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[PMID]:28076992
[Au] Autor:Zaami S; Montanari Vergallo G; Napoletano S; Signore F; Marinelli E
[Ad] Endereço:a Department of Anatomical, Histological, Forensic and Orthopaedic Sciences , Sapienza University of Rome , Rome , Italy.
[Ti] Título:The issue of delivery room infections in the Italian law. A brief comparative study with English and French jurisprudence.
[So] Source:J Matern Fetal Neonatal Med;31(2):223-227, 2018 Jan.
[Is] ISSN:1476-4954
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Delivery room infections are frequent, and many of them could be avoided through higher standards of care. The authors examine this issue by comparing it to English and French reality. Unlike England, in Italy and France the relationship established between health facility, physician and patient is outlined in a contract. In England, the judges' decisions converge toward a better and higher protection of the patient-the actor-and facilitate the probative task. In case of infections, including those occurring in the delivery room, three issues are evaluated: the hospital's negligent conduct, damages if any and causal nexus. Therefore, the hospital must demonstrate to have taken the appropriate asepsis measures according to current scientific knowledge concerning not only treatment, but also diagnosis, previous activities, surgery and post-surgery. In order to avoid a negative sentence, both physicians and hospital have to demonstrate their correct behavior and that the infection was caused by an unforeseeable event. The authors examine the most significant rulings by the Courts and the Supreme Court. They show that hospitals can avoid being accused of negligence and recklessness only if they can demonstrate to have implemented all the preventive measures provided for in the guidelines or protocols.
[Mh] Termos MeSH primário: Infecção Hospitalar
Salas de Parto/legislação & jurisprudência
Imperícia/legislação & jurisprudência
Complicações do Trabalho de Parto
Médicos/legislação & jurisprudência
Transtornos Puerperais
[Mh] Termos MeSH secundário: Antibacterianos/administração & dosagem
Antibacterianos/uso terapêutico
Feminino
Seres Humanos
Lactente
Mortalidade Infantil
Itália
Legislação Hospitalar
Mortalidade Materna
Gravidez
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170113
[St] Status:MEDLINE
[do] DOI:10.1080/14767058.2017.1281243


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[PMID]:28805361
[Au] Autor:Centers for Medicare & Medicaid Services (CMS), HHS
[Ti] Título:Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2018 Rates; Quality Reporting Requirements for Specific Providers; Medicare and Medicaid Electronic Health Record (EHR) Incentive Program Requirements for Eligible Hospitals, Critical Access Hospitals, and Eligible Professionals; Provider-Based Status of Indian Health Service and Tribal Facilities and Organizations; Costs Reporting and Provider Requirements; Agreement Termination Notices. Final rule.
[So] Source:Fed Regist;82(155):37990-8589, 2017 Aug 14.
[Is] ISSN:0097-6326
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2018. Some of these changes implement certain statutory provisions contained in the Pathway for Sustainable Growth Rate (SGR) Reform Act of 2013, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Medicare Access and CHIP Reauthorization Act of 2015, the 21st Century Cures Act, and other legislation. We also are making changes relating to the provider-based status of Indian Health Service (IHS) and Tribal facilities and organizations and to the low-volume hospital payment adjustment for hospitals operated by the IHS or a Tribe. In addition, we are providing the market basket update that will apply to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits for FY 2018. We are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) for FY 2018. In addition, we are establishing new requirements or revising existing requirements for quality reporting by specific Medicare providers (acute care hospitals, PPS-exempt cancer hospitals, LTCHs, and inpatient psychiatric facilities). We also are establishing new requirements or revising existing requirements for eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) participating in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. We are updating policies relating to the Hospital Value-Based Purchasing (VBP) Program, the Hospital Readmissions Reduction Program, and the Hospital-Acquired Condition (HAC) Reduction Program. We also are making changes relating to transparency of accrediting organization survey reports and plans of correction of providers and suppliers; electronic signature and electronic submission of the Certification and Settlement Summary page of the Medicare cost reports; and clarification of provider disposal of assets.
