Considering the Role of Socioeconomic Status in Hospital Outcomes Measures

Editorials2 December 2014Considering the Role of Socioeconomic Status in Hospital Outcomes MeasuresHarlan M. Krumholz, MD, SM and Susannah M. Bernheim, MD, MHSHarlan M. Krumholz, MD, SMFrom Yale University School of Medicine, New Haven, Connecticut, and Yale-New Haven Hospital Center for Outcomes Research and Evaluation, New Haven, Connecticut. and Susannah M. Bernheim, MD, MHSFrom Yale University School of Medicine, New Haven, Connecticut, and Yale-New Haven Hospital Center for Outcomes Research and Evaluation, New Haven, Connecticut.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M14-2308 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Our team at the Center for Outcomes Research and Evaluation at Yale-New Haven Hospital developed readmission measures for the Centers for Medicare & Medicaid Services with the goal of illuminating hospital performance and stimulating efforts to improve patient care. We believed that such efforts could improve patient recovery and reduce the occurrence of adverse health events after discharge. We developed these measures using data from administrative claims and validated them against measures using medical records data (1). National readmission rates within 30 days of hospital discharge were exceedingly high for common diagnoses, such as acute myocardial infarction, heart failure, and ...References1. Keenan PS, Normand SL, Lin Z, Drye EE, Bhat KR, Ross JS, et al. An administrative claims measure suitable for profiling hospital performance on the basis of 30-day all-cause readmission rates among patients with heart failure. Circ Cardiovasc Qual Outcomes. 2008;1:29-37. [PMID: 20031785] doi:10.1161/CIRCOUTCOMES.108.802686 CrossrefMedlineGoogle Scholar2. Daughtridge GW, Archibald T, Conway PH. Quality improvement of care transitions and the trend of composite hospital care. JAMA. 2014;311:1013-4. [PMID: 24618959] doi:10.1001/jama.2014.509 CrossrefMedlineGoogle Scholar3. Lipstein SH, Dunagan WC. The risks of not adjusting performance measures for sociodemographic factors. Ann Intern Med. 2014;161:594-6. [PMID: 25048401] doi:10.7326/M14-1601 LinkGoogle Scholar4. National Quality Forum. Risk Adjustment for Socioeconomic Status or Other Sociodemographic Factors. Technical Report. 2014. Accessed at www.qualityforum.org/Publications/2014/08/Risk_Adjustment_for_Socioeconomic_Status_or_Other_Sociodemographic_Factors.aspx on 23 October 2014. Google Scholar5. Kind AJ, Jencks S, Brock J, Yu M, Bartels C, Ehlenbach W, et al. Neighborhood socioeconomic disadvantage and 30-day rehospitalization. A restrospective cohort study. Ann Intern Med. 2014;161:765-74. doi:10.7326/M13-2946 LinkGoogle Scholar6. Bikdeli B, Wayda B, Bao H, Ross JS, Xu X, Chaudhry SI, et al. Place of residence and outcomes of patients with heart failure: analysis from the telemonitoring to improve heart failure outcomes trial. Circ Cardiovasc Qual Outcomes. 2014;7:749-56. [PMID: 25074375] doi:10.1161/CIRCOUTCOMES.113.000911 CrossrefMedlineGoogle Scholar7. Keyhani S, Myers LJ, Cheng E, Hebert P, Williams LS, Bravata DM. Effect of clinical and social risk factors on hospital profiling for stroke readmission.A cohort study. Ann Intern Med. 2014;161:775-84. doi:10.7326/M14-0361 LinkGoogle Scholar8. Smedley BD, Stith AY, Nelson AR; Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, DC: National Academies Pr; 2003. Google Scholar9. Ross JS, Bernheim SM, Lin Z, Drye EE, Chen J, Normand SL, et al. Based on key measures, care quality for Medicare enrollees at safety-net and non-safety-net hospitals was almost equal. Health Aff (Millwood). 2012;31:1739-48. [PMID: 22869652] doi:10.1377/hlthaff.2011.1028 CrossrefMedlineGoogle Scholar10. Medicare Payment Advisory Commission. Report to the Congress: Medicare and the Health Care Delivery System. 2013. Accessed at www.medpac.gov/documents/reports/jun13_entirereport.pdf on 23 October 2014. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Yale University School of Medicine, New Haven, Connecticut, and Yale-New Haven Hospital Center for Outcomes Research and Evaluation, New Haven, Connecticut.Grant Support: Dr. Krumholz is supported by the National Heart, Lung, and Blood Institute Center for Cardiovascular Outcomes Research at Yale University (grant U01 HL105270-05).Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-2308.Corresponding Author: Harlan M. Krumholz, MD, SM, Yale University School of Medicine, 1 Church Street, Suite 200, New Haven, CT 06510; e-mail, harlan.[email protected]edu.Current Author Addresses: Drs. Krumholz and Bernheim: Yale University School of Medicine, 1 Church Street, Suite 200, New Haven, CT 06510. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoNeighborhood Socioeconomic Disadvantage and 30-Day Rehospitalization Amy J.H. 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Hockenberry, PhD, E. Kathleen Adams, PhD, Arnold S. Milstein, MD, Ira B. Wilson, MD, MSc, and Edmund R. Becker, PhDThe Role of Socioeconomic Status in Hospital Outcomes MeasuresAlan M. Zaslavsky, PhD and Ashish K. Jha, MD, MPH 2 December 2014Volume 161, Issue 11Page: 833-834KeywordsDisclosureHealth careHealth care qualityHealth care quality assessmentLegislationMedicarePatientsPopulation statistics ePublished: 2 December 2014 Issue Published: 2 December 2014 Copyright & PermissionsCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...