Evidence map›Paper›PMID 37340256›Full record

Observational studyJournal of general internal medicine2023

Effectiveness of a Bundled Payments for Care Improvement Program for Chronic Obstructive Pulmonary Disease.

Amelia Waltman, R Tamara Konetzka, Stephanie Chia, Assad Ghani, Wen Wan, Steven R White, Rajlakshmi Krishnamurthy, Valerie G Press

Open access · bronzeAbstract readObservational Study
In one paragraph

Observational study in Journal of general internal medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.1field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 10 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Amelia WaltmanPritzker School of Medicine, University of Chicago, Chicago, USA.
R Tamara KonetzkaDepartment of Public Health Sciences, University of Chicago, Chicago, USA.
Stephanie ChiaCenter for Transformative Care, University of Chicago Medicine, Chicago, USA.
Assad GhaniCenter for Transformative Care, University of Chicago Medicine, Chicago, USA.
Wen WanSection of General Internal Medicine, Department of Medicine, University of Chicago, Chicago, USA.
Steven R WhiteSection of Pulmonary/Critical Care, Department of Medicine, University of Chicago, Chicago, USA.
Rajlakshmi KrishnamurthyCenter for Transformative Care, University of Chicago Medicine, Chicago, USA.
Valerie G PressSection of General Internal Medicine, Department of Medicine, University of Chicago, Chicago, USA. vpress@bsd.uchicago.edu.
University of Chicago · USChicago Department of Public Health · US

Funding

Research Design, Data, and Analytics CoreP30DK092949 · NIDDK · UNIVERSITY OF CHICAGO · PI MILDA Renne SAUNDERS · 2011 to 2026
$10.0M
The Virtual Mentored Implementation to Reduce REVISITS (Reducing Respiratory Emergent Visits using Implementation Science Interventions Tailored to Setting) StudyR01HL146644 · NHLBI · UNIVERSITY OF CHICAGO · PI PRESS, VALERIE G · 2020 to 2024
$3.9M
TELE-TOC: Telehealth Education Leveraging Electronic Transitions Of Care for COPD Patients - Resubmission - 1R01HS027804 · AHRQ · UNIVERSITY OF CHICAGO · PI ABRAHAM, JOANNA, ARORA, VINEET · 2021 to 2025
$2.0M
Short Term Aging-Related Research ProgramT35AG029795 · NIA · UNIVERSITY OF CHICAGO · PI Vineet Arora, DAVID O MELTZER · 2008 to 2026
$1.4M
AHRQ HHS R01 HS027804NHLBI NIH HHS R01 HL146644NIA NIH HHS T35 AG029795NIDDK NIH HHS P30 DK092949
6 · The paper itself

Abstract

backgroundThe Medicare Bundled Payments for Care Improvement (BPCI) program reimburses 90-day care episodes post-hospitalization. COPD is a leading cause of early readmissions making it a target for value-based payment reform.

objectiveEvaluate the financial impact of a COPD BPCI program. DESIGN, PARTICIPANTS,

interventionsA single-site retrospective observational study evaluated the impact of an evidence-based transitions of care program on episode costs and readmission rates, comparing patients hospitalized for COPD exacerbations who received versus those who did not receive the intervention. MAIN MEASURES: Mean episode costs and readmissions. KEY

resultsBetween October 2015 and September 2018, 132 received and 161 did not receive the program, respectively. Mean episode costs were below target for six out of eleven quarters for the intervention group, as opposed to only one out of twelve quarters for the control group. Overall, there were non-significant mean savings of $2551 (95% CI: - $811 to $5795) in episode costs relative to target costs for the intervention group, though results varied by index admission diagnosis-related group (DRG); there were additional costs of $4184 per episode for the least-complicated cohort (DRG 192), but savings of $1897 and $1753 for the most complicated index admissions (DRGs 191 and 190, respectively). A significant mean decrease of 0.24 readmissions per episode was observed in 90-day readmission rates for intervention relative to control. Readmissions and hospital discharges to skilled nursing facilities were factors of higher costs (mean increases of $9098 and $17,095 per episode respectively).

conclusionsOur COPD BPCI program had a non-significant cost-saving effect, although sample size limited study power. The differential impact of the intervention by DRG suggests that targeting interventions to more clinically complex patients could increase the financial impact of the program. Further evaluations are needed to determine if our BPCI program decreased care variation and improved quality of care. PRIMARY SOURCE OF

fundingThis research was supported by NIH NIA grant #5T35AG029795-12.

Indexed as

Patient Care BundlesPulmonary Disease, Chronic ObstructiveAgedDiagnosis-Related GroupsHospitalizationHospitalsHumansMedicareUnited Statesbundled Payment Care Initiativechronic obstructive pulmonary diseasemedicarequality of health carereadmissions

Identifiers

PMID37340256
PMCPMC10506991
OpenAlexW4381326013

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.