Unintended consequences of health care reform: impact of changes in payor mix on patient safety indicators,

Alex J Bartholomew; Alexander Zeymo; Kitty S. Chan; Nathan Aminpour; Ankit Mishra; Thomas DeLeire; Nawar Shara; Waddah B Al-Refaie

Study

Unintended consequences of health care reform: impact of changes in payor mix on patient safety indicators,

October 7, 2020

Bartholomew AJ, Zeymo A, Chan KS, et al. Ann Surg. 2020;272(4):612-619.

View more articles from the same authors.

This study used discharge data from five states to evaluate the impact of the Affordable Care Act’s Medicaid expansion on patient safety outcomes (measured using the PSI 90 composite). Results showed an overall improvement in patient safety in expansion states; however, when expansion states experienced an increase in their safety-net burden, they also experienced significantly more safety events compared to nonexpansion states.

PubMed citation

Available at

Related Resources From the Same Author(s)

Surgical teams' attitudes about surgical safety and the surgical safety checklist at 10 years: a multinational survey.

November 17, 2021

System factors affecting patient safety in the OR: an analysis of safety threats and resiliency.

August 25, 2021

Patient, surgeon, and health care worker safety during the COVID-19 pandemic.

November 3, 2021

Defining and studying errors in surgical care: a systematic review.

August 17, 2022

Changes in hospital-acquired conditions and mortality associated with the hospital-acquired condition reduction program.

September 29, 2021

Association of current opioid use with serious adverse events among older adult survivors of breast cancer.

October 14, 2020

Patient safety monitoring in acute care in a decentralized national health care system: conceptual framework and initial set of actionable indicators.

July 28, 2021

System factors affecting intraoperative risk and resilience: applying a novel integrated approach to study surgical performance and patient safety.

February 10, 2021

A partially structured postoperative handoff protocol improves communication in 2 mixed surgical intensive care units: findings from the Handoffs and Transitions in Critical Care (HATRICC) prospective cohort study.

February 6, 2019

Errors in surgery: a case control study.

December 14, 2022

Trainee autonomy and patient safety.

December 6, 2017

Changes in error patterns in unanticipated trauma deaths during 20 years: in pursuit of zero preventable deaths.

March 24, 2021

Alternatives to opioid education and a prescription drug monitoring program cumulatively decreased outpatient opioid prescriptions.

December 16, 2020

Errors during resuscitation: the impact of perceived authority on delivery of care.

March 25, 2020

Surgeon burnout, impact on patient safety and professionalism: a systematic review and meta-analysis.

March 16, 2022

Opioid dependence and overdose after surgery: rate, risk factors, and reasons.

September 21, 2022

U.S. compounding pharmacy-related outbreaks, 2001--2013: public health and patient safety lessons learned.

June 17, 2015

Absence or presence: silent discourse in the operating room and impact on surgical team action.

November 11, 2020

Crisis preparedness: a systems-based framework for avoiding harm in surgery.

November 30, 2022

Unintended consequences of patient online access to health records: a qualitative study in UK primary care.

November 16, 2022

Variation in the reporting of elective surgeries and its influence on patient safety indicators.

July 6, 2022

Influences of physical layout and space on patient safety and communication in ambulatory oncology practices: a multisite, mixed method investigation.

July 14, 2021

Bracing for the storm: one health care system's planning for the COVID-19 surge.

November 11, 2020

Impact of patient safety culture on missed nursing care and adverse patient events.

March 20, 2019

Ethical considerations and patient safety concerns for cancelling non-urgent surgeries during the COVID-19 pandemic: a review.

May 12, 2021

Finding the right balance: an evidence-informed guidance document to support the re-opening of Canadian nursing homes to family caregivers and visitors during the coronavirus disease 2019 pandemic.

October 28, 2020

Impact of an obstetrical hospitalist program on the safety events in a mid-sized obstetrical unit.

September 16, 2020

Relationships between pediatric safety indicators across a national sample of pediatric hospitals: dispelling the myth of the "safest" hospital.

June 22, 2022

Personality traits and traumatic outcome symptoms in registered nurses in the aftermath of a patient safety incident.

July 22, 2020

To what extent is the World Health Organization's Medication Safety Challenge being addressed in English hospital organizations? A descriptive study.

February 16, 2022

Declaring uncertainty: using quality improvement methods to change the conversation of diagnosis.

March 17, 2021

Unintended consequences of online consultations: a qualitative study in UK primary care.

February 2, 2022

Changes in weekend and weekday care quality of emergency medical admissions to 20 hospitals in England during implementation of the 7-day services national health policy.

November 25, 2020

The impact of adverse events on clinicians: what's in a name?

November 22, 2017

Association between implementing comprehensive learning collaborative strategies in a statewide collaborative and changes in hospital safety culture.

September 2, 2020

Patient harm and institutional avoidability of out-of-hours discharge from intensive care: an analysis using mixed methods.

March 23, 2022

Identifying trigger concepts to screen emergency department visits for diagnostic errors.

December 16, 2020

Triggers contributing to health care clinicians' disruptive behaviors.

