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https://www.readbyqxmd.com/read/29781923/going-beyond-clinical-care-to-reduce-health-care-spending-findings-from-the-j-chip-community-based-population-health-management-program-evaluation
#1
Shannon M E Murphy, Douglas E Hough, Martha L Sylvia, Melissa Sherry, Linda J Dunbar, Raymond Zollinger, Regina Richardson, Scott A Berkowitz, Kevin D Frick
BACKGROUND: Addressing both clinical and nonclinical determinants of health is essential for improving population health outcomes. In 2012, the Johns Hopkins Community Health Partnership (J-CHiP) implemented innovative population health management programs across acute and community environments. The community-based program involved multidisciplinary teams [ie, physicians, care managers (CM), health behavior specialists (HBS), community health workers, neighborhood navigators] and collaboration with community-based organizations to address social determinants...
May 17, 2018: Medical Care
https://www.readbyqxmd.com/read/29781284/opioid-prescription-among-sinus-surgeons
#2
Khashayar Arianpour, Brandon Nguyen, Brian Yuhan, Peter F Svider, Jean Anderson Eloy, Adam J Folbe
Background Misuse and diversion of opioids have contributed to the U.S. opioid crisis, making an understanding of specialty-specific and procedure-specific trends essential. Objective The objective of this analysis was to evaluate nationwide trends in opioid prescribing patterns among sinus surgeons performing functional endoscopic sinus surgery and maxillary sinus balloon dilation, specifically examining factors associated with variations. Methods High-volume sinus surgeons were identified through the Centers for Medicare and Medicaid Services database and cross-referenced against prescriptions to Medicare Part D beneficiaries during 2013 through 2015...
January 1, 2018: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/29776984/impact-of-psychiatric-comorbidities-on-health-care-utilization-and-cost-of-care-in-multiple-myeloma
#3
Shehzad Niazi, Ryan D Frank, Mayank Sharma, Vivek Roy, Steve Ames, Teresa Rummans, Aaron Spaulding, Taimur Sher, Meghna Ailawadhi, Kirtipal Bhatia, Salman Ahmed, Winston Tan, Asher Chanan-Khan, Sikander Ailawadhi
Approximately one third of cancer patients suffer from comorbid mood disorders that are associated with increased cost and poorer outcomes. The majority of patients with multiple myeloma (MM) are treated with corticosteroids; as many as three fourths of those taking corticosteroids develop neuropsychiatric complications, likely increasing morbidity and cost of care. MM patients diagnosed between 1991 and 2010 and reported in the Surveillance Epidemiology, and End Results-Medicare database were characterized as MM-Only, MM+Psychiatric (any psychiatric condition, preexisting or post-MM), or MM+Depression (depression as the only psychiatric diagnosis, preexisting or post-MM)...
May 22, 2018: Blood Advances
https://www.readbyqxmd.com/read/29758352/prospective-associations-of-c-reactive-protein-crp-levels-and-crp-genetic-risk-scores-with-risk-of-total-knee-and-hip-replacement-for-osteoarthritis-in-a-diverse-cohort
#4
Aladdin H Shadyab, Robert Terkeltaub, Charles Kooperberg, Alexander Reiner, Charles B Eaton, Rebecca D Jackson, Jessica L Krok-Schoen, Rany M Salem, Andrea Z LaCroix
OBJECTIVE: To examine associations of high-sensitivity C-reactive protein (CRP) levels and polygenic CRP genetic risk scores (GRS) with risk of end-stage hip or knee osteoarthritis (OA), defined as incident total hip (THR) or knee replacement (TKR) for OA. DESIGN: This study included a cohort of postmenopausal white, African American, and Hispanic women from the Women's Health Initiative. Women were followed from baseline to date of THR or TKR, death, or December 31, 2014...
