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Assessment of Variability in Hospital Readmissions Among Medicare Beneficiaries in the United States.

Record Type:	Language materials, manuscript : Monograph/item
Title/Author:	Assessment of Variability in Hospital Readmissions Among Medicare Beneficiaries in the United States./
Author:	Karichu, James K.
Description:	1 online resource (209 pages)
Notes:	Source: Dissertation Abstracts International, Volume: 78-09(E), Section: B.
Contained By:	Dissertation Abstracts International78-09B(E).
Subject:	Public health. -
Online resource:	click for full text (PQDT)
ISBN:	9781369733839

Assessment of Variability in Hospital Readmissions Among Medicare Beneficiaries in the United States.
Karichu, James K.

Assessment of Variability in Hospital Readmissions Among Medicare Beneficiaries in the United States. - 1 online resource (209 pages)

Source: Dissertation Abstracts International, Volume: 78-09(E), Section: B.

Thesis (Ph.D.)

Includes bibliographical references

Background: Medicare risk standardized hospital readmission rates (RSRRs) vary substantially among hospitals in the United States (U.S.). The Centers for Medicare and Medicaid Services (CMS) has indicated that variation in RSRRs suggests quality of care differences between hospitals. However, other factors beyond quality of care have been implicated in this variability. The purpose of this study was to assess the amount of variation in 30-day RSRRs attributable to the county of hospital location among fee-for service (FFS) Medicare beneficiaries with a principal discharge diagnosis of heart failure (HF), acute myocardial infarction (AMI), and pneumonia (PN) in the U.S.

Electronic reproduction.
Ann Arbor, Mich. :
ProQuest,
2018

Mode of access: World Wide Web

ISBN: 9781369733839Subjects--Topical Terms:

560998
Public health.
Index Terms--Genre/Form:

554714
Electronic books.

Assessment of Variability in Hospital Readmissions Among Medicare Beneficiaries in the United States.
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100 1 $a Karichu, James K. $3 1181428
245 1 0 $a Assessment of Variability in Hospital Readmissions Among Medicare Beneficiaries in the United States.
264 0 $c 2017
300 $a 1 online resource (209 pages)
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500 $a Source: Dissertation Abstracts International, Volume: 78-09(E), Section: B.
502 $a Thesis (Ph.D.) $c Kent State University $d 2017.
504 $a Includes bibliographical references
520 $a Background: Medicare risk standardized hospital readmission rates (RSRRs) vary substantially among hospitals in the United States (U.S.). The Centers for Medicare and Medicaid Services (CMS) has indicated that variation in RSRRs suggests quality of care differences between hospitals. However, other factors beyond quality of care have been implicated in this variability. The purpose of this study was to assess the amount of variation in 30-day RSRRs attributable to the county of hospital location among fee-for service (FFS) Medicare beneficiaries with a principal discharge diagnosis of heart failure (HF), acute myocardial infarction (AMI), and pneumonia (PN) in the U.S.
520 $a Methods: Data for the study were obtained from CMS, American Hospital Association (AHA), Area Health Resources Files (AHRF), County Health Rankings files, and U.S. Census Bureau data sets. Following data mergers, hierarchical linear modeling (HLM), with randomly varying intercepts, was conducted in SAS proc Glimmix. Results: For AMI, HF and PN 13.9, 37.3 and 26.5 percent respectively of variability in hospital-level RSRRs was attributable to the county of hospital location. Second, county-level per capita number of PCPs, percentage black-only resident population, the number of skilled nursing facilities per capita, and smoking rate were found to be statistically and independently associated with re-hospitalization across all three disease categories.
520 $a Conclusions: Findings from this study indicate that county-level factors explain a notable amount of variability in hospital RSRRs, but the size of explained variability varies by medical condition. These findings underscore the importance of neighborhood factors in explaining variability in hospital-level RSRRs.
533 $a Electronic reproduction. $b Ann Arbor, Mich. : $c ProQuest, $d 2018
538 $a Mode of access: World Wide Web
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650 4 $a Public policy. $3 1002398
650 4 $a Health sciences. $3 1179212
650 4 $a Health care management. $3 1148454
655 7 $a Electronic books. $2 local $3 554714
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710 2 $a ProQuest Information and Learning Co. $3 1178819
710 2 $a Kent State University. $b Public Health. $3 1181429
773 0 $t Dissertation Abstracts International $g 78-09B(E).
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=10592410 $z click for full text (PQDT)