[Mh] Termos MeSH primário: Registros Eletrônicos de Saúde/economia
Registros Eletrônicos de Saúde/legislação & jurisprudência
Assistência de Longa Duração/economia
Assistência de Longa Duração/legislação & jurisprudência
Medicaid/economia
Medicaid/legislação & jurisprudência
Medicare/economia
Medicare/legislação & jurisprudência
Sistema de Pagamento Prospectivo/economia
Sistema de Pagamento Prospectivo/legislação & jurisprudência
Garantia da Qualidade dos Cuidados de Saúde/economia
Garantia da Qualidade dos Cuidados de Saúde/legislação & jurisprudência
United States Indian Health Service/economia
United States Indian Health Service/legislação & jurisprudência
[Mh] Termos MeSH secundário: Economia Hospitalar/legislação & jurisprudência
Seres Humanos
Legislação Hospitalar/economia
Notificação Compulsória
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:T
[Da] Data de entrada para processamento:170815
[St] Status:MEDLINE


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[PMID]:28731391
[Au] Autor:Daniels AH; Ruttiman R; Eltorai AEM; DePasse JM; Brea BA; Palumbo MA
[Ad] Endereço:Division of Spine Surgery.
[Ti] Título:Malpractice litigation following spine surgery.
[So] Source:J Neurosurg Spine;27(4):470-475, 2017 Oct.
[Is] ISSN:1547-5646
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE Adverse events related to spine surgery sometimes lead to litigation. Few studies have evaluated the association between spine surgical complications and medical malpractice proceedings, outcomes, and awards. The aim of this study was to identify the most frequent causes of alleged malpractice in spine surgery and to gain insight into patient demographic and clinical characteristics associated with medical negligence litigation. METHODS A search for "spine surgery" spanning February 1988 to May 2015 was conducted utilizing the medicolegal research service VerdictSearch (ALM Media Properties, LLC). Demographic data for the plaintiff and defendant in addition to clinical data for the procedure and legal outcomes were examined. Spinal cord injury, anoxic/hypoxic brain injury, and death were classified as catastrophic complications; all other complications were classified as noncatastrophic. Both chi-square and t-tests were used to evaluate the effect of these variables on case outcomes and awards granted. RESULTS A total of 569 legal cases were examined; 335 cases were excluded due to irrelevance or insufficient information. Of the 234 cases included in this investigation, 54.2% (127 cases) resulted in a defendant ruling, 26.1% (61) in a plaintiff ruling, and 19.6% (46) in a settlement. The awards granted for plaintiff rulings ranged from $134,000 to $38,323,196 (mean $4,045,205 ± $6,804,647). Awards for settlements ranged from $125,000 to $9,000,000 (mean $1,930,278 ± $2,113,593), which was significantly less than plaintiff rulings (p = 0.022). Compared with cases without a delay in diagnosis of the complication, the cases with a diagnostic delay were more likely to result in a plaintiff verdict or settlement (42.9% vs 72.7%, p = 0.007) than a defense verdict, and were more likely to settle out of court (17.5% vs 40.9%, p = 0.008). Similarly, compared with cases without a delay in treatment of the complication, those with a therapeutic delay were more likely to result in a plaintiff verdict or settlement (43.7% vs 68.4%, p = 0.03) than a defense verdict, and were more likely to settle out of court (18.1% vs 36.8%, p = 0.04). Overall, 28% of cases (66/234) involved catastrophic complications. Physicians were more likely to lose cases (plaintiff verdict or settlement) with catastrophic complications (66.7% vs 37.5%, p < 0.001). In cases with a plaintiff ruling, catastrophic complications resulted in significantly larger mean awards than noncatastrophic complications ($6.1M vs $2.9M, p = 0.04). The medical specialty of the provider and the age or sex of the patient were not associated with the case outcome or award granted (p > 0.05). The average time to a decision for defendant verdicts was 5.1 years; for plaintiff rulings, 5.0 years; and for settlements, 3.4 years. CONCLUSIONS Delays in the diagnosis and the treatment of a surgical complication predict legal case outcomes favoring the plaintiff. Catastrophic complications are linked to large sums awarded to the plaintiff and are predictive of rulings against the physician. For physician defendants, the costs of settlements are significantly less than those of losing in court. Although this study provides potentially valuable data from a large series of postoperative litigation cases, it may not provide a true representation of all jurisdictions, each of which has variable malpractice laws and medicolegal environments.
