John D Birkmeyer
Dados Biográficos
| ID | 5533932 |
|---|---|
| NOME | John D Birkmeyer |
| PRENOMES | John D |
| SOBRENOME | Birkmeyer |
| ASSINATURA | BIRKMEYER J D |
| AFILIAÇÕES | University of Michigan |
| VERIFICADO | Não |
| TOTAL DE OBRAS | 13 |
| TOTAL DE CITAÇÕES | 0 |
| TOTAL COMO AUTOR | 13 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 1999 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2018 |
| ÍNDICE H | 0 |
Readmission Rates and Skilled Nursing Facility Utilization After Major Inpatient Surgery
BACKGROUND: There is widespread interest in reducing use of postacute care (ie, care after hospital discharge) following major surgery, provided that such reductions do not worsen quality outcomes such as readmission rates. OBJECTIVES: To describe the association between changes in skilled nursing facility (SNF) use and changes in readmission rates after surgery. RESEARCH DESIGN: This was a observational study. SUBJECTS: Fee-for-service Medicare …
Identifying Natural Alignments Between Ambulatory Surgery Centers and Local Health Systems
OBJECTIVE: To develop and compare methods for identifying natural alignments between ambulatory surgery centers (ASCs) and hospitals that anchor local health systems. MEASURES: Using all-payer data from Florida's State Ambulatory Surgery and Inpatient Databases (2005-2009), we developed 3 methods for identifying alignments between ASCS and hospitals. The first, a geographic proximity approach, used spatial data to assign an ASC to its nearest hos…
Mortality Among Older Adults Before Versus After Hospital Transition to Intensivist Staffing
BACKGROUND: A large body of research suggests that hospitals with intensive care units staffed by board-certified intensivists have lower mortality rates than those that do not. OBJECTIVE: To determine whether hospitals can reduce their mortality by adopting an intensivist staffing model. DESIGN: Retrospective, longitudinal study using 2003-2010 Medicare data and the Leapfrog Group Hospital surveys. SETTING AND PATIENTS: In total, 2,916,801 Medic…
Differences Between Physician Social Networks for Cardiac Surgery Serving Communities With High Versus Low Proportions of Black Residents
BACKGROUND: Compared with white patients, black patients are more likely to undergo cardiac surgery at low-quality hospitals, even when they live closer to high-quality ones. Opportunities for organizational interventions to alleviate this problem remain elusive. OBJECTIVES: To explore physician isolation in communities with high proportions of black residents as a factor contributing to racial disparities in access to high-quality hospitals for …
Ambulatory Surgery Centers and Outpatient Procedure Use Among Medicare Beneficiaries
BACKGROUND: There has been a strong push to move outpatient surgery from hospital settings to ambulatory surgery centers (ASCs). Despite the efficiency advantages of ASCs, many are concerned that these facilities could increase overall utilization. OBJECTIVE: To assess the impact of ASC opening on rates of outpatient surgery. DESIGN: This was a retrospective cohort study of Medicare beneficiaries undergoing outpatient surgery between 2001 and 201…
Composite Quality Measures for Common Inpatient Medical Conditions
Composite measures of quality for HF, AMI, and PNA performed better than existing measures at explaining variation in future mortality and predicting future high and low performers
Race and Timeliness of Transfer for Revascularization in Patients With Acute Myocardial Infarction
OBJECTIVES: Patients with acute myocardial infarction (AMI) who are admitted to hospitals without coronary revascularization are frequently transferred to hospitals with this capability. We sought to determine whether the timeliness of hospital transfer and quality of destination hospitals differed between black and white patients. METHODS: We evaluated all white and black Medicare beneficiaries admitted with AMI at nonrevascularization hospitals…
Hospital Volume and Failure to Rescue With High-risk Surgery
Differences in mortality between high and low-volume hospitals are not associated with large differences in complication rates. Instead, these differences seem to be associated with the ability of a hospital to effectively rescue patients from complications. Strategies focusing on the timely recognition and management of complications once they occur may be essential to improving outcomes at low-volume hospitals
Empirically Derived Composite Measures of Surgical Performance
