64,301 results match your criteria Medicare Patient Management [Journal]


Disparities in Breast Cancer Survival by Socioeconomic Status Despite Medicare and Medicaid Insurance.

Milbank Q 2018 Dec;96(4):706-754

Leonard and Madlyn Abramson Cancer Center of the University of Pennsylvania.

Policy Points Patients with low socioeconomic status (SES) experience poorer survival rates after diagnosis of breast cancer, even when enrolled in Medicare and Medicaid. Most of the difference in survival is due to more advanced cancer on presentation and the general poor health of lower SES patients, while only a very small fraction of the SES disparity is due to differences in cancer treatment. Even when comparing only low- versus not-low-SES whites (without confounding by race) the survival disparity between disparate white SES populations is very large and is associated with lower use of preventive care, despite having insurance. Read More

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December 2018

Erster Fallbericht einer beidseitigen zirkumskripten Morphea des Gesichts.

J Dtsch Dermatol Ges 2018 Dec;16(12):1480-1482

Dermatology, Venereology and Leprosy, Ellahi Medicare Clinic, Kashmir, India.

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December 2018

Two-year prevalence of dysphagia and related outcomes in head and neck cancer survivors: An updated SEER-Medicare analysis.

Head Neck 2018 Dec 7. Epub 2018 Dec 7.

Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.

Background: The aim of the study was to examine prevalence of dysphagia at the population level in head and neck cancer (HNC) survivors.

Methods: Surveillance, Epidemiology, and End Results-Medicare claims among 16 194 patients with HNC (2002-2011) were analyzed to estimate 2-year prevalence of dysphagia, stricture, and aspiration pneumonia, and derive treatment- and site-specific estimates.

Results: Prevalence of dysphagia, stricture, pneumonia, and aspiration pneumonia was 45. Read More

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December 2018
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University of Pittsburgh Medical Center Home Transitions Multidisciplinary Care Coordination Reduces Readmissions for Older Adults.

J Am Geriatr Soc 2018 Dec 8. Epub 2018 Dec 8.

Community Provider Services, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.

Objectives: To compare rates of 30- and 90-day hospital readmissions and observation or emergency department (ED) returns of older adults using the University of Pittsburgh Medical Center (UPMC) Health Plan Home Transitions (HT) with those of Medicare fee-for-service (FFS) controls without HT.

Design: Retrospective cohort study.

Setting: Analysis of home health and hospital records from 8 UPMC hospitals in Allegheny County, Pennsylvania, from July 1, 2015, to April 30, 2017. Read More

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December 2018
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Pharmacotherapy in Older Adults with Cardiovascular Disease: Report from an American College of Cardiology, American Geriatrics Society, and National Institute on Aging Workshop.

J Am Geriatr Soc 2018 Dec 7. Epub 2018 Dec 7.

Cardiovascular Division, Department of Internal Medicine, Washington University, St. Louis, Missouri.

Objectives: To identify the top priority areas for research to optimize pharmacotherapy in older adults with cardiovascular disease (CVD).

Design: Consensus meeting.

Setting: Multidisciplinary workshop supported by the National Institute on Aging, the American College of Cardiology, and the American Geriatrics Society, February 6-7, 2017. Read More

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December 2018

Improved Quality of Life With Anti-TNF Therapy Compared With Continued Corticosteroid Utilization in Crohn's Disease.

Inflamm Bowel Dis 2018 Dec 9. Epub 2018 Dec 9.

Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Background: Corticosteroids (CS) and anti-TNF drugs are used to treat Crohn's disease (CD). In this study, we assessed the net health benefit of initiating anti-TNF therapy relative to additional CS use in CD using a novel combination of a retrospective cohort study and a simulation model.

Methods: Using Medicaid data from 2001 to 2005 and Medicare data from 2006 to 2013, beneficiaries were identified with CD and CS use who subsequently received either an anti-TNF or reached a cumulative dose of >3000 mg CS during the year. Read More

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December 2018

Abatacept initiation in rheumatoid arthritis and the risk of cancer: a population-based comparative cohort study.

Rheumatology (Oxford) 2018 Dec 7. Epub 2018 Dec 7.

Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montréal, Québec, Canada.

Objective: To assess whether abatacept as initial biological DMARD (bDMARD) in the treatment of RA, when compared with other bDMARDs, is associated with an increased risk of cancer overall and by specific cancer sites (breast, lung, lymphoma, melanoma and non-melanoma skin cancer).

Methods: We performed a population-based cohort study among patients newly treated with bDMARDs within the US-based Truven MarketScan population and Supplemental US Medicare from 2007 to 2014. Cox proportional hazards models were used to estimate hazard ratios and 95% CIs of any cancer (and specific cancers) associated with initiation of abatacept, compared with initiation of other bDMARDs, adjusted for age and deciles of the propensity score. Read More

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December 2018

Changes in Provider Treatment Patterns for Dupuytren's Contracture: Analysis of Trends in Medicare Beneficiaries.

Plast Reconstr Surg Glob Open 2018 Oct 3;6(10):e1932. Epub 2018 Oct 3.

Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, Wash.

Background: Collagenase Clostridium histolyticum (CCH) injection has been shown to be a safe and effective treatment option for Dupuytren's contracture. We hypothesize that the gaining popularity of CCH has resulted in a change in treatment patterns among providers, with increased utilization of CCH injections in the management of Dupuytren's contracture from 2012 to 2014.

Methods: The Medicare Provider Utilization and Payment Data Public Use Files were used to identify all surgeons who submitted claims for surgical fasciectomy, needle aponeurotomy (NA), and CCH injection. Read More

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October 2018

Adult Primary Bone Sarcoma and Time to Treatment Initiation: An Analysis of the National Cancer Database.

Sarcoma 2018 11;2018:1728302. Epub 2018 Nov 11.

Orthopaedic and Rheumatologic Institute, Cleveland Clinic, Cleveland, OH 44195, USA.

Objective: The time to treatment interval (TTI), defined as the period from diagnosis to first definitive treatment, has very limited descriptions toward understanding delays in primary bone sarcoma (PBS) care. Our primary goal was to determine the national standard for time to treatment initiation (TTI) in PBS in adults and to identify characteristics associated with TTI variability.

Methods: An analysis of the National Cancer Database identified 15,083 adult patients with PBS diagnosed from 2004 to 2013. Read More

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November 2018

Extensive Nicolau Syndrome Following Intramuscular Injection of Paracetamol in a Patient Who Is HIV Positive.

J Cutan Aesthet Surg 2018 Jul-Sep;11(3):136-139

Dr. Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, New Delhi, India.

Nicolau syndrome (NS) is a type of adverse skin reaction occurring after parenteral drug injection. In certain conditions, it can cause ischemic necrosis of the skin and the underlying adipose tissue. The actual cause of NS is not clear though inflammation, vasospasm, and thromboembolic occlusion of blood vessels have been proposed. Read More

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December 2018

Treatment for Rotator Cuff Tear Is Influenced by Demographics and Characteristics of the Area Where Patients Live.

JB JS Open Access 2018 Sep 7;3(3):e0005. Epub 2018 Aug 7.

Departments of Health Services Policy and Management (C.G.C., S.B.F., B.C., and J.M.B.) and Exercise Science (C.A.T.), Center for Effectiveness Research in Orthopaedics, University of South Carolina, Columbia, South Carolina.

Background: Atraumatic rotator cuff tear is a common orthopaedic complaint for people >60 years of age. Lack of evidence or consensus on appropriate treatment for this type of injury creates the potential for substantial discretion in treatment decisions. To our knowledge, no study has assessed the implications of this discretion on treatment patterns across the United States. Read More

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September 2018

Impact of postcolectomy adhesion-related complications on healthcare utilization.

Clinicoecon Outcomes Res 2018 14;10:761-771. Epub 2018 Nov 14.

Medical Devices-Epidemiology, Johnson and Johnson, New Brunswick, NJ 08901, USA,

Objective: The objective of this study was to explore adhesion-related complications (ARCs) within 1 year after colectomy.

