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Medical Care

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https://www.readbyqxmd.com/read/28930892/costs-and-trends-in-utilization-of-low-value-services-among-older-adults-with-commercial-insurance-or-medicare-advantage
#1
Elizabeth A Carter, Pamela E Morin, Keith D Lind
BACKGROUND: Overutilization of low-value services (unnecessary or minimally beneficial tests or procedures) has been cited as a large contributor to the high costs of health care in the United States. OBJECTIVES: To analyze trends in utilization of low-value services from 2009 to 2014 among commercial and Medicare Advantage (MA) enrollees 50 and older. RESEARCH DESIGN: A retrospective analysis of deidentified claims obtained from the OptumLab Data Warehouse...
September 19, 2017: Medical Care
https://www.readbyqxmd.com/read/28930891/2016-medical-care-student-award-papers
#2
Julie M Zito, Linda D Green
No abstract text is available yet for this article.
September 19, 2017: Medical Care
https://www.readbyqxmd.com/read/28930890/trends-in-opioid-related-inpatient-stays-shifted-after-the-us-transitioned-to-icd-10-cm-diagnosis-coding-in-2015
#3
Kevin C Heslin, Pamela L Owens, Zeynal Karaca, Marguerite L Barrett, Brian J Moore, Anne Elixhauser
BACKGROUND: Trend analyses of opioid-related inpatient stays depend on the availability of comparable data over time. In October 2015, the US transitioned diagnosis coding from International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) to ICD-10-CM, increasing from ∼14,000 to 68,000 codes. This study examines how trend analyses of inpatient stays involving opioid diagnoses were affected by the transition to ICD-10-CM. SUBJECTS: Data are from Healthcare Cost and Utilization Project State Inpatient Databases for 14 states in 2015-2016, representing 26% of acute care inpatient discharges in the US...
September 19, 2017: Medical Care
https://www.readbyqxmd.com/read/28930889/the-burden-of-mental-illness-among-veterans-use-of-vha-health-care-services-by-those-with-service-connected-conditions
#4
Charles Maynard, Adam Batten, Chuan-Fen Liu, Karin Nelson, Stephan D Fihn
BACKGROUND: Little is known about how Veterans with service-connected conditions use health care provided by the Veterans Health Administration (VHA). OBJECTIVES: To ascertain what proportion of Veterans with service-connected conditions used VHA health care and whether it varied according to type of condition, combined disability rating, age, sex, military rank, or other characteristics and whether there were differences in receipt of inpatient and outpatient care...
September 19, 2017: Medical Care
https://www.readbyqxmd.com/read/28930888/what-matters-most-to-whom-racial-ethnic-and-language-differences-in-the-health-care-experiences-most-important-to-patients
#5
Rebecca L Collins, Ann Haas, Amelia M Haviland, Marc N Elliott
BACKGROUND: Some aspects of patient experience are more strongly related to overall ratings of care than others, reflecting their importance to patients. However, little is known about whether the importance of different aspects of this experience differs across subgroups. OBJECTIVES: To determine whether the aspects of health care most important to patients differ according to patient race, ethnicity, and language preference. RESEARCH DESIGN: In response to the 2013 Medicare Consumer Assessment of Health Plans Study (CAHPS) survey, patients rated their overall health care and completed items measuring five patient experience domains...
September 19, 2017: Medical Care
https://www.readbyqxmd.com/read/28922299/redesigning-oncology-care-delivery-early-wins-lessons-learned-and-a-roadmap
#6
Arif H Kamal
No abstract text is available yet for this article.
September 15, 2017: Medical Care
https://www.readbyqxmd.com/read/28922298/the-impact-of-nondifferential-exposure-misclassification-on-the-performance-of-propensity-scores-for-continuous-and-binary-outcomes-a-simulation-study
#7
Mollie E Wood, Stavroula Chrysanthopoulou, Hedvig M E Nordeng, Kate L Lapane
PURPOSE: To investigate the ability of the propensity score (PS) to reduce confounding bias in the presence of nondifferential misclassification of treatment, using simulations. METHODS: Using an example from the pregnancy medication safety literature, we carried out simulations to quantify the effect of nondifferential misclassification of treatment under varying scenarios of sensitivity and specificity, exposure prevalence (10%, 50%), outcome type (continuous and binary), true outcome (null and increased risk), confounding direction, and different PS applications (matching, stratification, weighting, regression), and obtained measures of bias and 95% confidence interval coverage...
