Karan Rai MD, MHA, Hillary Landau Western MD, MBA, Moksha Patel MD, Samuel Porter MD
Diuresis for hospitalized patients with acute decompensated heart failure is a routine clinical practice but one that remains reliant on error-prone and resource-intensive intake and output and weight measurements and is subject to wide provider variation. We sought to use quality improvement approaches to implement a data-driven predictive diuresis protocol based on natriuresis using the electronic health record to titrate dosing. Our initiative did not result in significant reductions in length of stay but did demonstrate a significant increase in the use of urine studies to guide diuresis and signals toward more aggressive diuretic dosing without an increase in adverse outcomes.
{"title":"Streamlining diuresis: A quality improvement approach to implementing a sodium-based predictive diuresis protocol","authors":"Karan Rai MD, MHA, Hillary Landau Western MD, MBA, Moksha Patel MD, Samuel Porter MD","doi":"10.1002/jhm.13560","DOIUrl":"10.1002/jhm.13560","url":null,"abstract":"<p>Diuresis for hospitalized patients with acute decompensated heart failure is a routine clinical practice but one that remains reliant on error-prone and resource-intensive intake and output and weight measurements and is subject to wide provider variation. We sought to use quality improvement approaches to implement a data-driven predictive diuresis protocol based on natriuresis using the electronic health record to titrate dosing. Our initiative did not result in significant reductions in length of stay but did demonstrate a significant increase in the use of urine studies to guide diuresis and signals toward more aggressive diuretic dosing without an increase in adverse outcomes.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 3","pages":"321-326"},"PeriodicalIF":2.4,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.13560","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142712260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Samir S. Shah MD, MSCE, MHM, The Journal of Hospital Medicine Editorial Leadership Team
<p>We are honored to lead the <i>Journal of Hospital Medicine</i> into its 20th year, continuing our commitment to publishing high-quality research and commentary that advance the field, influence policy, and improve patient care. Enhancing clinical knowledge also remains integral to our mission, hence the many forums to which our readers can avail themselves, including <i>Clinical Progress Notes, Clinical Guideline Highlights for the Hospitalist, Things We Do for No Reason™, Clinical Care Conundrums</i>, and, most recently, <i>Visual Vignettes</i>, a column focused on physical diagnosis.</p><p>We have also adapted to and shaped new ways of consuming medical information as we build a community around the journal. Our redesigned website and active engagement by our expanded digital media team on a variety of platforms, including LinkedIn, X (formerly Twitter), Instagram, and Threads, allow readers to engage with us in ways that best meet their needs. Moreover, our pioneering editorial and digital media fellowship programs play a key role in developing academic leaders. Notably, our commitment extends beyond research and education to embracing the dynamic ways healthcare intersects with society. Thus, we have published research and perspectives on vulnerable populations, such as Veterans, LGBTQ+ individuals, the elderly, children, and incarcerated individuals, and perspectives on voting rights, climate change, reproductive rights, and gun violence, issues that inevitably affect our patients and colleagues.</p><p>Healthcare, by its nature, intersects with policy and legislation. Decisions made by lawmakers—whether at the federal or state level—have a tangible effect on patient health. For example, changes to child labor laws in some states place some of our most vulnerable populations at risk of exploitation.<span><sup>1</sup></span> Permissive gun laws in one state are associated not only with higher within state gun-related suicides and homicides but also with other states' firearm-related deaths.<span><sup>2</sup></span> Decisions surrounding women's healthcare, including abortion access, contraception, and reproductive rights, are being made in statehouses across the country.<span><sup>3</sup></span> The consequences of these decisions are not abstract: we see them in the lives of real people—in children and adolescents, like the more than 1200 killed in gun-related violence in 2024, and in women who experienced life-threatening septic abortions due to delayed care in restrictive states.<span><sup>4, 5</sup></span></p><p>As healthcare providers, we are caregivers and advocates for our patients first and foremost. As a journal, our responsibility is to acknowledge and inform our readers about broader societal issues, including those shaped by political discourse, that directly influence our patients' health. The decisions those of us in healthcare make—from how to console grieving parents, counsel a pregnant woman whose fetus has chromosomal abno
