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https://www.readbyqxmd.com/read/28817376/association-between-hospice-spending-on-patient-care-and-rates-of-hospitalization-and-medicare-expenditures-of-hospice-enrollees
#1
Melissa D Aldridge, Andrew J Epstein, Abraham A Brody, Eric J Lee, R Sean Morrison, Elizabeth H Bradley
BACKGROUND: Care at the end of life is increasingly fragmented and is characterized by multiple hospitalizations, even among patients enrolled with hospice. OBJECTIVE: To determine whether hospice spending on direct patient care (including the cost of home visits, drugs, equipment, and counseling) is associated with hospital utilization and Medicare expenditures of hospice enrollees. DESIGN: Longitudinal, observational cohort study (2008-2010)...
August 17, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28817299/how-do-medicare-advantage-beneficiary-payments-vary-with-tenure
#2
Paul D Jacobs, Eamon Molloy
OBJECTIVES: To compare how premiums and expected out-of-pocket medical costs (OOPC) vary with the length of time Medicare Advantage (MA) beneficiaries have been enrolled in their plans. STUDY DESIGN: Descriptive and fixed effects regression analyses. METHODS: Using linked administrative enrollment and plan data, we compared the costs of the MA plans that beneficiaries chose with the costs of other plans available to them. We show predicted values adjusted for age, gender, race/ethnicity, disability, individual health risk, presence of mental health diagnoses, health plan quality, relative size of the plan's provider network, and the number of years continuously enrolled in the same plan...
June 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28817295/does-the-offer-of-free-prescriptions-increase-generic-prescribing
#3
Bruce Stuart, Franklin Hendrick, J Samantha Dougherty, Jing Xu
OBJECTIVES: To test if offering zero generic co-pays for oral antidiabetic drugs (OADs) and statins increases generic dispensing for low-income subsidy (LIS) recipients with diabetes enrolled in Medicare Part D. STUDY DESIGN: We analyzed a natural experiment in which LIS recipients were randomized to Part D plans in 2008. Some plans placed selected generic OADs and statins on zero co-pay tiers whereas others did not. Randomization eliminated selection effects which could bias the study findings...
June 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28815617/disparities-in-sinonasal-squamous-cell-carcinoma-short-and-long-term-outcomes-analysis-from-the-national-cancer-database
#4
Ryan M Carey, Arjun K Parasher, Alan D Workman, Carol H Yan, Jordan T Glicksman, Jinbo Chen, James N Palmer, Nithin D Adappa, Jason G Newman, Jason A Brant
OBJECTIVES/HYPOTHESIS: To examine sociodemographic, hospital-specific, and disease-related characteristics in relation to outcomes in sinonasal squamous cell carcinoma (SCC). STUDY DESIGN: The National Cancer Database was queried for location codes corresponding to the nasal cavity and paranasal sinuses and histology codes representing SCC malignancy. Multivariate analyses were performed against short- and long-term outcomes (overall survival, days to discharge, 30-day readmission, and 30- and 90-day mortality)...
August 16, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28807926/use-of-antihypertensive-medications-and-risk-of-adverse-breast-cancer-outcomes-in-a-seer-medicare-population
#5
Lu Chen, Jessica Chubak, Denise M Boudreau, William E Barlow, Noel S Weiss, Christopher I Li
BACKGROUND: It is unclear if use of common antihypertensive medications influences the risk of adverse breast cancer outcomes. METHODS: Using the linked Surveillance, Epidemiology and End-Results (SEER)-Medicare database, we identified 14,766 women between ages 66 and 80 years diagnosed with incident stage I/II breast cancer between 2007-2011. Medicare Part D data were obtained to characterize women's post-cancer use of various antihypertensive medications. Outcomes included a second breast cancer event (SBCE, a composite outcome defined as the first of a recurrence or a second contralateral primary breast cancer), breast cancer recurrence, and breast-cancer specific mortality...