September 15, 2017: Medical Care
https://www.readbyqxmd.com/read/28922297/quality-of-care-in-the-united-states-territories-1999-2012
#8
Sudhakar V Nuti, Yun Wang, Frederick A Masoudi, Marcella Nunez-Smith, Sharon-Lise T Normand, Karthik Murugiah, Orlando Rodríguez-Vilá, Joseph S Ross, Harlan M Krumholz
BACKGROUND: Millions of Americans live in the US territories, but health outcomes and payments among Medicare beneficiaries in these territories are not well characterized. METHODS: Among Fee-for-Service Medicare beneficiaries aged 65 years and older hospitalized between 1999 and 2012 for acute myocardial infarction (AMI), heart failure (HF), and pneumonia, we compared hospitalization rates, patient outcomes, and inpatient payments in the territories and states...
September 15, 2017: Medical Care
https://www.readbyqxmd.com/read/28922296/trajectories-of-glycemic-change-in-a-national-cohort-of-adults-with-previously-controlled-type-2-diabetes
#9
Rozalina G McCoy, Che Ngufor, Holly K Van Houten, Brian Caffo, Nilay D Shah
BACKGROUND: Individualized diabetes management would benefit from prospectively identifying well-controlled patients at risk of losing glycemic control. OBJECTIVES: To identify patterns of hemoglobin A1c (HbA1c) change among patients with stable controlled diabetes. RESEARCH DESIGN: Cohort study using OptumLabs Data Warehouse, 2001-2013. We develop and apply a machine learning framework that uses a Bayesian estimation of the mixture of generalized linear mixed effect models to discover glycemic trajectories, and a random forest feature contribution method to identify patient characteristics predictive of their future glycemic trajectories...
September 15, 2017: Medical Care
https://www.readbyqxmd.com/read/28863030/persistent-super-utilization-of-acute-care-services-among-subgroups-of-veterans-experiencing-homelessness
#10
Dorota Szymkowiak, Ann Elizabeth Montgomery, Erin E Johnson, Todd Manning, Thomas P O'Toole
BACKGROUND: Acute health care utilization often occurs among persons experiencing homelessness. However, knowing which individuals will be persistent super-utilizers of acute care is less well understood. OBJECTIVE: The objective of the study was to identify those more likely to be persistent super-utilizers of acute care services. RESEARCH DESIGN: We conducted a latent class analysis of secondary data from the Veterans Health Administration Corporate Data Warehouse, and Homeless Operations Management and Evaluation System...
August 31, 2017: Medical Care
https://www.readbyqxmd.com/read/28857964/author-response-for-identifying-increased-risk-of-readmission-and-in-hospital-mortality-using-hospital-administrative-data-the-ahrq-elixhauser-comorbidity-index
#11
Brian J Moore, Anne Elixhauser
No abstract text is available yet for this article.
August 28, 2017: Medical Care
https://www.readbyqxmd.com/read/28857963/identifying-increased-risk-of-readmission-and-in-hospital-mortality-using-hospital-administrative-data
#12
Alfredo De Giorgi, Fabio Fabbian
No abstract text is available yet for this article.
August 28, 2017: Medical Care
https://www.readbyqxmd.com/read/28857962/women-s-awareness-of-and-responses-to-messages-about-breast-cancer-overdiagnosis-and-overtreatment-results-from-a-2016-national-survey
#13
Rebekah H Nagler, Erika Franklin Fowler, Sarah E Gollust
BACKGROUND: Scientists, clinicians, and other experts aim to maximize the benefits of cancer screening while minimizing its harms. Chief among these harms are overdiagnosis and overtreatment. Although available data suggest that patient awareness of these harms is low, we know little about how patients respond to information about these phenomena. OBJECTIVES: Using the case of breast cancer screening, this study assesses women's awareness of and reactions to statements about overdiagnosis and overtreatment...
August 28, 2017: Medical Care
https://www.readbyqxmd.com/read/28857961/using-patient-reported-outcome-measures-to-improve-health-care-time-for-a-new-approach
#14
John P Browne, Stefan J Cano, Sarah Smith
No abstract text is available yet for this article.
