65,024 results match your criteria Medicare Patient Management [Journal]


Medicare incentive payments to U.S. ophthalmologists for use of electronic health records: 2011-2016.

Ophthalmology 2019 Feb 12. Epub 2019 Feb 12.

Department of Ophthalmology, University of Washington, Seattle, Washington.

Purpose: To investigate ophthalmologists' rate of attestation to meaningful use (MU) of their electronic health record (EHR) systems in the Medicare EHR Incentive Program and their continuity and success in receiving payments in comparison with other specialties.

Design: Administrative database study.

Participants: Eligible professionals participating in the Medicare EHR Incentive Program. Read More

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http://dx.doi.org/10.1016/j.ophtha.2019.01.030DOI Listing
February 2019

Association between commercial funding of Canadian patient groups and their views about funding of medicines: An observational study.

Authors:
Joel Lexchin

PLoS One 2019 15;14(2):e0212399. Epub 2019 Feb 15.

School of Health Policy and Management, York University, Toronto, ON, Canada.

Background: Patient groups represent the interest of their members when it comes to drug funding. Many patient groups receive grants from pharmaceutical companies that make products being considered for funding. This research examines whether there is an association between the positions that Canadian groups take about the products and conflicts of interest with the companies. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0212399PLOS
February 2019

Not all DVT is created equal: incidence of pre-existing chronic DVT among high-risk traumatized patients.

J Trauma Acute Care Surg 2019 Feb 13. Epub 2019 Feb 13.

University of Vermont Medical Center.

Background: Traumatized patients are at risk of developing Deep Vein Thrombosis (DVT) and DVT prophylaxis is the standard of care. The Centers for Medicare and Medicaid Services classifies DVT as a Hospital Acquired Condition and can deny payment for treatment of DVT and, in addition, place financial penalties on hospitals with higher than acceptable rates of DVT, unless the DVT was pre-existing. We sought to determine the rate of pre-existing chronic DVT among symptomatic traumatized inpatients at our ACS-verified Level 1 trauma center. Read More

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http://dx.doi.org/10.1097/TA.0000000000002228DOI Listing
February 2019

Insomnia as an Independent Predictor of Incident Cardiovascular Disease in HIV: Data from the Veterans Aging Cohort Study.

J Acquir Immune Defic Syndr 2019 Feb 7. Epub 2019 Feb 7.

Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), Indianapolis, Indiana.

Background: Insomnia is associated with increased cardiovascular disease (CVD) risk in the general population and is highly prevalent in people with HIV. The CVD risk conferred by insomnia in the HIV population is unknown.

Methods: Using the Veterans Aging Cohort Study-Survey Cohort, insomnia symptoms were measured and dummy coded with the item, "Difficulty falling or staying asleep?" (5-point scale from no difficulty to bothers a lot). Read More

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http://dx.doi.org/10.1097/QAI.0000000000001981DOI Listing
February 2019

Smoking and Smoking Cessation Among Persons with Tobacco- and Non-tobacco-Associated Cancers.

J Community Health 2019 Feb 14. Epub 2019 Feb 14.

Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health, 4770 Buford Highway, MS F76, Atlanta, GA, 30341, Georgia.

Purpose: To examine smoking and use of smoking cessation aids among tobacco-associated cancer (TAC) or non-tobacco-associated cancer (nTAC) survivors. Understanding when and if specific types of cessation resources are used can help with planning interventions to more effectively decrease smoking among all cancer survivors, but there is a lack of research on smoking cessation modalities used among cancer survivors.

Methods: Kentucky Cancer Registry data on incident lung, colorectal, pancreatic, breast, ovarian, and prostate cancer cases diagnosed 2007-2011, were linked with health administrative claims data (Medicaid, Medicare, private insurers) to examine the prevalence of smoking and use of smoking cessation aids 1 year prior and 1 year following the cancer diagnosis. Read More

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http://dx.doi.org/10.1007/s10900-019-00622-zDOI Listing
February 2019

Sodium-glucose Cotransporter-2 Inhibitors in Combination with Other Glucose-lowering Agents for the Treatment of Type 2 Diabetes Mellitus.

Indian J Endocrinol Metab 2018 Nov-Dec;22(6):827-836

Diabetes Medicare Centre, Chennai, Tamil Nadu, India.