{"title":"The Journal of Hospital Medicine turns 20","authors":"Samir S. Shah MD, MSCE, MHM, The Journal of Hospital Medicine Editorial Leadership Team","doi":"10.1002/jhm.13548","DOIUrl":"10.1002/jhm.13548","url":null,"abstract":"<p>We are honored to lead the <i>Journal of Hospital Medicine</i> into its 20th year, continuing our commitment to publishing high-quality research and commentary that advance the field, influence policy, and improve patient care. Enhancing clinical knowledge also remains integral to our mission, hence the many forums to which our readers can avail themselves, including <i>Clinical Progress Notes, Clinical Guideline Highlights for the Hospitalist, Things We Do for No Reason™, Clinical Care Conundrums</i>, and, most recently, <i>Visual Vignettes</i>, a column focused on physical diagnosis.</p><p>We have also adapted to and shaped new ways of consuming medical information as we build a community around the journal. Our redesigned website and active engagement by our expanded digital media team on a variety of platforms, including LinkedIn, X (formerly Twitter), Instagram, and Threads, allow readers to engage with us in ways that best meet their needs. Moreover, our pioneering editorial and digital media fellowship programs play a key role in developing academic leaders. Notably, our commitment extends beyond research and education to embracing the dynamic ways healthcare intersects with society. Thus, we have published research and perspectives on vulnerable populations, such as Veterans, LGBTQ+ individuals, the elderly, children, and incarcerated individuals, and perspectives on voting rights, climate change, reproductive rights, and gun violence, issues that inevitably affect our patients and colleagues.</p><p>Healthcare, by its nature, intersects with policy and legislation. Decisions made by lawmakers—whether at the federal or state level—have a tangible effect on patient health. For example, changes to child labor laws in some states place some of our most vulnerable populations at risk of exploitation.<span><sup>1</sup></span> Permissive gun laws in one state are associated not only with higher within state gun-related suicides and homicides but also with other states' firearm-related deaths.<span><sup>2</sup></span> Decisions surrounding women's healthcare, including abortion access, contraception, and reproductive rights, are being made in statehouses across the country.<span><sup>3</sup></span> The consequences of these decisions are not abstract: we see them in the lives of real people—in children and adolescents, like the more than 1200 killed in gun-related violence in 2024, and in women who experienced life-threatening septic abortions due to delayed care in restrictive states.<span><sup>4, 5</sup></span></p><p>As healthcare providers, we are caregivers and advocates for our patients first and foremost. As a journal, our responsibility is to acknowledge and inform our readers about broader societal issues, including those shaped by political discourse, that directly influence our patients' health. The decisions those of us in healthcare make—from how to console grieving parents, counsel a pregnant woman whose fetus has chromosomal abno","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 1","pages":"5-7"},"PeriodicalIF":2.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.13548","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p><i>Let's go down on the midaz, up on the fent</i>.</p><p><i>First peel off the vaso, then pull back on the levo</i>.</p><p><i>Dial down the FiO2, titrate the PEEP</i>.</p><p>There is so much titrating and tinkering in the ICU that at some point the patient is rendered seemingly passive, a recipient weathering the pressor escalations and opioid boluses until they meet the observational and objective parameters of comfort and clinical stability.</p><p>I think that it is because of this subliminally perceived passivity that I am so taken aback when an intubated patient breaks through the fog of sedation and begins pointing at my watch and at his mouth. Residents and I gather around his bed as the room is suddenly transformed into an enormous episode of charades in which we feverishly guess at what he is trying to say.</p><p>“It's 4:16 in the afternoon on July 22, 2024,” we say repeatedly alongside, “yes, we want to try and take that tube out soon.”</p><p>He scowls in exasperation, giving us a much-deserved eye roll.</p><p>We try to explain that there are a few more conditions we need to optimize before he can be extubated—that he has fluid in his lungs and a new pneumonia that we are now treating, that we had tried extubation once already and wanted to offer him the best second chance possible. But he keeps pointing at his mouth and throwing his hands up in the air, his composure adopting a new flavor of attitude and rightful frustration.</p><p>“Oh, we know,” we sympathize. “We really want that tube out, too.”</p><p>He throws his hands up in the air one more time, pleading for divine intervention to knock some sense into our heads.</p><p>As I meanwhile find wonder in the emotions now alighting a face that had been rendered expressionless for days, my attending puts an end to our futile charades. She holds out a piece of paper with a grid of letters and guides a pointing tool into his hand, bridging the chasm between patient and provider.</p><p>His hand tremulously crawls across the sheet. W-A-T-E-R.