2015
Development and Validation of an Algorithm to Identify Planned Readmissions From Claims Data
Horwitz LI, Grady JN, Cohen DB, Lin Z, Volpe M, Ngo CK, Masica AL, Long T, Wang J, Keenan M, Montague J, Suter LG, Ross JS, Drye EE, Krumholz HM, Bernheim SM. Development and Validation of an Algorithm to Identify Planned Readmissions From Claims Data. Journal Of Hospital Medicine 2015, 10: 670-677. PMID: 26149225, PMCID: PMC5459369, DOI: 10.1002/jhm.2416.Peer-Reviewed Original ResearchConceptsSame-hospital readmissionsNegative predictive valuePositive predictive valuePredictive valueReadmission measuresHospital-wide readmission measureGold standard chart reviewAdministrative claims-based algorithmDiagnostic cardiac catheterizationClaims-based algorithmLarge teaching centersAcute care hospitalsSmall community hospitalUnplanned readmissionChart reviewCardiac catheterizationScheduled careSpecificity 96.5Community hospitalReadmissionClaims dataCardiac devicesHealth systemTeaching centerPublic reporting
2014
Development and use of an administrative claims measure for profiling hospital-wide performance on 30-day unplanned readmission.
Horwitz LI, Partovian C, Lin Z, Grady JN, Herrin J, Conover M, Montague J, Dillaway C, Bartczak K, Suter LG, Ross JS, Bernheim SM, Krumholz HM, Drye EE. Development and use of an administrative claims measure for profiling hospital-wide performance on 30-day unplanned readmission. Annals Of Internal Medicine 2014, 161: s66-75. PMID: 25402406, PMCID: PMC4235629, DOI: 10.7326/m13-3000.Peer-Reviewed Original ResearchConceptsUnplanned readmissionReadmission measuresReadmission ratesReadmission riskMedicare feeHospital-wide readmission measureRisk-standardized readmission ratesPayer dataAdministrative Claims MeasureRisk-standardized ratesAverage-risk patientsUnplanned readmission rateDays of dischargeHospital risk-standardized readmission ratesAdult hospitalizationsComorbid conditionsPrincipal diagnosisClaims dataService claimsService beneficiariesReadmissionMeasure development studiesMedicaid ServicesRisk adjustmentHospital