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Medical Care

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https://www.readbyqxmd.com/read/28617703/using-self-reports-or-claims-to-assess-disease-prevalence-it-s-complicated
#1
Patricia St Clair, Étienne Gaudette, Henu Zhao, Bryan Tysinger, Roxanna Seyedin, Dana P Goldman
BACKGROUND: Two common ways of measuring disease prevalence include (1) using self-reported disease diagnosis from survey responses; (2) using disease-specific diagnosis codes found in administrative data. Because they do not suffer from self-report biases, claims are often assumed to be more objective. However, it is not clear that claims always produce better prevalence estimates. OBJECTIVE: Conduct an assessment of discrepancies between self-report and claims-based measures for 2 diseases in the US elderly to investigate definition, selection, and measurement error issues which may help explain divergence between claims and self-report estimates of prevalence...
June 14, 2017: Medical Care
https://www.readbyqxmd.com/read/28598891/effect-of-direct-to-consumer-advertising-dtca-on-statin-use-in-the-united-states
#2
Hsien-Yen Chang, Irene Murimi, Matthew Daubresse, Dima M Qato, Sherry L Emery, G Caleb Alexander
IMPORTANCE: The value of direct-to-consumer advertising (DTCA) of prescription drugs is widely debated, as is the effect of DTCA on prescription sales and health care utilization. OBJECTIVE: We examined the association between DTCA intensity for statin medications and prescription sales and cholesterol-related health care utilization. DESIGN, SETTING, AND PARTICIPANTS: We conducted an ecological study for 75 designated market areas from 2005 to 2009 in the United States using linked data regarding televised DTCA volume, non-DTCA marketing and promotion, retail, mail order and long-term care prescription drug sales, prescription drug and ambulatory care health care utilization, and contextual factors such as health care density and socioeconomic status...
June 8, 2017: Medical Care
https://www.readbyqxmd.com/read/28598890/comparing-population-based-risk-stratification-model-performance-using-demographic-diagnosis-and-medication-data-extracted-from-outpatient-electronic-health-records-versus-administrative-claims
#3
Hadi Kharrazi, Winnie Chi, Hsien-Yen Chang, Thomas M Richards, Jason M Gallagher, Susan M Knudson, Jonathan P Weiner
BACKGROUND: There is an increasing demand for electronic health record (EHR)-based risk stratification and predictive modeling tools at the population level. This trend is partly due to increased value-based payment policies and the increasing availability of EHRs at the provider level. Risk stratification models, however, have been traditionally derived from claims or encounter systems. This study evaluates the challenges and opportunities of using EHR data instead of or in addition to administrative claims for risk stratification...
June 8, 2017: Medical Care
https://www.readbyqxmd.com/read/28590958/constructing-a-measure-of-private-pay-nursing-home-days
#4
Kali S Thomas, Benjamin Silver, Pedro L Gozalo, David Dosa, David C Grabowski, Rajesh Makineni, Vincent Mor
BACKGROUND: Nursing home (NH) care is financed through multiple sources. Although Medicaid is the predominant payer for NH care, over 20% of residents pay out-of-pocket for their care. Despite this large percentage, an accepted measure of private-pay NH occupancy has not been established and little is known about the types of facilities and the long-term care markets that cater to this population. OBJECTIVES: To describe 2 novel measures of private-pay utilization in the NH setting, including the proportion of privately financed residents and resident days, and examine their construct validity...
June 6, 2017: Medical Care
https://www.readbyqxmd.com/read/28549001/contribution-of-natural-language-processing-in-predicting-rehospitalization-risk
#5
Christopher Norman, Thu Van Nguyen, Aurélie Névéol
No abstract text is available yet for this article.
May 25, 2017: Medical Care
https://www.readbyqxmd.com/read/28614185/survey-instruments-to-assess-patient-experiences-with-access-and-coordination-across-health-care-settings-available-and-needed-measures
#6
Martha Quinn, Claire Robinson, Jane Forman, Sarah L Krein, Ann-Marie Rosland
BACKGROUND: Improving access can increase the providers a patient sees, and cause coordination challenges. For initiatives that increase care across health care settings, measuring patient experiences with access and care coordination will be crucial. OBJECTIVES: Map existing survey measures of patient experiences with access and care coordination expected to be relevant to patients accessing care across settings. Preliminarily examine whether aspects of access and care coordination important to patients are represented by existing measures...
July 2017: Medical Care
https://www.readbyqxmd.com/read/28614184/coordinating-care-across-health-care-systems-for-veterans-with-gynecologic-malignancies-a-qualitative-analysis
#7
Jessica L Zuchowski, Joya G Chrystal, Alison B Hamilton, Elizabeth W Patton, Laurie C Zephyrin, Elizabeth M Yano, Kristina M Cordasco
BACKGROUND: Veterans concurrently using both Veterans Affairs (VA) and community providers and facilities have increased coordination needs related to bridging their care across health care settings. Women Veterans commonly require a combination of VA and community care if they have women-specific specialty care needs, such as gynecologic malignancies. OBJECTIVES: We assessed VA women's health providers' and administrators' perceptions of coordination challenges for Veterans' gynecologic cancer care, and potential approaches for addressing these challenges...