May 11, 2018: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/29752327/adherence-to-guidelines-for-breast-surveillance-in-breast-cancer-survivors
#5
Kathryn J Ruddy, Lindsey Sangaralingham, Rachel A Freedman, Sarah Mougalian, Heather Neuman, Caprice Greenberg, Ahmedin Jemal, Narjust Duma, Tufia C Haddad, Valerie Lemaine, Karthik Ghosh, Tina J Hieken, Katie Hunt, Celine Vachon, Cary Gross, Nilay D Shah
Background: Guidelines recommend annual mammography after curative-intent treatment for breast cancer. The goal of this study was to assess contemporary patterns of breast imaging after breast cancer treatment. Methods: Administrative claims data were used to identify privately insured and Medicare Advantage beneficiaries with nonmetastatic breast cancer who had residual breast tissue (not bilateral mastectomy) after breast surgery between January 2005 and May 2015. We calculated the proportion of patients who had a mammogram, MRI, both, or neither during each of 5 subsequent 13-month periods...
May 2018: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/29747864/cost-effectiveness-analysis-of-biopsy-strategies-for-endometrial-cancer-diagnosis-in-women-with-postmenopausal-bleeding-pipelle-sampling-curette-versus-dilatation-curettage
#6
Yan Yi, Cindy L Bryce, Shalkar Adambekov, Robert P Edwards, Sharon L Goughnour, Faina Linkov
BACKGROUND: Endometrial sampling is widely used for accurate diagnosis of endometrial cancer (EC), which is the most common gynecologic cancer in US women. The objective of this study was to explore the cost-effectiveness of two endometrial sampling procedures for diagnosing EC: (1) Pipelle endometrial sampling (Pipelle), and (2) dilatation & curettage (D&C), while accounting for sampling procedure failure rates and diagnostic accuracy in women with postmenopausal bleeding (PMB)...
May 7, 2018: Gynecologic Oncology
https://www.readbyqxmd.com/read/29744855/recognition-and-diagnosis-of-obstructive-sleep-apnea-in-older-americans
#7
Tiffany J Braley, Galit Levi Dunietz, Ronald D Chervin, Lynda D Lisabeth, Lesli E Skolarus, James F Burke
OBJECTIVES: To estimate the proportion of older Americans at risk for obstructive sleep apnea (OSA) who receive OSA evaluations, diagnosis, and treatment. DESIGN: Cross sectional study. SETTING: National Health and Aging Trends Study (NHATS), Round 3 survey. PARTICIPANTS: Community-dwelling Medicare beneficiaries age 65 and older (N=1,052). MEASUREMENTS: NHATS participants were asked specific questions about sleep disturbances, including items that resembled critical elements of a validated instrument used to assess OSA risk (the STOP-Bang questionnaire)...
May 9, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29741217/the-effect-of-implementing-a-tobacco-treatment-service-on-adherence-to-evidence-based-practice-in-an-inpatient-state-owned-psychiatric-hospital
#8
Chizimuzo T C Okoli, Yazan D Al-Mrayat, Barbara Stead
BACKGROUND AND OBJECTIVES: The Centers for Medicare and Medicaid Services (CMS) requires reporting of specific tobacco treatment (TT) measures. We examined compliance to these measures before and after initiation of a specialized TT service in a state-psychiatric hospital. METHODS: Using a retrospective analysis, patient records (N = 3669) were examined, using one-way ANOVAs, for changes in rates of tobacco use screening and treatment between September-December 2015 (pre-implementation of CMS requirements), and January-April, May-August, and September-December 2016 (post-implementation of the CMS requirements)...
May 9, 2018: American Journal on Addictions
https://www.readbyqxmd.com/read/29739799/healthcare-utilization-and-statin-re-initiation-among-medicare-beneficiaries-with-a-history-of-myocardial-infarction
#9
John N Booth, Lisandro D Colantonio, Robert S Rosenson, Monika M Safford, Ligong Chen, Meredith L Kilgore, Todd M Brown, Benjamin Taylor, Ricardo Dent, Keri L Monda, Paul Muntner, Emily B Levitan
BACKGROUND: Contact with the healthcare system represents an opportunity for individuals who discontinue statins to re-initiate treatment. To help identify opportunities for healthcare providers to emphasize the risk-lowering benefits accrued through restarting statins, we determined the types of healthcare utilization associated with statin re-initiation among patients with history of a myocardial infarction. METHODS AND RESULTS: Medicare beneficiaries with a statin pharmacy fill claim within 30 days of hospital discharge for a myocardial infarction in 2007 to 2012 (n=158 795) were followed for 182 days postdischarge to identify treatment discontinuation, defined as 60 continuous days without statins (n=24 461)...
