MARC details
| 000 -LEADER |
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| fixed length control field |
04403nam a22003857a 4500 |
| 008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION |
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| fixed length control field |
170411s20162016 xxu||||| |||| 00| 0 eng d |
| 022 ## - INTERNATIONAL STANDARD SERIAL NUMBER |
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| International Standard Serial Number |
1072-7515 |
| 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 |
27261414 |
| 245 ## - TITLE STATEMENT |
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| Title |
Vulnerable Hospitals and Cancer Surgery Readmissions: Insights into the Unintended Consequences of the Patient Protection and Affordable Care Act. |
| 251 ## - Source |
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| Source |
Journal of the American College of Surgeons. 223(1):142-51, 2016 Jul |
| 252 ## - Abbreviated Source |
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| Abbreviated source |
J Am Coll Surg. 223(1):142-51, 2016 Jul |
| 253 ## - Journal Name |
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| Journal name |
Journal of the American College of Surgeons |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. |
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| Year |
2016 |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. |
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| Manufacturer |
FY2017 |
| 266 ## - Date added to catalog |
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| Date added to catalog |
2017-05-24 |
| 501 ## - WITH NOTE |
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| Local holdings |
Available online from MWHC library: 1997 - present, Available in print through MWHC library:1999-2007MH - AdolescentMH - AdultMH - AgedMH - Aged, 80 and overMH - CaliforniaMH - Databases, FactualMH - FemaleMH - HumansMH - Logistic ModelsMH - MaleMH - Medicaid/sn [Statistics & Numerical Data]MH - Middle AgedMH - *Neoplasms/su [Surgery]MH - *Patient Protection and Affordable Care ActMH - Patient Readmission/lj [Legislation & Jurisprudence]MH - Patient Readmission/st [Standards]MH - *Patient Readmission/sn [Statistics & Numerical Data]MH - Quality Indicators, Health Care/lj [Legislation & Jurisprudence]MH - *Quality Indicators, Health Care/sn [Statistics & Numerical Data]MH - Risk AdjustmentMH - Safety-net Providers/lj [Legislation & Jurisprudence]MH - Safety-net Providers/st [Standards]MH - *Safety-net Providers/sn [Statistics & Numerical Data]MH - United StatesMH - Young Adult |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
BACKGROUND: Penalties from the Hospital Readmission Reduction Program can push financially strained, vulnerable patient-serving hospitals into additional hardship. In this study, we quantified the association between vulnerable hospitals and readmissions and examined the respective contributions of patient- and hospital-related factors. |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
CONCLUSIONS: Vulnerable status of hospitals is associated with higher readmission rates after major cancer surgery. These findings reinforce the call to account for socioeconomic variables in risk adjustments for hospitals who serve a disproportionate share of disadvantaged patients. |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
Copyright (c) 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved. |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
METHODS: A total of 110,857 patients who underwent major cancer operations were identified from the 2004-2011 State Inpatient Database of California. Vulnerable hospitals were defined as either self-identified safety net hospitals (SNHs) or hospitals with a high percentage of Medicaid patients (high Medicaid hospitals [HMHs]). We used multivariable logistic regression to determine the association between vulnerable hospitals and readmission. Patient and hospital contributions to the elevation in odds of readmission were assessed by comparing estimates from models with different subsets of predictors. |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
RESULTS: Of the 355 hospitals, 13 were SNHs and 31 were HMHs. After adjusting for Hospital Readmission Reduction Program variables, SNHs had higher 30-day (odds ratio [OR] = 1.32; 95% CI, 1.18-1.47), 90-day (OR = 1.28; 95% CI, 1.18-1.38), and repeated readmissions (OR = 1.33; 95% CI, 1.18-1.49); HMHs also had higher 30-day (OR = 1.18; 95% CI, 1.05-1.32), 90-day (OR = 1.28; 95% CI, 1.16-1.42), and repeated readmissions (OR = 1.24; 95% CI, 1.01-1.54). Compared with patient characteristics, hospital factors accounted for a larger proportion of the increase in odds of readmission among SNHs (60% to 93% vs 24% to 39%), but a smaller proportion among HMHs (9% to 15% vs 60% to 115%). |
| 546 ## - LANGUAGE NOTE |
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| Language note |
English |
| 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 |
| 656 ## - INDEX TERM--OCCUPATION |
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| Department |
Surgery/General Surgery |
| 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 |
Hechenbleikner, Elizabeth |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
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| Local Authors |
Shara, Nawar M |
| 790 ## - Authors |
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| All authors |
Al-Refaie WB, Hechenbleikner E, Hong Y, Johnson LB, Shara N, Zheng C |
| 856 ## - ELECTRONIC LOCATION AND ACCESS |
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| DOI |
<a href="https://dx.doi.org/ 10.1016/j.saa.2016.11.024">https://dx.doi.org/ 10.1016/j.saa.2016.11.024</a> |
| Public note |
https://dx.doi.org/ 10.1016/j.saa.2016.11.024 |
| -- |
https://dx.doi.org/10.1016/j.jamcollsurg.2016.04.042 |
| 856 ## - ELECTRONIC LOCATION AND ACCESS |
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| DOI |
<a href="https://dx.doi.org/10.1016/j.jamcollsurg.2016.04.042">https://dx.doi.org/10.1016/j.jamcollsurg.2016.04.042</a> |
| Public note |
https://dx.doi.org/ 10.1016/j.saa.2016.11.024 |
| -- |
https://dx.doi.org/10.1016/j.jamcollsurg.2016.04.042 |
| 942 ## - ADDED ENTRY ELEMENTS (KOHA) |
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| Koha item type |
Journal Article |
| Item type description |
Article |
