Title |
Association of hospice utilization and publicly reported outcomes following hospitalization for pneumonia or heart failure: a retrospective cohort study
|
---|---|
Published in |
BMC Health Services Research, January 2018
|
DOI | 10.1186/s12913-017-2801-3 |
Pubmed ID | |
Authors |
Soowhan Lah, Emily L. Wilson, Sarah Beesley, Iftach Sagy, James Orme, Victor Novack, Samuel M. Brown |
Abstract |
The Center for Medicare and Medicaid Services (CMS) and the Hospital Quality Alliance began collecting and reporting United States hospital performance in the treatment of pneumonia and heart failure in 2008. Whether the utilization of hospice might affect CMS-reported mortality and readmission rates is not known. Hospice utilization (mean days on hospice per decedent) for 2012 from the Dartmouth Atlas (a project of the Dartmouth Institute that reports a variety of public health and policy-related statistics) was merged with hospital-level 30-day mortality and readmission rates for pneumonia and heart failure from CMS. The association between hospice use and outcomes was analyzed with multivariate quantile regression controlling for quality of care metrics, acute care bed availability, regional variability and other measures. 2196 hospitals reported data to both CMS and the Dartmouth Atlas in 2012. Higher rates of hospice utilization were associated with lower rates of 30-day mortality and readmission for pneumonia but not for heart failure. Higher quality of care was associated with lower rates of mortality for both pneumonia and heart failure. Greater acute care bed availability was associated with increased readmission rates for both conditions (p < 0.05 for all). Higher rates of hospice utilization were associated with lower rates of 30-day mortality and readmission for pneumonia as reported by CMS. While causality is not established, it is possible that hospice referrals might directly affect CMS outcome metrics. Further clarification of the relationship between hospice referral patterns and publicly reported CMS outcomes appears warranted. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 1 | 33% |
Unknown | 2 | 67% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 1 | 33% |
Science communicators (journalists, bloggers, editors) | 1 | 33% |
Scientists | 1 | 33% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 52 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 10 | 19% |
Other | 5 | 10% |
Student > Bachelor | 5 | 10% |
Researcher | 3 | 6% |
Student > Postgraduate | 3 | 6% |
Other | 6 | 12% |
Unknown | 20 | 38% |
Readers by discipline | Count | As % |
---|---|---|
Nursing and Health Professions | 8 | 15% |
Medicine and Dentistry | 7 | 13% |
Pharmacology, Toxicology and Pharmaceutical Science | 2 | 4% |
Business, Management and Accounting | 2 | 4% |
Biochemistry, Genetics and Molecular Biology | 2 | 4% |
Other | 6 | 12% |
Unknown | 25 | 48% |