</p><p>Our room falls silent, our reassurances of the imminence of extubation melting to the ground.</p><p>By my final week of my first month in the ICU as a trainee, I had come to understand how the agency of a critically ill patient is temporarily contained in favor of that same agency's long-term preservation. Holding beneficence in the highest esteem, we ask patients to ascribe to our lab draws, treatments, and procedures; more often than not, consent is provided by surrogate decision makers in lieu of the patients themselves. And so it can provoke a sense of discomfort when a patient rouses from the sedation spell and begins to soulfully inhabit the body that until then had been rolled, stuck, and proceduralized. I wanted them to agree with the care they had been receiving, to continue along with the gameplan that we had so meticulously outlined through hours upon hours of rounds, albeit absent their direct participation. I found that any reluctan
{"title":"Our futile charades","authors":"Ella Eisinger BS","doi":"10.1002/jhm.13553","DOIUrl":"10.1002/jhm.13553","url":null,"abstract":"<p><i>Let's go down on the midaz, up on the fent</i>.</p><p><i>First peel off the vaso, then pull back on the levo</i>.</p><p><i>Dial down the FiO2, titrate the PEEP</i>.</p><p>There is so much titrating and tinkering in the ICU that at some point the patient is rendered seemingly passive, a recipient weathering the pressor escalations and opioid boluses until they meet the observational and objective parameters of comfort and clinical stability.</p><p>I think that it is because of this subliminally perceived passivity that I am so taken aback when an intubated patient breaks through the fog of sedation and begins pointing at my watch and at his mouth. Residents and I gather around his bed as the room is suddenly transformed into an enormous episode of charades in which we feverishly guess at what he is trying to say.</p><p>“It's 4:16 in the afternoon on July 22, 2024,” we say repeatedly alongside, “yes, we want to try and take that tube out soon.”</p><p>He scowls in exasperation, giving us a much-deserved eye roll.</p><p>We try to explain that there are a few more conditions we need to optimize before he can be extubated—that he has fluid in his lungs and a new pneumonia that we are now treating, that we had tried extubation once already and wanted to offer him the best second chance possible. But he keeps pointing at his mouth and throwing his hands up in the air, his composure adopting a new flavor of attitude and rightful frustration.</p><p>“Oh, we know,” we sympathize. “We really want that tube out, too.”</p><p>He throws his hands up in the air one more time, pleading for divine intervention to knock some sense into our heads.</p><p>As I meanwhile find wonder in the emotions now alighting a face that had been rendered expressionless for days, my attending puts an end to our futile charades. She holds out a piece of paper with a grid of letters and guides a pointing tool into his hand, bridging the chasm between patient and provider.</p><p>His hand tremulously crawls across the sheet. W-A-T-E-R.</p><p>Our room falls silent, our reassurances of the imminence of extubation melting to the ground.</p><p>By my final week of my first month in the ICU as a trainee, I had come to understand how the agency of a critically ill patient is temporarily contained in favor of that same agency's long-term preservation. Holding beneficence in the highest esteem, we ask patients to ascribe to our lab draws, treatments, and procedures; more often than not, consent is provided by surrogate decision makers in lieu of the patients themselves. And so it can provoke a sense of discomfort when a patient rouses from the sedation spell and begins to soulfully inhabit the body that until then had been rolled, stuck, and proceduralized. I wanted them to agree with the care they had been receiving, to continue along with the gameplan that we had so meticulously outlined through hours upon hours of rounds, albeit absent their direct participation. I found that any reluctan","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 3","pages":"327-328"},"PeriodicalIF":2.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.13553","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"On healing and humanity","authors":"Samir S. Shah MD, MSCE, MHM","doi":"10.1002/jhm.13549","DOIUrl":"10.1002/jhm.13549","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"19 12","pages":"1103"},"PeriodicalIF":2.4,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Erin M. Thomas PT, DPT, James Smith PT, DPT, MA, Alisa Curry PT, DPT, Marka Salsberry PT, DPT, Kyle Ridgeway PT, DPT, Beth Hunt PT, DPT, Kristen Desanto MSLS, MS, RD, AHIP, Jason R. Falvey PT, DPT, PhD
Background
Hospital readmissions pose significant burdens on healthcare systems, particularly among older adults. While efforts to reduce readmissions have historically focused on medical management, emerging evidence suggests physical function may also play a role in successful care transitions. However, there is a limited understanding of the relationship between functional measures and readmission risk. This systematic review aims to assess the association between physical function impairments and hospital readmissions.