Involvement of multiple physiological pathways and complex pathogenesis is responsible for the onset and progression of type 2 diabetes mellitus (T2DM). Since it is difficult to manage multiple pathophysiological defects by monotherapy, a combination therapy with two or more oral antidiabetic agents (OADs) may help achieve euglycemia in T2DM patients. Choice of OADs is difficult with growing armamentarium of antidiabetic therapy. Read More

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http://dx.doi.org/10.4103/ijem.IJEM_162_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6330851PMC
February 2019

Emergency department sepsis huddles: Achieving excellence for sepsis benchmarks in New York State.

Am J Emerg Med 2019 Feb 7. Epub 2019 Feb 7.

Emergency Department, Good Samaritan Hospital Medical Center, United States of America.

The sepsis order set at our institution was created with the intent to facilitate the prompt initiation of appropriate sepsis care. Once clinical features meeting criteria for systemic inflammatory response syndrome (SIRS) are identified and an infectious source is considered, a "sepsis huddle" is concomitantly initiated. The sepsis huddle was implemented in March of 2016 in order to increase compliance with the sepsis bundles. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.02.007DOI Listing
February 2019

TEVAR Versus Open Surgery in Medicare Patients With Descending Thoracic Aneurysms: And the Winner Is?

J Am Coll Cardiol 2019 Feb;73(6):652-653

New Mexico Heart Institute, Albuquerque, New Mexico; University of New Mexico, Albuquerque, New Mexico.

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http://dx.doi.org/10.1016/j.jacc.2018.11.037DOI Listing
February 2019

Endovascular Versus Open Repair of Intact Descending Thoracic Aortic Aneurysms.

J Am Coll Cardiol 2019 Feb;73(6):643-651

Department of Cardiothoracic Surgery, Stanford University, School of Medicine, Stanford, California. Electronic address:

Background: For the management of descending thoracic aortic aneurysms, recent evidence has suggested that outcomes of open surgical repair may surpass thoracic endovascular aortic repair (TEVAR) in as early as 2 years.

Objectives: The purpose of this study was to evaluate the comparative effectiveness of TEVAR and open surgical repair in the treatment of intact descending thoracic aortic aneurysms.

Methods: Using the Medicare database, a retrospective study using regression discontinuity design and propensity score matching was performed on patients with intact descending thoracic aortic aneurysms who underwent TEVAR or open surgical repair between 1999 and 2010 with follow-up through 2014. Read More

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http://dx.doi.org/10.1016/j.jacc.2018.10.086DOI Listing
February 2019

Clinical and Sociobehavioral Prediction Model of 30-Day Hospital Readmissions Among People With HIV and Substance Use Disorder: Beyond Electronic Health Record Data.

J Acquir Immune Defic Syndr 2019 Mar;80(3):330-341

Division of General Internal Medicine, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX.

Background: Under the Affordable Care Act, hospitals receive reduced reimbursements for excessive 30-day readmissions. However, the Centers for Medicare and Medicaid Services does not consider social and behavioral variables in expected readmission rate calculations, which may unfairly penalize systems caring for socially disadvantaged patients, including patients with HIV.

Setting: Randomized controlled trial of patient navigation with or without financial incentives in HIV-positive substance users recruited from the inpatient setting at 11 US hospitals. Read More

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http://Insights.ovid.com/crossref?an=00126334-201903010-0001
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http://dx.doi.org/10.1097/QAI.0000000000001925DOI Listing
March 2019
1 Read

Medication adherence as a measure of the quality of care provided by physicians.

Am J Manag Care 2019 02;25(2):78-83

USC Schaeffer Center, VPD Suite 414, Los Angeles, CA 90087. Email:

Objectives: To assess the extent to which medication adherence in congestive heart failure (CHF) and diabetes may serve as a measure of physician-level quality.

Study Design: A retrospective analysis of Medicare data from 2007 to 2009, including parts A (inpatient), B (outpatient), and D (pharmacy).

Methods: For each disease, we assessed the correlation between medication adherence and health outcomes at the physician level. Read More

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February 2019

Epilepsy Among Elderly Medicare Beneficiaries: A Validated Approach to Identify Prevalent and Incident Epilepsy.

Med Care 2019 Feb 12. Epub 2019 Feb 12.

Department of Medicine, Mongan Institute, Massachusetts General Hospital.

Background: Uncertain validity of epilepsy diagnoses within health insurance claims and other large datasets have hindered efforts to study and monitor care at the population level.

Objectives: To develop and validate prediction models using longitudinal Medicare administrative data to identify patients with actual epilepsy among those with the diagnosis.

