May 13, 2020


A new study published in JAMA Network Open, “Association Between Medicare Expenditures and Adverse Events for Patients With Acute Myocardial Infarction, Heart Failure, or Pneumonia in the United States,” found that hospitals with higher adverse rates are more likely to have higher costs for patients discharged certain cardiac conditions and pneumonia. Qualidigm, the mission-driven healthcare consulting company based in Wethersfield, Conn., with the Agency for Healthcare Research and Quality (AHRQ), the Centers for Medicare & Medicaid Services (CMS), and other national leading institutions, conducted the study.

Researchers compared medical record data from the Medicare Patient Safety Monitoring System, the nation’s largest medical record abstraction-based surveillance system designed for patient safety tracking, with 30-day episode-of-care expenditure data from CMS. The study focused on acute care hospitals in the United States treating Medicare fee-for-service patients for heart attack, heart failure, or pneumonia between 2011 and 2016. The final study sample included approximately 2,200 hospitals and nearly 45,000 patients.

“The results of this study suggest that hospitals with poor performance, based on actual documented adverse events are likely to have higher 30-day expenditures for patients discharged with acute myocardial infarction, heart failure, or pneumonia,” said Yun Wang, PhD, lead author of the study and also a Senior Research Scientist at Harvard School of Public Health. “While reductions in adverse events often require additional resources, hospitals that make these investments could experience long-term reductions in both Medicare expenditures and hospital costs, in addition to delivering safer care.”

“We are pleased this study confirms the correlation between higher adverse event rates and additional costs to patient care,” said Timothy Elwell, PhD, Qualidigm president and CEO. “The results appear to support the adage that “quality pays”. Hospitals that make needed investments to reduce adverse events to improve patient safety may witness a reduction in healthcare costs.”

Access the article on JAMA Network Open.

Yun Wang is the lead and corresponding author for this study and a Qualidigm consultant. Co-authors include: Noel Eldridge, MS (AHRQ); Mark L. Metersky, MD (University of Connecticut School of Medicine, also affiliated with Qualidigm); Nancy Sonnenfeld, PhD (Centers for Medicare & Medicaid Services); David Rodrick, PhD (AHRQ); Jonathan M. Fine, MD (Asthma, Pulmonary and Critical Medicine, Norwalk Hospital); Sheila Eckenrode, MA, RN (Qualidigm); Deron H. Galusha, MS (Yale School of Medicine and Qualidigm Consultant); Anila Tasimi, BS (Qualidigm); David R. Hunt, MD (Office of the National Coordinator for Health Information Technology); Susannah M. Bernheim, MD, MHS (Yale School of Medicine); Sharon-Lise T. Normand, PhD (Harvard Medical School); Harlan M. Krumholz, MD, SM (Yale School of Medicine).