Readmission rates in not-for-profit vs. proprietary hospitals before and after the hospital readmission reduction program implementation.

BACKGROUND: The Patient Protection and Affordable Care Act established the Hospital Readmission Reduction Program (HRRP) to penalize hospitals with excessive 30-day hospital readmissions of Medicare enrollees for specific conditions. This policy was aimed at increasing the quality of care delivered to patients and decreasing the amount of money paid for potentially preventable hospital readmissions. While it has been established that the number of 30-day hospital readmissions decreased after program implementation, it is unknown whether this effect occurred equally between not-for-profit and proprietary hospitals. The aim of this study was to determine whether or not the HRRP decreased readmission rates equally between not-for-profit and proprietary hospitals between 2010 and 2012. METHODS: Data on readmissions came from the Dartmouth Atlas and hospital ownership data came from the Centers for Medicare and Medicaid Services. Data were joined using the Medicare provider number. Using a difference-in-differences approach, bivariate and regression analyses were conducted to compare readmission rates between not-for-profit and proprietary hospitals between 2010 and 2012 and were adjusted for hospital characteristics. RESULTS: In 2010, prior to program implementation, unadjusted readmission rates for proprietary and not-for-profit hospitals were 16.16% and 15.78%, respectively. In 2012, following program implementation, 30-day readmission rates dropped to 15.76% and 15.29% for proprietary and not-for-profit hospitals. The data suggest that the implementation of the Hospital Readmission Reduction Program had similar effects on not-for-profit and proprietary hospitals with respect to readmission rates, even after adjusting for confounders. CONCLUSIONS: Although not-for-profit hospitals had lower 30-day readmission rates than proprietary hospitals in both 2010 and 2012, they both decreased after the implementation of the HRRP and the decreases were not statistically significantly different. Thus, this study suggests that the Hospital Readmission Reduction Program was equally effective in reducing readmission rates, despite ownership status

Social Determinants of Health in Pulmonary Arterial Hypertension Patients in the United States: Clinician Perspective and Health Policy Implications

Social determinants of health (SDoH) can impact the vulnerable pulmonary arterial hypertension (PAH) population, especially during the COVID-19 pandemic. Providers\u27 understanding of SDoH at the point of care and their impact is unknown. We conducted semi-structured virtual interviews with US clinicians at 17 pulmonary hypertension (PH) centers and one patient advocate from the Pulmonary Hypertension Association. We sought participants\u27 perspective on SDoH in PAH and their impact. Transcripts were developed and analyzed for key themes to assess potential policy implications. Participants served a large PAH population and demonstrated high awareness of SDoH and its impact on treatment and outcomes. They reported that patients\u27 SDoH, including socioeconomic status, health insurance, access to health care, education levels, health literacy, employment status, and insecurities associated with housing, food, transportation, and family support, impacted health and well-being. COVID-19-related social isolation, mental health, and substance abuse contributed to significant inequities in care provision and outcomes. While telemedicine helped clinicians manage patients remotely during the pandemic, there was a concern for patients with limited access to this medium. Participants reported no formal screening for SDoH at the point of care. With the recognition and the desire to act upon health inequities associated with SDoH, participants felt that it was vital for their centers to have a dedicated PH social worker and support staff to optimize care and outcomes. An approach that integrates SDoH in PAH care management, streamlined through institutional policy, could address health disparities leading to improved healthcare access, outcomes, and quality of care

Accrediting Graduate Programs in Healthcare Quality and Safety

The number of master\u27s degree programs in healthcare quality and safety (HQS) has increased significantly over the past decade. Academic accreditation provides assurance that educational programs are of a high quality and meet the needs of students, employers, and the general public. Under the guidance of the Commission on Accreditation of Healthcare Management Education, faculty from 9 universities collaborated in the development of criteria and related content domains to be used in the accreditation of graduate programs in HQS. Thirteen content domains were identified. Four of the content domains, safety and error science, improvement science and quality principles, evidence-based practice, and measurement and process improvement are thought to be foundational domains for graduate education in HQS. This article describes the development of the content domains and accompanying standards for accreditation of graduate programs in HQS

Efficacy of COVID-19 Public Health Measures in Philadelphia, New York City, Baltimore, and Chicago

Introduction: From the early days of the pandemic, US cities have implemented a variety of public health measures to reduce the spread of COVID-19. This study investigates which policies were most effective in reducing cases of COVID-19 in four major cities: Philadelphia, New York City, Baltimore, and Chicago. Methods: Through a cross-comparative analysis, we developed a timeline that tracked the implementation of a range of public health measures along with changes in COVID-19 cases, hospitalizations, and deaths. Data were collected from publicly available government sites and from press releases. Results: The results from the stay-at-home orders illustrate the delayed impact it has in reducing COVID-19 cases and hospitalizations. The mask mandate led to the immediate and sustained reduction in cases across all four cities. During the spike of COVID-19 in the Fall of 2020, restrictions on indoor dining contributed significantly to reducing COVID-19 cases. Discussion: Of all the measures that were examined, the implementation of mask mandates was most closely associated with a decline in COVID-19 cases, hospitalizations, and deaths across all four cities. Restrictions on indoor dining were also associated with a reduction in COVID-19 cases. Future studies should further investigate the adherence to different policies to better understand their impacts

Democratizing Public Health Research with Synthetic Data

Public health researchers face significant challenges when it comes to sharing their data with other researchers and leveraging it in classroom settings. Using artificial intelligence (AI), it is possible to generate synthetic datasets that maintain the statistical accuracy and granularity of the original data without compromising patient privacy. Synthetic data also enables researchers to address bias by generating the exact patients needed to answer research questions

Working With JCPH Doctoral Students

This webinar contains information for TJU faculty on how to support and mentor doctoral students in the Jefferson College of Population Health

Trust, Timing and COVID: Attitudes and Vaccine Policy

Thanks to a concerted effort by government and private industry, safe and effective vaccines for COVID-19 are in circulation, with more expected to receive emergency use authorization in the near future. But that\u27s the first part of the solution. In order to protect our population, we need to understand how people\u27s beliefs, attitudes and past experience influence their willingness to get vaccinated. What is the best way to reach at-risk populations? Who are the trusted messengers? And where will people feel safe receiving vaccine? Join us for a candid conversation with experts from Tivity Health. Presentation: 55:3

10 Years of Progress in Population Health: Connecting Health and Healthcare

Table of Contents 6 - A City of Firsts, A College of Firsts 8 - Upstream & Downstream 14 - Innovations in Education 16 - Equipped with the Tools 17 - Working Towards Community Health at a Population Level 18 - Community Health Requires Community Partnership 19 - Bridging the Academic-Industry Divide 20 - The Center for Population Health Innovation Supports Lifelong Learning 22 - Investing in Research, Investing in Health 23 - 1989 Jefferson Center for Population Health 24 - Research in Actio