Key result
Hospitals with the highest share of dual-eligible patients had higher 30-day all-cause readmissions compared with lowest-share hospitals (adjusted OR 1.24; 95% CI 1.14-1.35).
Why the study?
Little is known about the association of a hospital's share of Medicare-Medicaid dual-eligible beneficiaries with heart failure quality of care and outcomes under peer group-based payment systems.
Does admission to hospitals with a higher share of dual-eligible patients increase 30-day all-cause readmission in older patients with heart failure?
Population
258 995 hospitalized HF patients 65 years or older across 455 sites
Comparison
Hospitals grouped into quintiles based on their share of dual-eligible patients
Design
Retrospective cohort study
Follow-up
30 days
Authors
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May warrant targeted quality efforts at safety-net hospitals; extends disparity data but leaves causality open for trials.
Cohort (n=258,995)
Yes
Does admission to hospitals with a higher share of dual-eligible patients increase 30-day all-cause readmission in older patients with heart failure?
Odds Ratio: 1.24 (95% CI 1.14–1.35)
Hospitals caring for a higher proportion of dual-eligible Medicare and Medicaid patients have lower adherence to key heart failure process measures and higher 30-day readmission rates.
Bahiru et al. (2021) conducted a cohort in Heart failure (n=258,995). High hospital share of dual-eligible patients (quintile 5) vs. Low hospital share of dual-eligible patients (quintile 1) was evaluated on 30-day all-cause readmission (OR 1.24, 95% CI 1.14-1.35). Hospitals with the highest share of dual-eligible patients had higher 30-day all-cause readmissions compared with lowest-share hospitals (adjusted OR 1.24; 95% CI 1.14-1.35).
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