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https://www.readbyqxmd.com/read/28108823/which-clinical-and-patient-factors-influence-the-national-economic-burden-of-hospital-readmissions-after-total-joint-arthroplasty
#1
Steven M Kurtz, Edmund C Lau, Kevin L Ong, Edward M Adler, Frank R Kolisek, Michael T Manley
BACKGROUND: The Affordable Care Act of 2010 advanced the economic model of bundled payments for total joint arthroplasty (TJA), in which hospitals will be financially responsible for readmissions, typically at 90 days after surgery. However, little is known about the financial burden of readmissions and what patient, clinical, and hospital factors drive readmission costs. QUESTIONS/PURPOSES: (1) What is the incidence, payer mix, and demographics of THA and TKA readmissions in the United States? (2) What patient, clinical, and hospital factors are associated with the cost of 30- and 90-day readmissions after primary THA and TKA? (3) Are there any differences in the economic burden of THA and TKA readmissions between payers? (4) What types of THA and TKA readmissions are most costly to the US hospital system? METHODS: The recently developed Nationwide Readmissions Database from the Healthcare Cost and Utilization Project (2006 hospitals from 21 states) was used to identify 719,394 primary TJAs and 62,493 90-day readmissions in the first 9 months of 2013 based on International Classification of Diseases, 9th Revision, Clinical Modification codes...
January 20, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28103923/risk-adjustment-methods-for-all-payer-comparative-performance-reporting-in-vermont
#2
Karl Finison, MaryKate Mohlman, Craig Jones, Melanie Pinette, David Jorgenson, Amy Kinner, Tim Tremblay, Daniel Gottlieb
BACKGROUND: As the emphasis in health reform shifts to value-based payments, especially through multi-payer initiatives supported by the U.S. Center for Medicare & Medicaid Innovation, and with the increasing availability of statewide all-payer claims databases, the need for an all-payer, "whole-population" approach to facilitate the reporting of utilization, cost, and quality measures has grown. However, given the disparities between the different populations served by Medicare, Medicaid, and commercial payers, risk-adjustment methods for addressing these differences in a single measure have been a challenge...
January 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28073146/value-based-care-in-hepatology
#3
REVIEW
Mario Strazzabosco, John I Allen, Elizabeth O Teisberg
The migration from legacy fee-for-service reimbursement to payments linked to high value health care is accelerating in the United States because of new legislation and re-design of payments from the Centers for Medicare and Medicaid Services (CMS). Since patients with chronic diseases account for substantial use of health care resources, payers and health systems are focusing on maximizing the value of care for these patients. Since chronic liver diseases impose a major health burden worldwide affecting the health and lives of many individuals and families as well as substantial costs for individuals and payers, hepatologists must understand how they can improve their practices ...
January 10, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28070000/anesthesia-technique-and-outcomes-of-mechanical-thrombectomy-in-patients-with-acute-ischemic-stroke
#4
Kimon Bekelis, Symeon Missios, Todd A MacKenzie, Stavropoula Tjoumakaris, Pascal Jabbour
BACKGROUND AND PURPOSE: The impact of anesthesia technique on the outcomes of mechanical thrombectomy for acute ischemic stroke remains an issue of debate. We investigated the association of general anesthesia with outcomes in patients undergoing mechanical thrombectomy for ischemic stroke. METHODS: We performed a cohort study involving patients undergoing mechanical thrombectomy for ischemic stroke from 2009 to 2013, who were registered in the New York Statewide Planning and Research Cooperative System database...
January 9, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28069525/utilization-of-the-nsqip-pediatric-database-in-development-and-validation-of-a-new-predictive-model-of-pediatric-postoperative-wound-complications
#5
Ilan I Maizlin, David T Redden, Elizabeth A Beierle, Mike K Chen, Robert T Russell
BACKGROUND: Surgical wound classification, introduced in 1964, stratifies the risk of surgical site infection (SSI) based on a clinical estimate of the inoculum of bacteria encountered during the procedure. Recent literature has questioned the accuracy of predicting SSI risk based on wound classification. We hypothesized that a more specific model founded on specific patient and perioperative factors would more accurately predict the risk of SSI. STUDY DESIGN: Using all observations from the 2012 to 2014 pediatric National Quality Surgical Improvement-Pediatric (NSQIP-P) Participant Use File, patients were randomized into model creation and model verification datasets...