Research Design, Subjects, Measures: We used linked electronic health records and Medicare administrative data including claims to predict epilepsy status. Read More

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http://dx.doi.org/10.1097/MLR.0000000000001072DOI Listing
February 2019

The Asylum Seeker Integrated Healthcare Pathway: a collaborative approach to improving access to primary health care in South Eastern Melbourne, Victoria, Australia.

Aust J Prim Health 2019 Feb 14. Epub 2019 Feb 14.

It is important to address the health needs of asylum seekers within the early stages of their arrival in Australia, as this impacts all aspects of their resettlement. However, asylum seekers face a range of barriers to accessing timely and appropriate health care in the community. In 2012, the increasing number of asylum seekers in Australia placed additional demand on health and social services in high-settlement regions. Read More

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http://dx.doi.org/10.1071/PY18028DOI Listing
February 2019

The Timing of Corticosteroid Injections After Arthroscopic Shoulder Procedures Affects Postoperative Infection Risk.

Am J Sports Med 2019 Feb 13:363546518825348. Epub 2019 Feb 13.

Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, USA.

Background:: Corticosteroid injections are sometimes used in the postoperative period after shoulder arthroscopy; however, a well-defined safety profile has not been established.

Purpose:: To examine the association between the timing of postoperative corticosteroid injections and rates of infection after shoulder arthroscopy.

Study Design:: Cohort study; Level of evidence, 3. Read More

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http://dx.doi.org/10.1177/0363546518825348DOI Listing
February 2019

Palliative Care Use Among Patients with Bladder Cancer.

BJU Int 2019 Feb 13. Epub 2019 Feb 13.

Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA.

Objectives: To describe the rate and determinants of palliative care use among Medicare beneficiaries with bladder cancer and encourage a national dialogue on improving coordinated urologic, oncologic, and palliative care in patients with genitourinary malignancies.

Materials And Methods: Using Surveillance, Epidemiology, and End Results-Medicare data, we identified patients diagnosed with muscle-invasive bladder cancer between 2008-2013. Our primary outcome was receipt of palliative care, defined as the presence of a claim submitted by a Hospice and Palliative Medicine subspecialist. Read More

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http://dx.doi.org/10.1111/bju.14708DOI Listing
February 2019

CMS Billing Guidelines and Student Documentation: a New Era or New Burden?

J Gen Intern Med 2019 Feb 12. Epub 2019 Feb 12.

Department of Medicine, Stanford University School of Medicine, 300 Pasteur Dr. Stanford, Stanford, CA, 94305, USA.

The Centers for Medicare and Medicaid Services (CMS) recently revised their Medicare Claims Processing Manual with the addition of CR 10412, a provision that permits teaching providers to fully bill for medical student notes. This change will have significant implications on the documentation duties of teaching physicians and trainees. Potential benefits of this provision include reduced documentation burden on house officers, improved medical student empowerment, and the infusion of more original content into the electronic medical record. Read More

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http://link.springer.com/10.1007/s11606-019-04853-7
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http://dx.doi.org/10.1007/s11606-019-04853-7DOI Listing
February 2019
1 Read

How Much Does a Readmission Cost the Bundle Following Primary Hip and Knee Arthroplasty?

J Arthroplasty 2019 Jan 23. Epub 2019 Jan 23.

Department of Orthopaedic Surgery, The Rothman Institute at Thomas Jefferson University, Philadelphia, PA.

Background: As alternative payment models increase in popularity for total joint arthroplasty (TJA), providers and hospitals now share the financial risk associated with unexpected readmissions. While studies have identified postacute care as a driver for costs in a bundle, the fiscal burden associated with specific causes of readmission is unclear. The purpose of this study is to quantify the additional costs associated with each of the causes of readmission following primary TJA. Read More

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http://dx.doi.org/10.1016/j.arth.2019.01.029DOI Listing
January 2019

Long-term out of pocket expenditure of people with cancer: comparing health service cost and use for indigenous and non-indigenous people with cancer in Australia.

Int J Equity Health 2019 Feb 12;18(1):32. Epub 2019 Feb 12.

Menzies School of Health Research, Charles Darwin University, Darwin, Australia.

Background: Indigenous Australians diagnosed with cancer have poorer survival compared to non-Indigenous Australians. We aim to: 1) identify differences by Indigenous status in out-of-pocket expenditure for the first three-years post-diagnosis; 2) identify differences in the quantity and cost of healthcare services accessed; and 3) estimate the number of additional services required if access was equal between Indigenous and non-Indigenous people with cancer.

