27,613 results match your criteria elderly medicare


Assessment of Potentially Preventable Hospital Readmissions After Major Surgery and Association With Public vs Private Health Insurance and Comorbidities.

JAMA Netw Open 2021 Apr 1;4(4):e215503. Epub 2021 Apr 1.

Department of Surgery, University of Michigan, Ann Arbor.

Importance: Rehospitalization after major surgery is common and represents a significant cost to the health care system. Little is known regarding the causes of these readmissions and the degree to which they may be preventable.

Objective: To evaluate the degree to which readmissions after major surgery are potentially preventable. Read More

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Schizophrenia hospitalization in the US 2005-2014: Examination of trends in demographics, length of stay, and cost.

Medicine (Baltimore) 2021 Apr;100(15):e25206

Health Policy and Leadership, School of Public Health, Loma Linda University, Los Angeles CA.

Abstract: Primarily we aimed to examine the crude and standardized schizophrenia hospitalization trend from 2005 to 2014. We hypothesized that there will be a statistically significant linear trend in hospitalization rates for schizophrenia from 2005 to 2014. Secondarily we also examined trends in hospitalization by race/ethnicity, age, gender, as well as trends in hospitalization Length of Stay (LOS) and inflation adjusted cost. Read More

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Physicians Treating Alzheimer's Disease Patients Should Be Aware that Televised Direct-to-Consumer Advertising Links More Strongly to Drug Utilization in Older Patients.

Authors:
Robin Feldman

J Alzheimers Dis 2021 Apr 5. Epub 2021 Apr 5.

Arthur J. Goldberg Distinguished Professor of Law and Director of the Center for Innovation at University of California, Hastings Law, San Francisco, CA, USA.

Background: US direct-to-consumer advertising spending for medicine has soared in recent decades. Advertising has been shown to impact drug utilization. Most Alzheimer's disease patients are above age 65 and may take a range of prescription medications for various disease states. Read More

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Bariatric surgery outcomes in Medicare beneficiaries.

Obes Sci Pract 2021 Apr 22;7(2):176-191. Epub 2020 Dec 22.

Department of Surgery University of Minnesota Minneapolis Minnesota USA.

Background: The Medicare population is increasing while the prevalence of obesity remains high. Bariatric surgery is the most efficacious treatment of obesity and its comorbidities. The objective of this investigation was to assess trends in utilization, readmission, mortality, and cost of bariatric surgery in the Medicare population. Read More

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Decomposing Racial and Ethnic Disparities in Nursing Home Influenza Vaccination.

J Am Med Dir Assoc 2021 Apr 7. Epub 2021 Apr 7.

Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI, USA; Center for Gerontology and Healthcare Research, Brown University School of Public Health, Providence, RI, USA; Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA; Center of Innovation in Long-Term Services and Supports, Providence Veterans Affairs Medical Center, Providence, RI, USA.

Objectives: Quantify how observable characteristics contribute to influenza vaccination disparities among White, Black, and Hispanic nursing home (NH) residents.

Design: Retrospective cohort.

Setting And Participants: Short- and long-stay U. Read More

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What a mesh! An Australian experience using national female continence surgery trends over 20 years.

World J Urol 2021 Apr 9. Epub 2021 Apr 9.

Department of Urology, Austin Health, Melbourne, VIC, Australia.

Purpose: To review the evolution of female continence surgical practice in Australia over the last 20 years and observe whether vaginal mesh controversies impacted these trends.

Materials And Methods: From January 2000 to December 2019, medicare benefit schedule codes for female continence procedures were identified and extracted for: mesh sling, fascial sling, bulking agent, female urethral prosthesis, colposuspension, and removal of sling. Population-adjusted incidences per 100,000 persons were calculated using publicly available demographic data. Read More

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Trends in Emergency Department Utilization Among Women With Leiomyomas in the United States.

Obstet Gynecol 2021 Apr 8. Epub 2021 Apr 8.

Division of Reproductive Endocrinology and Infertility and the Division of Gynecology, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, and the Department of Emergency Medicine, Henry Ford Hospital, Detroit, Michigan.

