Lorazepam is associated with Lower Hospital Readmission Rates for Psychoses Patients at Southern California Hospital at Hollywood based on Real World Evidence Study of Medicare Claims Data

---

In Lorazepam, Psychoses

Background:

Psychosis is frequently associated with hospital readmission. Readmission is a hospital quality measure that reflects dimensions of quality of inpatient care and also impacts overall programs by payers such as CMS’s Star Rating Program, HRRP and Value Based Purchasing. Lorazepam is a benzodiazepine used for treating anxiety, insomnia, or sleep difficulty due to anxiety or stress, status epilepticus (continuous seizures), and as a medication given right before anesthesia. Studies have shown that Lorazepam gives better anxiety relief compared to a placebo.

Dexur’s analysis of Real-World Evidence based on Medicare Claims data showed that the use of Lorazepam within 7 days of hospitalization was associated with lower hospital readmission rates for Psychoses Patients at Southern California Hospital at Hollywood in Hollywood, California. Reduction in readmission rates helps hospitals improve their outcomes for various cost and quality programs. Dexur is an approved entity to perform Medicare claims data analysis, which it uses to perform quality outcomes analysis. Dexur has published several papers with Harvard Medical School on quality outcomes related topics. Dexur’s analysis of Drugs and their impact on quality outcomes, such as readmissions and mortality, are used by Hospitals, IDNs, and ACOs to implement best practices and manage Real World Evidence based risk factors.

Methods:

We conducted a retrospective study using Dexur’s analysis of Real-World Evidence from Medicare Claims data, for hospitalizations at Southern California Hospital at Hollywood between January 2017 to September 2019. Our methodology criteria was as follows:

1. Inclusion Criteria: Selected Medical Hospitalizations with Primary Diagnosis with Psychoses related codes (Listed in table below)

2. Stratified Selected population into cohorts

   1. Psychoses patients who dispensed Lorazepam within 7 Days of Hospitalization using Part D drugs claims database

   2. Psychoses patients who did not dispense Lorazepam within 7 Days of Hospitalization

3. 30 Day readmission rates were analyzed for both population cohorts

Results:

Overall, Lorazepam was associated with lower hospital readmission rates for all Primary ICD/DRG Diagnosis Codes examined at Southern California Hospital at Hollywood . For patients whose primary DRG Diagnosis was “Psychoses”(885) and when Lorazepam was used within 7 days of hospitalization, the readmission rate was 53.13% compared to the cohort where Lorazepam was not used, whose readmission rate was 63.55. The readmission odds ratio for these cohorts was 0.65. The use of Lorazepam was associated with a 35% lower readmission rate when used within 7 days of hospitalization. The full list of studied ICD/DRG codes, readmission rates, odds ratios, confidence intervals, and percentage reduction in readmission with Lorazepam at Southern California Hospital at Hollywood is shown below.

Primary ICD/DRG Diagnosis Code	Primary ICD/DRG Diagnosis Code Description	Total Hospitalizations without Lorazepam	Readmission Without Lorazepam	Readmission Rate without Lorazepam	Total Hospitalizations with Lorazepam	Readmission with Lorazepam	Readmission Rate with Lorazepam	Readmission Odds Ratio	Reduction in Readmission with Lorazepam (%)	Confidence Interval (-)	Confidence Intervals (+)
885	Psychoses	2,568

Dexur also leveraged Medicare claims data to understand what percentage of patients hospitalized with Psychoses were not prescribed Lorazepam within 7 days of discharge.

ICD/DRG CODE	Hospital	Hospitalizations with Psychoses	% of Hospitalizations without Lorazepam
885	Southern California Hospital at Hollywood	2,585	99.34%
	Southcoast Behavioral Health Hospital - Dartmouth	3,195	99.66%
	North Vista Hospital	2,543	99.57%

​Hospitalizations with Psychoses = Above Listed ICD/DRG Codes

If figures are shared with “At Least” - this implies that the drug utilization within 7 days post hospitalization is less than 11

Conclusions:

According to analysis of Real-World Evidence of Medicare Claims data, for hospitalizations between January January 2017 to September 2019, the use of Lorazepam within 7 days of hospitalization can lead to substantial reductions in hospital readmission rates of Psychoses patients at Southern California Hospital at Hollywood. This analysis shows that a significant number of Patients are not dispensed Lorazepam after Psychoses hospitalizations at Southern California Hospital at Hollywood or major US Hospitals.

lorazepam-associated-lower-hospital-readmission-rates-psychoses-patients-southern-california-hospital