July 2017: Medical Care
https://www.readbyqxmd.com/read/28614178/patterns-of-opioid-use-and-risk-of-opioid-overdose-death-among-medicaid-patients
#8
Renu K Garg, Deborah Fulton-Kehoe, Gary M Franklin
BACKGROUND: The Centers for Disease Control and Prevention recognizes Medicaid as a high-risk population for fatal opioid overdose. Further research is needed to identify factors that put Medicaid patients at increased risk. OBJECTIVE: To determine whether patterns of opioid use are associated with risk of opioid-related mortality among opioid users. DESIGN: This is a retrospective cohort study. PATIENTS: In total, 150,821 noncancer pain patients aged 18-64 years with ≥1 opioid prescription, April 2006 to December 2010, Washington Medicaid...
July 2017: Medical Care
https://www.readbyqxmd.com/read/28614177/the-affordable-care-act-reduces-hypertension-treatment-disparities-for-mexican-heritage-latinos
#9
Ryan M McKenna, Héctor E Alcalá, Félice Lê-Scherban, Dylan H Roby, Alexander N Ortega
OBJECTIVES: Mexican-heritage Latinos have lower prevalence of hypertension, but have worse patterns of treatment and control compared with non-Latino whites. This study examined the impact of the Affordable Care Act (ACA) insurance expansion on reducing disparities in treatment and medication use among Mexican-heritage Latinos with hypertension. RESEARCH DESIGN: Using the 2009-2014 waves of the California Health Interview Survey, we examine health care access, utilization, and medication use among Mexican-heritage Latinos and non-Latino whites with hypertension...
July 2017: Medical Care
https://www.readbyqxmd.com/read/28538332/examining-drivers-of-health-care-spending-evidence-on-self-referral-among-a-privately-insured-population
#10
Jean M Mitchell, James D Reschovsky, Roy J Film, Luisa Franzini
BACKGROUND: Despite the enactment of laws to restrict the practice of self-referral, exceptions in these prohibitions have enabled these arrangements to persist and proliferate. Most research documenting the effects of self-referral arrangements analyzed claims records from Medicare beneficiaries. Empirical evidence documenting the effects of self-referral on use of services and spending incurred by persons with private insurance is sparse. OBJECTIVES: We analyzed health insurance claims records from a large private insurer in Texas to evaluate the effects of physician self-referral arrangements involving physical therapy on the treatment of patients with frozen shoulder syndrome, elbow tendinopathy or tendinitis, and patellofemoral pain syndrome...
July 2017: Medical Care
https://www.readbyqxmd.com/read/28498200/evaluating-the-veterans-choice-program-lessons-for-developing-a-high-performing-integrated-network
#11
Kristin M Mattocks, Baligh Yehia
No abstract text is available yet for this article.
July 2017: Medical Care
https://www.readbyqxmd.com/read/28498199/incorporating-alternative-care-site-characteristics-into-estimates-of-substitutable-ed-visits
#12
Nathan Seth Trueger, Kao-Ping Chua, Aamir Hussain, Aisha T Liferidge, Stephen R Pitts, Jesse M Pines
BACKGROUND: Several recent efforts to improve health care value have focused on reducing emergency department (ED) visits that potentially could be treated in alternative care sites (ie, primary care offices, retail clinics, and urgent care centers). Estimates of the number of these visits may depend on assumptions regarding the operating hours and functional capabilities of alternative care sites. However, methods to account for the variability in these characteristics have not been developed...
July 2017: Medical Care
https://www.readbyqxmd.com/read/28498198/development-of-a-risk-adjustment-model-for-the-inpatient-rehabilitation-facility-discharge-self-care-functional-status-quality-measure
#13
Anne Deutsch, Poonam Pardasaney, Jeniffer Iriondo-Perez, Melvin J Ingber, Kristie A Porter, Tara McMullen
BACKGROUND: Functional status measures are important patient-centered indicators of inpatient rehabilitation facility (IRF) quality of care. We developed a risk-adjusted self-care functional status measure for the IRF Quality Reporting Program. This paper describes the development and performance of the measure's risk-adjustment model. METHODS: Our sample included IRF Medicare fee-for-service patients from the Centers for Medicare & Medicaid Services' 2008-2010 Post-Acute Care Payment Reform Demonstration...
July 2017: Medical Care
https://www.readbyqxmd.com/read/28498197/overuse-of-health-care-services-in-the-management-of-cancer-a-systematic-review
#14
Shrujal S Baxi, Minal Kale, Salomeh Keyhani, Benjamin R Roman, Annie Yang, Antonio P Derosa, Deborah Korenstein
BACKGROUND: Overuse, the provision of health services for which harms outweigh the benefits, results in suboptimal patient care and may contribute to the rising costs of cancer care. We performed a systematic review of the evidence on overuse in oncology. METHODS: We searched Medline, EMBASE, the Cochrane Library, Web of Science, SCOPUS databases, and 2 grey literature sources, for articles published between December 1, 2011 and March 10, 2017. We included publications from December 2011 to evaluate the literature since the inception of the ABIM Foundation's Choosing Wisely initiative in 2012...