Methods: Using Truven MarketScan® Commercial and Medicare databases, the first inpatient colectomies during 2009-2013 (index) were identified: left, right, partial, transverse, or total. One-year continuous enrollment was required pre and postindex. Read More

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November 2018

Functional Status is Associated With 30-Day Potentially Preventable Readmissions Following Home Health Care.

Med Care 2018 Dec 10. Epub 2018 Dec 10.

Division of Rehabilitation Sciences.

Background: Beginning in 2019, home health agencies' rates of potentially preventable hospital readmissions over the 30 days following discharge will be publicly reported.

Objectives: Our primary objective was to determine the association between patients' functional status at discharge from home health care and 30-day potentially preventable readmissions. A secondary objective was to identify the most common conditions resulting in potentially preventable readmissions. Read More

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December 2018
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Reduced Awareness of Memory Deficit is Associated With Increased Medicare Home Health Care Use in Dementia.

Alzheimer Dis Assoc Disord 2018 Dec 6. Epub 2018 Dec 6.

Cognitive Neuroscience Division of the Taub Institute for Research on Alzheimer's Disease and the Aging Brain and the G.H. Sergievsky Center, Columbia University Medical Center.

Objective: The objective of this study was to examine whether reduced awareness of memory deficits in individuals with dementia is associated with more frequent need for Medicare home health care services.

Methods: Cross-sectional analyses were conducted in a multicenter, clinic-based cohort. In total, 192 participants diagnosed with dementia and their informants were independently asked whether or not the participant demonstrated cognitive symptoms of dementia related to memory and word-finding. Read More

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December 2018

Mortality Risk in Homebound Older Adults Predicted from Routinely Collected Nursing Data.

Nurs Res 2018 Dec 6. Epub 2018 Dec 6.

Assistant Professor, University at Buffalo School of Nursing, Buffalo, NY Associate Professor, University at Buffalo School of Nursing, Buffalo, NY Assistant Professor, University at Buffalo Department of Computer Science and Engineering, Buffalo, NY Associate Professor, Director Center for Nursing Informatics, University of Minnesota School of Nursing, Minneapolis, MN.

Background: Newer analytic approaches for developing predictive models provides a method of creating decision support to translate findings into practice.

Objectives: To develop and validate a clinically interpretable predictive model for 12-month mortality risk among community-dwelling older adults. This is done by using routinely collected nursing assessment data to aide homecare nurses in identifying older adults who are at risk for decline, providing an opportunity to develop care plans that support patient and family goals for care. Read More

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December 2018

INTER-HOSPITAL VARIABILITY IN TIME TO DISCHARGE TO REHABILITATION AMONG INSURED TRAUMA PATIENTS.

J Trauma Acute Care Surg 2018 Dec 5. Epub 2018 Dec 5.

Department of Surgery, Stanford University School of Medicine, Stanford, CA.

Background: Hospital costs are partly a function of length of stay (LOS), which can be impacted by the local availability of post-acute care (PAC) resources (inpatient rehabilitation and skilled nursing facilities), particularly for injured patients. We hypothesized that LOS for trauma patients destined for PAC would be variable based on insurance type and hospitals from which they are discharged.

Methods: We used the 2014-2015 National Inpatient Sample from the Healthcare Cost and Utilization Project (HCUP). Read More

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December 2018

Effects of the Mental Health Parity and Addiction Equity Act on Specialty Outpatient Behavioral Health Spending and Utilization.

J Ment Health Policy Econ 2018 Sep;21(3):91-103

Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,

Background: For decades, insurance plans in the United States have applied more restrictive treatment limits and higher cost-sharing burdens for mental health and substance use treatments compared to physical health treatments. The Mental Health Parity and Addiction Equity Act (MHPAEA) required health plans that offer mental health and substance use benefits to offer them at parity with physical health benefits starting in January 2010.

Aims Of The Study: To determine the effect of MHPAEA on out-of-pocket spending and utilization of outpatient specialty behavioral health services. Read More

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September 2018

Patterns of performance and improvement in US Medicare's Hospital Star Ratings, 2016-2017.

BMJ Qual Saf 2018 Dec 8. Epub 2018 Dec 8.

Department of Medicine, Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri, USA.