August 28, 2017: Medical Care
https://www.readbyqxmd.com/read/28787347/improved-correction-of-misclassification-bias-with-bootstrap-imputation
#15
Carl van Walraven
OBJECTIVE: Diagnostic codes used in administrative database research can create bias due to misclassification. Quantitative bias analysis (QBA) can correct for this bias, requires only code sensitivity and specificity, but may return invalid results. Bootstrap imputation (BI) can also address misclassification bias but traditionally requires multivariate models to accurately estimate disease probability. This study compared misclassification bias correction using QBA and BI. STUDY DESIGN: Serum creatinine measures were used to determine severe renal failure status in 100,000 hospitalized patients...
August 4, 2017: Medical Care
https://www.readbyqxmd.com/read/28731893/validity-of-administrative-data-in-identifying-cancer-related-events-in-adolescents-and-young-adults-a-population-based-study-using-the-impact-cohort
#16
Sumit Gupta, Paul C Nathan, Nancy N Baxter, Cindy Lau, Corinne Daly, Jason D Pole
BACKGROUND: Despite the importance of estimating population level cancer outcomes, most registries do not collect critical events such as relapse. Attempts to use health administrative data to identify these events have focused on older adults and have been mostly unsuccessful. We developed and tested administrative data-based algorithms in a population-based cohort of adolescents and young adults with cancer. METHODS: We identified all Ontario adolescents and young adults 15-21 years old diagnosed with leukemia, lymphoma, sarcoma, or testicular cancer between 1992-2012...
July 20, 2017: Medical Care
https://www.readbyqxmd.com/read/28906314/quality-of-care-in-the-united-states-territories-1999-2012
#17
Sudhakar V Nuti, Yun Wang, Frederick A Masoudi, Marcella Nunez-Smith, Sharon-Lise T Normand, Karthik Murugiah, Orlando Rodríguez-Vilá, Joseph S Ross, Harlan M Krumholz
BACKGROUND: Millions of Americans live in the US territories, but health outcomes and payments among Medicare beneficiaries in these territories are not well characterized. METHODS: Among Fee-for-Service Medicare beneficiaries aged 65 years and older hospitalized between 1999 and 2012 for acute myocardial infarction (AMI), heart failure (HF), and pneumonia, we compared hospitalization rates, patient outcomes, and inpatient payments in the territories and states...
October 2017: Medical Care
https://www.readbyqxmd.com/read/28906313/two-innovative-cancer-care-programs-have-potential-to-reduce-utilization-and-spending
#18
Erin M Colligan, Erin Ewald, Nancy L Keating, Shriram Parashuram, Michelle Spafford, Sarah Ruiz, Adil Moiduddin
BACKGROUND: Cancer patients often present to the emergency department (ED) and hospital for symptom management, but many of these visits are avoidable and costly. OBJECTIVE: We assessed the impact of 2 Health Care Innovation Awards that used an oncology medical home model [Community Oncology Medical Home (COME HOME)] or patient navigation model [Patient Care Connect Program (PCCP)] on utilization and spending. METHODS: Participants in COME HOME and PCCP models were matched to similar comparators using propensity scores...
October 2017: Medical Care
https://www.readbyqxmd.com/read/28906312/redesigning-oncology-care-delivery-early-wins-lessons-learned-and-a-roadmap
#19
Arif H Kamal
No abstract text is available yet for this article.
October 2017: Medical Care
https://www.readbyqxmd.com/read/28806374/long-acting-reversible-contraception-among-homeless-women-veterans-with-chronic-health-conditions-a-retrospective-cohort-study
#20
Lori M Gawron, Andrew Redd, Ying Suo, Warren Pettey, David K Turok, Adi V Gundlapalli
BACKGROUND: US women Veterans are at increased risk of homelessness and chronic health conditions associated with unintended pregnancy. Veterans Health Administration (VHA) provision of long-acting reversible contraception (LARC) can assist in healthy pregnancy planning. OBJECTIVES: To evaluate perinatal risk factors and LARC exposure in ever-homeless women Veterans. RESEARCH DESIGN: A retrospective cohort study of women Veterans using VHA administrative data from fiscal years 2002-2015...
September 2017: Medical Care
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