January 6, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28062313/evolution-in-the-utilization-of-biliary-interventions-in-the-united-states-results-of-a-nationwide-longitudinal-study-from-1998-to-2013
#6
Robert J Huang, Nirav C Thosani, Monique T Barakat, Abhishek Choudhary, Alka Mithal, Gurkirpal Singh, Saurabh Sethi, Subhas Banerjee
BACKGROUND AND AIMS: Bile duct surgery (BDS), percutaneous transhepatic cholangiography (PTC), and endoscopic retrograde cholangiopancreatography (ERCP) are alternative interventions used to treat biliary disease. We aim to describe trends in ERCP, BDS, and PTC on a nationwide level in the United States. METHODS: We used the National Inpatient Sample to estimate age-standardized utilization trends of inpatient diagnostic ERCP, therapeutic ERCP, BDS, and PTC between 1998 and 2013...
January 3, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28059662/emergency-department-evaluation-and-30-day-readmission-after-craniotomy-for-primary-brain-tumor-resection-in-new-york-state
#7
Symeon Missios, Kimon Bekelis
OBJECTIVE Fragmentation of care has been recognized as a major contributor to 30-day readmissions after surgical procedures. The authors investigated the association of evaluation in the hospital where the original procedure was performed with the rate of 30-day readmissions for patients presenting to the emergency department (ED) after craniotomy for primary brain tumor resection. METHODS A cohort study was conducted, involving patients who were evaluated in the ED within 30 days after discharge following a craniotomy for primary brain tumor resection between 2009 and 2013, and who were registered in the Statewide Planning and Research Cooperative System (SPARCS) database of New York State...
January 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28048778/su-f-t-101-insight-into-dosimetry-workload-and-planning-timelines-a-6-year-review-at-one-institution
#8
R Cardan, R Popple, H Smith, J Fiveash
PURPOSE: To elucidate realistic clinical treatment planning workload and timelines to improve understanding for patients, payers, and other institutions involved in radiotherapy processes. METHODS: A web based tool was developed using Oracle Express (Oracle Corp, Redwood City, CA) which allowed communication between the physicians and staff about the current state of the patient plan. For 6 years, all patient courses were logged and time-stamped in 22 discreet steps which detailed start and stop times for simulation, contouring, and treatment planning tasks...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28040270/a-systematic-review-of-financial-and-economic-assessments-of-bovine-viral-diarrhea-virus-bvdv-prevention-and-mitigation-activities-worldwide
#9
REVIEW
Beate Pinior, Clair L Firth, Veronika Richter, Karin Lebl, Martine Trauffler, Monika Dzieciol, Sabine E Hutter, Johann Burgstaller, Walter Obritzhauser, Petra Winter, Annemarie Käsbohrer
Infection with bovine viral diarrhea virus (BVDV) results in major economic losses either directly through decreased productive performance in cattle herds or indirectly, such as through expenses for control programs. The aim of this systematic review was to review financial and/or economic assessment studies of prevention and/or mitigation activities of BVDV at national, regional and farm level worldwide. Once all predefined criteria had been met, 35 articles were included for this systematic review. Studies were analyzed with particular focus on the type of financially and/or economically-assessed prevention and/or mitigation activities...