Background: Publicly reported quality data can help consumers make informed choices about where to seek medical care. The Centers for Medicare and Medicaid Services developed a composite Hospital Compare Overall Star Rating for US acute-care hospitals in 2016. However, patterns of performance and improvement have not been previously described. Read More

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December 2018

Survival among Veterans Obtaining Dialysis in VA and Non-VA Settings.

J Am Soc Nephrol 2018 Dec 7. Epub 2018 Dec 7.

Health Services Research and Development, Durham Veterans Affairs Health Care System, Durham, North Carolina.

Background: Outcomes of veterans with ESRD may differ depending on where they receive dialysis and who finances this care, but little is known about variation in outcomes across different dialysis settings and financial arrangements.

Methods: We examined survival among 27,241 Veterans Affairs (VA)-enrolled veterans who initiated chronic dialysis in 2008-2011 at () VA-based units, () community-based clinics through the Veterans Affairs Purchased Care program (VA-PC), () community-based clinics under Medicare, or () more than one of these settings ("dual" care). Using a Cox proportional hazards model, we compared all-cause mortality across dialysis settings during the 2-year period after dialysis initiation, adjusting for demographic and clinical characteristics. Read More

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December 2018

Mobile Health, Information Preferences, and Surrogate Decision-Making Preferences of Family Caregivers of People With Dementia in Rural Hispanic Communities: Cross-Sectional Questionnaire Study.

J Med Internet Res 2018 Dec 10;20(12):e11682. Epub 2018 Dec 10.

School of Information, The University of Texas at Austin, Austin, TX, United States.

Background: Mobile health (mHealth) technology holds promise for promoting health education and reducing health disparities and inequalities in underserved populations. However, little research has been done to develop mHealth interventions for family caregivers of people with dementia, particularly those in rural Hispanic communities, who often serve as surrogate decision makers for their relatives with dementia.

Objective: As part of a larger project to develop and test a novel, affordable, and easy-to-use mHealth intervention to deliver individually tailored materials in rural Hispanic communities, in this pilot study, we aimed to examine (1) characteristics of people with dementia and their family caregivers in rural Hispanic communities, (2) caregivers' preferences for types and amounts of health information and participation in surrogate decision making, and (3) caregivers' mobile device usage and their desire for receiving information via mobile devices. Read More

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December 2018

Preoperative Endoscopic Retrograde Cholangiopancreatography is not Associated With Increased Pancreatic Cancer Mortality.

Clin Gastroenterol Hepatol 2018 Dec 6. Epub 2018 Dec 6.

Icahn School of Medicine at Mount Sinai, Henry D Janowitz Division of Gastroenterology, 1 Gustave Levy Place, New York, NY 10029. Electronic address:

Background And Aims: Endoscopic Retrograde Cholangiopancreatography (ERCP) before surgery for pancreatic cancer has been associated with infectious complications after surgery. Little is known about the effects of preoperative ERCP on survival of patients with pancreatic cancer. We investigated whether ERCP before surgery affects overall survival, after controlling for confounding factors. Read More

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December 2018

Risk Calculator to Predict 30-Day Readmission After Coronary Artery Bypass: A Strategic Decision Support Tool.

Heart Lung Circ 2018 Nov 29. Epub 2018 Nov 29.

Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Division of Cardiac Surgery, Harrington Heart and Vascular Institute, Cleveland, OH, USA.

Background: Re-admission is an important source of patient dissatisfaction and increased hospital costs. A simple calculator to determine the probability of re-admission may help guide patient dismissal planning.

Methods: Using the national readmissions database (NRD), we identified admissions for isolated primary coronary artery bypass (CABG) and stratified them according to 30-day readmission. Read More

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November 2018

The pharmacist's role in shaping the future of value-based payment models in state Medicaid programs.

J Am Pharm Assoc (2003) 2018 Dec 4. Epub 2018 Dec 4.

Objectives: To describe roles for pharmacists to facilitate payer-initiated value-based contracts within state Medicaid programs.

Summary: According to the Centers for Medicare and Medicaid Services, prescription drug expenditures are expected to see the fastest annual growth in the health care sector over the next decade owing to a greater number of costly specialty medications and overall higher drug prices. Increased prescription costs make value-based contracts particularly compelling opportunities for payers. Read More

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December 2018

Association Between Executive Dysfunction and Instrumental Activities of Daily Living: Racial and Ethnic Differences Among Community-Dwelling Older Adults in the Southeastern US.

