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Project Information
FY 2009-2010
Assessing the Rural Relevance of Hospital Outpatient Quality Measures
Expected completion date: 8/10
Research Center: Upper Midwest Rural Health Research Center
Principal Investigator: Ira Moscovice, Ph.D., 612-624-8618, mosco001@umn.edu
Contact Person: Michelle Casey, MS, 612-623-8316, mcasey@umn.edu
Funder: Office of Rural Health Policy
Date the project was funded: 9/09
Short Abstract: The purpose of this project is to (1) determine the diagnoses that are most commonly treated and the procedures most commonly performed in rural hospital outpatient settings; and (2) to evaluate the rural relevance of the proposed new CMS outpatient quality measures and other potential outpatient quality measures.
Detailed Abstract
- Statement of the problem: Initial efforts to develop hospital quality measures focused on inpatient settings, but quality measures focused on outpatient settings are of increasing interest to policymakers. A few outpatient measures have been field-tested in rural hospitals, but most measures have not been assessed for their rural relevancy.
- Project goals: The purpose of this project is to (1) determine the diagnoses that are most commonly treated and the procedures most commonly performed in rural hospital outpatient settings; and (2) to evaluate the rural relevance of the proposed new CMS outpatient quality measures and other potential outpatient quality measures.
- Methods: This project will have three parts: (1) an analysis of outpatient Medicare data to identify the most common diagnoses and procedures in rural hospital outpatient settings; (2) a review of the literature and specifications for outpatient quality measures proposed by CMS and other potential outpatient measures; and (3) an expert panel to evaluate the rural relevance of the measures.
- Anticipated Publications or Products: The products for this project will include a final report, a policy brief, an article that will be submitted to a peer-reviewed journal, and presentation abstracts that will be submitted to state, regional, and national conferences.
Rural Implications of Health Care Reform: Issues Related to Quality of Care, Health Information Technology, and Care Coordination
Expected completion date: 8/10
Research Center: Upper Midwest Rural Health Research Center
Principal Investigator: Ira Moscovice, Ph.D., 612-624-8618, mosco001@umn.edu
Contact Person: Ira Moscovice, Ph.D., 612-624-8618, mosco001@umn.edu
Funder: Office of Rural Health Policy
Date the project was funded: 9/09
Short Abstract: The purpose of this project is to provide support to the Office of Rural Health Policy on rural health care reform issues.
Detailed Abstract
- Statement of the problem: Rural areas present special challenges for health care reform. It is important to examine the rural implications of health care reform proposals.
Project goals: The purpose of this project is to provide support to the
- Office of Rural Health Policy on rural health care reform issues.
Methods: The UMRHRC has access to a variety of potential data sources that can be used to assess the rural implications of health care reform. The specific analytic approaches used to address rural health care reform issues will depend on the topics chosen and the available data.
- Anticipated Publications or Products: Quick turn-around policy briefs.
The Effect of Type and Timeliness of Post-Acute Care on Preventable Hospital Readmissions for Rural Medicare Beneficiaries
Expected completion date: 8/10
Research Center: Upper Midwest Rural Health Research Center
Principal Investigator: Ira Moscovice, Ph.D., 612-624-8618, mosco001@umn.edu
Contact Person: Marilyn Klug, Ph.D., 701-787-0089, mklug@medicine.nodak.edu
Funder: Office of Rural Health Policy
Date the project was funded: 9/09
Short Abstract: The purpose of this project is to (1) determine how location of hospitals used for initial admissions by rural patients affects readmission rates; (2) assess how the use of swing beds affects rural patients’ readmissions; and (3) examine the impact of the type and timeliness of post-acute care, including home health care, skilled nursing, and physician visits, on readmissions for rural patients.
Detailed Abstract
- Statement of the problem: Readmission within 30 days of hospital discharge is an increasingly utilized measure of hospital care quality. Current knowledge of rural patients care quality may be expanded by assessing how patients’ use of rural hospitals, urban hospitals, and rural and urban hospital combinations and the type and timing of health services received by patients during and after hospital stays influence the likelihood of readmissions.
- Project goals: The purpose of this project is to (1) determine how location of hospitals used for initial admissions by rural patients affects readmission rates; (2) assess how the use of swing beds affects rural patients’ readmissions; and (3) examine the impact of the type and timeliness of post-acute care, including home health care, skilled nursing, and physician visits, on readmissions for rural patients.
- Methods: Kaplan-Meier curves and Medicare inpatient data for 2007 will be used to compare the probability of readmission for rural beneficiaries based on hospital location. The inpatient data will be matched with 5% carrier (physician/Part B), skilled nursing facility, and home health care data from the Medicare Chronic Condition Data Warehouse for beneficiaries with congestive heart failure and chronic obstructive pulmonary disease. The effect of the use of various post-acute services on readmissions will be analyzed using Cox regression while controlling for time to receive services, demographics, and patient severity.
- Anticipated Publications or Products: The products for this project will include a final report, a policy brief, an article that will be submitted to a peer-reviewed journal, and presentation abstracts that will be submitted to state, regional, and national conferences
Previous Funding Cycles:
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