August 14, 2017: Cancer Epidemiology, Biomarkers & Prevention
https://www.readbyqxmd.com/read/28806455/association-of-state-access-standards-with-accessibility-to-specialists-for-medicaid-managed-care-enrollees
#6
Chima D Ndumele, Michael S Cohen, Paul D Cleary
Importance: Medicaid recipients have consistently reported less timely access to specialists than patients with other types of coverage. By 2018, state Medicaid agencies will be required by the Center for Medicare and Medicaid Services (CMS) to enact time and distance standards for managed care organizations to ensure an adequate supply of specialist physicians for enrollees; however, there have been no published studies of whether these policies have significant effects on access to specialty care...
August 14, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28802891/time-to-second-line-treatment-and-subsequent-relative-survival-in-older-patients-with-relapsed-chronic-lymphocytic-leukemia-small-lymphocytic-lymphoma
#7
Eric M Ammann, Tait D Shanafelt, Melissa C Larson, Kara B Wright, Bradley D McDowell, Brian K Link, Elizabeth A Chrischilles
BACKGROUND: Novel targeted therapies offer excellent short-term outcomes in patients with chronic lymphocytic leukemia and small lymphocytic lymphoma (CLL/SLL). However, there is disagreement over how widely these therapies should be used in place of standard chemo-immunotherapy (CIT). We investigated whether stratification on the length of the interval between first-line (T1) and second-line (T2) treatments could identify a subgroup of older patients with relapsed CLL/SLL with an expectation of normal overall survival, and for whom CIT could be an acceptable treatment choice...
July 19, 2017: Clinical Lymphoma, Myeloma & Leukemia
https://www.readbyqxmd.com/read/28789803/preliminary-performance-on-the-new-cms-sepsis-1-national-quality-measure-early-insights-from-the-emergency-quality-network-e-qual
#8
Arjun K Venkatesh, Todd Slesinger, Jessica Whittle, Tiffany Osborn, Emily Aaronson, Craig Rothenberg, Nalani Tarrant, Pawan Goyal, Donald M Yealy, Jeremiah D Schuur
STUDY OBJECTIVE: We describe current hospital-level performance for the Centers for Medicare & Medicaid Services' Severe Sepsis/Septic Shock Early Management Bundle (SEP-1) quality measure and qualitatively assess emergency department (ED) sepsis quality improvement best practice implementation. METHODS: Using a standardized Web-based submission portal, we surveyed quality improvement data from volunteer hospital-based EDs participating in the Emergency Quality Network Sepsis Initiative...
August 5, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28783450/health-care-use-by-older-adults-with-acute-myeloid-leukemia-at-the-end-of-life
#9
Rong Wang, Amer M Zeidan, Stephanie Halene, Xiao Xu, Amy J Davidoff, Scott F Huntington, Nikolai A Podoltsev, Cary P Gross, Steven D Gore, Xiaomei Ma
Purpose Little is known about the patterns and predictors of the use of end-of-life health care among patients with acute myeloid leukemia (AML). End-of-life care is particularly relevant for older adults with AML because of their poor prognosis. Methods We performed a population-based, retrospective cohort study of patients with AML who were ≥ 66 years of age at diagnosis and diagnosed during the period from 1999 to 2011 and died before December 31, 2012. Medicare claims were used to assess patterns of hospice care and use of aggressive treatment...
August 7, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28780129/purpose-in-life-and-hospitalization-for-ambulatory-care-sensitive-conditions-in-old-age
#10
Robert S Wilson, Ana W Capuano, Bryan D James, Priscilla Amofa, Zoe Arvanitakis, Raj Shah, David A Bennett, Patricia A Boyle
OBJECTIVE: To test the hypothesis that higher level of purpose in life is associated with lower subsequent odds of hospitalization. DESIGN: Longitudinal cohort study. SETTING: Participants' residences in the Chicago metropolitan area. PARTICIPANTS: A total of 805 older persons who completed uniform annual clinical evaluations. MEASUREMENTS: Participants annually completed a standard self-report measure of purpose in life, a component of well-being...
