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Responses of Massachusetts hospitals to a state mandate to collect race, ethnicity and language data from patients: a qualitative study
<p>Abstract</p> <p>Background</p> <p>A Massachusetts regulation implemented in 2007 has required all acute care hospitals to report patients' race, ethnicity and preferred language using standardized methodology based on self-reported information from patients. This study assessed implementation of the regulation and its impact on the use of race and ethnicity data in performance monitoring and quality improvement within hospitals.</p> <p>Methods</p> <p>Thematic analysis of semi-structured interviews with executives from a representative sample of 28 Massachusetts hospitals in 2009.</p> <p>Results</p> <p>The number of hospitals using race, ethnicity and language data internally beyond refining interpreter services increased substantially from 11 to 21 after the regulation. Thirteen of these hospitals were utilizing patient race and ethnicity data to identify disparities in quality performance measures for a variety of clinical processes and outcomes, while 16 had developed patient services and community outreach programs based on findings from these data. Commonly reported barriers to data utilization include small numbers within categories, insufficient resources, information system requirements, and lack of direction from the state.</p> <p>Conclusions</p> <p>The responses of Massachusetts hospitals to this new state regulation indicate that requiring the collection of race, ethnicity and language data can be an effective method to promote performance monitoring and quality improvement, thereby setting the stage for federal standards and incentive programs to eliminate racial and ethnic disparities in the quality of health care.</p
Infectious Diseases in Older Adults of LongāTerm Care Facilities: Update on Approach to Diagnosis and Management
Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/143696/1/jgs15248_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/143696/2/jgs15248.pd
Analysis of 30-day readmissions among neurosurgical patients: surgical complication avoidance as key to quality improvement
The Individualized Quality Control PlanāComing Soon to Clinical Microbiology Laboratories Everywhere!
Financial impact of reducing door-to-balloon time in ST-elevation myocardial infarction: a single hospital experience
<p>Abstract</p> <p>Background</p> <p>The impact of reducing door-to-balloon time on hospital revenues, costs, and net income is unknown.</p> <p>Methods</p> <p>We prospectively determined the impact on hospital finances of (1) emergency department physician activation of the catheterization lab and (2) immediate transfer of the patient to an immediately available catheterization lab by an in-house transfer team consisting of an emergency department nurse, a critical care unit nurse, and a chest pain unit nurse. We collected financial data for 52 consecutive ST-elevation myocardial infarction patients undergoing emergency percutaneous intervention from October 1, 2004āAugust 31, 2005 and compared this group to 80 consecutive ST-elevation myocardial infarction patients from September 1, 2005āJune 26, 2006 after protocol implementation.</p> <p>Results</p> <p>Per hospital admission, insurance payments (hospital revenue) decreased (36,670 vs. 16,185, P = 0.039) along with total hospital costs (31,453 vs. 9,242, P = 0.009). Hospital net income per admission was unchanged (7134, P = 0.95) as the drop in hospital revenue equaled the drop in costs. For every 1077 for private payers and 70,430 Ā± 53,514 Ā± 100,000 (7.7% vs. 0%, P = 0.022) all contributed to decreasing ST-elevation myocardial infarction hospitalization revenue. One-year post-discharge financial follow-up revealed similar results: Insurance payments: 53,741 vs. 23,125, P = 0.044; Total hospital costs: 37,434 vs. 15,561, P = 0.007; Net Income: 9159, P = 0.855.</p> <p>Conclusion</p> <p>All of the financial benefits of reducing door-to-balloon time in ST-elevation myocardial infarction go to payers both during initial hospitalization and after one-year follow-up.</p> <p>Trial Registration</p> <p><b>ClinicalTrials.gov ID</b>: NCT00800163</p
The Effect of the Hospital Readmission Reduction Program on the Duration of Observation Stays: Using Regression Discontinuity to Estimate Causal Effects
Under Pressure: Financial Effect of the Hospital-Acquired Conditions Initiative-A Statewide Analysis of Pressure Ulcer Development and Payment
Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/112254/1/jgs13475.pd
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