Objective: To describe trends in emergency department (ED) visits in the United States with a primary diagnosis of leiomyomas, subsequent admissions, and associated charges.

Methods: The Healthcare Cost and Utilization Project Nationwide Emergency Department Sample database was used to retrospectively identify all ED visits from 2006 to 2017 among women aged 18-55 years with a primary diagnosis of leiomyomas as indicated by International Classification of Diseases (ICD) diagnosis codes. Trends in ED visits and subsequent admissions were analyzed and stratified by patient and hospital characteristics. Read More

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Quality of Preventive and Chronic Illness Care for Insured Adults With Opioid Use Disorder.

JAMA Netw Open 2021 Apr 1;4(4):e214925. Epub 2021 Apr 1.

Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

Importance: Nearly all initiatives to improve care for individuals with opioid use disorder (OUD) have focused on improving OUD identification and treatment. Whether individuals with OUD have lower quality of care than individuals without OUD remains unclear.

Objective: To measure quality of non-OUD preventive and chronic illness care and care coordination for individuals with OUD compared with individuals without OUD. Read More

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Linking Australian Stroke Clinical Registry data with Australian government Medicare and medication dispensing claims data and the potential for bias.

Aust N Z J Public Health 2021 Apr 5. Epub 2021 Apr 5.

Stroke & Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Victoria.

Objective: We aim to report the accuracy of linking data from a non-government-held clinical quality registry to national claims data and identify associated sources of systematic bias.

Methods: Patients with stroke or transient ischaemic attack admitted to hospitals participating in the Australian Stroke Clinical Registry (AuSCR) were linked with Medicare and medication dispensings through the Australian Medicare enrolment file (MEF). The proportion of registrants in the datasets was calculated and factors associated with a non-merge assessed using multivariable analyses. Read More

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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

U.S. State Life Tables, 2018.

Natl Vital Stat Rep 2021 Mar;70(1):1-18

Objectives-This report presents complete period life tables for each of the 50 states and the District of Columbia by sex based on age-specific death rates in 2018. Methods-Data used to prepare the 2018 state-specific life tables include 2018 final mortality statistics; July 1, 2018 population estimates based on the 2010 decennial census; and 2018 Medicare data for persons aged 66-99. The methodology used to estimate the state-specific life tables is the same as that used to estimate the 2018 national life tables, with some modifications. Read More

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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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Association of immune-checkpoint inhibitors and the risk of immune-related colitis among elderly patients with advanced melanoma: real-world evidence from the SEER-Medicare database.

Ther Adv Drug Saf 2021 2;12:2042098621991279. Epub 2021 Feb 2.

Center for Health Outcomes and PharmacoEconomic Research, University of Arizona, Drachman Hall room B306H, 1295 N. Martin Avenue, Tucson, AZ 85721, USA.

Background: The use of anti-cytotoxic T-lymphocyte antigen 4 (anti-CTLA4) therapy (ipilimumab) and anti-programmed cell-death 1 (anti-PD1) agents (nivolumab and pembrolizumab) in advanced melanoma have been associated with immune-related adverse events (irAEs) including colitis. We aimed to estimate the incidence and the risk of colitis in elderly patients with advanced melanoma treated with anti-CTLA4 and anti-PD1 in the real-world setting.

Methods: Elderly patients (age ⩾ 65 years) diagnosed with advanced melanoma between 2011 and 2015 and treated with anti-CTLA4 or anti-PD1 agents were identified from the Surveillance, Epidemiology, and End Results (SEER)-Medicare data. Read More

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February 2021

Clinical characteristics and outcomes for 7,995 patients with SARS-CoV-2 infection.

PLoS One 2021 31;16(3):e0243291. Epub 2021 Mar 31.

Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut, United States of America.

Objective: Severe acute respiratory syndrome virus (SARS-CoV-2) has infected millions of people worldwide. Our goal was to identify risk factors associated with admission and disease severity in patients with SARS-CoV-2.