Methods: We used CancerCostMod, a model using linked administrative data. Read More

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http://dx.doi.org/10.1186/s12939-019-0931-4DOI Listing
February 2019

The impact of race and insurance status on baseline histopathology profile in patients with chronic rhinosinusitis.

Int Forum Allergy Rhinol 2019 Feb 12. Epub 2019 Feb 12.

Department of Otorhinolaryngology - Head and Neck Surgery, Rush Sinus Program, Rush University Medical Center, Chicago, IL 60612.

Background: Chronic rhinosinusitis (CRS) is an inflammatory disease process characterized by different phenotypes and histopathology profiles. Race and access to care have been implicated in CRS disease severity. Structural histopathology reporting may aid in delineating the inflammatory burden responsible for this effect. Read More

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http://dx.doi.org/10.1002/alr.22295DOI Listing
February 2019

Performance of the Centers for Medicare & Medicaid Services' Opioid Overutilization Criteria for Classifying Opioid Use Disorder or Overdose.

JAMA 2019 02;321(6):609-611

Department of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, Gainesville.

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http://dx.doi.org/10.1001/jama.2018.20404DOI Listing
February 2019

Buprenorphine Coverage in the Medicare Part D Program for 2007 to 2018.

JAMA 2019 02;321(6):607-609

School of Medicine, Oregon Health & Science University, Portland.

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http://dx.doi.org/10.1001/jama.2018.20391DOI Listing
February 2019

Association of Survival With Femoropopliteal Artery Revascularization With Drug-Coated Devices.

JAMA Cardiol 2019 Feb 12. Epub 2019 Feb 12.

Smith Center for Outcomes Research in Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.

Importance: In a recent meta-analysis of randomized clinical trials, femoropopliteal artery revascularization with paclitaxel drug-coated devices was associated with increased long-term all-cause mortality compared with non-drug-coated devices. However, to our knowledge, these findings have not been replicated in other data sources and may be subject to confounding from missing data associated with patient withdrawal and loss to follow-up.

Objective: To evaluate differences in all-cause mortality between patients who were treated with drug-coated devices vs non-drug-coated devices for femoropopliteal artery revascularization. Read More

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http://cardiology.jamanetwork.com/article.aspx?doi=10.1001/j
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http://dx.doi.org/10.1001/jamacardio.2019.0325DOI Listing
February 2019
4 Reads

Cannabis Dependence or Abuse in Kidney Transplantation: Implications for Posttransplant Outcomes.

Transplantation 2019 Feb 4. Epub 2019 Feb 4.

Division of Nephrology, Saint Louis University School of Medicine, St. Louis, MO, USA.

Background: Cannabis is categorized as an illicit drug in most US states, but legalization for medical indications is increasing. Policies and guidance regarding cannabis use in transplant patients remain controversial.

Methods: We examined a database linking national kidney transplant records (n=52,689) with Medicare claims to identify diagnoses of cannabis dependence or abuse (CDOA) and associations (adjusted hazard ratio, 95% LCL aHR95% UCL) with graft, patient and other clinical outcomes. Read More

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http://dx.doi.org/10.1097/TP.0000000000002599DOI Listing
February 2019

Variability in Critical Care-Related Charge Markups in Medicare Patients.

Am Surg 2018 Oct;84(10):1622-1625

Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Charge markups for health care are variable and inflated several times beyond cost. Using the 2015 Medicare Provider Fee-For-Service Utilization and Payment Data file, we identified providers who billed for critical care hours and related procedures, including CPR, EKG interpretation, central line placement, arterial line placement, chest tube/thoracentesis, and emergent endotracheal intubation. Markup ratios (MRs), defined as the amount charged divided by the amount allowable, were calculated and compared; 42. Read More

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October 2018
1 Read

Fully-integrated medical home for people with severe and persistent mental illness: A description and outcome analysis of a Medicare Advantage Chronic Special Needs Program.

Authors:
Robert Myers

Ment Illn 2018 Nov 5;10(2):7819. Epub 2018 Dec 5.

Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA.

People with severe persistent mental illness pose a significant challenge to managed care organizations and society in general. The financial costs are staggering as is the community impact including homelessness and incarceration. This population also has a high incident of chronic comorbid disorders that not only drives up healthcare costs but also significantly shortens longevity. Read More

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http://dx.doi.org/10.4081/mi.2018.7819DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6342024PMC
November 2018
1 Read

Neonatal Cerebral Air Embolism.