Objective
This systematic review aims to assess the association between physical function impairments and hospital readmissions.
Methods
A systematic review was conducted following PRISMA guidelines, with studies identified through databases including PubMed, CINAHL, Embase, and others published January 1, 2010–December 31, 2022. Inclusion criteria encompassed observational studies of adults aged 50 and older in the United States, reporting readmissions within 90 days of discharge and assessing physical function across domains of the International Classification of Function model. Data extraction and risk of bias assessment were independently conducted by two authors using the Scottish Intercollegiate Guidelines Network (SIGN) tool.
Results
Seventeen studies, representing 80,008 participants, were included in this systematic review. Patient populations included a wide array of medical populations, including general medical inpatients and those undergoing cardiac surgery. Across various functional measures assessed before or during admission, impairments were consistently associated with increased risk for hospital readmissions up to 90 days after admission. Measures of participation, including life-space mobility, were also associated with increased readmission risk.
Conclusions
Functional impairments are robust predictors of hospital readmissions in older adults. Routine assessment of physical function during hospitalization can improve risk stratification and may support successful care transitions, particularly in older adults.
{"title":"Association of physical function with hospital readmissions among older adults: A systematic review","authors":"Erin M. Thomas PT, DPT, James Smith PT, DPT, MA, Alisa Curry PT, DPT, Marka Salsberry PT, DPT, Kyle Ridgeway PT, DPT, Beth Hunt PT, DPT, Kristen Desanto MSLS, MS, RD, AHIP, Jason R. Falvey PT, DPT, PhD","doi":"10.1002/jhm.13538","DOIUrl":"10.1002/jhm.13538","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hospital readmissions pose significant burdens on healthcare systems, particularly among older adults. While efforts to reduce readmissions have historically focused on medical management, emerging evidence suggests physical function may also play a role in successful care transitions. However, there is a limited understanding of the relationship between functional measures and readmission risk. This systematic review aims to assess the association between physical function impairments and hospital readmissions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This systematic review aims to assess the association between physical function impairments and hospital readmissions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review was conducted following PRISMA guidelines, with studies identified through databases including PubMed, CINAHL, Embase, and others published January 1, 2010–December 31, 2022. Inclusion criteria encompassed observational studies of adults aged 50 and older in the United States, reporting readmissions within 90 days of discharge and assessing physical function across domains of the International Classification of Function model. Data extraction and risk of bias assessment were independently conducted by two authors using the Scottish Intercollegiate Guidelines Network (SIGN) tool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventeen studies, representing 80,008 participants, were included in this systematic review. Patient populations included a wide array of medical populations, including general medical inpatients and those undergoing cardiac surgery. Across various functional measures assessed before or during admission, impairments were consistently associated with increased risk for hospital readmissions up to 90 days after admission. Measures of participation, including life-space mobility, were also associated with increased readmission risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Functional impairments are robust predictors of hospital readmissions in older adults. Routine assessment of physical function during hospitalization can improve risk stratification and may support successful care transitions, particularly in older adults.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 3","pages":"277-287"},"PeriodicalIF":2.4,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.13538","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joséphine A. Cool MD, Benjamin T. Galen MD, Ria Dancel MD