J Natl Med Assoc 2018 Dec 4. Epub 2018 Dec 4.

The George Washington School of Medicine and Health Sciences, Washington, DC, USA.

Objective: Examining cultural differences in assessment of cognitive/functional disability among older Americans is needed. This analysis examined associations between day-to-day function, measured by activities of daily living (ADL), and cognition, measured by CLOX scores, among older African American (AA) and non-Hispanic White (nHW) community-dwelling women and men.

Methods: Design- Cross-sectional. Read More

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December 2018

Common femoral artery antegrade and retrograde approaches have similar access site complications.

J Vasc Surg 2018 Dec 4. Epub 2018 Dec 4.

Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Mass.

Objective: Ipsilateral antegrade access (AA) is an alternative access option for contralateral retrograde access (RA) in treating infrainguinal occlusive disease. Our goal was to assess whether AA is associated with higher access site complications.

Methods: The Vascular Quality Initiative database was searched from 2010 to 2017 for all infrainguinal peripheral vascular interventions. Read More

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December 2018

Relation of Race, Apparent Disability, and Stroke Risk With Warfarin Prescribing for Atrial Fibrillation in Patients Receiving Maintenance Hemodialysis.

Am J Cardiol 2018 Nov 24. Epub 2018 Nov 24.

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

Little is known about how warfarin is prescribed for stroke prevention in maintenance dialysis patients with chronic atrial fibrillation (AF). We examined patterns of warfarin use, and associated factors, after AF diagnosis. This retrospective cohort analysis studied US Medicare patients receiving maintenance dialysis January 1, 2008, to June 30, 2010. Read More

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November 2018

Leading a Dialysis Organization: Role and Responsibilities of the Chief Medical Officer (Nephrologist Leadership in a Dialysis Provider Organization).

Adv Chronic Kidney Dis 2018 Nov;25(6):485-489

Satellite Healthcare, San Jose, CA. Electronic address:

The early beginning of the end-stage kidney disease program with the introduction of the Medicare Act of 1973 was marked by nephrologist entrepreneurs pioneering dialysis centers to deliver dialysis addressing the clinical needs of patients in a collaborative effort between physicians and nurses. As the number of patients grew, a system reliably providing dialysis treatments for many more patients than was ever anticipated was required to enable the demands of the increased scale. Solutions appropriate to respond to the growing needs of out-patient dialysis centers were developed combining emerging technology, clinical advances, and operational efficiency. Read More

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November 2018

Statins associate with improved mortality among patients with certain histological subtypes of lung cancer.

Lung Cancer 2018 Dec 25;126:89-96. Epub 2018 Oct 25.

Department of Molecular and Systems Biology, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA; Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, NH 03755, USA; Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH 03755, USA; Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA. Electronic address:

Objectives: To measure the association between statin exposure and mortality in lung cancer patients belonging to different categories of histological subtype.

Materials And Methods: A cohort of 19,974 individuals with incident lung cancer between 2007 and 2011 was identified using the SEER-Medicare linked database. Statin exposure both pre- and post-diagnosis was analyzed to identify a possible association with cancer-specific mortality in patients stratified by histological subtype. Read More

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December 2018

The Value of Claims-Based Nontraditional Risk Factors in Predicting Long-term Mortality After MitraClip Procedure.

Can J Cardiol 2018 Dec 13;34(12):1648-1654. Epub 2018 Oct 13.

Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center. Electronic address:

Background: We sought to identify nontraditional risk factors coded in administrative claims data and evaluate their ability to improve prediction of long-term mortality in patients undergoing percutaneous mitral valve repair.

Methods: Patients undergoing transcatheter mitral valve repair using MitraClip implantation between September 28, 2010, and September 30, 2015 were identified among Medicare fee-for-service beneficiaries. We used nested Cox regression models to identify claims codes predictive of long-term mortality. Read More

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December 2018

Advance care planning in medicare/medicaid-funded agencies: providing a training in cultural competence.