Indian Pediatr 2018 Dec;55(12):1089-1090

Department of Neonatalogy, Surya Children Medicare, Mumbai, India.

Background: Vascular air embolism (VAE) is rare but potentially lethal condition, and survival is rarely reported in newborn.

Characteristics: A preterm (27+1 weeks) neonate on Continuous positive airway pressure developed sudden cardiac asystole on day 3 of life and required 30 minutes of cardiopulmonary resuscitation.

Observation: Infant had air embolism in liver and brain. Read More

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December 2018

Perioperative Orthopedic Surgical Home: Optimizing Total Joint Arthroplasty Candidates and Preventing Readmission.

J Arthroplasty 2019 Jan 18. Epub 2019 Jan 18.

Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY.

Background: It is well recognized that unplanned readmissions following total joint arthroplasty (TJA) are more prevalent in patients with comorbidities. However, few investigators have delayed surgery and medically optimized patients prior to surgery. In its current form, the Perioperative Orthopedic Surgical Home (POSH) is a surgeon-led screening and optimization initiative targeting 8 common modifiable comorbidities. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S08835403193004
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http://dx.doi.org/10.1016/j.arth.2019.01.020DOI Listing
January 2019
5 Reads

Association Between Clinician Specialization in Nursing Home Care and Nursing Home Clinical Quality Scores.

J Am Med Dir Assoc 2019 Feb 7. Epub 2019 Feb 7.

Division of Healthcare Policy and Economics, Weill Cornell Medical College, New York, NY.

Importance: While the number of prescribing clinicians (physicians and nurse practitioners) who provide any nursing home care remained stable over the past decade, the number of clinicians who focus their practice exclusively on nursing home care has increased by over 30%.

Objectives: To measure the association between regional trends in clinician specialization in nursing home care and nursing home quality.

Design: Retrospective cross-sectional study. Read More

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http://dx.doi.org/10.1016/j.jamda.2018.12.017DOI Listing
February 2019

Analysis of relative effectiveness of high-dose versus standard-dose influenza vaccines using an instrumental variable method.

Vaccine 2019 Feb 8. Epub 2019 Feb 8.

Sanofi Pasteur, Swiftwater, PA, USA; Leslie Dan School of Pharmacy, University of Toronto, Toronto, ON, Canada. Electronic address:

Background: Observational studies of the relative effectiveness of influenza vaccines are essential for public health decision making. Their estimates, however, are subject to bias due to unmeasured confounders. Instrumental variable (IV) methods can control for observed and unobserved confounders. Read More

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http://dx.doi.org/10.1016/j.vaccine.2019.01.063DOI Listing
February 2019

Timely linkage of individuals to substance use disorder treatment: development, implementation, and evaluation of FindHelpNowKY.org.

BMC Public Health 2019 Feb 11;19(1):177. Epub 2019 Feb 11.

Kentucky Injury Prevention and Research Center, University of Kentucky, 333 Waller Ave., Suite 242, Lexington, KY, 40504, USA.

Background: Substance use disorders (SUD) have steadily increased over the last two decades. Seeking SUD treatment involves searching SUD treatment facility types (inpatient, outpatient and intensive outpatient, residential and family residential, and detoxification facilities) that offer specialized SUD treatment depending on individual needs and preferences. Referrals to SUD treatment require innovative strategies that rapidly link individuals to SUD treatment when they are at the critical stage of readiness. Read More

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http://dx.doi.org/10.1186/s12889-019-6499-5DOI Listing
February 2019

Identifying Potentially Avoidable Hospitalizations in Medicare Patients With Prostate Cancer: A Retrospective Analysis.

J Oncol Pract 2019 Feb 11:JOP1800560. Epub 2019 Feb 11.

3 Rutgers-Cancer Institute of New Jersey, New Brunswick, NJ.

Purpose:: If identifiable, potentially avoidable hospitalizations (PAHs) can serve as an important target for cost containment efforts in oncology.

Methods:: PAHs among a cohort of Medicare patients with prostate cancer were identified using a two-stage consensus-driven review process. In stage 1, two clinicians independently evaluated admissions records using a case review form, which we modified from a previous study to assess for PAHs. Read More

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http://dx.doi.org/10.1200/JOP.18.00560DOI Listing
February 2019

Risk of Atrial Fibrillation in Black Versus White Medicare Beneficiaries With Implanted Cardiac Devices.

