Timely estimation of National Admission, readmission, and observation-stay rates in medicare patients with acute myocardial infarction, heart failure, or pneumonia using near real-time claims data
Abstract Background To estimate, prior to finalization of claims, the national monthly numbers of admissions and rates of 30-day readmissions and post-discharge observation-stays for Medicare fee-for-service beneficiaries hospitalized with acute myocardial infarction (AMI), heart failure (HF), or pn...
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| Format: | Article |
| Language: | English |
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BMC
2020-08-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12913-020-05611-w |
| _version_ | 1819230113483456512 |
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| author | Shu-Xia Li Yongfei Wang Sonam D. Lama Jennifer Schwartz Jeph Herrin Hao Mei Zhenqiu Lin Susannah M. Bernheim Steven Spivack Harlan M. Krumholz Lisa G. Suter |
| author_facet | Shu-Xia Li Yongfei Wang Sonam D. Lama Jennifer Schwartz Jeph Herrin Hao Mei Zhenqiu Lin Susannah M. Bernheim Steven Spivack Harlan M. Krumholz Lisa G. Suter |
| author_sort | Shu-Xia Li |
| collection | DOAJ |
| description | Abstract Background To estimate, prior to finalization of claims, the national monthly numbers of admissions and rates of 30-day readmissions and post-discharge observation-stays for Medicare fee-for-service beneficiaries hospitalized with acute myocardial infarction (AMI), heart failure (HF), or pneumonia. Methods The centers for Medicare & Medicaid Services (CMS) Integrated Data Repository, including the Medicare beneficiary enrollment database, was accessed in June 2015, February 2017, and February 2018. We evaluated patterns of delay in Medicare claims accrual, and used incomplete, non-final claims data to develop and validate models for real-time estimation of admissions, readmissions, and observation stays. Results These real-time reporting models accurately estimate, within 2 months from admission, the monthly numbers of admissions, 30-day readmission and observation-stay rates for patients with AMI, HF, or pneumonia. Conclusions This work will allow CMS to track the impact of policy decisions in real time and enable hospitals to better monitor their performance nationally. |
| first_indexed | 2024-12-23T11:23:54Z |
| format | Article |
| id | doaj.art-9c1d717475134f20aeb0220c6733a456 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-23T11:23:54Z |
| publishDate | 2020-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-9c1d717475134f20aeb0220c6733a4562022-12-21T17:49:00ZengBMCBMC Health Services Research1472-69632020-08-012011910.1186/s12913-020-05611-wTimely estimation of National Admission, readmission, and observation-stay rates in medicare patients with acute myocardial infarction, heart failure, or pneumonia using near real-time claims dataShu-Xia Li0Yongfei Wang1Sonam D. Lama2Jennifer Schwartz3Jeph Herrin4Hao Mei5Zhenqiu Lin6Susannah M. Bernheim7Steven Spivack8Harlan M. Krumholz9Lisa G. Suter10Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of MedicineSection of Cardiovascular Medicine, Department of Internal Medicine, Yale School of MedicineSection of Cardiovascular Medicine, Department of Internal Medicine, Yale School of MedicineSection of Cardiovascular Medicine, Department of Internal Medicine, Yale School of MedicineSection of Cardiovascular Medicine, Department of Internal Medicine, Yale School of MedicineSection of Cardiovascular Medicine, Department of Internal Medicine, Yale School of MedicineSection of Cardiovascular Medicine, Department of Internal Medicine, Yale School of MedicineSection of Cardiovascular Medicine, Department of Internal Medicine, Yale School of MedicineSection of Cardiovascular Medicine, Department of Internal Medicine, Yale School of MedicineSection of Cardiovascular Medicine, Department of Internal Medicine, Yale School of MedicineCenter for Outcomes Research and Evaluation, Yale-New Haven Health SystemAbstract Background To estimate, prior to finalization of claims, the national monthly numbers of admissions and rates of 30-day readmissions and post-discharge observation-stays for Medicare fee-for-service beneficiaries hospitalized with acute myocardial infarction (AMI), heart failure (HF), or pneumonia. Methods The centers for Medicare & Medicaid Services (CMS) Integrated Data Repository, including the Medicare beneficiary enrollment database, was accessed in June 2015, February 2017, and February 2018. We evaluated patterns of delay in Medicare claims accrual, and used incomplete, non-final claims data to develop and validate models for real-time estimation of admissions, readmissions, and observation stays. Results These real-time reporting models accurately estimate, within 2 months from admission, the monthly numbers of admissions, 30-day readmission and observation-stay rates for patients with AMI, HF, or pneumonia. Conclusions This work will allow CMS to track the impact of policy decisions in real time and enable hospitals to better monitor their performance nationally.http://link.springer.com/article/10.1186/s12913-020-05611-wReal-time reportingPrediction modelsMedicare claims dataReadmissionObservation stay |
| spellingShingle | Shu-Xia Li Yongfei Wang Sonam D. Lama Jennifer Schwartz Jeph Herrin Hao Mei Zhenqiu Lin Susannah M. Bernheim Steven Spivack Harlan M. Krumholz Lisa G. Suter Timely estimation of National Admission, readmission, and observation-stay rates in medicare patients with acute myocardial infarction, heart failure, or pneumonia using near real-time claims data BMC Health Services Research Real-time reporting Prediction models Medicare claims data Readmission Observation stay |
| title | Timely estimation of National Admission, readmission, and observation-stay rates in medicare patients with acute myocardial infarction, heart failure, or pneumonia using near real-time claims data |
| title_full | Timely estimation of National Admission, readmission, and observation-stay rates in medicare patients with acute myocardial infarction, heart failure, or pneumonia using near real-time claims data |
| title_fullStr | Timely estimation of National Admission, readmission, and observation-stay rates in medicare patients with acute myocardial infarction, heart failure, or pneumonia using near real-time claims data |
| title_full_unstemmed | Timely estimation of National Admission, readmission, and observation-stay rates in medicare patients with acute myocardial infarction, heart failure, or pneumonia using near real-time claims data |
| title_short | Timely estimation of National Admission, readmission, and observation-stay rates in medicare patients with acute myocardial infarction, heart failure, or pneumonia using near real-time claims data |
| title_sort | timely estimation of national admission readmission and observation stay rates in medicare patients with acute myocardial infarction heart failure or pneumonia using near real time claims data |
| topic | Real-time reporting Prediction models Medicare claims data Readmission Observation stay |
| url | http://link.springer.com/article/10.1186/s12913-020-05611-w |
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