December 23, 2016: Preventive Veterinary Medicine
https://www.readbyqxmd.com/read/28033286/maximizing-cost-effectiveness-by-adjusting-treatment-strategy-according-to-glaucoma-severity
#10
Ricardo Augusto Paletta Guedes, Vanessa Maria Paletta Guedes, Carlos Eduardo de Mello Gomes, Alfredo Chaoubah
BACKGROUND: The aim of this study is to determine the most cost-effective strategy for the treatment of primary open-angle glaucoma (POAG) in Brazil, from the payer's perspective (Brazilian Public Health System) in the setting of the Glaucoma Referral Centers. METHODS: Study design was a cost-effectiveness analysis of different treatment strategies for POAG. We developed 3 Markov models (one for each glaucoma stage: early, moderate and advanced), using a hypothetical cohort of POAG patients, from the perspective of the Brazilian Public Health System (SUS) and a horizon of the average life expectancy of the Brazilian population...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28002151/use-of-biologic-therapy-in-racial-minorities-with-rheumatoid-arthritis-from-2-us-health-care-systems
#11
Gail S Kerr, Christopher Swearingen, Ted R Mikuls, Yusuf Yazici
BACKGROUND: In the United States, there is racial/ethnic disparity in the care of rheumatoid arthritis (RA), yet there are limited data regarding the impact of varied health care systems on treatment outcomes. OBJECTIVE: The aim fo this study was to compare the frequencies of use of disease-modifying antirheumatic drugs and biologic agents in racial minorities with RA in a single-payer and variable-access health systems. METHODS: Rheumatoid arthritis disease status was examined in the Ethnic Minority Rheumatoid Arthritis Consortium (EMRAC) and Veterans Affairs Rheumatoid Arthritis Registry (VARA); frequencies of prednisone and disease-modifying antirheumatic drugs and biologic agent use at enrollment were documented...
January 2017: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/27991417/the-economic-burden-of-chronic-psychotic-disorders-in-ontario
#12
Claire de Oliveira, Joyce Cheng, Juergen Rehm, Paul Kurdyak
BACKGROUND: Chronic psychotic disorders are severe and disabling mental disorders associated with poor psychiatric and medical outcomes. These disorders are considered one of the most costly mental disorders due young age at onset and the need for intensive health care over the life course. AIMS OF THE STUDY: The purpose of this study was to estimate the direct health care costs of chronic psychotic disorders in Ontario in 2012 from the perspective of the third-party payer (i...
December 1, 2016: Journal of Mental Health Policy and Economics
https://www.readbyqxmd.com/read/27987628/arbitration-board-setting-reimbursement-amounts-for-pharmaceutical-innovations-in-germany-when-price-negations-between-payers-and-manufacturers-fail-an-empirical-analysis-of-5-years-experience
#13
Saskia Ludwig, Charalabos-Markos Dintsios
BACKGROUND: In Germany, an arbitration board is setting reimbursement amounts for drug innovations when price negations between payers and manufacturers fail. OBJECTIVE: To empirically analyze all arbitrations since the reform of Germany's Act to Reorganize the Pharmaceuticals' Market in the Statutory Health Insurance System came into effect. METHODS: All available relevant documents up to January 2016 were screened and the identified contentious issues between the negotiation parties extracted...
December 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27979021/indoor-tobacco-legislation-is-associated-with-fewer-emergency-department-visits-for-asthma-exacerbation-in-children
#14
Christina E Ciaccio, Tami Gurley-Calvez, Theresa I Shireman
BACKGROUND: During the past 3 decades, numerous cities and states have adopted laws that ban smoking in public indoor spaces. The rationale for these policies has been to protect nonsmokers from the adverse health effects of secondhand smoke. OBJECTIVE: To determine whether the implementation of indoor smoking legislation is associated with a decrease in emergency department visits for asthma in children. METHODS: This retrospective analysis used a natural experiment to estimate the impact of clean indoor air legislation on the rate of emergency department admissions for asthma exacerbation in children...
December 2016: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/27973617/quantifying-geographic-variation-in-health-care-outcomes-in-the-united-states-before-and-after-risk-adjustment
#15
Barry L Rosenberg, Joshua A Kellar, Anna Labno, David H M Matheson, Michael Ringel, Paige VonAchen, Richard I Lesser, Yue Li, Justin B Dimick, Atul A Gawande, Stefan H Larsson, Hamilton Moses
BACKGROUND: Despite numerous studies of geographic variation in healthcare cost and utilization at the local, regional, and state levels across the U.S., a comprehensive characterization of geographic variation in outcomes has not been published. Our objective was to quantify variation in US health outcomes in an all-payer population before and after risk-adjustment. METHODS AND FINDINGS: We used information from 16 independent data sources, including 22 million all-payer inpatient admissions from the Healthcare Cost and Utilization Project (which covers regions where 50% of the U...
