title: Community Level Association between Home Health and Nursing Home Performance on Quality and Hospital 30-day Readmissions for Medicare Patients.
abstract: We evaluated whether community-level home health agencies and nursing home performance is associated with community-level hospital 30-day all-cause risk-standardized readmission rates for Medicare patients used data from the Centers for Medicare & Medicaid Service from 2010 to 2012. Our final sample included 2,855 communities that covered 4,140 hospitals with 6,751,713 patients, 13,060 nursing homes with 1,250,648 residents, and 7,613 home health agencies providing services to 35,660 zipcodes. Based on a mixed effect model, we found that increasing nursing home performance by one star for all of its 4 measures and home health performance by 10 points for all of its 6 measures is associated with decreases of 0.25% (95% CI 0.17-0.34) and 0.60% (95% CI 0.33-0.83), respectively, in community-level risk-standardized readmission rates.
authors.affiliation: Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut, United States of America.
authors.forename: Yun
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Qualidigm, Wethersfield, Connecticut, United States of America.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Pandolfi
authors.affiliation: Section of Pulmonary and Critical Care Medicine, Norwalk Hospital, Norwalk, Connecticut, United States of America.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Fine
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of Connecticut School of Medicine, Farmington, Connecticut, United States of America.
authors.forename: Mark L
authors.initials: ML
authors.lastname: Metersky
authors.affiliation: Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut, United States of America; Department of General Internal Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut, United States of America.
authors.forename: Changqin
authors.initials: C
authors.lastname: Wang
authors.affiliation: Qualidigm, Wethersfield, Connecticut, United States of America.
authors.forename: Shih-Yieh
authors.initials: SY
authors.lastname: Ho
authors.affiliation: Department of General Internal Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut, United States of America.
authors.forename: Deron
authors.initials: D
authors.lastname: Galusha
authors.affiliation: Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut, United States of America; Department of General Internal Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut, United States of America.
authors.forename: Sudhakar V
authors.initials: SV
authors.lastname: Nuti
authors.affiliation: Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut, United States of America; Department of General Internal Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut, United States of America.
authors.forename: Karthik
authors.initials: K
authors.lastname: Murugiah
authors.affiliation: Qualidigm, Wethersfield, Connecticut, United States of America.
authors.forename: Ann
authors.initials: A
authors.lastname: Spenard
authors.affiliation: Qualidigm, Wethersfield, Connecticut, United States of America.
authors.forename: Timothy
authors.initials: T
authors.lastname: Elwell
authors.affiliation: Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut, United States of America; Department of General Internal Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut, United States of America.
authors.forename: Harlan M
authors.initials: HM
authors.lastname: Krumholz
keywords: Continuity of Care Transition and Discharge Planning; Outcomes measurement; Quality Improvement; Readmission; Teamwork