BACKGROUND Since October of 2012, Medicare's Hospital Readmissions Reduction Program has fined 2,200 hospitals a total of $500 million. Although the program penalizes readmission to any hospital, many institutions can only track readmissions to their own hospitals. We sought to determine the extent to which same-hospital readmission rates can be used to estimate all-hospital readmission rates a...

The increasing frequency of antibiotic resistance in hospital-acquired infections is a major public health concern that has both biological and economic causes. Here we develop conceptual mathematical models that couple the economic incentives and population biology of hospital infection control (HIC). We show that the optimal investment by a hospital for HIC changes with the proportion of pati...

OBJECTIVE To develop a hospital mortality prediction model based on data from the Hospital Information System of the Brazilian National Health System. METHODS This was a cross-sectional study using data from 453,515 authorizations for hospital admission relating to 332 hospitals in Rio Grande do Sul, Southern Brazil in the year 2005. From the ratio between observed and expected deaths, the ho...

BACKGROUND While improvements in nursing practice environments are considered essential to address the nursing shortage, relatively little is known about the nursing practice environments in most hospitals. OBJECTIVES The objectives of this study are to describe variations in nursing practice environments across hospitals and to examine their associations to hospital bed size, community size,...

UNLABELLED OBJECTIVES To assess electronic health record (EHR) adoption and meaningful use among US children's hospitals through 2011 and compare these outcomes with adult hospitals and among subgroups of children's hospitals. We hypothesized that children's hospitals would show progress since our initial evaluation of health information technology (HIT) implementation in 2008. METHODS We ide...

BACKGROUND Laparoscopic gastrectomy (LG) is becoming more widely indicated, although its application has not been investigated sufficiently in community-based gastrointestinal research because the small number of gastric cancers in western countries might have limited its use. However, concerns have been raised regarding variations in the quality of care with LG. To contribute to improving the ...

BACKGROUND Data-driven risk stratification models built using data from a single hospital often have a paucity of training data. However, leveraging data from other hospitals can be challenging owing to institutional differences with patients and with data coding and capture. OBJECTIVE To investigate three approaches to learning hospital-specific predictions about the risk of hospital-associa...

BACKGROUND The prevalence of heart failure is 3 to 20 per 1,000 population, but may exceed 100 per 1,000 in the over 65 age group. Some 1-2% of the total healthcare budget is consumed in the management of heart failure. AIM As hospital costs account for approximately 70% of this expenditure we determined the cost of treating heart failure in an Irish teaching hospital. METHODS Cost evaluati...

BACKGROUND Better outcomes have been found among hospitals treating higher volumes of patients for specific surgical and medical conditions. We examined hospital ischemic stroke (IS) volume and 30-day mortality to inform regionalization planning. METHODS AND RESULTS Using a population-based hospital discharge administrative database (2005/2006 to 2011/2012), average annual IS patient volumes ...

status. Methods: New ischemic stroke (ICD-10 code I63) patients (no previous stroke within one year) between April 1, 2006 and March 31, 2009 (N= 4,350) were followed for one year using hospital Discharge Abstract Database. The severity of the stroke was obtained from the ambulatory care database. Median hospital costs by CMG+ group were obtained from Alberta Health. Hospitals were classified a...