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Relationship of Neighborhood Greenness to Alzheimer's Disease and Non-Alzheimer's Dementia Among 249,405 U.S. Medicare Beneficiaries.

J Alzheimers Dis 2021 Apr 1. Epub 2021 Apr 1.

Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.

Background: Neighborhood greenness (vegetative presence) has been linked to multiple health outcomes, but its relationship to Alzheimer's disease (AD) and non-Alzheimer's (non-AD) dementia has been less studied.

Objective: This study examines the relationship of greenness to both AD and non-AD dementia in a population-based sample of Medicare beneficiaries.

Methods: Participants were 249,405 US Medicare beneficiaries aged >  65 living in Miami-Dade County, FL, from 2010 to 2011. Read More

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Long-term outcomes of aortic root operations in the United States among Medicare beneficiaries.

J Thorac Cardiovasc Surg 2021 Feb 25. Epub 2021 Feb 25.

Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC. Electronic address:

Objective: The best method of aortic root repair in older patients remains unknown given a lack of comparative effectiveness of long-term outcomes data. The objective of this study was to compare long-term outcomes of different surgical approaches for aortic root repair in Medicare patients using The Society of Thoracic Surgeons Adult Cardiac Surgery Database-Centers for Medicare & Medicaid Services-linked data.

Methods: A retrospective cohort study was performed by querying the Society of Thoracic Surgeons Adult Cardiac Surgery Database for patients aged 65 years or more who underwent elective aortic root repair with or without aortic valve replacement. Read More

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February 2021

Trends in Opioid Use Disorder Among Older Adults: Analyzing Medicare Data, 2013-2018.

Am J Prev Med 2021 Mar 4. Epub 2021 Mar 4.

Department of Health Policy, Management, and Behavior, School of Public Health, University at Albany, Rensselaer, New York.

Introduction: Opioid use disorder has grown rapidly over the years and is a public health crisis in the U.S. Although opioid use disorder is widely studied, relatively little is known about it among older adults. Read More

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Differences in Function and Healthcare Cost of Older Adults with Dementia by Long-Term Care Service Type: A National Dataset Analysis.

Healthcare (Basel) 2021 Mar 10;9(3). Epub 2021 Mar 10.

Mokpo National Quarantine Station, 20 Haean-ro, 177 Beon-gil, Mokpo-si 58754, Korea.

This study aims to analyze the function and cost changes among long-term care insurance (LTCI) beneficiaries with low-severity dementia according to their LTCI service type. Data were collected from the Korean LTCI and national health insurance (NHI) datasets. Participants were 4414 beneficiaries with dementia aged 65 or older who received LTC services continuously for 4 years (2008-2011). Read More

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Changes in utilization of immediate-release, extended-release, and liquid formulation medications relative to bariatric surgery: a segmented regression analysis.

Surg Obes Relat Dis 2021 Mar 3. Epub 2021 Mar 3.

Department of Surgery, College of Medicine, University of Florida, Gainesville, Florida.

Background: Changes in gut anatomy following bariatric surgery impacts medication absorption, often requiring changes in medication formulations.

Objectives: To assess changes in utilization of extended-release (ER), immediate-release (IR), and liquid formulations 360 days before and after bariatric surgery.

Setting: Large U. Read More

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Who Is (and Is Not) Receiving Telemedicine Care During the COVID-19 Pandemic.

Am J Prev Med 2021 Mar 6. Epub 2021 Mar 6.

RAND Corporation, Santa Monica, California.

Introduction: The COVID-19 pandemic has forced telehealth to be the primary means through which patients interact with their providers. There is a concern that the pandemic will exacerbate the existing disparities in overall healthcare utilization and telehealth utilization. Few national studies have examined the changes in telehealth use during the COVID-19 pandemic. Read More

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Obstructive Sleep Apnea Treatment and Dementia Risk in Older Adults.

Sleep 2021 Mar 26. Epub 2021 Mar 26.

