay we review the recent history of injury outcome prediction and suggest how the future may play out.
Jan 21, 2021
Journal Article
Performance Of Safety-Net Hospitals In Year 1 Of The Comprehensive Care For Joint Replacement Model
This article finds safety-net hospitals were less likely to receive rewards in year one of the Comprehensive Care for Joint Replacement model because of their quality and spending performance.
Jan 21, 2021
Journal Article
Impact of the Choice of Risk Model for Identifying Low-risk Patients Using the 2014 American College of Cardiology/American Heart Association Perioperative Guidelines
The aim of this study is to determine how often three risk-prediction tools agree on the classification of patients as low risk (less than 1%) of major adverse cardiac event.
Jan 20, 2021
Journal Article
Variation in Readmission Rates Among Hospitals Following Admission for Traumatic Injury
We wished to determine if hospitals differed in their adjusted readmission rates following an index hospital admission for traumatic injury.
Jan 20, 2021
Journal Article
Variability in Case Durations for Common Surgical Procedures
This is an exploratory study to quantify the facility-level variation in surgical case duration for common surgeries.
Jan 20, 2021
Journal Article
Comparison of Two Prognostic Models in Trauma Outcome
This study compared the anatomical injury components of the Trauma Audit and Research Network model with the Trauma Mortality Prediction Model.
Jan 15, 2021
Journal Article
Risk Prediction Tools: The Need for Greater Transparency
If risk prediction tools are to be used in clinical care, it is essential that they be vetted with the same care as any new drug or medical device.
Jan 15, 2021
Journal Article
Raising the Alarm on Brain Attacks in Surgical Patients: Are We Doing Enough to Prevent and Treat Postoperative Strokes?
The time is right to update existing clinical practice guidelines on the management of patients at high risk for perioperative acute ischemic stroke.
Jan 15, 2021
Journal Article
Impact on Hospital Ranking of Basing Readmission Measures on a Composite Endpoint of Death or Readmission Versus Readmissions Alone
Hospital performance on readmissions is significantly different from hospital performance on a composite metric based on readmission and mortality.
Jan 14, 2021
Journal Article
Building Bridges Across Clinical Registries
For precision medicine and predictive analytics to become mainstream, we need an infrastructure that connects the massive number of digital breadcrumbs (Big Data) generated by individual patients over their lifetimes.
Jan 14, 2021
Journal Article
Does Medicare Advantage Reduce Racial Disparity in 30-Day Rehospitalization for Medicare Beneficiaries?
This study determined potential racial and ethnic disparities in risk for all-cause 30-day readmission among traditional Medicare and Medicare Advantage beneficiaries initially hospitalized for acute myocardial infarction, congestive heart failure, or pneumonia.
Jan 14, 2021
Journal Article
Impact of Medicare's Nonpayment Program on Hospital-acquired Conditions
This article determines whether Medicare's Nonpayment Program was associated with changes in incidence of hospital-acquired conditions, and whether this association varies across hospitals with differential Medicare patient load.
Dec 31, 2020
Journal Article
Quality of Quality Measurement: Impact of Risk Adjustment, Hospital Volume, and Hospital Performance
Monte Carlo simulation was used to examine the accuracy of performance profiling as a function of statistical methodology, case volume, and the extent to which hospital or physician performance deviates from the average.
Dec 31, 2020
Journal Article
The Differential Mortality of Glasgow Coma Score in Patients with and Without Head Injury
This article determines if the association of Glasgow Coma Score with mortality is influenced by the presence of traumatic brain injury.
Dec 31, 2020
Journal Article
Outcomes Are Worse in US Patients Undergoing Surgery on Weekends Compared With Weekdays
The aim of this study was to determine whether patients undergoing surgery on weekends are more likely to die or experience a major complication compared with patients undergoing surgery on a weekday.
Dec 31, 2020
Journal Article
Disparities in 30-Day Rehospitalization Rates Among Medicare Skilled Nursing Facility Residents by Race and Site of Care
This article examines racial and site-of-care disparities in all-cause and potentially avoidable 30-day rehospitalization rates among a national cohort of Medicare skilled nursing facility residents.
Dec 30, 2020
Journal Article
Does Mandating Nursing Home Participation in Quality Reporting Make a Difference? Evidence From Massachusetts
In this study, we investigate one of the mechanisms that may detract from the effectiveness of health care quality report cards: voluntary versus mandatory participation of nursing homes in public quality reporting.