Design: This was an observational, retrospective study based on real-world data for 7,995 patients with SARS-CoV-2 from a clinical data repository. Read More

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Risk Factors Associated With SARS-CoV-2 Infections, Hospitalization, and Mortality Among US Nursing Home Residents.

JAMA Netw Open 2021 03 1;4(3):e216315. Epub 2021 Mar 1.

Sealy Center on Aging, Department of Internal Medicine, The University of Texas Medical Branch, Galveston.

Importance: Nursing home residents account for approximately 40% of deaths from SARS-CoV-2.

Objective: To identify risk factors for SARS-CoV-2 incidence, hospitalization, and mortality among nursing home residents in the US.

Design, Setting, And Participants: This retrospective longitudinal cohort study was conducted in long-stay residents aged 65 years or older with fee-for-service Medicare residing in 15 038 US nursing homes from April 1, 2020, to September 30, 2020. Read More

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Adverse Drug Event Risk Assessment by the Virtual Addition of COVID-19 Repurposed Drugs to Medicare and Commercially Insured Patients' Drug Regimens: A Drug Safety Simulation Study.

Clin Transl Sci 2021 Mar 30. Epub 2021 Mar 30.

TRHC, Precision Pharmacotherapy Research & Development Institute, 13485 Veterans Way, Suite 410, Orlando, FL, 32827, USA.

Drug safety is generally established from clinical trials, by pharmacovigilance programs and during observational Phase IV safety studies according to drug intended or approved indications. The objective of this study was to estimate the risk of potential adverse drug events (ADE) associated with drugs repurposed for COVID-19 treatment in a large-scale population. Drug claims were used to calculate a baseline medication risk score (MRS) indicative of ADE risk level. Read More

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Impact of Radiation on Cardiovascular Outcomes in Older Resectable Esophageal Cancer Patients With Medicare.

Am J Clin Oncol 2021 Mar 29. Epub 2021 Mar 29.

University of California San Diego School of Medicine Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla Department of Radiation Oncology, Stanford University, Stanford, CA Center for Health Research, Kaiser Permanente Northwest, Portland, OR.

Objectives: Preoperative radiotherapy improves outcomes for operable esophageal cancer patients, though the proximity of the heart to the esophagus puts patients at risk of radiation-induced cardiovascular disease. This study characterizes the impact of radiotherapy and different radiation techniques on cardiovascular morbidity among a cohort of esophageal cancer patients.

Materials And Methods: We identified 1125 patients aged 65 and older diagnosed between 2000 and 2011 with esophageal cancer who received surgery alone, or surgery preceded by either preoperative chemotherapy or preoperative chemoradiation from the Surveillance Epidemiology and End Results (SEER)-Medicare database. Read More

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Life Expectancy and Treatment Patterns in Elderly Patients With Low-Risk Papillary Thyroid Cancer: A Population-Based Analysis.

Endocr Pract 2021 Mar 14;27(3):228-235. Epub 2020 Dec 14.

Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York. Electronic address:

Objective: Guidelines endorse active surveillance for low-risk papillary thyroid carcinoma (PTC), but this is not commonly utilized. Those with limited life expectancy due to age and comorbidity may be best suited for active surveillance given their higher likelihood of other-cause mortality compared to disease-specific mortality.

Methods: Surveillance, epidemiology, and end results-Medicare was queried for patients >65 years with T1, N0, M0 PTC who received surgery. Read More

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Effect of compliance with GOLD treatment recommendations on COPD health care resource utilization, cost, and exacerbations among patients with COPD on maintenance therapy.

J Manag Care Spec Pharm 2021 Mar 29:1-13. Epub 2021 Mar 29.

HealthCore, Wilmington, DE.

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) report for the management of chronic obstructive pulmonary disease (COPD) focuses on reducing existing symptoms, decreasing the risk of future exacerbations, and improving health status by recommending specific drug therapy based on exacerbation risk and symptoms. However, disparities exist between evidence-based recommendations and clinical practice. Research that quantifies the real-world effect of COPD regimen alignment with the GOLD recommendations on clinical and economic outcomes is needed. Read More

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Cancer diagnoses and survival rise as 65-year-olds become Medicare-eligible.