{"title":"Point-counterpoint: Should hospitalists perform their own bedside procedures?","authors":"Joséphine A. Cool MD, Benjamin T. Galen MD, Ria Dancel MD","doi":"10.1002/jhm.13545","DOIUrl":"10.1002/jhm.13545","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 1","pages":"89-93"},"PeriodicalIF":2.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christina Belza PhD, MN, Christina Diong MSc, Eleanor Pullenayegum PhD, Katherine E. Nelson MD, PhD, Kazuyoshi Aoyama MD, PhD, Longdi Fu MSc, Francine Buchanan BA, MLIS, PhD, Sanober Diaz MSc, Ori Goldberg MD, MPH, Astrid Guttmann MDCM, MSc, Charlotte Moore Hepburn MD, Sanjay Mahant MD, MSc, Rachel Martens, Natasha R. Saunders MD, MSc, Eyal Cohen MD, MSc
Decreased severe respiratory illness was observed during the first 2 years of the COVID-19 pandemic, with a relatively smaller decrease among children with medical complexity (CMC) compared to non-CMC. We extended this analysis to the third pandemic year (April 1, 2022, to March 31, 2023) when pandemic public health measures were loosened. A population-based repeated cross-sectional study evaluated respiratory hospitalizations among CMC and non-CMC (<18 years) in Ontario, Canada. Among the 67,517 CMC and 3,006,504 non-CMC in Ontario, there were more CMC respiratory hospitalizations compared with the expected prepandemic levels (n = 3145 hospitalizations, corresponding to rate ratio [RR], 1.20; 95% confidence interval [CI], 1.16–1.25) with an even larger relative increase among non-CMC (n = 6653, RR, 1.36; 95% CI, 1.34–1.38). Increased intensive care unit admissions for respiratory illness were also observed (CMC: RR, 1.44; 95% CI, 1.31–1.59; non-CMC: RR, 2.02; 95% CI, 1.89–2.16). Understanding respiratory surge drivers may provide insights to protect at-risk children from respiratory morbidity.
{"title":"Respiratory hospitalizations and ICU admissions among children with and without medical complexity at the end of the COVID-19 pandemic","authors":"Christina Belza PhD, MN, Christina Diong MSc, Eleanor Pullenayegum PhD, Katherine E. Nelson MD, PhD, Kazuyoshi Aoyama MD, PhD, Longdi Fu MSc, Francine Buchanan BA, MLIS, PhD, Sanober Diaz MSc, Ori Goldberg MD, MPH, Astrid Guttmann MDCM, MSc, Charlotte Moore Hepburn MD, Sanjay Mahant MD, MSc, Rachel Martens, Natasha R. Saunders MD, MSc, Eyal Cohen MD, MSc","doi":"10.1002/jhm.13505","DOIUrl":"10.1002/jhm.13505","url":null,"abstract":"<p>Decreased severe respiratory illness was observed during the first 2 years of the COVID-19 pandemic, with a relatively smaller decrease among children with medical complexity (CMC) compared to non-CMC. We extended this analysis to the third pandemic year (April 1, 2022, to March 31, 2023) when pandemic public health measures were loosened. A population-based repeated cross-sectional study evaluated respiratory hospitalizations among CMC and non-CMC (<18 years) in Ontario, Canada. Among the 67,517 CMC and 3,006,504 non-CMC in Ontario, there were more CMC respiratory hospitalizations compared with the expected prepandemic levels (<i>n</i> = 3145 hospitalizations, corresponding to rate ratio [RR], 1.20; 95% confidence interval [CI], 1.16–1.25) with an even larger relative increase among non-CMC (<i>n</i> = 6653, RR, 1.36; 95% CI, 1.34–1.38). Increased intensive care unit admissions for respiratory illness were also observed (CMC: RR, 1.44; 95% CI, 1.31–1.59; non-CMC: RR, 2.02; 95% CI, 1.89–2.16). Understanding respiratory surge drivers may provide insights to protect at-risk children from respiratory morbidity.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 3","pages":"266-270"},"PeriodicalIF":2.4,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kyle Bagshaw MPH, Cameron J. Gettel MD, MHS, Li Qin PhD, Zhenqiu Lin PhD, Lisa G. Suter MD, Eve Rothenberg BA, Prince Omotosho BS, Reena Duseja MD, MS, James Krabacher BS, Michelle Schreiber MD, Tyson Nakashima BS, Raquel Myers PhD, JD, MPH, Arjun K. Venkatesh MD, MBA, MHS
Background/Objective
The Centers for Medicare & Medicaid Services (CMS) Overall Hospital Quality Star Rating, established in 2016, is a summary of publicly available quality information for acute care hospitals. In July 2023, Veterans Health Administration (VHA) hospitals became eligible to receive a CMS Overall Hospital Quality Star Rating for the first time. Our objective was to compare performance in quality ratings among VHA and non-VHA hospitals.