May 8, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29739303/the-utilization-of-formal-physical-therapy-after-shoulder-arthroplasty
#10
Eric R Wagner, Muriel J Solberg, Laurence D Higgins
Study Design Epidemiological retrospective database study. Background It is widely believed that structured rehabilitation programs by professional therapists help guide patients through the various recovery periods after shoulder arthroplasty, speeding up their recovery and improving their final functional gains. However, to our knowledge, there are no studies providing information about the current state of physical rehabilitation use after shoulder arthroplasty. Objectives Describe the variation in physical rehabilitation utilization after total and reverse total shoulder arthroplasty and identify differences in utilization based on type of insurance (private versus public), gender, age, region of the country, and type of replacement...
May 8, 2018: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/29738396/hypovitaminosis-d-in-orthopaedic-trauma-which-guidelines-should-be-followed
#11
Brett Schiffman, Hobie Summers, Mitchell Bernstein, Frank DiSilvio, Sarah Foyil, William Lack
OBJECTIVE: To evaluate risk factors for hypovitaminosis D and determine the baseline vitamin D supplementation associated with normal vitamin D levels at presentation. DESIGN: Prospective observational study. SETTING: Level I trauma center. PATIENTS: 259 adult patients undergoing operative treatment for orthopaedic trauma (OTA 11-15, 21-23, 31-34, 41-44, 61-62, 70C, 81-82, 87) between January 1 and December 31, 2014...
May 3, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29736940/growing-reinsurance-payments-weaken-competitive-bidding-in-medicare-part-d
#12
Jeah Jung, Roger Feldman
OBJECTIVES: To examine variation in risk-adjusted reinsurance payments across Part D plans, analyze its implications for the program, and explore options to reduce reinsurance payments. DATA/STUDY DESIGN: 2007-2015 Part D Plan Payment and Premium data; 2010-2013 Part D Prescription Drug Event data; and 2013 Part D Plan Formulary Files. PRINCIPAL FINDINGS: Risk-adjusted reinsurance payments varied widely across plans at a given out-of-pocket (OOP) premium...
May 7, 2018: Health Services Research
https://www.readbyqxmd.com/read/29735614/emergency-providers-opioid-prescribing-behaviors-among-medicare-part-d-beneficiaries-in-north-carolina-2013-2014-medication-utilization-and-costs
#13
Brittany Williams, Geoffrey Mospan, Rebecca Seabock, Chris Gillette, Michelle DeGeeter
BACKGROUND This study sought to quantify utilization and costs associated with opioid prescribing by emergency providers for Medicare Part D beneficiaries in North Carolina and the United States from 2013 to 2014. METHODS This was a retrospective examination of the Medicare Provider Utilization and Payment Data: Part D Prescriber datasets from 2013-2014. The main variables of interest were total number of prescription claims and total Medicare Part D medication costs for opioid analgesic medications. Generalized estimating equations were used to analyze the data...
May 2018: North Carolina Medical Journal
https://www.readbyqxmd.com/read/29734263/medicare-expenditures-and-health-care-utilization-in-a-multiethnic-community-based-population-with-dementia-from-incidence-to-death
#14
Katherine A Ornstein, Carolyn W Zhu, Evan Bollens-Lund, Melissa D Aldridge, Howard Andrews, Nicole Schupf, Yaakov Stern
INTRODUCTION: While individuals live with dementia for many years, utilization and expenditures from disease onset through the end-of-life period have not been examined in ethnically diverse samples. METHODS: We used a multiethnic, population-based, prospective study of cognitive aging (Washington Heights-Inwood Columbia Aging Project) linked to Medicare claims to examine total Medicare expenditures and health care utilization among individuals with clinically diagnosed incident dementia from disease onset to death...