[Mh] Termos MeSH primário: Imperícia/legislação & jurisprudência
Coluna Vertebral/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Fatores Etários
Bases de Dados Factuais
Diagnóstico Tardio
Feminino
Seres Humanos
Legislação Hospitalar
Masculino
Imperícia/economia
Meia-Idade
Complicações Pós-Operatórias/economia
Complicações Pós-Operatórias/epidemiologia
Complicações Pós-Operatórias/terapia
Fatores Sexuais
Cirurgiões/legislação & jurisprudência
Estados Unidos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170722
[St] Status:MEDLINE
[do] DOI:10.3171/2016.11.SPINE16646


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[PMID]:28613458
[Au] Autor:Scotti S
[Ad] Endereço:National Conference of State Legislatures.
[Ti] Título:Tracking rural hospital closures.
[So] Source:NCSL Legisbrief;25(21):1-2, 2017 Jun.
[Is] ISSN:1068-2716
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:(1) Over 50 percent of primary care health professional shortage areas (HPSAs) were in rural areas in November 2016, according to the Health Resources and Services Administration. (2) Rural areas face a higher uninsured rate than metropolitan areas. (3) Rural hospitals tend to have low patient volume, a high portion of patients on Medicare and Medicaid, and a high number of uninsured patients.
[Mh] Termos MeSH primário: Fechamento de Instituições de Saúde/economia
Fechamento de Instituições de Saúde/legislação & jurisprudência
Acesso aos Serviços de Saúde/economia
Acesso aos Serviços de Saúde/legislação & jurisprudência
Saúde da População Rural/economia
Saúde da População Rural/legislação & jurisprudência
[Mh] Termos MeSH secundário: Economia Hospitalar/legislação & jurisprudência
Seres Humanos
Reembolso de Seguro de Saúde/economia
Reembolso de Seguro de Saúde/legislação & jurisprudência
Legislação Hospitalar/economia
Medicaid
Pessoas sem Cobertura de Seguro de Saúde
Medicare/economia
Medicare/legislação & jurisprudência
População Rural
Telemedicina/economia
Telemedicina/legislação & jurisprudência
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170707
[Lr] Data última revisão:
170707
[Sb] Subgrupo de revista:T
[Da] Data de entrada para processamento:170615
[St] Status:MEDLINE


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[PMID]:28343207
[Au] Autor:Galeska-Sliwka A; Sliwka M
[Ad] Endereço:Zaklad Podstaw Prawa Medycznego Collegium Medicum Im. Ludwika Rydygiera W Bydgoszczy, Uniwersytet Mikolaja Kopernika, Torun, Polska.
[Ti] Título:[Liability for damages resulting from hospital falls].
[So] Source:Wiad Lek;70(1):128-132, 2017.
[Is] ISSN:0043-5147
[Cp] País de publicação:Poland
[La] Idioma:pol
[Ab] Resumo:The aim of the work is to analyze the conditions for liability of medical institutions for damages resulting from hospital fails. The study identifies achievements of polish jurisprudence. The authors also pointed to factors specific for claims of this type. The paper discusses: legal consequences of failure to provide security of patient stay and the responsibilities of hospitals in relation to patients especially vulnerable to falls. It also analyzes the problems faced by patients claiming compensation for damages resulting from such events: constraints of the evidence in establishing the conditions for liability, the argument unpredictability of event and the detrimental impact of the actions taken in the hospital to reduce the risk of falling.