June 30, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28777196/adaptation-of-the-acute-organ-failure-score-for-use-in-a-medicare-population
#11
Katherine R Courtright, Scott D Halpern, Brian Bayes, Michael O Harhay, Eli Raneses, Patricia Kipnis, Gabriel J Escobar, Meeta Prasad Kerlin
OBJECTIVES: Without widely available physiologic data, a need exists for ICU risk adjustment methods that can be applied to administrative data. We sought to expand the generalizability of the Acute Organ Failure Score by adapting it to a commonly used administrative database. DESIGN: Retrospective cohort study. SETTING: One hundred fifty-one hospitals in Pennsylvania. PATIENTS: A total of 90,733 ICU admissions among 77,040 unique patients between January 1, 2009, and December 1, 2009, in the Medicare Provider Analysis and Review database...
August 2, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28768271/long-term-outcomes-and-associated-risk-factors-of-post-hospitalization-dialysis-dependent-acute-kidney-injury-patients
#12
Ajay S Rathore, Tushar Chopra, Jennie Z Ma, Wenjun Xin, Emaad M Abdel-Rahman
BACKGROUND/AIMS: Acute kidney injury requiring dialysis (AKI-D) is associated with poor outcomes. Centers for Medicare and Medicaid Services have reversed their clarification allowing AKI-D patients to be dialyzed at outpatient dialysis units. Data assessing long-term outcomes of AKI-D patients and their predictors is needed to adopt guidelines to ensure adequate management. We assessed long-term outcomes and associated risk factors of AKI-D patients who survived 90 days post-hemodialysis (HD) initiation...
July 29, 2017: Nephron
https://www.readbyqxmd.com/read/28761352/use-of-angiotensin-converting-enzyme-inhibitors-and-freedom-from-amputation-after-lower-extremity-revascularization
#13
Jared E Kray, Viktor Y Dombrovskiy, Todd R Vogel
OBJECTIVE: Angiotensin-converting enzyme inhibitors (ACEIs) have not been well evaluated in conjunction with lower extremity revascularization (LER). This study evaluated freedom from amputation in patients who underwent either an open (OPEN) or endovascular (ENDO) revascularization with and without utilization of an ACEI. MATERIALS AND METHODS: Patients who underwent LER were identified from 2007-2008 Medicare Provider Analysis and Review files. Demographics, comorbidities, and disease severity were obtained...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28760602/longer-wait-times-affect-future-use-of-vha-primary-care
#14
Edwin S Wong, Chuan-Fen Liu, Susan E Hernandez, Matthew R Augustine, Karin Nelson, Stephan D Fihn, Paul L Hebert
BACKGROUND: Improving access to the Veterans Health Administration (VHA) is a high priority, particularly given statutory mandates of the Veterans Access, Choice and Accountability Act. This study examined whether patient-reported wait times for VHA appointments were associated with future reliance on VHA primary care services. METHODS: This observational study examined 13,595 VHA patients dually enrolled in fee-for-service Medicare. Data sources included VHA administrative data, Medicare claims and the Survey of Healthcare Experiences of Patients (SHEP)...
July 29, 2017: Healthcare
https://www.readbyqxmd.com/read/28760097/adherence-to-antipsychotic-therapy-association-with-hospitalization-and-medicare-spending-among-part-d-enrollees-with-schizophrenia
#15
Pamela Roberto, Nicole Brandt, Eberechukwu Onukwugha, Eleanor Perfetto, Christopher Powers, Bruce Stuart
OBJECTIVE: This study examined relationships among antipsychotic adherence, hospitalization, and hospital expenditures in a sample of 13,861 Medicare Part D enrollees with schizophrenia. METHODS: Utilization and expenditure data were obtained from the Centers for Medicare and Medicaid Services Chronic Conditions Warehouse for 2011 and 2012. Adherence was measured with the proportion of days covered and stratified into four categories. Probit regressions and two-part generalized linear models were used to examine relationships between adherence in year 1 and outcomes in year 2...