BACKGROUND: Individual quality measures have significant limitations for assessing surgical performance. Despite growing interest in composite measures, empirically-based methods for combining multiple domains of surgical quality are not well established. OBJECTIVE: To develop and validate a composite measure of surgical performance that best describes variation in hospital mortality rates and forecasts future performance. RESEARCH DESIGN: Using …
Socioeconomic Status and Surgical Mortality in the Elderly
BACKGROUND: Although racial disparities in the quality of surgical care are well described, the impact of socioeconomic status on operative mortality is relatively unexplored. METHODS: We used Medicare data to identify all patients undergoing 1 of 6 common, high risk surgical procedures between 1999 and 2003. We constructed a summary measure of socioeconomic status for each US ZIP code using data from the 2000 US Census linked to the patient's ZI…
Are Mortality Rates for Different Operations Related
BACKGROUND: Except in cardiac surgery, measuring quality with procedure-specific mortality rates is unreliable because of small sample sizes at individual hospitals. Statistical power can be improved by combining mortality data from multiple operations. We sought to determine whether this approach would still be useful in understanding performance with individual procedures. METHODS: We studied 11 high-risk operations performed in the national Me…
Hospital Volume and Surgical Mortality in the United States
BACKGROUND: Although numerous studies suggest that there is an inverse relation between hospital volume of surgical procedures and surgical mortality, the relative importance of hospital volume in various surgical procedures is disputed. METHODS: Using information from the national Medicare claims data base and the Nationwide Inpatient Sample, we examined the mortality associated with six different types of cardiovascular procedures and eight typ…
Patient Preferences for Location of Care
BACKGROUND: Regionalization of high-risk surgical procedures to selected high-volume centers has been proposed as a way to reduce operative mortality. For patients, however, travel to regional centers may be undesirable despite the expected mortality benefit. OBJECTIVE: To determine the strength of patient preferences for local care. DESIGN: Using a scenario of potentially resectable pancreatic cancer and a modification of the standard gamble uti…
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Patient Preferences for Location of Care
BACKGROUND: Regionalization of high-risk surgical procedures to selected high-volume centers has been proposed as a way to reduce operative mortality. For patients, however, travel to regional centers may be undesirable despite the expected mortality benefit. OBJECTIVE: To determine the strength of patient preferences for local care. DESIGN: Using a scenario of potentially resectable pancreatic cancer and a modification of the standard gamble uti…
Hospital Volume and Surgical Mortality in the United States
BACKGROUND: Although numerous studies suggest that there is an inverse relation between hospital volume of surgical procedures and surgical mortality, the relative importance of hospital volume in various surgical procedures is disputed. METHODS: Using information from the national Medicare claims data base and the Nationwide Inpatient Sample, we examined the mortality associated with six different types of cardiovascular procedures and eight typ…
Are Mortality Rates for Different Operations Related
BACKGROUND: Except in cardiac surgery, measuring quality with procedure-specific mortality rates is unreliable because of small sample sizes at individual hospitals. Statistical power can be improved by combining mortality data from multiple operations. We sought to determine whether this approach would still be useful in understanding performance with individual procedures. METHODS: We studied 11 high-risk operations performed in the national Me…
Socioeconomic Status and Surgical Mortality in the Elderly
BACKGROUND: Although racial disparities in the quality of surgical care are well described, the impact of socioeconomic status on operative mortality is relatively unexplored. METHODS: We used Medicare data to identify all patients undergoing 1 of 6 common, high risk surgical procedures between 1999 and 2003. We constructed a summary measure of socioeconomic status for each US ZIP code using data from the 2000 US Census linked to the patient's ZI…
Empirically Derived Composite Measures of Surgical Performance