[Mh] Termos MeSH primário: Acidentes por Quedas/economia
Compensação e Reparação
Legislação Hospitalar
Responsabilidade Legal/economia
[Mh] Termos MeSH secundário: Seres Humanos
Polônia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170713
[Lr] Data última revisão:
170713
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170327
[St] Status:MEDLINE


  6 / 2320 MEDLINE  
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[PMID]:28229326
[Au] Autor:Brenner LH; Teo WZ; Bal BS
[Ad] Endereço:BalBrenner/Orthopaedic Law Center, Chapel Hill, NC, USA.
[Ti] Título:Medicolegal Sidebar: Expanding Hospital Liability-The Concept of Willful Blindness.
[So] Source:Clin Orthop Relat Res;475(5):1315-1318, 2017 May.
[Is] ISSN:1528-1132
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Fraude/legislação & jurisprudência
Gastos em Saúde/legislação & jurisprudência
Legislação Hospitalar
Responsabilidade Legal
[Mh] Termos MeSH secundário: Seres Humanos
Estados Unidos
[Pt] Tipo de publicação:EDITORIAL
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170224
[St] Status:MEDLINE
[do] DOI:10.1007/s11999-017-5282-0


  7 / 2320 MEDLINE  
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[PMID]:28167739
[Au] Autor:Wise J
[Ad] Endereço:London.
[Ti] Título:Charging overseas patients upfront could cause "chaos," BMA warns.
[So] Source:BMJ;356:j655, 2017 Feb 06.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Honorários e Preços
Financiamento Pessoal
Legislação Hospitalar
Migrantes
[Mh] Termos MeSH secundário: Procedimentos Cirúrgicos Eletivos/economia
Inglaterra
Seres Humanos
Mecanismo de Reembolso
Medicina Estatal
[Pt] Tipo de publicação:NEWS
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170208
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j655


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[PMID]:28109011
[Au] Autor:Terp S; Wang B; Raffetto B; Seabury SA; Menchine M
[Ad] Endereço:Department of Emergency Medicine, Keck School of Medicine, Angeles, CA.
[Ti] Título:Individual Physician Penalties Resulting From Violation of Emergency Medical Treatment and Labor Act: A Review of Office of the Inspector General Patient Dumping Settlements, 2002-2015.
[So] Source:Acad Emerg Med;24(4):442-446, 2017 Apr.
[Is] ISSN:1553-2712
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The objective was to describe characteristics of civil monetary penalty settlements levied by the Office of the Inspector General (OIG) against individual physicians related to violation of the Emergency Medical Treatment and Labor Act (EMTALA). METHODS: Descriptions of all civil monetary penalty settlements between 2002 and 2015 were obtained from the OIG. Characteristics of settlements against individual physicians related to EMTALA violations were described including settlement date, location, amount, whether there was an associated hospital settlement, the medical specialty of the physician involved, and the nature of the allegation. RESULTS: Of 196 OIG civil monetary penalty settlements related to EMTALA, eight (4%) were levied against individual physicians, and 188 (96%) against facilities. Seven of the eight penalties against individual physicians were imposed upon on-call specialists, including six who failed to respond to evaluate and treat a patient in the emergency department (ED), and one who failed to accept appropriate transfer of a patient requiring higher level of care. The only penalty imposed on an emergency physician involved a case where a provider repeatedly failed to provide a medical screening examination to a pregnant teen based on the erroneous belief that a minor could not be evaluated or treated absent parental consent. Four of eight penalties against individual physicians were levied within the first 3 years of the 14-year study period. Half of all physician settlements were associated with a separate hospital civil monetary penalty settlement. CONCLUSIONS: For emergency physicians, a civil monetary penalty is a feared consequence of EMTALA enforcement, as a physician can be held individually liable for fine of up to $50,000 not covered by malpractice insurance. Although EMTALA is an actively enforced law, and violation of the EMTALA statute often results in hospital citations and fines, and occasionally facility closure, we found that individual physicians are rarely penalized by the OIG following EMTALA violation. Individual physician penalties are far less common than hospital citations or fines related to EMTALA or malpractice claims or payments. The majority of penalties against individual physicians were levied upon on-call specialists who refused to evaluate and treat ED patients. Only one emergency physician was fined during the study period for a clear violation of the EMTALA statute. Physicians should be diligent to ensure appropriate patient care and that facilities are compliant with the EMTALA statute, but should be aware that settlements against individual physicians are a rare consequence of EMTALA enforcement.