J Am Heart Assoc 2019 Feb;8(4):e010661

1 Clinical and Translational Neuroscience Unit Feil Family Brain and Mind Research Institute Weill Cornell Medical College New York NY.

Background Black individuals in the United States experience higher rates of ischemic stroke than other racial groups but have lower rates of clinically apparent atrial fibrillation ( AF ). It is unclear whether blacks truly have less AF or simply more undiagnosed AF . Methods and Results We performed a retrospective cohort study using inpatient and outpatient claims from 2009 to 2015 for a 5% nationally representative sample of Medicare beneficiaries. Read More

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http://dx.doi.org/10.1161/JAHA.118.010661DOI Listing
February 2019
1 Read

Early withdrawal and non-withdrawal death in the months following hemodialysis initiation: A retrospective cohort analysis.

Hemodial Int 2019 Feb 11. Epub 2019 Feb 11.

Chronic Disease Research Group, Hennepin Healthcare Research Institute, Minneapolis, Minnesota, USA.

Introduction: Whether and how factors associated with elective hemodialysis withdrawal differ from those associated with non-withdrawal death soon after maintenance hemodialysis initiation have not been well studied.

Methods: A retrospective cohort analysis was performed using USRDS data from 2011 to 2014. Patients were randomly categorized 2:1 into training and validation samples. Read More

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http://dx.doi.org/10.1111/hdi.12723DOI Listing
February 2019

Weighing the Effects of Vertical Integration Versus Market Concentration on Hospital Quality.

Med Care Res Rev 2019 Feb 9:1077558719828938. Epub 2019 Feb 9.

1 Rice University, Houston, TX, USA.

Provider organizations are increasing in complexity, as hospitals acquire physician practices and physician organizations grow in size. At the same time, hospitals are merging with each other to improve bargaining power with insurers. We analyze 29 quality measures reported to the Center for Medicare and Medicaid Services' Hospital Compare database for 2008 to 2015 to test whether vertical integration between hospitals and physicians or increases in hospital market concentration influence patient outcomes. Read More

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http://dx.doi.org/10.1177/1077558719828938DOI Listing
February 2019

Timing of Abatacept Before Elective Arthroplasty and Risk of Post-operative Outcomes.

Arthritis Care Res (Hoboken) 2019 Feb 11. Epub 2019 Feb 11.

University of Alabama at Birmingham, Division of Clinical Immunology and Rheumatology.

Objectives: Guidelines recommend holding biologic therapies before hip and knee arthroplasty, yet evidence to inform optimal timing is limited. We aimed to determine whether holding abatacept infusions is associated with lower risk of adverse post-operative outcomes.

Methods: This retrospective cohort study using U. Read More

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http://doi.wiley.com/10.1002/acr.23843
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http://dx.doi.org/10.1002/acr.23843DOI Listing
February 2019
2 Reads

A cost-utility analysis comparing large volume displacement oncoplastic surgery to mastectomy with free flap reconstruction in the treatment of breast cancer.

Am J Surg 2019 Jan 31. Epub 2019 Jan 31.

Department of Surgery, Indiana Medical Center, Indianapolis, IN, USA.

Purpose: Breast cancer surgical treatment may include large volume displacement oncoplastic surgery (LVOS) or mastectomy with free flap reconstruction (MFFR). We investigated the cost-utility between LVOS versus MFFR to determine which approach was most cost-effective.

Methods: A literature review was performed to calculate probabilities for clinical outcomes for each surgical option (LVOS versus MFFR), and to obtain utility scores that were converted into quality adjusted life years (QALYs) as measures for clinical effectiveness. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.01.037DOI Listing
January 2019

High Medicaid Nursing Homes: Organizational and Market Factors Associated With Financial Performance.

Inquiry 2019 Jan-Dec;56:46958018825061

1 The University of Alabama at Birmingham, USA.

High Medicaid nursing homes (85% and higher of Medicaid residents) operate in resource-constrained environments. High Medicaid nursing homes (on average) have lower quality and poorer financial performance. However, there is significant variation in performance among high Medicaid nursing homes. Read More

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http://dx.doi.org/10.1177/0046958018825061DOI Listing
February 2019

Nursing Home Quality and Financial Performance: Is There a Business Case for Quality?