September 16, 2020

Safety in pediatric hospice and palliative care: a qualitative study.

September 23, 2020

Outcomes and patient safety in overlapping vs. nonoverlapping total joint arthroplasty: a systematic review and meta-analysis.

January 19, 2022

Error reduction in trauma care: lessons from an anonymized, national, multicenter mortality reporting system.

March 23, 2022

Enhancing teamwork communication and patient safety responsiveness in a paediatric intensive care unit using the daily safety huddle tool.

March 18, 2020

Fast does not imply flawed: analyzing emergency physician productivity and medical errors.

December 14, 2022

Defining diagnostic error: a scoping review to assess the impact of the National Academies' report Improving Diagnosis in Health Care.

May 25, 2022

Effect of a multispecialty faculty handoff initiative on safety culture and handoff quality.

April 20, 2022

Transparency, public reporting, and a culture of change to quality and safety in cardiac surgery.

November 9, 2022

A systems approach to analyzing and preventing hospital adverse events.

June 24, 2020

Cognitive bias impact on management of postoperative complications, medical error, and standard of care.

November 4, 2020

Retrospective review for medication dose errors in pediatric emergency department medication orders that bypassed pharmacist review.

March 25, 2020

Association of surgeon-patient sex concordance with postoperative outcomes,

December 22, 2021

Provider-patient communication and hospital ratings: perceived gaps and forward thinking about the effects of COVID-19.

December 16, 2020

Intended and unintended consequences: changes in opioid prescribing practices for postsurgical, acute, and chronic pain indications following two policies in North Carolina, 2012-2018 - controlled and single-series interrupted time series analyses.

February 15, 2023

Redeployment of health care workers in the COVID-19 pandemic: a qualitative study of health system leaders' strategies.

May 19, 2021

Improving allergy documentation: a retrospective electronic health record system-wide patient safety initiative.

January 1, 2022

Factors influencing family member perspectives on safety in the intensive care unit: a systematic review.

December 9, 2020

A machine learning approach to reclassifying miscellaneous patient safety event reports.

July 29, 2020

Secondary traumatic stress in ob-gyn: a mixed methods analysis assessing physician impact and needs.

July 21, 2021

Does increased schedule flexibility lead to change? A national survey of program directors on 2017 work hours requirements.

September 23, 2020

Clinical and economic impacts of explicit tools detecting prescribing errors: a systematic review.

May 26, 2021

Impact of providing patients access to electronic health records on quality and safety of care: a systematic review and meta-analysis.

July 8, 2020

Resilience from a stakeholder perspective: the role of next of kin in cancer care.

September 23, 2020

COVID-19: patient safety and quality improvement skills to deploy during the surge.

June 24, 2020

Translating electronic health record-based patient safety algorithms from research to clinical practice at multiple sites.

August 3, 2022

Communication patterns during routine patient care in a pediatric intensive care unit: the behavioral impact of in situ simulation.

May 11, 2022

Patient safety assurance in the age of defensive medicine: a review.

March 2, 2022

Evaluation of postoperative handover using a tool to assess information transfer and teamwork.

May 4, 2011

Using patient safety indicators to estimate the impact of potential adverse events on outcomes.

January 30, 2008

Medication safety in mental health hospitals: a mixed-methods analysis of incidents reported to the National Reporting and Learning System.

August 4, 2021

A high-reliability organization framework for health care: a multiyear implementation strategy and associated outcomes.

November 4, 2020

A national mixed-methods evaluation of preparedness for general surgery residency and the association with resident burnout.

September 2, 2020

Employee silence in health care: charting new avenues for leadership and management.

August 3, 2022

Learning from incident reporting? Analysis of incidents resulting in patient injuries in a web-based system in Swedish health care.

December 9, 2020

Opioid guidelines for common dental surgical procedures: a multidisciplinary panel consensus.

March 25, 2020

Association between surgeon technical skills and patient outcomes.

September 9, 2020

Long-term impacts faced by patients and families after harmful healthcare events.

December 15, 2021

Institutional COVID-19 protocols: focused on preparation, safety, and care consolidation.

September 30, 2020

Avoiding a second wave of medical errors: the importance of human factors in the context of a pandemic.

August 26, 2020

Patient safety in primary care: conceptual meanings to the health care team and patients.

November 25, 2020

Influence of socioeconomic bias on emergency medicine resident decision making and patient care.

August 19, 2020

Twelve-month review of infusion pump near-miss medication and dose selection errors and user-initiated "good save" corrections: retrospective study.

November 4, 2020

Encouraging patients to speak up about problems in cancer care.

January 12, 2022

Impact of remote consultations on antibiotic prescribing in primary healthcare: systematic review.

December 2, 2020

Patient and hospital characteristics associated with delayed diagnosis of appendicitis.

February 1, 2023

The impact of electronic communication of medication discontinuation (CancelRx) on medication safety: a pilot study.

October 5, 2022

Long-term care nurses' experiences with patient safety incident management: a qualitative study.

August 4, 2021

How safe do dying people feel at home? Patients' perception of safety while receiving specialist community palliative care.

