Did This Health Care Policy Do Harm?

Did This Health Care Policy Do Harm?

A well-intentioned program created by the Affordable Care Act may have led to patient deaths. No patient leaves the hospital hoping to return soon. But a decade ago, one in five Medicare patients who were hospitalized for... read more

Association of Antibiotic Treatment with Outcomes in Patients Hospitalized for an Asthma Exacerbation Treated with Systemic Corticosteroids

Association of Antibiotic Treatment with Outcomes in Patients Hospitalized for an Asthma Exacerbation Treated with Systemic Corticosteroids

Antibiotic therapy may be associated with a longer hospital length of stay, higher hospital cost, and similar risk of treatment failure. These results highlight the need to reduce inappropriate antibiotic prescribing among... read more

Assessment of the Safety of Discharging Select Patients Directly Home From the ICU

Assessment of the Safety of Discharging Select Patients Directly Home From the ICU

The discharge of select adult patients directly home from the ICU is common, and it is not associated with increased health care utilization or increased mortality. Among the 6732 patients included in the study, 2826 (42%)... read more

Caring for Critically Ill Patients with the ABCDEF Bundle

Caring for Critically Ill Patients with the ABCDEF Bundle

ABCDEF bundle performance showed significant and clinically meaningful improvements in outcomes including survival, mechanical ventilation use, coma, delirium, restraint-free care, ICU readmissions, and post-ICU discharge... read more

Direct Discharge From ICU OK for Some Patients

Direct Discharge From ICU OK for Some Patients

Discharging patients home directly from the intensive care unit (ICU) is associated with outcomes similar to those seen in patients discharged after a follow-up stay on a hospital ward, the authors of a large, population-based... read more

Unplanned Early Hospital Readmission Among Critical Care Survivors

Unplanned Early Hospital Readmission Among Critical Care Survivors

Although some readmissions are medically unavoidable, for many ICU survivors complex health and psychosocial issues contribute concurrently to early rehospitalisation. Care pathways that anticipate and institute anticipatory... read more

Out-of-hours Discharge from ICU, In-hospital Mortality and ICU Readmission Rates

Out-of-hours Discharge from ICU, In-hospital Mortality and ICU Readmission Rates

Out-of-hours discharge from an ICU is strongly associated with both in-hospital death and ICU readmission. These effects persisted across all definitions of “out of hours” and across healthcare systems in different geographical... read more

Indicators of ICU Capacity Strain

Indicators of ICU Capacity Strain

We identified and characterized 16 indicators of strained ICU capacity across the spectrum of healthcare quality domains. Future work should aim to evaluate their implementation into practice and assess their value for evaluating... read more

When Should Nutritional Support Be Implemented in a Hospitalized Patient?

At the time of admission to the hospital, malnutrition is already present in over 20% of patients. Hospitalized patients are particularly susceptible to developing malnutrition because of increased catabolic states in acute... read more

Temporal Trends in Incidence, Sepsis-Related Mortality, and Hospital-Based Acute Care After Sepsis

Temporal Trends in Incidence, Sepsis-Related Mortality, and Hospital-Based Acute Care After Sepsis

Owing to increasing incidence and declining mortality, the number of sepsis survivors at risk for hospital readmission rose significantly between 2010 and 2015. The 30-day hospital readmission rates for sepsis declined modestly... read more

The Utility of ICU Readmission as a Quality Indicator and the Effect of Selection

The Utility of ICU Readmission as a Quality Indicator and the Effect of Selection

Intensive care readmission rates are used to signal quality, yet it is unclear whether they represent poor quality in the transition of care from the ICU to the ward, patient factors, or differences in survival of the initial... read more

A Qualitative Exploration of the Discharge Process and Factors Predisposing to Readmissions to the ICU

A Qualitative Exploration of the Discharge Process and Factors Predisposing to Readmissions to the ICU

Severe illness predisposes ICU patients to readmission, especially when goals of care were not adequately addressed. Communication, premature discharge, and other factors, mostly unrelated to the patient were also perceived... read more

Postoperative Pain Predicts 30-day Readmission

Postoperative Pain Predicts 30-day Readmission

Postoperative pain trajectories identify populations at risk for 30-day readmissions and ED visits, and do not seem to be mediated by postdischarge complications. Addressing pain control expectations before discharge may... read more

Your plumber offers a money-back guarantee. Should your doctor?

One recommendation is that patients shouldn't have to pay for their care if they experience certain avoidable complications up to 90 days after surgery. A participating hospital would guarantee its work, or patients would... read more

Are hospital readmission penalties a good idea?

Are hospital readmission penalties a good idea?

A closely watched experiment in health care has unfolded over the last few years: Financial incentives for hospitals to reduce readmissions. It was a feature of the Affordable Care Act, and researchers are now assessing its... read more

Association of the Hospital Readmissions Reduction Program Implementation With Readmission and Mortality Outcomes in Heart Failure

Association of the Hospital Readmissions Reduction Program Implementation With Readmission and Mortality Outcomes in Heart Failure

Among fee-for-service Medicare beneficiaries discharged after heart failure hospitalizations, implementation of the HRRP was temporally associated with a reduction in 30-day and 1-year readmissions but an increase in 30-day... read more

Oral Antibiotics Preferred for Pediatric Pneumonia

Oral Antibiotics Preferred for Pediatric Pneumonia

Children with complicated pneumonia should be discharged from the hospital with oral instead of intravenous (IV) antibiotics when possible, according to a new study. The results showed no significant differences in treatment... read more