University of Michigan, Michigan Medicine, Department of Neurology, Ann Arbor, Michigan, United States.

Study Objectives: To examine associations between PAP therapy, adherence and incident diagnoses of Alzheimer's disease (AD), mild cognitive impairment (MCI), and dementia not-otherwise-specified (DNOS) in older adults.

Methods: This retrospective study utilized Medicare 5% fee-for-service claims data of 53,321 beneficiaries, aged 65+, with an OSA diagnosis prior to 2011. Study participants were evaluated using ICD-9 codes for neurocognitive syndromes [AD(n=1,057), DNOS(n=378), and MCI(n=443)] that were newly-identified between 2011-2013. Read More

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Trends in the utilization and reimbursement of coronary revascularization in the United States Medicare population from 2010 to 2018.

Catheter Cardiovasc Interv 2021 Mar 24. Epub 2021 Mar 24.

Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.

Objective: To determine utilization and reimbursement trends of coronary revascularization procedures in the US Medicare population from 2000 to 2018.

Background: US Medicare population is increasing, and coronary revascularization decreased in the 2000s.

Methods: This is a population-based, cross sectional study of US Medicare beneficiaries from 2010 to 2018. Read More

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Coronary revascularization outcomes in relation to skilled nursing facility use following hospital discharge.

Clin Cardiol 2021 Mar 23. Epub 2021 Mar 23.

Division of Cardiology, UNC School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.

Background: Observational analyses comparing coronary artery bypass surgery (CABG) and percutaneous coronary intervention (PCI) among elderly or frail patients are likely biased by treatment selection. PCI is typically chosen for frail patients, while CABG is more common for patients with good recovery potential.

Hypothesis: We hypothesized that skilled nursing facility (SNF) use after revascularization is a measure of relative frailty associated with outcomes following coronary revascularization. Read More

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U.S. Preventive Services Task Force Update and Computed Tomography for Colorectal Cancer Screening Among Privately Insured Population.

Am J Prev Med 2021 Mar 19. Epub 2021 Mar 19.

Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, Georgia; Department of Radiology and Imaging Sciences, School of Medicine, Emory University, Atlanta, Georgia. Electronic address:

Introduction: The Affordable Care Act of 2010 mandated private health plans to fully cover the services recommended by the U.S. Preventive Services Task Force. Read More

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Hospice care utilisation among elderly patients who died with hepatocellular carcinoma in the United States.

JHEP Rep 2021 Apr 27;3(2):100236. Epub 2021 Jan 27.

Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, USA.

Background & Aims: The benefits of hospice care in Medicare recipients with hepatocellular carcinoma (HCC) have not been fully evaluated, which we aimed to study.

Methods: We used nationally representative samples of the Medicare beneficiaries in the USA (2011-2016) to assess the impact of hospice care on the outcomes of patients with HCC. Hospice care benefits on the survival time, length of stay (LOS), 30-day readmissions, and daily charges during the last year and month of life were assessed by logistic regression and generalised linear regression. Read More

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Inpatient rehabilitation service utilization and outcomes under US ACA Medicaid expansion.

BMC Health Serv Res 2021 Mar 20;21(1):258. Epub 2021 Mar 20.

Department of Epidemiology and Environmental Health, Division of Health Services Policy and Practice, The State University of New York - Buffalo, Buffalo, NY, USA.

Background: To investigate the impact of the US Medicaid expansion on care utilization and health outcomes of patients treated in the inpatient rehabilitation facilities (IRF).

Methods: A retrospective observational study with a difference-in-difference design. The data was obtained from Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI). Read More

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Prevalence of Concurrent Functional Vision and Hearing Impairment and Association With Dementia in Community-Dwelling Medicare Beneficiaries.

JAMA Netw Open 2021 Mar 1;4(3):e211558. Epub 2021 Mar 1.

Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

Importance: Impairments in vision or hearing are common and have been independently linked to higher risk of dementia in older adults. There is a limited understanding of the prevalence of concurrent functional vision and hearing impairment (dual sensory impairment) and its contribution to dementia risk.

Objective: To examine the age-specific prevalence of functional dual sensory impairment among older adults, and to investigate the cross-sectional and 7-year longitudinal associations between functional dual sensory impairment and dementia. Read More

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Evaluation of State Cannabis Laws and Rates of Self-harm and Assault.

JAMA Netw Open 2021 Mar 1;4(3):e211955. Epub 2021 Mar 1.

Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, Palo Alto, California.

Importance: State cannabis laws are changing rapidly. Research is inconclusive about their association with rates of self-harm and assault. Existing studies have not considered variations in cannabis commercialization across states over time. Read More

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US national trends in bariatric surgery: A decade of study.

Surgery 2021 Mar 10. Epub 2021 Mar 10.

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

Background: Since the 1990s, the number of bariatric surgeries has dramatically increased, including the number of bariatric centers in the United States; no recent studies have yet assessed trends of bariatric surgery. This study aims to assess the trends of bariatric surgery and the change in utilization by the type of surgery, from 2006 to 2015, using real-world data.

Methods: A cross-sectional analysis of MarketScan databases of privately insured beneficiaries aged equal to or more than 18 years, to assess the annual incidence rate of bariatric surgery type of surgery from 2006 to 2015. Read More

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Implications of the End-Stage Renal Disease Treatment Choices Model among U.S. Dialysis Providers.

Nephrol Nurs J 2021 Jan-Feb;48(1):11-17

Executive Director, Quality Insights.

The End Stage Renal Disease Treatment Choices (ETC) Model is a mandatory payment model designed to encourage greater use of home dialysis and kidney transplantation among Medicare beneficiaries with kidney failure and to reduce Medicare expenditures while enhancing the quality of care offered to patients with kidney failure. The ETC model will run for six years, from January 1, 2021, to June 30, 2027. This article provides an overview of the ETC Model and analyzes its implications for dialysis providers. Read More

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Rural/urban differences in discharge from rehabilitation in older adults with traumatic brain injury.

J Am Geriatr Soc 2021 Mar 6. Epub 2021 Mar 6.

Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island, USA.

Background/objectives: Rates of traumatic brain injury (TBI) among older adults and treatment of this population in nursing homes are increasing. The objective of this study is to examine differences in the quality of care and outcomes of older adults with TBI in rural and urban settings by (1) comparing the rates of successful community discharge; and (2) reasons for not achieving successful discharge among patients in rural and urban environments.

Design: Retrospective national cohort study of skilled nursing facility (SNF) patients using Medicare inpatient claims linked with Minimum Data Set assessments. Read More

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Change in Denture Procedures after Implementation of National Health Insurance Coverage for the Elderly in Korea: A Nationwide Database.

Int J Environ Res Public Health 2021 Feb 25;18(5). Epub 2021 Feb 25.

Laboratory of Health & Exercise Science, Sahmyook University, Seoul 01795, Korea.

Background: Dental health is an important factor in daily life routines and is closely associated with maintaining a health-related quality of life. This study examined denture procedure changes after implementation of the National Health Insurance (NHI) Coverage of Dentures for the elderly.

Methods: We used the "Korean Community Health Survey (KCHS)" developed by the Korea Centers for Diseases Control and Prevention. Read More

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February 2021

Frailty and Post-hospitalization Outcomes in Patients With Heart Failure With Preserved Ejection Fraction.

Am J Cardiol 2021 Mar 3. Epub 2021 Mar 3.

Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama.

Given the role of comorbid conditions in the pathophysiology of HFpEF, we aimed to identify and rank the importance of comorbid conditions associated with post-hospitalization outcomes of older adults hospitalized for HFpEF. We examined data from 4,605 Medicare beneficiaries hospitalized in 2007-2014 for HFpEF based on ICD-9-CM codes for acute diastolic heart failure (428.31 or 428. Read More

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Rehabilitation Response to COVID-19: Optimizing Recovery and Social Reintegration for Military Beneficiaries.