Gerontol Geriatr Educ 2018 Dec 8:1-12. Epub 2018 Dec 8.

c NoVa AHEC at Mason, College of Health and Human Services , George Mason University , Fairfax , VA , USA.

This study presents a training that was developed for staff members at Medicare/Medicaid agencies to improve their knowledge and comfort levels in working on advance care planning (ACP) with their clients in a culturally competent manner. The training was developed to address the need to clarify the different types and purposes of ACP and to help develop the skills needed to work with clients of diverse cultural backgrounds. The evaluation of findings from the training showed the positive impacts that it had on participants; in particular, they exhibited demonstrated improvement in their knowledge of and comfort levels with ACP. Read More

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December 2018

Trends in Utilization of Statin Therapy and Contraindicated Statin Use in HIV--Infected Adults Treated With Antiretroviral Therapy From 2007 Through 2015.

J Am Heart Assoc 2018 Dec;7(24):e010345

2 University of Alabama at Birmingham AL.

Background HIV is associated with an increased risk for atherosclerotic cardiovascular disease, which may result in many people living with HIV taking a statin. Some statins are contraindicated with certain antiretroviral therapies ( ART ) and other medications commonly used by HIV -infected patients. Methods and Results We analyzed trends in the use of statins, including contraindicated statins, between 2007 and 2015 among HIV -infected patients aged ≥19 years taking ART who had employer-sponsored or Medicare supplemental health insurance in the Marketscan database (n=186 420). Read More

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December 2018

Age matters when comparing hemiarthroplasty and total hip arthroplasty for femoral neck fractures in Medicare patients.

Hip Int 2018 Dec 11:1120700018816924. Epub 2018 Dec 11.

Department of Orthopaedic Surgery, University of North Carolina, Chapel Hill, NC, USA.

Introduction:: The optimal treatment of patients with a displaced intracapsular femoral neck fracture remains controversial. We utilised a national database of Medicare patients to determine if there was any difference in complications and reoperation rate of patients undergoing total hip arthroplasty (THA) or hemiarthroplasty (HA) for femoral neck fractures.

Methods:: This study utilised the PearlDiver Patient Records Database, a national for-fee database of Medicare patient procedure and diagnosis records from 2005 to 2012. Read More

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December 2018

Statin use is associated with less postoperative cardiac arrhythmia after total hip arthroplasty.

Hip Int 2018 Dec 10:1120700018816091. Epub 2018 Dec 10.

Department of Orthopaedic Surgery, Stanford University, Redwood City, CA, USA.

Introduction:: While statins have been found to reduce postoperative atrial fibrillation after cardiac surgery, little is known about their use in total hip arthroplasty (THA). This study investigated if statins would similarly reduce postoperative arrhythmias in patients undergoing THA.

Methods:: We queried a large Medicare and private-payer database from 2005 to 2012 and identified 12,075 patients who were on a statin prior to THA. Read More

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December 2018

Adverse Drug Events as a Reason for Adult Hospitalization: A Nationwide Readmission Study.

Ann Pharmacother 2018 Dec 10:1060028018818571. Epub 2018 Dec 10.

1 Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.

Background: Adverse drug events (ADEs) are common; however, there are limited data on the impact of ADEs on post-discharge outcomes.

Objectives: To identify ADEs responsible for readmission within 6 months of hospital discharge in the United States. Secondary objectives were to examine whether demographic, clinical, and hospital characteristics were associated with ADE readmission. Read More

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December 2018

Shining Sunlight on Industry Payments in Oral and Maxillofacial Surgery: The Sunshine Act.

J Oral Maxillofac Surg 2018 Nov 12. Epub 2018 Nov 12.

Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA.

Purpose: To characterize industry payments to oral and maxillofacial surgeons (OMSs) and to determine the accuracy of the Centers for Medicare and Medicaid Services (CMS) Open Payments Databases.

Materials And Methods: This was a cross-sectional study of the CMS General and Research Payments Databases in 2016 for clinicians categorized as OMSs. General payments include consulting fees, honoraria, gifts, entertainment, food and beverage, travel and education, and others. Read More

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November 2018
1 Read

Rapid and substantial increases in anticoagulant use and expenditure in Australia following the introduction of new types of oral anticoagulants.