Dec 30, 2020
Journal Article
Feasibility of Report Cards for Measuring Anesthesiologist Quality for Cardiac Surgery
We conducted a study of 55,436 patients undergoing cardiac surgery between 2009 and 2012. Hierarchical logistic regression modeling was used to examine the variation in in-hospital mortality or major complications.
Dec 30, 2020
Journal Article
What Can the National Quality Forum Tell Us About Performance Measurement in Anesthesiology?
In this article, we describe the current state of performance measurement in anesthesia care at the national level and highlight gaps and opportunities in performance measurement for anesthesiologists.
Dec 30, 2020
Journal Article
Redesigning Surgical Decision Making for High-Risk Patients
This article discusses how patients should be counseled about the risks of complications and functional impairment after major surgery.
Dec 30, 2020
Journal Article
Racial Disparities in the Use of Blood Transfusion in Major Surgery
We detected racial disparities in the use of blood transfusion for patients undergoing major surgery.
Dec 30, 2020
Journal Article
Trends in Family Ratings of Experience With Care and Racial Disparities Among Maryland Nursing Homes
We analyzed trends of consumer ratings publicly reported for Maryland nursing homes during 2007-2010, and determined whether racial/ethnic disparities in experiences with care changed.
Dec 29, 2020
Journal Article
Hospital Readmission After Noncardiac Surgery: The Role of Major Complications
To examine whether the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) predicted risk of major complications can be used to identify surgical patients at risk for rehospitalization.
Dec 22, 2020
Journal Article
Anesthesiologists and the Transformation of the Healthcare System: A Call to Action
This is the second in a series of six editorials on the changing definitions of safety across the perioperative period and how anesthesiologists can participate in and lead the transformation of health care with focus on patient value.
Dec 18, 2020
Journal Article
Effectiveness of Nonpublic Report Cards for Reducing Trauma Mortality
Nonpublic reporting of hospital risk-adjusted mortality rates does not lead to improved in-hospital mortality outcomes in trauma patients.
Dec 17, 2020
Journal Article
Satisfaction With Massachusetts Nursing Home Care Was Generally High During 2005–09, With Some Variability Across Facilities
Satisfaction with care in Massachusetts nursing homes is high, but family members are less satisfied with the physical and social activities available to residents.
Dec 17, 2020
Journal Article
Association Between Surgical Resident Involvement and Blood Use in Noncardiac Surgery
Senior surgery resident participation in noncardiac surgery is associated with a 56% to 78% higher risk of receiving a blood transfusion intraoperatively.
Dec 16, 2020
Journal Article
Preoperative Thrombocytopenia and Postoperative Outcomes After Noncardiac Surgery
Platelet count abnormalities found in preoperative coagulation testing are associated with increased risk of blood transfusion, mortality, and major complications.
Dec 16, 2020
Journal Article
Racial and Ethnic Differences in Outcomes in Older Patients With Acute Ischemic Stroke
Long-term outcomes of acute ischemic stroke vary by race/ethnicity among older patients with AIS.
Dec 16, 2020
Journal Article
Trends in Racial Disparities for Injured Patients Admitted to Trauma Centers
We performed an observational cohort study to determine whether outcome disparities between black and white trauma patients have decreased over the last 10 years.
Dec 10, 2020
Journal Article
Impact of Present-on-admission Indicators on Risk-adjusted Hospital Mortality Measurement
We sought to develop and validate a risk index for in-hospital mortality using only present-on-admission diagnoses, principal procedures, and secondary procedures occurring before the date of the principal procedure.
Dec 10, 2020
Journal Article
Blood Transfusion in the Perioperative Period
Anemia is associated with perioperative mortality and morbidity, and blood transfusion exposes the patient to both infectious and noninfectious complications.
Dec 10, 2020
Journal Article
State "Technical Assistance Programs" for Nursing Home Quality Improvement: Variations and Potential Implications
We conducted a national survey on state technical assistance programs for nursing homes to collect data on program design, operations, financing, and perceived effectiveness.
Dec 4, 2020
Journal Article
Mental Illness, Access to Hospitals with Invasive Cardiac Services, and Receipt of Cardiac Procedures by Medicare Acute Myocardial Infarction Patients
Mental illness was associated with reduced cardiac procedure use within each type of admitting hospital (with on-site invasive cardiac services or not).