Med J (Ft Sam Houst Tex) 2021 Jan-Mar(PB 8-21-01/02/03):70-78

Chair, Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences; Chief, Department of Rehabilitation, Walter Reed National Military Medical Center.

COVID-19 is a novel disease with complex primary and secondary health effects that may significantly impact the functional independence and quality of life of patients and their families. While the term "rehabilitation" is often associated with exercise, the interventions employed by rehabilitation professionals in both the inpatient and outpatient setting are much more complex and very relevant in caring for individuals hospitalized with respiratory infections. Since the start of the pandemic, the Department of Rehabilitation at Walter Reed National Military Medical Center has cared for over 85% of the military beneficiaries admitted to the hospital for COVID-19. Read More

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Racial disparities in diabetes care among incident breast, prostate, and colorectal cancer survivors: a SEER Medicare study.

J Cancer Surviv 2021 Mar 4. Epub 2021 Mar 4.

Weill Cornell Medicine, New York, NY, USA.

Background: Many cancer survivors with co-morbid diabetes receive less diabetes management than their non-cancer counterparts. We sought to determine if racial/ethnic disparities exist in recommended diabetes care within 12 months of an incident breast, prostate, or colorectal cancer diagnosis. Because co-morbid diabetes decreases long-term survival, identifying predictors of guideline-concordant diabetes care is important. Read More

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What Works to Address Violence Against Children (VAC) in and Around Schools.

Trauma Violence Abuse 2021 Mar 3:1524838021998309. Epub 2021 Mar 3.

Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.

Violence against children (VAC) is a pervasive, global issue with both short- and long-term health, social, and economic consequences. This systematic review sought to identify best practices for designing and implementing social and behavior change communication (SBCC) programs targeting VAC in and around schools. Combinations of key search terms within five domains were entered into four databases: PubMed Central, Google Scholar, Sociological Abstracts, and EBSCOhost. Read More

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Evaluation of statin discontinuation stratified by primary versus secondary prevention following bariatric surgery: a retrospective cohort study.

Surg Obes Relat Dis 2021 Jan 29. Epub 2021 Jan 29.

Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, Florida; Center for Drug Evaluation and Safety-University of Florida, Gainesville, Florida. Electronic address:

Background: Bariatric surgery leads to an improvement in hyperlipidemia and a subsequent decline in the use of hyperlipidemia-related medications, including statins. In patients with a history of atherosclerotic cardiovascular disease (ASCVD), it is recommended to continue statins; however, it is unknown whether there is a differential risk for statin discontinuation in patients with and without a history of ASCVD.

Objectives: To estimate the rates and factors associated with statin discontinuation following bariatric surgery. Read More

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January 2021

Prevalence of statin utilization and adherence among privately insured subjects in the Commonwealth of Puerto Rico.

J Manag Care Spec Pharm 2021 Mar;27(3):392-398

Irma L Rangel College of Pharmacy, Texas A&M University, College Station, TX.

Puerto Ricans are the Hispanic subgroup with the highest adjusted prevalence of statin-eligible patients. However, no study has described statin utilization and adherence among subjects living on the island of Puerto Rico. To (a) estimate the prevalence of beneficiaries with diabetes aged between 40 and 75 years; (b) estimate the prevalence of statin utilization among beneficiaries with diabetes; and (c) estimate secondary adherence to statins among beneficiaries with diabetes. Read More

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Health care resource utilization and costs among adult patients with hemophilia A on factor VIII prophylaxis: an administrative claims analysis.

J Manag Care Spec Pharm 2021 Mar;27(3):316-326

Division of Pediatric Hematology/Oncology, Rady Children's Hospital, San Diego, CA.