2016: PloS One
https://www.readbyqxmd.com/read/27919741/implementation-of-a-clinical-documentation-improvement-curriculum-improves-quality-metrics-and-hospital-charges-in-an-academic-surgery-department
#16
Cynthia Reyes, Alissa Greenbaum, Catherine Porto, John C Russell
BACKGROUND: Accurate clinical documentation (CD) is necessary for many aspects of modern healthcare, including excellent communication, quality metrics reporting, and legal documentation. New requirements have mandated the adoption of ICD-10-CM coding systems, adding another layer of complexity to CD. A clinical documentation improvement (CDI) and ICD-10 training program was created for healthcare providers in our academic surgery department. We aimed to assess the impact of our CDI curriculum by comparing quality metrics, coding and reimbursement before and after implementation of our CDI program...
December 2, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27917479/hospital-postacute-care-referral-networks-is-referral-concentration-associated-with-medicare-style-bundled-payments
#17
Ramandeep Kaur, Jennifer N Perloff, Christopher Tompkins, Christine E Bishop
OBJECTIVE: To evaluate whether Medicare-style bundled payments are lower or higher for beneficiaries discharged from hospitals with postacute care (PAC) referrals concentrated among fewer PAC providers. DATA SOURCE: Medicare Part A and Part B claim (2008-2012) for all beneficiaries residing in any of 17 market areas: the Provider of Service file, the Healthcare Cost Report Information System, and the Dartmouth Atlas. STUDY DESIGN: An observational study in which hospitals were distinguished according to PAC referral concentration, which is the tendency to utilize fewer rather than more PAC providers...
December 5, 2016: Health Services Research
https://www.readbyqxmd.com/read/27891527/the-multimorbidity-index-a-tool-for-assessing-the-prognosis-of-patients-from-their-history-of-illness
#18
Farrokh Alemi, Cari R Levy, Raya E Kheirbek
BACKGROUND: The Multimorbidity (MM) Index predicts the prognosis of patients from their diagnostic history. In contrast to existing approaches with broad diagnostic categories, it treats each diagnosis as a separate independent variable using individual International Classification of Disease, Revision 9 (ICD-9) codes. OBJECTIVE: This paper describes the MM Index, reviews the published data on its accuracy, and provides procedures for implementing the Index within electronic health record (EHR) systems...
2016: EGEMS
https://www.readbyqxmd.com/read/27882839/real-world-drug-costs-of-treating-hepatitis-c-genotypes-1-4-with-direct-acting-antivirals-initiating-treatment-at-fibrosis-0-2-and-3-4
#19
Timothy A Bach, Kathy Zaiken
BACKGROUND: Direct-acting antivirals (DAA) for the treatment of hepatitis C virus (HCV) have drastically improved outcomes but are also very costly. For this reason, priority for treatment is often given to patients with a higher fibrosis score at baseline by payers and providers rather than treating all eligible patients. Simulation studies have suggested that waiting to treat patients until fibrosis 3-4 may be more costly and result in worse outcomes; however, real-world implications are unknown...
December 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27882552/trends-and-the-utilization-of-transoral-robotic-surgery-with-neck-dissection-in-new-york-state
#20
Catherine H Frenkel, Jie Yang, Mengru Zhang, Elliot Regenbogen, Dana A Telem, Ghassan J Samara
OBJECTIVES: The timing of neck dissection (ND) in relation to transoral robotic surgery (TORS) is controversial. This study identifies local practice patterns and economic and social access disparities during adoption of TORS. STUDY DESIGN: We analyzed utilization patterns of TORS and ND using the New York Statewide Planning and Research Cooperative System all-payer administrative database. Statewide head and neck cancer incidence from the Centers for Disease Control and Prevention (Bethesda, MD) was used to control for overall cancer incidence...
November 24, 2016: Laryngoscope
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