PLoS One 2018 6;13(12):e0208824. Epub 2018 Dec 6.

National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia.

Objectives: To quantify changes in anticoagulant use in Australia since the introduction of Non-vitamin K antagonist anticoagulants (NOACs) and to estimate government expenditure.

Design: Interrupted-time-series analysis quantifying anticoagulant dispensing, before and after first Pharmaceutical Benefits Scheme (PBS) NOAC listing in August 2009 for venous thromboembolism prevention; and expanded listing for stroke prevention in non-valvular atrial fibrillation (AF) in August 2013, up to June 2016. Estimated government expenditure on PBS-listed anticoagulants. Read More

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December 2018

National Health Care Spending In 2017: Growth Slows To Post-Great Recession Rates; Share Of GDP Stabilizes.

Health Aff (Millwood) 2018 Dec 6:101377hlthaff201805085. Epub 2018 Dec 6.

Aaron Catlin is a deputy director in the National Health Statistics Group, CMS Office of the Actuary.

Total nominal US health care spending increased 3.9 percent to $3.5 trillion in 2017, slowing from growth of 4. Read More

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December 2018

Low-value care: antipsychotic medication use among community-dwelling medicare beneficiaries with Alzheimer's disease and related dementias and without severe mental illness.

Aging Ment Health 2018 Dec 6:1-7. Epub 2018 Dec 6.

a Department of Pharmaceutical Systems and Policy , West Virginia University , Morgantown , WV , USA.

Background: Antipsychotic medication use among elderly with Alzheimer's disease and related dementias (ADRD) and without severe mental illness is considered as low-value care. Our objective was to assess the factors associated with this inappropriate use of antipsychotic medications among community-dwelling Medicare beneficiaries with ADRD and without severe mental illness.

Methods: This study used a retrospective cross-sectional design. Read More

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December 2018

Indirect Estimation of Race/Ethnicity for Survey Respondents Who Do Not Report Race/Ethnicity.

Med Care 2018 Dec 4. Epub 2018 Dec 4.

RAND Corporation, Santa Monica, CA.

Background: Researchers are increasingly interested in measuring race/ethnicity, but some survey respondents skip race/ethnicity items.

Objectives: The main objectives of this study were to investigate the extent to which racial/ethnic groups differ in skipping race/ethnicity survey items, the degree to which this reflects reluctance to disclose race/ethnicity, and the utility of imputing missing race/ethnicity.

Research Design: We applied a previously developed method for imputing race/ethnicity from administrative data (Medicare Bayesian Improved Surname and Geocoding 2. Read More

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December 2018
1 Read

Quality-based ratings in Medicare and trends in kidney transplantation.

Health Serv Res 2018 Dec 5. Epub 2018 Dec 5.

The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.

Objective: To assess the relationship between the 2007 Medicare regulation enforcing quality standards for transplant centers and trends in kidney transplantation.

Data Sources: Transplant centers' biannual reports and the national registry for kidney transplantation from 2003 to 2010.

Study Design: Non-compliant (low-performing) centers were compared with centers in compliance with quality standards according to: number of transplants, waiting-list registrations, and rates of graft failures, transfers, and deaths. Read More

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December 2018
1 Read

New Achievements in High-Pressure Processing to Preserve Human Milk Bioactivity.

Front Pediatr 2018 16;6:323. Epub 2018 Nov 16.

Neonatal and Intensive Care Department, University Hospital, Medical University of Warsaw, Warsaw, Poland.

High-pressure processing (HPP) is a non-thermal technology that is being increasingly applied in food industries worldwide. It was proposed that this method could be used as an alternative to holder pasteurization (HoP; 62.5°C, 30 min) in milk banks but its impact on the immunologic, enzymatic and hormonal components of human milk has not yet been evaluated in detail. Read More

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November 2018
2 Reads

Predicting Costs Exceeding Bundled Payment Targets for Total Joint Arthroplasty.

J Arthroplasty 2018 Nov 15. Epub 2018 Nov 15.