Cancer 2021 Mar 29. Epub 2021 Mar 29.

Division of Thoracic Surgery, Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, California.

Background: A Medicare effect has been described to account for increased health care utilization occurring at the age of 65 years. The existence of such an effect in cancer care, where it would be most likely to reduce mortality, has been unclear.

Methods: Patients aged 61 to 69 years who were diagnosed with lung, breast, colon, or prostate cancer from 2004 to 2016 were identified with the Surveillance, Epidemiology, and End Results database and were dichotomized on the basis of eligibility for Medicare (61-64 vs 65-69 years). Read More

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How Well Does the Brief Interview for Mental Status Identify Risk for Cognition Mediated Functional Impairment in a Community Sample?

Arch Rehabil Res Clin Transl 2021 Mar 13;3(1):100102. Epub 2021 Jan 13.

University of Wisconsin-Madison, Department of Kinesiology-Occupational Therapy, Madison, WI.

Objective: To determine the adequacy of the Brief Interview for Mental Status (BIMS) compared with other screening tools in identifying individuals with limitations in functional cognition and instrumental activities of daily living (IADL).

Design: Cross-sectional observational study.

Setting: Midsized midwestern city. Read More

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Examining the association of medical-dental integration with closure of medical care gaps among the elderly population.

J Am Dent Assoc 2021 Apr;152(4):302-308

Background: The integration of medical and dental care in the dental setting offers a unique opportunity to close medical care gaps, such as providing immunizations and laboratory-based tests, compared with traditional nonintegrated settings.

Methods: We used a matched cohort study design among patients 65 years or older (n = 2,578) with an index dental visit to the Kaiser Permanente Northwest medical-dental integration (MDI) program from June 1, 2018, through December 31, 2019. MDI patients were matched 1:1 to non-MDI controls (n = 2,578) on 14 characteristics. Read More

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Alignment of diagnosis and pharmacy claims data coding of medication adherence among patients with diabetes or hypertension.

J Manag Care Spec Pharm 2021 Apr;27(4):497-506

Division of Nephrology, University of Tennessee Health Science Center, and Memphis VA Medical Center, Memphis, TN.

ICD-10-CM codes exist that facilitate provider designation of patients as "nonadherent to therapy"; however, it is unclear whether this label accurately reflects patient behavior according to widely accepted medication adherence metrics using pharmacy claims data. To determine the extent to which patients are accurately coded for and have calculated rates of nonadherence using ICD-10-CM codes and claims, respectively. This was a retrospective cohort study using commercial insurance and Medicare Advantage claims data from 2015 to 2016. 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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Racial/Ethnic Disparities in Interhospital Transfer for Conditions With a Mortality Benefit to Transfer Among Patients With Medicare.

JAMA Netw Open 2021 Mar 1;4(3):e213474. Epub 2021 Mar 1.

Harvard Medical School, Boston, Massachusetts.

Importance: Interhospital transfer (IHT) of patients is a common occurrence in modern health care. Racial/ethnic disparities are prevalent throughout US health care, but their presence in IHT is not well characterized.

Objective: To determine if there are racial/ethnic disparities in IHT for medical diagnoses for which IHT is associated with a mortality benefit. Read More

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Marked Increase in Spinal Deformity Surgery Throughout the United States.

Spine (Phila Pa 1976) 2021 Mar 23. Epub 2021 Mar 23.

Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, The Spine Center at Pennsylvania Hospital, University of Pennsylvania Hospital System, Philadelphia, PA United States Department of Orthopaedic Surgery, Columbia University Medical Center, The Spine Hospital at New York-Presbyterian, New York, NY United States Department of Orthopaedic Surgery, Yale School of Medicine, New Haven, CT United States Department of Neurological Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA United States.

Study Design: Retrospective Cohort Database Study.

Objective: To investigate trends in utilization and demographics in Spinal Deformity Surgery.

Summary Of Background Data: The aging population in the United States will likely result in increased incidence of adult degenerative scoliosis. Read More

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