Standard of care for bleed prevention in patients with severe congenital hemophilia A is continuous prophylaxis with factor VIII (FVIII), typically administered intravenously 2-3 times per week in the home setting. Nonfactor prophylaxis and gene therapy are emerging novel prophylaxis strategies for hemophilia A, and it is important to compare their health economics with that of FVIII prophylaxis. Current data on resource utilization and costs in the adult hemophilia A prophylaxis population are limited, and a structured approach to analyze annual costs in these patients using administrative claims data has not been previously reported. Read More

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A data visualisation method for assessing exposure misclassification in case-crossover studies: the example of tricyclic antidepressants and the risk of hip fracture in older people.

BMC Med Res Methodol 2021 Feb 27;21(1):43. Epub 2021 Feb 27.

Quality Use of Medicines and Pharmacy Research Centre (QUMPRC), UniSA Clinical and Health Sciences, CEA-19, University of South Australia, Adelaide, SA, 5001, Australia.

Background: The case-crossover design is suited to medication safety studies but is vulnerable to exposure misclassification. Using the example of tricyclic antidepressants and the risk of hip fracture, we present a data visualisation tool for observing exposure misclassification in case-crossover studies.

Methods: A case-crossover study was conducted using Australian Government Department of Veterans' Affairs claims data. Read More

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February 2021

Healthcare resource utilization and costs of major atherothrombotic vascular events among patients with peripheral artery disease after revascularization.

J Med Econ 2021 Jan-Dec;24(1):402-409

Division of Cardiology, University of Colorado School of Medicine, Denver, CO, USA.

Aims: Peripheral artery disease (PAD), often treated with lower extremity revascularization, is associated with risk of major atherothrombotic vascular events (acute limb ischemia [ALI], major non-traumatic lower-limb amputation, myocardial infarction [MI], ischemic stroke, cardiovascular death). This study aims to assess healthcare resource utilization and costs of such events among patients with PAD after revascularization.

Materials And Methods: Patients aged ≥50 years with PAD who were treated with lower-extremity revascularization were identified from Optum Clinformatics Data Mart claims database (01/2014-06/2019). Read More

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February 2021

Trends and racial disparities in aggressive end-of-life care for a national sample of women with ovarian cancer.

Cancer 2021 Feb 25. Epub 2021 Feb 25.

Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, Michigan.

Background: The clinical landscape has moved toward less aggressive end-of-life care for women with ovarian cancer. However, whether there has been a decline in the use of aggressive end-of-life services is unknown. The authors evaluated current national trends and racial disparities in end-of-life care among women with ovarian cancer using the Surveillance, Epidemiology, and End Results-Medicare-linked data set. Read More

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February 2021

Estimated Medicaid Costs Associated with Hepatitis A During an Outbreak - West Virginia, 2018-2019.

MMWR Morb Mortal Wkly Rep 2021 Feb 26;70(8):269-272. Epub 2021 Feb 26.

Hepatitis A is a vaccine-preventable disease caused by the hepatitis A virus (HAV). Transmission of the virus most commonly occurs through the fecal-oral route after close contact with an infected person. Widespread outbreaks of hepatitis A among persons who use illicit drugs (injection and noninjection drugs) have increased in recent years (1). Read More

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February 2021

Association between exenatide use and incidence of Alzheimer's disease.

Alzheimers Dement (N Y) 2021 14;7(1):e12139. Epub 2021 Feb 14.

USC Schaeffer Center for Health Policy and Economics Los Angeles California USA.

Introduction: Recent developments suggest that insulin-sensitizing agents used to treat type II diabetes (T2DM) may also prove useful in reducing the risk of Alzheimer's disease (AD). The objective of this study is o analyze the association between exenatide use among Medicare beneficiaries with T2DM and the incidence of AD.

Methods: We performed a retrospective cohort analysis on claims data from a 20% random sample of Medicare beneficiaries with T2DM from 2007 to 2013 (n = 342,608). Read More

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February 2021