MARC details
| 000 -LEADER |
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| fixed length control field |
04096nam a22005777a 4500 |
| 008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION |
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| fixed length control field |
201006s20202020 xxu||||| |||| 00| 0 eng d |
| 022 ## - INTERNATIONAL STANDARD SERIAL NUMBER |
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| International Standard Serial Number |
0003-4932 |
| 024 ## - OTHER STANDARD IDENTIFIER |
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| Standard number or code |
00000658-202010000-00019 [pii] |
| 024 ## - OTHER STANDARD IDENTIFIER |
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| Standard number or code |
10.1097/SLA.0000000000004203 [doi] |
| 040 ## - CATALOGING SOURCE |
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| Original cataloging agency |
Ovid MEDLINE(R) |
| 099 ## - LOCAL FREE-TEXT CALL NUMBER (OCLC) |
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| PMID |
32932318 |
| 245 ## - TITLE STATEMENT |
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| Title |
Unintended Consequences of Health Care Reform: Impact of Changes in Payor Mix on Patient Safety Indicators. |
| 251 ## - Source |
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| Source |
Annals of Surgery. 272(4):612-619, 2020 10. |
| 252 ## - Abbreviated Source |
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| Abbreviated source |
Ann Surg. 272(4):612-619, 2020 10. |
| 252 ## - Abbreviated Source |
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| Former abbreviated source |
Ann Surg. 272(4):612-619, 2020 Oct. |
| 253 ## - Journal Name |
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| Journal name |
Annals of surgery |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. |
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| Year |
2020 |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. |
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| Manufacturer |
FY2021 |
| 265 ## - SOURCE FOR ACQUISITION/SUBSCRIPTION ADDRESS [OBSOLETE] |
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| Publication status |
ppublish |
| 265 ## - SOURCE FOR ACQUISITION/SUBSCRIPTION ADDRESS [OBSOLETE] |
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| Publication status |
ppublish |
| 266 ## - Date added to catalog |
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| Date added to catalog |
2020-10-06 |
| 268 ## - Previous citation |
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| -- |
Annals of Surgery. 272(4):612-619, 2020 Oct. |
| 501 ## - WITH NOTE |
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| Local holdings |
Available online through MWHC library: 1885 - present, Available in print through MWHC library: 1999 - 2006 |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
CONCLUSIONS: Despite overall improvement in patient safety, increased SNB was associated with increased safety events in expansion states. Accordingly, Centers for Medicare and Medicaid Services measures may unintentionally penalize hospitals with increased SNB following Medicaid expansion. |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
METHODS: Three hundred fifty-eight hospitals were identified using State Inpatient Databases (2012-2015) from 3 expansions (KY, MD, NJ) and 2 nonexpansion (FL, NC) states. PSI-90 scores were calculated using Agency for Healthcare Research and Quality modules. Hospital Medicaid and uninsured patients were categorized into safety-net burden (SNB) quartiles. Hospital-level, multivariate linear regression was performed to measure the effects of expansion and change in SNB on PSI-90. |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
OBJECTIVE: To evaluate the impact of the Affordable Care Act's Medicaid expansion on patient safety metrics at the hospital level by expansion status, across varying levels of safety-net burden, and over time. |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
RESULTS: PSI-90 decreased (safety improved) over time across all hospitals (-5.2%), with comparable reductions in expansion versus nonexpansion states (-5.9% vs -4.7%, respectively; P = 0.441) and across high SNB hospitals within expansion versus nonexpansion states (-3.9% vs -5.2%, P = 0.639). Pre-ACA SNB quartile did not predict changes in PSI-90 post-ACA. However, when hospitals increased their SNB by 5%, they incurred significantly more safety events in expansion relative to nonexpansion states (+1.87% vs -14.0%, P = 0.013). |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
SUMMARY BACKGROUND DATA: Medicaid expansion has raised concerns over the influx of additional medically and socially complex populations on hospital systems. Whether increases in Medicaid and uninsured payor mix impact hospital performance metrics remains largely unknown. We sought to evaluate the effects of expansion on Centers for Medicare and Medicaid Services-endorsed Patient Safety Indicators (PSI-90). |
| 546 ## - LANGUAGE NOTE |
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| Language note |
English |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
*Economics, Hospital |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
*Health Care Reform |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
*Patient Protection and Affordable Care Act |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
*Patient Safety |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Humans |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Medicaid/og [Organization & Administration] |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Medically Uninsured |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Medicare/og [Organization & Administration] |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Safety-net Providers/ec [Economics] |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
United States |
| 651 ## - SUBJECT ADDED ENTRY--GEOGRAPHIC NAME |
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| Institution |
MedStar Health Research Institute |
| 651 ## - SUBJECT ADDED ENTRY--GEOGRAPHIC NAME |
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| Institution |
MedStar Washington Hospital Center |
| 657 ## - INDEX TERM--FUNCTION |
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| Medline publication type |
Journal Article |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
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| Local Authors |
Al-Refaie, Waddah B |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
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| Local Authors |
Chan, Kitty |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
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| Local Authors |
Shara, Nawar M |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
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| Local Authors |
Zeymo, Alexander |
| 790 ## - Authors |
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| All authors |
Al-Refaie WB, Aminpour N, Bartholomew AJ, Chan KS, DeLeire T, Mishra A, Shara N, Zeymo A |
| 856 ## - ELECTRONIC LOCATION AND ACCESS |
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| DOI |
<a href="https://dx.doi.org/10.1097/SLA.0000000000004203">https://dx.doi.org/10.1097/SLA.0000000000004203</a> |
| Public note |
https://dx.doi.org/10.1097/SLA.0000000000004203 |
| -- |
https://dx.doi.org/10.1097/SLA.0000000000004203 |
| 856 ## - ELECTRONIC LOCATION AND ACCESS |
|---|
| DOI |
<a href="https://dx.doi.org/10.1097/SLA.0000000000004203">https://dx.doi.org/10.1097/SLA.0000000000004203</a> |
| Public note |
https://dx.doi.org/10.1097/SLA.0000000000004203 |
| -- |
https://dx.doi.org/10.1097/SLA.0000000000004203 |
| 942 ## - ADDED ENTRY ELEMENTS (KOHA) |
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| Koha item type |
Journal Article |
| Item type description |
Article |