Inquiry 2019 Jan-Dec;56:46958018825191

4 The University of Southern Mississippi, Hattiesburg, MS, USA.

This study examines the relationship between nursing home quality and financial performance to assess whether there is a business case for quality. Secondary data sources included the Online Survey Certification and Reporting (OSCAR), Certification and Survey Provider Enhanced Reporting (CASPER), Medicare Cost Reports, Minimum Data Set (MDS 2.0), Area Resource File (ARF), and LTCFocus for all free-standing, nongovernment nursing homes for 2000 to 2014. Read More

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http://dx.doi.org/10.1177/0046958018825191DOI Listing
February 2019

Impact of Oncology Drug Shortages on Chemotherapy Treatment.

Clin Pharmacol Ther 2019 Feb 10. Epub 2019 Feb 10.

University of Southern California and NBER.

Prescription drug shortages began to increase markedly in the mid-2000s, including sterile injectable products such as chemotherapy drugs. Using Medicare claims linked to Surveillance Epidemiology and End Results (SEER), we examined outpatient chemotherapy use during shortage periods relative to the months before and after a shortage for newly diagnosed patients with breast, colorectal, leukemia, lung, lymphoma, ovarian or pancreatic cancer (N=182,470). For most drugs, we found little impact of shortages on either the fraction of patients receiving that drug or the quantity provided. Read More

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http://doi.wiley.com/10.1002/cpt.1390
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http://dx.doi.org/10.1002/cpt.1390DOI Listing
February 2019
4 Reads

The Risk of Sjogren's Syndrome in the Older adults with Gout: A Medicare Claims Study.

Joint Bone Spine 2019 Feb 6. Epub 2019 Feb 6.

Department of Medicine at the School of Medicine, University of Alabama at Birmingham, 1720 Second Ave. South, Birmingham, 35294-0022 AL, USA.

Objectives: In the absence of previous studies, our objective was to assess whether gout was associated with an increase or decrease in the risk of Sjogren's Syndrome (SS) in older adults, 65 years or older.

Methods: We used the 5% Medicare claims from 2006-2012. A multivariable Cox regression model assessed the association of gout with incident SS adjusting for age, sex, race, Charlson-Romano comorbidity index, and the use of medications for cardiovascular diseases (statins, beta-blockers, diuretics, ACE-inhibitors) and gout (allopurinol, febuxostat). Read More

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http://dx.doi.org/10.1016/j.jbspin.2019.01.022DOI Listing
February 2019
1 Read

How Have 30-Day Readmission Penalties Affected Racial Disparities in Readmissions?: an Analysis from 2007 to 2014 in Five US States.

J Gen Intern Med 2019 Feb 8. Epub 2019 Feb 8.

Department of Health Management and Policy, University of Kentucky, Lexington, KY, USA.

Background: Thirty-day readmission penalties implemented with the Hospital Readmission Reduction Program (HRRP) place a larger burden on safety-net hospitals which treat a disproportionate share of racial minorities, leading to concerns that already large racial disparities in readmissions could widen.

Objective: To examine whether there were changes in Black-White disparities in 30-day readmissions for acute myocardial infarction (AMI), congestive heart failure (CHF), or pneumonia following the passage and implementation of HRRP, and to compare disparities across safety-net and non-safety-net hospitals.

Design: Repeated cross-sectional analysis, stratified by safety-net status. Read More

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http://link.springer.com/10.1007/s11606-019-04841-x
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http://dx.doi.org/10.1007/s11606-019-04841-xDOI Listing
February 2019
3 Reads

Centers for Medicare and Medicaid Services Positive Airway Pressure Adherence Criteria May Limit Treatment to Many Medicare Beneficiaries.

J Clin Sleep Med 2019 Feb 4. Epub 2019 Feb 4.

Study Objectives: Centers for Medicare and Medicaid Services (CMS) reimbursement for positive airway pressure (PAP) devices for obstructive sleep apnea treatment is dependent on patients meeting adherence expectations within the first 3 months on therapy. Adherence is defined as usage of the device for at least 4 hours per night on 70% of nights during a consecutive 30-day period. We hypothesize that the adherence pattern may be established beyond this initial period, which may limit the opportunity to treat many patients. Read More

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February 2019
3 Reads

Preceptor Expansion Initiative Takes Multitactic Approach to Addressing Shortage of Clinical Training Sites.

Fam Med 2019 02;51(2):159-165

S.U.N.Y. Upstate Medical University.