Dec 3, 2020
Journal Article
Medicare Advantage Associated With More Racial Disparity Than Traditional Medicare For Hospital Readmissions
Risk-reduction strategies adopted by Medicare Advantage plans to prevent hospital readmissions have not succeeded in lowering the markedly higher rates of readmission for black patients compared to white patients.
Jul 26, 2017
Journal Article
Rates of Major Obstetrical Complications Vary Almost Fivefold Among U. S. Hospitals
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.
Aug 1, 2014
Journal Article
Increases in Mortality, Length of Stay, and Cost Associated with Hospital-Acquired Infections in Trauma Patients
Many hospital-acquired infections are preventable; reducing them would reduce in-hospital mortality, length of stay, and inpatient costs for trauma patients.
Jul 1, 2011
Journal Article
Impact of Date Stamping on Patient Safety Measurement in Patients Undergoing CABG: Experience with the AHRQ Patient Safety Indicators
The Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators (PSIs) provide information on hospital risk-adjusted rates for potentially preventable adverse events. Use of the present-on-admission indicator increases PSI accuracy.
Aug 13, 2008
Journal Article
Are High-Quality Cardiac Surgeons Less Likely to Operate on High-Risk Patients Compared to Low-Quality Surgeons? Evidence from New York State
Finds that high-risk coronary artery bypass graft patients are significantly more likely to receive care from high-quality surgeons compared with lower-risk patients.
2008
Journal Article
Impact of the Present-On-Admission Indicator on Hospital Quality Measurement: Experience with the Agency for Healthcare Research and Quality (AHRQ) Inpatient Quality Indicators
Measures of hospital quality using routinely available administrative data do not include a present-on-admission indicator to distinguish between preexisting conditions and complications. The inclusion of the indicator frequently changes rankings.
2008
Journal Article
A Trauma Mortality Prediction Model Based on the Anatomic Injury Scale
Develop a statistically rigorous trauma mortality prediction model based on empiric estimates of severity for each injury in the abbreviated injury scale (AIS) and compare the performance of this new model with the injury severity score (ISS).
2008
Journal Article
Nurse Working Conditions and Patient Safety Outcomes
Nurse working conditions were associated with all outcomes measured. Improving working conditions will most likely promote patient safety.
Jun 1, 2007
Journal Article
Effect of Complications on Mortality After Coronary Artery Bypass Grafting Surgery: Evidence from New York State
The objective of this study is to quantify the increased odds of dying from complications after isolated coronary artery bypass grafting surgery.
2007
Journal Article
Estimating the Potential Impact of Regionalizing Health Care Delivery Based on Volume Standards Versus Risk-Adjusted Mortality Rate
Whether basing regionalization on risk-adjusted mortality would lead to better population outcomes than basing regionalization on procedure volume.
2007
Journal Article
Misspecification Issues in Risk Adjustment and Construction of Outcome-Based Quality Indicators
Hospital report cards reporting risk-adjusted health outcomes are increasingly used to benchmark quality of care.
2007
Journal Article
Racial Differences in the Use of Epidural Analgesia for Labor
There is strong evidence that pain is undertreated in black and Hispanic patients.
2007
Journal Article
Use of a Matching Algorithm to Evaluate Hospital Coronary Artery Bypass Grafting Performance as an Alternative to Conventional Risk Adjustment
Basing outcome assessment on matching or regression modeling yielded similar findings on hospital ranking but moderate level of agreement on quality.
2007
Journal Article
Accuracy of Hospital Report Cards Based on Administrative Data
Many of the publicly available health quality report cards are based on administrative data.
2006
Journal Article
Does Date Stamping ICD-9-CM Codes Increase the Value of Clinical Information in Administrative Data?
Comorbidity measures are designed to exclude complications when they map International Classification of Diseases codes to diagnostic categories.
2006
Journal Article
Impact of Changing the Statistical Methodology on Hospital and Surgeon Ranking: The Case of the New York State Cardiac Surgery Report Card
Risk adjustment is central to the generation of health outcome report cards.
2006
Journal Article
Impact of Patient Volume on the Mortality Rate of Adult Intensive Care Unit Patients
There is evidence that high ICU patient volumes are associated with lower mortality rates in high-risk critically ill adults.
2006
Journal Article
The Relation Between Surgeon Volume and Outcome Following Off-Pump Vs On-Pump Coronary Artery Bypass Graft Surgery
Off-pump coronary artery bypass graft (CABG) surgery has been recently reintroduced into clinical practice.
2006