December 21, 2022

Patient misidentification events in the Veterans Health Administration: a comprehensive review in the context of high-reliability health care.

October 21, 2020

Improving diagnostic performance through feedback: the Diagnosis Learning Cycle.

September 1, 2021

Evaluating the Patient Safety Indicators: how well do they perform on Veterans Health Administration data?

September 7, 2005

The physiology of failure: identifying risk factors for mortality in emergency general surgery patients using a regional health system integrated electronic medical record.

September 7, 2022

Why is patient safety a challenge? Insights from the Professionalism Opinions of Medical Students' research.

November 2, 2022

Usability and accessibility of publicly available patient safety databases.

June 1, 2022

Incidence, nature and causes of avoidable significant harm in primary care in England: retrospective case note review.

December 16, 2020

Patient safety informatics: criteria development for assessing the maturity of digital patient safety in hospitals.

June 29, 2022

Restructuring of a general surgery residency program in an epicenter of the coronavirus disease 2019 pandemic: lessons from New York City.

July 29, 2020

Society for Maternal-Fetal Medicine Special Statement: a maternal transport briefing form and checklist.

December 23, 2020

Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK primary care.

August 11, 2021

Hospital acquired infections in surgical patients: impact of COVID-19-related infection prevention measures.

April 20, 2022

Evaluating a patient safety learning laboratory to create an interdisciplinary ecosystem for health care innovation.

July 13, 2022

The safety of health care for ethnic minority patients: a systematic review.

July 29, 2020

Related Resources

Impact of repeated reimbursement penalties on hospital total quality scores.

April 17, 2024

Making Healthcare Safer IV: A Continuous Updating of Patient Safety Harms and Practices.

April 3, 2024

2024 National Impact Assessment of the Centers for Medicare & Medicaid Services (CMS) Quality Measures Report.

March 20, 2024

Assessing the excess costs of the in-hospital adverse events covered by the AHRQ's Patient Safety Indicators in Switzerland.

February 21, 2024

Validity of 16 AHRQ Patient Safety Indicators to identify in-hospital complications: a medical record review across nine Swiss hospitals.

January 10, 2024

It depends who you ask: divergences in staff and external stakeholder narratives about the causes of a healthcare failure.

November 29, 2023

An exploratory analysis of the association between hospital quality measures and financial performance.

November 15, 2023

Adverse Events.

November 8, 2023

Annual Speak Up Data Reports.

September 6, 2023

Patient safety trends in 2022: an analysis of 256,679 serious events and incidents from the nation’s largest event reporting database.

May 17, 2023

Patient Safety Primers

Patient Safety Indicators.

April 26, 2023

National statutory reporting: not even ticking the boxes? The quality of 'Learning from Deaths' reporting in quality accounts within the NHS in England 2017-2020.

March 1, 2023

Is anybody 'Learning' from deaths? Sequential content and reflexive thematic analysis of national statutory reporting within the NHS in England 2017-2020.

February 22, 2023

Using potentially preventable severe maternal morbidity to monitor hospital performance.

February 8, 2023

The impact of meaningful use and electronic health records on hospital patient safety.

November 2, 2022

The deterrent effect of tort law: evidence from medical malpractice reform.

September 28, 2022

Concordance of hospital ranks and category ratings using the current technical specification of US Hospital Star Ratings and reasonable alternative specifications.

August 31, 2022

Risk reduction strategy to decrease incidence of retained surgical items.

August 31, 2022

Acute clinical deterioration and consumer escalation: the understanding and perceptions of hospital staff.

August 31, 2022

Combined impact of Medicare's hospital pay for performance programs on quality and safety outcomes is mixed.

August 10, 2022

Long-term care healthcare-associated infections in 2021: an analysis of 17,971 reports.

July 13, 2022

Relationships between pediatric safety indicators across a national sample of pediatric hospitals: dispelling the myth of the "safest" hospital.

June 22, 2022

Adverse Events in Hospitals: A Quarter of Medicare Patients Experienced Harm in October 2018.

May 25, 2022

Association of measured quality with financial health among U.S. hospitals.

May 4, 2022

Incorporating harms into the weighting of the Revised AHRQ Patient Safety for Selected Indicators Composite (PSI 90).

January 26, 2022

Hospital Performance Report.

October 28, 2021

Changes in hospital-acquired conditions and mortality associated with the hospital-acquired condition reduction program.

September 29, 2021

Patient safety monitoring in acute care in a decentralized national health care system: conceptual framework and initial set of actionable indicators.

July 28, 2021

An evolving hospital quality star rating system from CMS: aligning the stars.

May 26, 2021

Hospital Compare.

May 13, 2021

See More About The Topic

Hospitals

Quality and Safety Professionals

Policy Makers

Hospital Medicine

Nurse Care

Unintended consequences of health care reform: impact of changes in payor mix on patient safety indicators,

Patient Safety Indicators.

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Unintended consequences of health care reform: impact of changes in payor mix on patient safety indicators,

Patient Safety Indicators.

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Submit Your Innovations

Continue as a Guest

Continue Logged In

Submit Your Innovations

Continue as a Guest

Continue logged in

New Users to the PSNet site