Methods
We used the hospital quality measure scores posted to Care Compare on Medicare.gov as of January 2023 as our primary data set. We conducted a pair of analyses to characterize the performance of VHA hospitals compared to non-VHA hospitals: an overall analysis including all rated hospitals, and a matched analysis in which only a single nearby hospital was included for each VHA hospital.
Results
Of the 4518 non-VHA hospitals, 2962 (65.6%) received a Star Rating, compared to 114 (84%) of 136 VHA hospitals. VHA hospitals tended to receive higher ratings overall (one-star: 8%; two-star: 11%; three-star: 14%; four-star: 35%; five-star: 32%) than non-VHA (one-star: 8%; two-star: 22%; three-star: 29%; four-star: 26%; five-star: 15%). A similar pattern was observed in the matched analysis.
Conclusions
VHA hospitals tended to perform better on the Overall Star Rating compared to non-VHA hospitals, as evidenced by being more likely to receive a four- or five-star rating. The eligibility of VHA hospitals to receive an Overall Star Rating signifies an important addition to the program that will allow Veterans to make more informed healthcare decisions.
{"title":"Inclusion of Veterans Health Administration hospitals in Centers for Medicare & Medicaid Services Overall Hospital Quality Star Ratings","authors":"Kyle Bagshaw MPH, Cameron J. Gettel MD, MHS, Li Qin PhD, Zhenqiu Lin PhD, Lisa G. Suter MD, Eve Rothenberg BA, Prince Omotosho BS, Reena Duseja MD, MS, James Krabacher BS, Michelle Schreiber MD, Tyson Nakashima BS, Raquel Myers PhD, JD, MPH, Arjun K. Venkatesh MD, MBA, MHS","doi":"10.1002/jhm.13523","DOIUrl":"10.1002/jhm.13523","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Objective</h3>\u0000 \u0000 <p>The Centers for Medicare & Medicaid Services (CMS) Overall Hospital Quality Star Rating, established in 2016, is a summary of publicly available quality information for acute care hospitals. In July 2023, Veterans Health Administration (VHA) hospitals became eligible to receive a CMS Overall Hospital Quality Star Rating for the first time. Our objective was to compare performance in quality ratings among VHA and non-VHA hospitals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used the hospital quality measure scores posted to Care Compare on Medicare.gov as of January 2023 as our primary data set. We conducted a pair of analyses to characterize the performance of VHA hospitals compared to non-VHA hospitals: an overall analysis including all rated hospitals, and a matched analysis in which only a single nearby hospital was included for each VHA hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 4518 non-VHA hospitals, 2962 (65.6%) received a Star Rating, compared to 114 (84%) of 136 VHA hospitals. VHA hospitals tended to receive higher ratings overall (one-star: 8%; two-star: 11%; three-star: 14%; four-star: 35%; five-star: 32%) than non-VHA (one-star: 8%; two-star: 22%; three-star: 29%; four-star: 26%; five-star: 15%). A similar pattern was observed in the matched analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>VHA hospitals tended to perform better on the Overall Star Rating compared to non-VHA hospitals, as evidenced by being more likely to receive a four- or five-star rating. The eligibility of VHA hospitals to receive an Overall Star Rating signifies an important addition to the program that will allow Veterans to make more informed healthcare decisions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 3","pages":"258-265"},"PeriodicalIF":2.4,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.13523","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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