Resurrecting immortal‐time bias in the study of readmissions
dc.contributor.author | Hugar, Lee A. | |
dc.contributor.author | Borza, Tudor | |
dc.contributor.author | Oerline, Mary K. | |
dc.contributor.author | Hollenbeck, Brent K. | |
dc.contributor.author | Skolarus, Ted A. | |
dc.contributor.author | Jacobs, Bruce L. | |
dc.date.accessioned | 2020-04-02T18:38:49Z | |
dc.date.available | WITHHELD_13_MONTHS | |
dc.date.available | 2020-04-02T18:38:49Z | |
dc.date.issued | 2020-04 | |
dc.identifier.citation | Hugar, Lee A.; Borza, Tudor; Oerline, Mary K.; Hollenbeck, Brent K.; Skolarus, Ted A.; Jacobs, Bruce L. (2020). "Resurrecting immortal‐time bias in the study of readmissions." Health Services Research 55(2): 273-276. | |
dc.identifier.issn | 0017-9124 | |
dc.identifier.issn | 1475-6773 | |
dc.identifier.uri | https://hdl.handle.net/2027.42/154628 | |
dc.description.abstract | ObjectiveTo compare readmission rates as measured by the Centers for Medicare and Medicaid Services and the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) methods.Data Sources20 percent sample of national Medicare data for patients undergoing cystectomy, colectomy, abdominal aortic aneurysm (AAA) repair, and total knee arthroplasty (TKA) between 2010 and 2014.Study DesignRetrospective cohort study comparing 30‐day readmission rates.Data Collection/Extraction MethodsPatients undergoing cystectomy, colectomy, abdominal aortic aneurysm repair, and total knee arthroplasty between 2010 and 2014 were identified.Principal FindingsCystectomy had the highest and total knee arthroplasty had the lowest readmission rate. The NSQIP measure reported significantly lower rates for all procedures compared to the CMS measure, which reflects an immortal‐time bias.ConclusionsWe found significantly different readmission rates across all surgical procedures when comparing CMS and NSQIP measures. Longer length of stay exacerbated these differences. Uniform outcome measures are needed to eliminate ambiguity and synergize research and policy efforts. | |
dc.publisher | Medicare Payment Advisory Commission | |
dc.publisher | Wiley Periodicals, Inc. | |
dc.subject.other | surgery | |
dc.subject.other | health policy/politics/law/regulation | |
dc.subject.other | administrative data uses | |
dc.subject.other | Medicare | |
dc.subject.other | program evaluation | |
dc.subject.other | quality of care/patient safety | |
dc.title | Resurrecting immortal‐time bias in the study of readmissions | |
dc.type | Article | |
dc.rights.robots | IndexNoFollow | |
dc.subject.hlbsecondlevel | Public Health | |
dc.subject.hlbtoplevel | Health Sciences | |
dc.description.peerreviewed | Peer Reviewed | |
dc.description.bitstreamurl | https://deepblue.lib.umich.edu/bitstream/2027.42/154628/1/hesr13252-sup-0001-Authormatrix.pdf | |
dc.description.bitstreamurl | https://deepblue.lib.umich.edu/bitstream/2027.42/154628/2/hesr13252.pdf | |
dc.description.bitstreamurl | https://deepblue.lib.umich.edu/bitstream/2027.42/154628/3/hesr13252_am.pdf | |
dc.identifier.doi | 10.1111/1475-6773.13252 | |
dc.identifier.source | Health Services Research | |
dc.identifier.citedreference | U.S. Centers for Medicare & Services Medicaid. Readmissions Reduction Program (HRRP). https://www.cms.gov/medicare/medicare-fee-for-service-payment/acuteinpatientpps/readmissions-reduction-program.html. Accessed May 5, 2018. | |
dc.identifier.citedreference | PricewaterhouseCoopers. The Price of Excess: Identifying Waste in Healthcare Spending; 2008. www.pwc.com/hri. Accessed February 19, 2018. | |
dc.identifier.citedreference | Qasim M, Andrews RM. Post‐Surgical Readmissions among Patients Living in the Poorest Communities, 2009: Statistical Brief #142. Healthcare Cost and Utilization Project. https://www.hcup-us.ahrq.gov/reports/statbriefs/sb_readmission.jsp. Accessed April 20, 2018. | |
dc.identifier.citedreference | Gandaglia G, Varda B, Sood A, et al. Short‐term perioperative outcomes of patients treated with radical cystectomy for bladder cancer included in the National Surgical Quality Improvement Program (NSQIP) database. Can Urol Assoc J. 2014; 8 ( 9–10 ): E681 ‐ E687. | |
dc.identifier.citedreference | Stitzenberg KB, Chang Y, Smith AB, et al. Exploring the burden of inpatient readmissions after major cancer surgery. J Clin Oncol. 2015; 33 ( 5 ): 455 ‐ 464. | |
dc.identifier.citedreference | Lucas DJ, Haider A, Haut E, et al. Assessing readmission after general, vascular, and thoracic surgery using ACS‐NSQIP. Ann Surg. 2013; 258 ( 3 ): 430 ‐ 439. | |
dc.identifier.citedreference | Suissa S. Immortal time bias in pharmacoepidemiology. Am J Epidemiol. 2008; 167 ( 4 ): 492 ‐ 499. | |
dc.identifier.citedreference | American College of Surgeons. User Guide for the 2015 ACS NSQIP Participant Use Data File (PUF). https://www.facs.org/~/media/files/qualityprograms/nsqip/nsqip_puf_user_guide_2015.ashx. Accessed May 5, 2018. | |
dc.identifier.citedreference | Hechenbleikner EM, Makary MA, Samarov DV, et al. Hospital readmission by method of data collection. J Am Coll Surg. 2013; 216: 1150 ‐ 1158. | |
dc.identifier.citedreference | Joynt KE, Orav EJ, Jha AK. Thirty‐day readmission rates for medicare beneficiaries by race and site of care. J Am Med Assoc. 2011; 305 ( 7 ): 675. | |
dc.identifier.citedreference | Lawson EH, Hall BL, Louie R, Zingmond DS, Ko CY. Identification of modifiable factors for reducing readmission after colectomy: a national analysis. Surgery. 2014; 155 ( 5 ): 754 ‐ 766. | |
dc.identifier.citedreference | Berenson RA, Paulus RA, Kalman NS. Medicare’s readmissions‐reduction program — a positive alternative. N Engl J Med. 2012; 366 ( 15 ): 1364 ‐ 1366. | |
dc.identifier.citedreference | Ody C, Msall L, Dafny LS, et al. Decrease in readmissions credited to medicare’s program to reduce hospital readmissions have been overstated. Health Aff. 2019; 38 ( 1 ): 36 ‐ 43. | |
dc.identifier.citedreference | Medicare Payment Advisory Commission. Refining the hospital readmissions reduction program. In: Report to the Congress: Medicare and the Health Care Delivery System. Washington: Medicare Payment Advisory Commission; 2013: 91 ‐ 114. | |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
Files in this item
Remediation of Harmful Language
The University of Michigan Library aims to describe library materials in a way that respects the people and communities who create, use, and are represented in our collections. Report harmful or offensive language in catalog records, finding aids, or elsewhere in our collections anonymously through our metadata feedback form. More information at Remediation of Harmful Language.
Accessibility
If you are unable to use this file in its current format, please select the Contact Us link and we can modify it to make it more accessible to you.