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The American Journal of Managed Care January 2018
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Juliet Rumball-Smith, MBChB, PhD; Paul Shekelle, MD, PhD; and Cheryl L. Damberg, PhD
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Hospital Participation in Meaningful Use and Racial Disparities in Readmissions
Mark Aaron Unruh, PhD; Hye-Young Jung, PhD; Rainu Kaushal, MD, MPH; and Joshua R. Vest, PhD, MPH
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Timothy J. Daskivich, MD, MSHPM; Garen Abedi, MD, MS; Sherrie H. Kaplan, PhD, MPH; Douglas Skarecky, BS; Thomas Ahlering, MD; Brennan Spiegel, MD, MSHS; Mark S. Litwin, MD, MPH; and Sheldon Greenfield, MD
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Eva Chang, PhD, MPH; Katherine Blondon, MD, PhD; Courtney R. Lyles, PhD; Luesa Jordan, BA; and James D. Ralston, MD, MPH
Hospitalized Patients' and Family Members' Preferences for Real-Time, Transparent Access to Their Hospital Records
Michael J. Waxman, MD, MPH; Kurt Lozier, MBA; Lana Vasiljevic, MS; Kira Novakofski, PhD; James Desemone, MD; John O'Kane, RRT-NPS, MBA; Elizabeth M. Dufort, MD; David Wood, MBA; Ashar Ata, MBBS, PhD; Louis Filhour, PhD, RN; & Richard J. Blinkhorn Jr, MD

Hospital Participation in Meaningful Use and Racial Disparities in Readmissions

Mark Aaron Unruh, PhD; Hye-Young Jung, PhD; Rainu Kaushal, MD, MPH; and Joshua R. Vest, PhD, MPH
Hospital participation in Meaningful Use was associated with reduced disparities in 30-day readmissions for African American Medicare beneficiaries.
ABSTRACT

Objectives: To measure the impact of hospital participation in Meaningful Use (MU) on disparities in 30-day readmissions associated with race.

Study Design: A retrospective cohort study that compared the likelihood of 30-day readmission for Medicare beneficiaries discharged from hospitals participating in Stage 1 of MU with the likelihood of readmission for beneficiaries concurrently discharged from hospitals that were not participating in the initiative.

Methods: Inpatient claims for 2,414,205 Medicare beneficiaries from Florida, New York, and Washington State were used as the primary data source. The study period (2009-2013) included at least 2 years of baseline data prior to each hospital initiating participation in MU. Estimates were derived with linear regression models that included hospital and time fixed effects. By including both hospital and time fixed effects, estimates were based on discharges from the same hospital in the same time period.

Results: MU participation among hospitals was not associated with a statistically significant change in readmissions for the broader Medicare population (percentage points [PP], 0.6; 95% CI, –0.2 to 1.4), but hospitals’ participation in the initiative was associated with a lower likelihood of readmission for African American beneficiaries (PP, –0.9; 95% CI, –1.5 to –0.4).

Conclusions: Hospital participation in MU reduced disparities in 30-day readmissions for African American Medicare beneficiaries.

Am J Manag Care. 2018;24(1):38-42

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