BACKGROUND: Individual quality measures have significant limitations for assessing surgical performance. Despite growing interest in composite measures, empirically-based methods for combining multiple domains of surgical quality are not well established. OBJECTIVE: To develop and validate a composite measure of surgical performance that best describes variation in hospital mortality rates and forecasts future performance. RESEARCH DESIGN: Using …
Race and Timeliness of Transfer for Revascularization in Patients With Acute Myocardial Infarction
OBJECTIVES: Patients with acute myocardial infarction (AMI) who are admitted to hospitals without coronary revascularization are frequently transferred to hospitals with this capability. We sought to determine whether the timeliness of hospital transfer and quality of destination hospitals differed between black and white patients. METHODS: We evaluated all white and black Medicare beneficiaries admitted with AMI at nonrevascularization hospitals…
Hospital Volume and Failure to Rescue With High-risk Surgery
Differences in mortality between high and low-volume hospitals are not associated with large differences in complication rates. Instead, these differences seem to be associated with the ability of a hospital to effectively rescue patients from complications. Strategies focusing on the timely recognition and management of complications once they occur may be essential to improving outcomes at low-volume hospitals
Composite Quality Measures for Common Inpatient Medical Conditions
Composite measures of quality for HF, AMI, and PNA performed better than existing measures at explaining variation in future mortality and predicting future high and low performers
Ambulatory Surgery Centers and Outpatient Procedure Use Among Medicare Beneficiaries
BACKGROUND: There has been a strong push to move outpatient surgery from hospital settings to ambulatory surgery centers (ASCs). Despite the efficiency advantages of ASCs, many are concerned that these facilities could increase overall utilization. OBJECTIVE: To assess the impact of ASC opening on rates of outpatient surgery. DESIGN: This was a retrospective cohort study of Medicare beneficiaries undergoing outpatient surgery between 2001 and 201…
Differences Between Physician Social Networks for Cardiac Surgery Serving Communities With High Versus Low Proportions of Black Residents
BACKGROUND: Compared with white patients, black patients are more likely to undergo cardiac surgery at low-quality hospitals, even when they live closer to high-quality ones. Opportunities for organizational interventions to alleviate this problem remain elusive. OBJECTIVES: To explore physician isolation in communities with high proportions of black residents as a factor contributing to racial disparities in access to high-quality hospitals for …
Mortality Among Older Adults Before Versus After Hospital Transition to Intensivist Staffing
BACKGROUND: A large body of research suggests that hospitals with intensive care units staffed by board-certified intensivists have lower mortality rates than those that do not. OBJECTIVE: To determine whether hospitals can reduce their mortality by adopting an intensivist staffing model. DESIGN: Retrospective, longitudinal study using 2003-2010 Medicare data and the Leapfrog Group Hospital surveys. SETTING AND PATIENTS: In total, 2,916,801 Medic…
Identifying Natural Alignments Between Ambulatory Surgery Centers and Local Health Systems
OBJECTIVE: To develop and compare methods for identifying natural alignments between ambulatory surgery centers (ASCs) and hospitals that anchor local health systems. MEASURES: Using all-payer data from Florida's State Ambulatory Surgery and Inpatient Databases (2005-2009), we developed 3 methods for identifying alignments between ASCS and hospitals. The first, a geographic proximity approach, used spatial data to assign an ASC to its nearest hos…
Readmission Rates and Skilled Nursing Facility Utilization After Major Inpatient Surgery
BACKGROUND: There is widespread interest in reducing use of postacute care (ie, care after hospital discharge) following major surgery, provided that such reductions do not worsen quality outcomes such as readmission rates. OBJECTIVES: To describe the association between changes in skilled nursing facility (SNF) use and changes in readmission rates after surgery. RESEARCH DESIGN: This was a observational study. SUBJECTS: Fee-for-service Medicare …
Medicine (12 obras) · Internal Medicine (9 obras) · Internal Medicine (8 obras) · Surgery (7 obras) · Emergency Medicine (6 obras) · Emergency Medicine (6 obras) · Surgery (6 obras) · Sepsis Diagnosis and Treatment (5 obras) · Cardiac, Anesthesia and Surgical Outcomes (4 obras) · Mortality rate (4 obras)