[Mh] Termos MeSH primário: Medicina de Emergência/legislação & jurisprudência
Legislação Hospitalar
Imperícia/legislação & jurisprudência
Transferência de Pacientes/legislação & jurisprudência
Má Conduta Profissional/legislação & jurisprudência
[Mh] Termos MeSH secundário: Adolescente
Medicina de Emergência/economia
Serviço Hospitalar de Emergência/legislação & jurisprudência
Feminino
Seres Humanos
Imperícia/economia
Gravidez
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170531
[Lr] Data última revisão:
170531
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170122
[St] Status:MEDLINE
[do] DOI:10.1111/acem.13159


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[PMID]:27412678
[Au] Autor:Ivaskiene T; Mauricas M; Ivaska J
[Ti] Título:Hospital Exemption for Advanced Therapy Medicinal Products: Issue in Application in the European Union Member States.
[So] Source:Curr Stem Cell Res Ther;12(1):45-51, 2017.
[Is] ISSN:2212-3946
[Cp] País de publicação:United Arab Emirates
[La] Idioma:eng
[Ab] Resumo:Regulation (EC) 1394/2007 of the European Parliament and the Council on advanced therapy medicinal products and amending Directive 2001/83/EC and Regulation (EC) No 726/2004 allowed the use of non - authorized advanced therapy medicinal products under the certain circumstances. This socalled hospital exemption rule needs to be applied in the each Member State of the European Union individually and for this purpose Member States should provide national procedures and control measures. The aim of this article is to clear up the criteria for hospital exemption listed in Regulation (EC) 1394/2007 and to contrast the difference in implementing hospital exemption rule into national legal regimes on examples of the United Kingdom, Lithuania and Poland.
[Mh] Termos MeSH primário: Terapia Baseada em Transplante de Células e Tecidos/utilização
União Europeia
Terapia Genética/utilização
Hospitais
Legislação Hospitalar
Terapias em Estudo/utilização
Engenharia Tecidual/utilização
[Mh] Termos MeSH secundário: Terapia Baseada em Transplante de Células e Tecidos/métodos
Ensaios de Uso Compassivo
Terapia Genética/métodos
Seres Humanos
Engenharia Tecidual/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170217
[Lr] Data última revisão:
170217
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160715
[St] Status:MEDLINE


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[PMID]:28027367
[Au] Autor:Desai NR; Ross JS; Kwon JY; Herrin J; Dharmarajan K; Bernheim SM; Krumholz HM; Horwitz LI
[Ad] Endereço:Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut2Center for Outcomes Research and Evaluation, New Haven, Connecticut.
[Ti] Título:Association Between Hospital Penalty Status Under the Hospital Readmission Reduction Program and Readmission Rates for Target and Nontarget Conditions.