In late 2015, the Society of Teachers of Family Medicine (STFM) was charged with Family Medicine for America's Health's (FMAHealth) Workforce Education and Development Core Team's task of identifying, developing, and disseminating resources for community preceptors. The charge from FMAHealth came at a time when STFM was discussing strategies to address the critical shortage of clinical training sites for medical students. STFM hosted a summit to identify the most significant reasons for the shortage of community preceptors and shape the priorities, leadership, and investments needed to ensure the ongoing education of the primary care workforce. Read More

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https://journals.stfm.org/familymedicine/2019/february/theob
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http://dx.doi.org/10.22454/FamMed.2019.379892DOI Listing
February 2019
2 Reads

Starting Up a Hospital at Home Program: Facilitators and Barriers to Implementation.

J Am Geriatr Soc 2019 Feb 8. Epub 2019 Feb 8.

Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

Background: Hospital at home (HaH) is a model of care that provides acute-level services in the home. HaH has been shown to improve quality and patient satisfaction, and reduce iatrogenesis and costs. Uptake of HaH in the United States has been limited, and little research exists on how to implement it successfully. Read More

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http://dx.doi.org/10.1111/jgs.15782DOI Listing
February 2019

A Closer Look at the Relationship Between Industry and Orthopaedic Sports Medicine Surgeons.

Orthop J Sports Med 2019 Jan 22;7(1):2325967118823175. Epub 2019 Jan 22.

UPMC Rooney Sports Complex, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Background: A recent study demonstrated that discrepancies exist between disclosures reported by authors publishing in and disclosures listed in the Physician Payments Sunshine Act-initiated Open Payments database, managed by the Centers for Medicare & Medicaid Services (CMS). However, no study to date has explored the relationship between the biopharmaceutical and device industry (industry) and the membership base of the American Orthopaedic Society for Sports Medicine (AOSSM).

Purpose: To critically examine the relationship between orthopaedic sports medicine surgeons and industry. Read More

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http://dx.doi.org/10.1177/2325967118823175DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6344948PMC
January 2019

Outcomes for Hemodialysis Patients Given Cardiopulmonary Resuscitation for Cardiac Arrest at Outpatient Dialysis Clinics.

J Am Soc Nephrol 2019 Feb 7. Epub 2019 Feb 7.

Duke Clinical Research Institute.

Background: Out-of-hospital cardiac arrest, the leading cause of death among patients on hemodialysis, occurs frequently within outpatient dialysis centers. Practice guidelines recommend resuscitation training for all dialysis clinic staff and on-site defibrillator availability, but the extent of staff involvement in cardiopulmonary resuscitation (CPR) efforts and its association with outcomes is unknown.

Methods: We used data from the Cardiac Arrest Registry to Enhance Survival and the Centers for Medicare & Medicaid Services dialysis facility database to identify patients who had cardiac arrest within outpatient dialysis clinics between 2010 and 2016 in the southeastern United States. Read More

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http://dx.doi.org/10.1681/ASN.2018090911DOI Listing
February 2019
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Nurse practitioners and physician assistants in emergency medical services who billed independently, 2012-2016.

Am J Emerg Med 2019 Jan 31. Epub 2019 Jan 31.

The Johns Hopkins Bloomberg School of Public Health, United States of America.

Objective: As nurse practitioners (NPs) and physician assistants (PAs) become an integral part of delivering emergency medical services, we examined the involvement of NPs and PAs who billed independently in emergency departments (EDs).

Methods: We used Medicare provider utilization and payment data from 2012 to 2016 to conduct a retrospective analysis. We examined the changes in the number of each clinician type who billed independently for four common emergency services (CPT codes: 99282-5), the change in their service volume, and the change in their average number of services billed. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.01.052DOI Listing
January 2019

Racial and socioeconomic disparities associated with 90-day mortality among patients with head and neck cancer in the United States.

Oral Oncol 2019 Feb 29;89:95-101. Epub 2018 Dec 29.

Saint Louis University School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Saint Louis, United States; Saint Louis University Cancer Center, Saint Louis, United States. Electronic address:

Objectives: To quantify head and neck cancer (HNC) mortality rates and identify racial and socioeconomic factors associated with 90-day mortality.

Methods: The National Cancer Database (2004-2014) was queried for eligible HNC cases (n = 260,011) among adults treated with curative intent. Outcome of interest was any-cause 90-day mortality. Read More

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http://dx.doi.org/10.1016/j.oraloncology.2018.12.023DOI Listing
February 2019