July 2017: Medical Care
https://www.readbyqxmd.com/read/28498196/identifying-increased-risk-of-readmission-and-in-hospital-mortality-using-hospital-administrative-data-the-ahrq-elixhauser-comorbidity-index
#15
Brian J Moore, Susan White, Raynard Washington, Natalia Coenen, Anne Elixhauser
OBJECTIVE: We extend the literature on comorbidity measurement by developing 2 indices, based on the Elixhauser Comorbidity measures, designed to predict 2 frequently reported health outcomes: in-hospital mortality and 30-day readmission in administrative data. The Elixhauser measures are commonly used in research as an adjustment factor to control for severity of illness. DATA SOURCES: We used a large analysis file built from all-payer hospital administrative data in the Healthcare Cost and Utilization Project State Inpatient Databases from 18 states in 2011 and 2012...
July 2017: Medical Care
https://www.readbyqxmd.com/read/28481762/the-monthly-cycle-of-hypoglycemia-an-observational-claims-based-study-of-emergency-room-visits-hospital-admissions-and-costs-in-a-commercially-insured-population
#16
Sanjay Basu, Seth A Berkowitz, Hilary Seligman
BACKGROUND: Multipayer initiatives have sought to address social determinants of health, such as food insecurity, by linking primary care patients to social services. It remains unclear whether such social determinants contribute to avoidable short-term health care costs. OBJECTIVES: We sought to quantify costs and mitigating factors for the increased risk of hypoglycemia at the end of each month among low-income Americans, a phenomenon related to exhaustion of food budgets...
July 2017: Medical Care
https://www.readbyqxmd.com/read/28437321/medical-expenditures-associated-with-diabetes-among-youth-with-medicaid-coverage
#17
Sundar S Shrestha, Ping Zhang, Theodore J Thompson, Edward W Gregg, Ann Albright, Giuseppina Imperatore
BACKGROUND: Information on diabetes-related excess medical expenditures for youth is important to understand the magnitude of financial burden and to plan the health care resources needed for managing diabetes. However, diabetes-related excess medical expenditures for youth covered by Medicaid program have not been investigated recently. OBJECTIVE: To estimate excess diabetes-related medical expenditures among youth aged below 20 years enrolled in Medicaid programs in the United States...
July 2017: Medical Care
https://www.readbyqxmd.com/read/28437320/development-of-a-claims-based-frailty-indicator-anchored-to-a-well-established-frailty-phenotype
#18
Jodi B Segal, Hsien-Yen Chang, Yu Du, Jeremy D Walston, Michelle C Carlson, Ravi Varadhan
BACKGROUND: Fried and colleagues described a frailty phenotype measured in the Cardiovascular Health Study (CHS). This phenotype is manifest when ≥3 of the following are present: low grip strength, low energy, slowed waking speed, low physical activity, or unintentional weight loss. We sought to approximate frailty phenotype using only administrative claims data to enable frailty to be assessed without physical performance measures. STUDY DESIGN: We used the CHS cohort data linked to participants Medicare claims...
July 2017: Medical Care
https://www.readbyqxmd.com/read/28437319/quality-of-antiepileptic-treatment-among-older-medicare-beneficiaries-with-epilepsy-a-retrospective-claims-data-analysis
#19
Maria Pisu, Joshua Richman, Kendra Piper, Roy Martin, Ellen Funkhouser, Chen Dai, Lucia Juarez, Jerzy P Szaflarski, Edward Faught
BACKGROUND: Enzyme-inducing antiepileptic drugs (EI-AEDs) are not recommended for older adults with epilepsy. Quality Indicator for Epilepsy Treatment 9 (QUIET-9) states that new patients should not receive EI-AEDs as first line of treatment. In light of reported racial/ethnic disparities in epilepsy care, we investigated EI-AED use and QUIET-9 concordance across major racial/ethnic groups of Medicare beneficiaries. RESEARCH DESIGN: Retrospective analyses of 2008-2010 Medicare claims for a 5% random sample of beneficiaries 67 years old and above in 2009 augmented for minority representation...
July 2017: Medical Care
https://www.readbyqxmd.com/read/28410339/patterns-of-buprenorphine-naloxone-treatment-for-opioid-use-disorder-in-a-multistate-population
#20
Brendan Saloner, Matthew Daubresse, G Caleb Alexander
BACKGROUND: Buprenorphine-naloxone treatment for opioid use disorder has rapidly expanded, yet little is known about treatment outcomes among patients in the general population. OBJECTIVE: To examine predictors of treatment duration, dosage, and continuity in a diverse community setting. RESEARCH DESIGN: We examined QuintilesIMS Real World Data, an all-payer, pharmacy claims database, to conduct an analysis of individuals age 18 years and above initiating buprenorphine-naloxone treatment between January 2010 and July 2012 in 11 states...
July 2017: Medical Care
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