Guideliner icd 10 code teleflex12/28/2023 Similar patterns were observed for patients hospitalized with HF (30-day postadmission mortality: aOR, 3.5 95% CI, 3.4-3.7 30-day postdischarge mortality: aOR, 3.5 95% CI, 3.3-3.6 and 30-day readmission: aOR, 2.9 95% CI, 2.8-3.0) and among patients with pneumonia (30-day postadmission mortality: aOR, 2.5 95% CI, 2.3-2.6 30-day postdischarge mortality: aOR, 3.0 95% CI, 2.9-3.2 and 30-day readmission: aOR, 2.8 95% CI, 2.7-2.9). Among patients hospitalized for AMI, an HFRS more than 15 (compared with an HFRS <5) was associated with a higher risk of 30-day postadmission mortality (adjusted odds ratio, 3.6 95% CI, 3.4-3.8), 30-day postdischarge mortality (aOR, 4.0 95% CI, 3.7-4.3), and 30-day readmission (aOR, 3.0 95% CI, 2.9-3.1) after multivariable adjustment for age, sex, race, and comorbidities. The mean (SD) HFRS was 7.3 (7.4) for patients with AMI, 10.8 (8.3) for patients with HF, and 8.2 (5.7) for patients with pneumonia. Results For 785 127 participants, there were 166 200 hospitalizations for AMI, 348 619 for HF, and 270 308 for pneumonia. We evaluated the incremental effect of adding the Hospital Frailty Risk Score (HFRS) to current comorbidity-based risk-adjustment models for 30-day outcomes across all conditions. Main Outcomes and Measures Rates of mortality within 30 days of admission and 30 days of discharge, as well as 30-day readmission rates by frailty group. Objective To determine whether the addition of frailty measures to traditional comorbidity-based risk-adjustment models improved prediction of outcomes for patients with AMI, HF, and pneumonia.ĭesign, Setting, and Participants A nationwide cohort study included Medicare fee-for-service beneficiaries 65 years and older in the United States between January 1 and December 1, 2016. This may have important implications for hospitals that tend to care for frail populations and participate in Centers for Medicare & Medicaid Services value-based payment programs, which use these risk-adjusted metrics to determine reimbursement. Importance The addition of a claims-based frailty metric to traditional comorbidity-based risk-adjustment models for acute myocardial infarction (AMI), heart failure (HF), and pneumonia improves the prediction of 30-day mortality and readmission. Meaning Unless frailty is adequately captured in risk-adjustment metrics, it is possible that hospitals that care for a higher proportion of frail patients are disproportionately financially penalized for worse outcomes owing to unrecognized comorbidities among the patients they care for, rather than quality of care delivered. When added to traditional comorbidities typically used in risk-adjustment models for these conditions, this claims-based frailty score significantly improved prediction of 30-day outcomes. Question Does the addition of frailty to traditional comorbidity-based risk-adjustment models improve the prediction of 30-day mortality and readmission for these conditions?įindings In this cohort study of 785 127 participants, frailty as determined by an International Statistical Classification of Diseases and Related Health Problems, Tenth Revision claims-based frailty score was associated with a higher risk of 30-day outcomes for acute myocardial infarction, heart failure, and pneumonia hospitalizations. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
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