August 1, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28754865/gene-methylation-biomarkers-in-sputum-as-a-classifier-for-lung-cancer-risk
#16
Shuguang Leng, Guodong Wu, Donna M Klinge, Cynthia L Thomas, Elia Casas, Maria A Picchi, Christine A Stidley, Sandra J Lee, Seena Aisner, Jill M Siegfried, Suresh Ramalingam, Fadlo R Khuri, Daniel D Karp, Steven A Belinsky
CT screening for lung cancer reduces mortality, but will cost Medicare ~2 billion dollars due in part to high false positive rates. Molecular biomarkers could augment current risk stratification used to select smokers for screening. Gene methylation in sputum reflects lung field cancerization that remains in lung cancer patients post-resection. This population was used in conjunction with cancer-free smokers to evaluate classification accuracy of a validated eight-gene methylation panel in sputum for cancer risk...
July 15, 2017: Oncotarget
https://www.readbyqxmd.com/read/28754579/rapid-discharge-to-home-after-total-knee-arthroplasty-is-safe-in-eligible-medicare-patients
#17
Gregory G Klingenstein, Scott D Schoifet, Rajesh K Jain, Jeremy J Reid, Manny D Porat, Mojisola K Otegbeye
BACKGROUND: This study was aimed at assessing the risk of readmission for Medicare patients discharged home within a day of total knee arthroplasty (TKA) compared to those discharged on day 2 or beyond in a community medical center. METHODS: A hospital inpatient database was queried for all unilateral, primary TKAs performed on patients 65 years or older from January 1, 2013, to December 31, 2015. A total of 2287 patients met the study criteria, of which 1502 were discharged within a day (short stay), and 785 were discharged on day 2 or beyond (traditional stay)...
June 27, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28752188/association-between-survival-time-with-metastatic-breast-cancer-and-aggressive-end-of-life-care
#18
Melissa K Accordino, Jason D Wright, Sowmya Vasan, Alfred I Neugut, Tal Gross, Grace C Hillyer, Dawn L Hershman
PURPOSE: For women with stage IV breast cancer (BC), the association between survival time (ST) and use of aggressive end-of-life (EOL) care is unknown. METHODS: We used the SEER-Medicare database to identify women with stage IV BC diagnosed 2002-2011 who died by 12/31/2012. Aggressive EOL care was defined as receipt in the last month of life: >1 ED visit, >1 hospitalization, ICU admission, life-extending procedures, hospice admission within 3 days of death, IV chemotherapy within 14 days of death, and/or ≥10 unique physician encounters in the last 6 months of life...
July 27, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28750586/a-controlled-clinical-trial-of-a-clinically-tuned-powered-ankle-prosthesis-in-people-with-transtibial-amputation
#19
Emily S Gardinier, Brian M Kelly, Jeffrey Wensman, Deanna H Gates
OBJECTIVE: To determine whether there are changes in level walking performance for people using a powered ankle prosthesis that was tuned by an independent, manufacturer-certified prosthetist in accordance with device recommendations. DESIGN: Intervention study with cross-over design. SETTING: Laboratory. PARTICIPANTS: Convenience sample of 10 individuals with unilateral, transtibial amputation, and 10 age- and gender-matched control participants...
July 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28747463/impact-of-stroke-center-certification-on-mortality-after-ischemic-stroke-the-medicare-cohort-from-2009-to-2013
#20
Shumei Man, Jesse D Schold, Ken Uchino
BACKGROUND AND PURPOSE: An increasing number of hospitals have been certified as primary stroke centers (PSCs). It remains unknown whether the action toward PSC certification has improved the outcome of stroke care. This study aimed to understand whether PSC certification reduced stroke mortality. METHODS: We examined Medicare fee-for-service beneficiaries aged ≥65 years who were hospitalized between 2009 and 2013 for ischemic stroke. Hospitals were classified into 3 groups: new PSCs, the hospitals that received initial PSC certification between 2009 and 2013 (n=634); existing PSCs, the PSCs certified before 2009 (n=785); and non-SCs, the hospitals that have never been certified as PSCs (n=2640)...
July 26, 2017: Stroke; a Journal of Cerebral Circulation
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