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September 4, 2018Health Services ResearchOpen Access

Effects of Medicare Medical Reviews on Ambiguous Short‐Stay Hospital Admissions

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Why the study?

Does Medicare's Medical Review program reduce the likelihood of short-stay inpatient admissions for targeted diagnoses like non-specific chest pain?

Population

Medicare beneficiaries with six primary intake diagnoses likely targeted by Medical Review, including…

Comparison

Medicare's Medical Review (MR) program vs Hospital visits occurring in Medicare…

Design

Cohort

Authors

BSBenjamin SilverRTI InternationalMRMomotazur RahmanRhode Island Department of HealthBWBrad WrightUniversity of South Carolina

Discussion

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Implication

MR modestly reduced short-stay admissions for nonspecific chest pain; leaves open effects on patient outcomes in observational data.

Structured PICO

Does Medicare's Medical Review program reduce the likelihood of short-stay inpatient admissions for targeted diagnoses like non-specific chest pain?

P
Population
Medicare beneficiaries (Part A and Part B claims, 2007-2010) with six primary intake diagnoses likely targeted by Medical Review, including 'Non-Specific Chest Pain'.
I
Intervention
Medicare's Medical Review (MR) program
C
Comparator
Hospital visits occurring in Medicare Administrative Contractors (MACs) that had not implemented the Medical Review program during the period of interest
O
Outcome
Likelihood of short-stay inpatient admission

Medicare's Medical Review program modestly reduced the prevalence of short inpatient hospitalizations for diagnoses like non-specific chest pain, particularly in larger and non-system hospitals.

Cite This Study

Silver et al. (2018) studied this question.

synapsesocial.com/papers/6a797e8214b028facf0dcf00https://doi.org/10.1111/1475-6773.13036
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