Relationship Between Insurance Status and Receipt of Cardiac Tests and Procedures During Hospitalization: A Cross-Sectional Study.

Background: Prior analyses of the relationship between insurance status and receipt of tests and procedures have yielded conflicting findings and have focused on outpatient care. We sought to characterize the relationship between primary payer and diagnostic and procedural intensity, comparing rates of cardiac tests and procedures in matched hospitalized Medicaid and commercially insured patients.

Methods And Results: We created a propensity score-matched sample of Medicaid and commercially insured adults hospitalized at all acute care hospitals in Kentucky, Maryland, New Jersey, and North Carolina from 2016 to 2018.

Development of a hospital coding intensity measure based on sepsis diagnoses.

Significant variation in coding intensity among hospitals has been observed and can lead to reimbursement inequities and inadequate risk adjustment for quality measures. Reliable tools to quantify hospital coding intensity are needed. We hypothesized that coded sepsis rates among patients hospitalized with common infections may serve as a useful surrogate for coding intensity and derived a hospital-level sepsis coding intensity measure using prevalence of "sepsis" primary diagnoses among patients hospitalized with urinary tract infection, cellulitis, and pneumonia.

Inpatient safety outcomes following the 2011 residency work-hour reform.

Background: The impact of the 2011 residency work-hour reforms on patient safety is not known.

Objective: To evaluate the association between implementation of the 2011 reforms and patient safety outcomes at a large academic medical center.

Design: Observational study using difference-in-differences estimation strategy to evaluate whether safety outcomes improved among patients discharged from resident and hospitalist (nonresident) services before (2008-2011) and after (2011-2012) residency work-hour changes.