The Cardiovascular Outcomes Research Center at Yale University will focus on research to promote hospital and regional excellence in patient outcomes and healthcare value. To accomplish this, the Yale team will leverage its expertise with the Centers for Medicare &Medicaid Services (CMS) outcomes measures;extend its pioneering work in positive deviance research and mixed methods approaches;build upon its longstanding collaborations with top outcomes researchers throughout the country;and engage with individuals and organizations capable of transforming the products of the research into practice. We will pursue two related research projects, and will leverage the Center to promote inter-institutional collaboration and the development of early stage investigators. Project 1 aims are: To characterize hospital and Hospital Referral Region (HRR) performance, assess time trends, and determine factors associated with performance and improvement, defined by the CMS publicly reported measures for acute myocardial infarction (AMI), heart failure (HF), percutaneous coronary intervention (PCI), and internal cardioverter defibrillators (ICD);to investigate hospital and regional performance using novel measures that focus on a longer episode of care (1-year mortality measures for patients hospitalized with AMI and HF) and population-based hospitalization rates (HRR hospitalization rates for AMI and HF);to characterize the costs of care for AMI and HF during the index hospitalization, in the first 30 days, and 1 year after admission;and investigate how costs and payments relate to hospital and regional performance (30-day and 1-year risk-standardized mortality and 30- day eadmission). Project 2 aims are: To develop hypotheses concerning the hospital organizational strategies associated with exceptionally low hospital-level risk-standardized 30-day mortality and readmission rates for patients undergoing PCI;and to survey hospitals in order to test hypotheses about which specific hospital organizational strategies are associated with better performance on these PCI outcomes. This project will involve a partnership with the American College of Cardiology's National Cardiovascular Data Registry, and will elucidate the organizational and clinical strategies associated with the best hospital performance for PCI patients. Together, these studies will respond to the need for evidence to guide efforts to improve care and better understand how to shift the curve of performance at the hospital and regional level toward better outcomes.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01HL105270-03
Application #
8319435
Study Section
Special Emphasis Panel (ZHL1-CSR-J (S1))
Program Officer
Cook, Nakela L
Project Start
2010-09-30
Project End
2014-07-31
Budget Start
2012-08-01
Budget End
2013-07-31
Support Year
3
Fiscal Year
2012
Total Cost
$1,445,090
Indirect Cost
$546,214
Name
Yale University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
043207562
City
New Haven
State
CT
Country
United States
Zip Code
06520
Ho, Vivian; Ross, Joseph S; Steiner, Claudia A et al. (2017) A Nationwide Assessment of the Association of Smoking Bans and Cigarette Taxes With Hospitalizations for Acute Myocardial Infarction, Heart Failure, and Pneumonia. Med Care Res Rev 74:687-704
Lichtman, Judith H; Jones, Michael R; Leifheit, Erica C et al. (2017) Carotid Endarterectomy and Carotid Artery Stenting in the US Medicare Population, 1999-2014. JAMA 318:1035-1046
Dharmarajan, Kumar; Hsieh, Angela; Dreyer, Rachel P et al. (2017) Relationship Between Age and Trajectories of Rehospitalization Risk in Older Adults. J Am Geriatr Soc 65:421-426
Minges, Karl E; Herrin, Jeph; Fiorilli, Paul N et al. (2017) Development and validation of a simple risk score to predict 30-day readmission after percutaneous coronary intervention in a cohort of medicare patients. Catheter Cardiovasc Interv 89:955-963
Wang, Yun; Spatz, Erica S; Tariq, Maliha et al. (2017) Home Health Agency Performance in the United States: 2011-15. J Am Geriatr Soc 65:2572-2579
Dreyer, Rachel P; Sciria, Christopher; Spatz, Erica S et al. (2017) Young Women With Acute Myocardial Infarction: Current Perspectives. Circ Cardiovasc Qual Outcomes 10:
Low, Jeffrey; Ross, Joseph S; Ritchie, Jessica D et al. (2017) Comparison of two independent systematic reviews of trials of recombinant human bone morphogenetic protein-2 (rhBMP-2): the Yale Open Data Access Medtronic Project. Syst Rev 6:28
Bucholz, Emily M; Beckman, Adam L; Kiefe, Catarina I et al. (2017) Life Years Gained From Smoking-Cessation Counseling After Myocardial Infarction. Am J Prev Med 52:38-46
Dreyer, Rachel P; Dharmarajan, Kumar; Kennedy, Kevin F et al. (2017) Sex Differences in 1-Year All-Cause Rehospitalization in Patients After Acute Myocardial Infarction: A Prospective Observational Study. Circulation 135:521-531
Xu, Xiao; Bao, Haikun; Strait, Kelly M et al. (2017) Perceived Stress After Acute Myocardial Infarction: A Comparison Between Young and Middle-Aged Women Versus Men. Psychosom Med 79:50-58

Showing the most recent 10 out of 253 publications