Post-Discharge Events (2004, 2008-2019)

<h2>Overview</h2>
<p>The Dartmouth Institute for Health Policy and Clinical Practice (TDI) has created a publicly available source of data that provides researchers, payers, regulators, and innovators with metrics that quantify temporal and regional patterns of health care spending and utilization in the United States. Using CMS Medicare claims data (mostly for age >64 enrollees), Atlas researchers built cohorts (“denominators”) and numerous measures or events (“numerators”) which were then used to calculate rates either by geography or for patients assigned to specific hospitals. These rates, which are calculated consistently across time and place, provide researchers with opportunities to evaluate spatial and temporal variation/trends. </p>

<p>This entry contains post-discharge event rates for fee-for-service (FFS) Medicare beneficiaries, age 65 and older discharged from hospitals for medical and surgical conditions. Rates are provided for the percentage of patients readmitted within 30 days, the percentage of patients having an emergency room visit within 30 days, the percentage of patients seeing a primary care clinician within two weeks, and the percentage of patients seeing any clinician within two weeks. These rates are provided for six separate cohorts: patients discharged for medical conditions, surgical conditions, hip fracture, congestive heart failure, acute myocardial infarction, and pneumonia. Rates are provided at the state, county, hospital referral region (HRR), hospital service area (HSA), and hospital levels. All annual rates have been adjusted for age, sex, and race.</p>

<p>In addition to the standard annual rates, race-stratified (black and non-black) HRR-level rates have been provided for 2008-2009 (both years combined). These race-stratified rates were adjusted for age and sex.</p>

<p> Users downloading data should review the methods sections of the related publication for context as well as for information about any temporal changes in methods. All reports in the Dartmouth Atlas of Health Care series are available from the National Library of Medicine <a href="https://www.ncbi.nlm.nih.gov/books/NBK584737/">https://www.ncbi.nlm.nih.gov/books/NBK584737/</a> <p>

<p> Note that for the general Dartmouth Atlas rate datasets, which span multiple decades, the author list includes all Dartmouth staff (programmers, analysts, supervisors, etc.) involved in generating all types of Atlas rates across all years. We do not attempt to assign individuals to specific datasets or years. <p>