Department of Orthopaedics, Duke University Hospital, Duke Orthopaedics at Page Road, Durham, NC.

Background: The Center for Medicare and Medicaid Services has instituted bundled reimbursement models for total joint arthroplasty (TJA), which includes target prices for each procedure. Some patients exceed these targets; however, currently there are no tools to accurately predict this preoperatively. We hypothesized that a validated comorbidity index combined with patient demographics would adequately predict excess cost-of-care prior to hospitalization. Read More

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November 2018

Post-Acute Care among Older Adults with Stage I to III Colorectal Cancer.

J Am Geriatr Soc 2018 Dec 3. Epub 2018 Dec 3.

Department of Surgery, Dallas VA Hospital & University of Texas Southwestern, Dallas, Texas.

Background: Little information is available on the long-term use of post-acute care among older patients with colorectal cancer (CRC), relative to individuals without cancer. This study examines the use of post-acute care among older cancer survivors (>65 y) with CRC and compares it with noncancer patients up to 5 years from surgery.

Design: Retrospective cohort. Read More

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December 2018

Unmet social support needs among older adults with cancer.

Cancer 2018 Dec 3. Epub 2018 Dec 3.

Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama.

Background: Adequate social support for older adults is necessary to maintain quality of life and reduce mortality and morbidity. However, little is known regarding the social support needs of older adults with cancer. The objective of the current study was to examine social support needs, specifically the unmet needs, among older adults with cancer. Read More

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December 2018

Analysis of Physician Variation in Provision of Low-Value Services.

JAMA Intern Med 2018 Dec 3. Epub 2018 Dec 3.

Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.

Importance: Facing new financial incentives to reduce unnecessary spending, health care organizations may attempt to reduce wasteful care by influencing physician practices or selecting more cost-effective physicians. However, physicians' role in determining the use of low-value services has not been well described.

Objectives: To quantify variation in provision of low-value health care services among primary care physicians and to estimate the proportion of variation attributable to physician characteristics that may be used to predict performance. Read More

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December 2018

Imputation of race/ethnicity to enable measurement of HEDIS performance by race/ethnicity.

Health Serv Res 2018 Dec 3. Epub 2018 Dec 3.

RAND Corporation, Pittsburgh, Pennsylvania.

Objective: To improve an existing method, Medicare Bayesian Improved Surname Geocoding (MBISG) 1.0 that augments the Centers for Medicare & Medicaid Services' (CMS) administrative measure of race/ethnicity with surname and geographic data to estimate race/ethnicity.

Data Sources/study Setting: Data from 284 627 respondents to the 2014 Medicare CAHPS survey. Read More

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December 2018

Lobar versus sub-lobar surgery for pulmonary typical carcinoid, a population-based analysis.

J Thorac Dis 2018 Oct;10(10):5850-5859

Division of Hematology, Oncology, Blood & Marrow Transplantation, Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.

Background: The optimal surgery for resectable pulmonary typical carcinoid (TC), e.g., lobar resection (L-R) sub-lobar resection (SL-R), is controversial. Read More

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October 2018

Trends in Insomnia Diagnosis and Treatment Among Medicare Beneficiaries, 2006-2013.

Am J Geriatr Psychiatry 2018 Nov 2. Epub 2018 Nov 2.

Department of Neurology (SET), Columbia University, New York.

Objective: Insomnia is an important clinical problem affecting the elderly. We examined trends in insomnia diagnosis and treatment among Medicare beneficiaries over an eight-year period.

Methods: This was a time-series analysis of Medicare administrative data for years 2006-2013. Read More

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November 2018

Disparities in minimally invasive surgery for colorectal cancer in Florida.

Am J Surg 2018 Nov 27. Epub 2018 Nov 27.

Department of Surgery, Mayo Clinic, Jacksonville, FL, USA. Electronic address:

Background: The cost of minimally invasive surgery (MIS) raises potential for racial and social disparities. The aim of this study was to identify the racial, socioeconomic and geographic disparities associated with MIS for colorectal cancer (CRC) in Florida.

Methods: Using the Florida Inpatient Discharge Dataset, we examined the clinical data of patients who underwent elective resections for CRC during 2013-2015. Read More

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November 2018