[So] Source:JAMA;316(24):2647-2656, 2016 12 27.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Readmission rates declined after announcement of the Hospital Readmission Reduction Program (HRRP), which penalizes hospitals for excess readmissions for acute myocardial infarction (AMI), heart failure (HF), and pneumonia. Objective: To compare trends in readmission rates for target and nontarget conditions, stratified by hospital penalty status. Design, Setting, and Participants: Retrospective cohort study of Medicare fee-for-service beneficiaries older than 64 years discharged between January 1, 2008, and June 30, 2015, from 2214 penalty hospitals and 1283 nonpenalty hospitals. Difference-interrupted time-series models were used to compare trends in readmission rates by condition and penalty status. Exposure: Hospital penalty status or target condition under the HRRP. Main Outcomes and Measures: Thirty-day risk adjusted, all-cause unplanned readmission rates for target and nontarget conditions. Results: The study included 48 137 102 hospitalizations of 20 351 161 Medicare beneficiaries. In January 2008, the mean readmission rates for AMI, HF, pneumonia, and nontarget conditions were 21.9%, 27.5%, 20.1%, and 18.4%, respectively, at hospitals later subject to financial penalties and 18.7%, 24.2%, 17.4%, and 15.7% at hospitals not subject to penalties. Between January 2008 and March 2010, prior to HRRP announcement, readmission rates were stable across hospitals (except AMI at nonpenalty hospitals). Following announcement of HRRP (March 2010), readmission rates for both target and nontarget conditions declined significantly faster for patients at hospitals later subject to financial penalties compared with those at nonpenalized hospitals (for AMI, additional decrease of -1.24 [95% CI, -1.84 to -0.65] percentage points per year relative to nonpenalty discharges; for HF, -1.25 [95% CI, -1.64 to -0.86]; for pneumonia, -1.37 [95% CI, -1.80 to -0.95]; and for nontarget conditions, -0.27 [95% CI, -0.38 to -0.17]; P < .001 for all). For penalty hospitals, readmission rates for target conditions declined significantly faster compared with nontarget conditions (for AMI, additional decline of -0.49 [95% CI, -0.81 to -0.16] percentage points per year relative to nontarget conditions [P = .004]; for HF, -0.90 [95% CI, -1.18 to -0.62; P < .001]; and for pneumonia, -0.57 [95% CI, -0.92 to -0.23; P < .001]). In contrast, among nonpenalty hospitals, readmissions for target conditions declined similarly or more slowly compared with nontarget conditions (for AMI, additional increase of 0.48 [95% CI, 0.01-0.95] percentage points per year [P = .05]; for HF, 0.08 [95% CI, -0.30 to 0.46; P = .67]; for pneumonia, 0.53 [95% CI, 0.13-0.93; P = .01]). After HRRP implementation in October 2012, the rate of change for readmission rates plateaued (P < .05 for all except pneumonia at nonpenalty hospitals), with the greatest relative change observed among hospitals subject to financial penalty. Conclusions and Relevance: Medicare fee-for-service patients at hospitals subject to penalties under the HRRP had greater reductions in readmission rates compared with those at nonpenalized hospitals. Changes were greater for target vs nontarget conditions for patients at the penalized hospitals but not at the other hospitals.
[Mh] Termos MeSH primário: Planos de Pagamento por Serviço Prestado/estatística & dados numéricos
Hospitais/estatística & dados numéricos
Medicare/estatística & dados numéricos
Readmissão do Paciente/estatística & dados numéricos
Readmissão do Paciente/tendências
[Mh] Termos MeSH secundário: Doença Aguda
Idoso
Economia Hospitalar/estatística & dados numéricos
Economia Hospitalar/tendências
Planos de Pagamento por Serviço Prestado/legislação & jurisprudência
Planos de Pagamento por Serviço Prestado/tendências
Insuficiência Cardíaca/epidemiologia
Número de Leitos em Hospital/estatística & dados numéricos
Seres Humanos
Análise de Séries Temporais Interrompida
Legislação Hospitalar
Estudos Longitudinais
Infarto do Miocárdio/epidemiologia
Readmissão do Paciente/legislação & jurisprudência
Pneumonia/epidemiologia
Estudos Retrospectivos
Fatores de Tempo
Estados Unidos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161228
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2016.18533



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