May 4, 2018: Alzheimer Disease and Associated Disorders
https://www.readbyqxmd.com/read/29732393/real-world-effectiveness-of-chemotherapy-in-elderly-patients-with-metastatic-bladder-cancer-in-the-united-states
#15
Matthew D Galsky, Sumanta Kumar Pal, Shih-Wen Lin, Sarika Ogale, Marko Zivkovic, Joseph Simpson, Christina Derleth, Christina Schiff, Guru Sonpavde
Background: Outcomes for patients with metastatic bladder cancer (mBC) are generally poor and progressively worse following first-line (1L) chemotherapy. Objective: To evaluate treatment patterns, survival outcomes, and characteristics of a large, real-world US population of elderly patients with advanced mBC receiving 1L and second-line (2L) treatment retrospectively. Methods: We identified patients with advanced mBC (aged ≥66 years)-newly diagnosed between January 1, 2004, and December 31, 2011-in the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) Program-Medicare linked database and assessed their palliative systemic chemotherapy treatments and survival outcomes...
April 26, 2018: Bladder Cancer
https://www.readbyqxmd.com/read/29726596/cost-implications-of-intraprocedural-thrombotic-events-and-bleeding-in-percutaneous-coronary-intervention-results-from-the-champion-phoenix-economics-study
#16
Hector Tamez, Philip Généreux, Robert W Yeh, Amit P Amin, Weihong Fan, Harvey D White, Ajay J Kirtane, Gregg W Stone, C Michael Gibson, Robert A Harrington, Deepak L Bhatt, Duane S Pinto
BACKGROUND: Despite improvements in percutaneous coronary intervention (PCI), intraprocedural thrombotic events (IPTE) and bleeding complications occur and are prognostically important. These have not been included in prior economic studies. METHODS: PHOENIX ECONOMICS was a substudy of the CHAMPION PHOENIX trial, evaluating cangrelor during PCI. Hospital bills were reviewed from 1,171 patients enrolled at 22 of 63 US sites. Costs were estimated using standard methods including resource-based accounting, hospital billing data, and the Medicare fee schedule...
May 4, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29725191/sistas-inspiring-sistas-through-activity-and-support-sistas-study-design-and-demographics-of-participants
#17
Malcolm Bevel, Oluwole A Babatunde, Sue P Heiney, Heather M Brandt, Michael D Wirth, Thomas G Hurley, Samira Khan, Hiluv Johnson, Cassandra M Wineglass, Tatiana Y Warren, E Angela Murphy, Erica Sercy, Amanda S Thomas, James R Hébert, Swann Arp Adams
Introduction: Recruiting racial, ethnic, and other underserved minorities into conventional clinic-based and other trials is known to be challenging. The Sistas Inspiring Sistas Through Activity and Support (SISTAS) Program was a one-year randomized controlled trial (RCT) to promote physical activity and healthy eating among AA women in SC to reduce inflammatory biomarkers, which are linked to increased breast cancer (BrCa) risk and mortality. This study describes the development, recruitment, and implementation of the SISTAS clinical trial and provides baseline characteristics of the study participants...
2018: Ethnicity & Disease
https://www.readbyqxmd.com/read/29724650/increased-nationwide-use-of-stereoencephalography-for-intracranial-epilepsy-electroencephalography-recordings
#18
Hussam Abou-Al-Shaar, Andrea A Brock, Bornali Kundu, Dario J Englot, John D Rolston
Intracranial electroencephalography (iEEG) can be performed using minimally invasive stereo-electroencephalography (SEEG) or by implanting subdural electrodes via a craniotomy or multiple burr holes. There is anecdotal evidence that SEEG is becoming more common in the United States, though this has yet to be quantified. To address this question, all SEEG and burr hole/craniotomy subdural iEEG procedures were extracted from the Centers for Medicare and Medicaid Services Part B data files for the years 2000-2016...
April 30, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29721713/medicaid-or-medicare-insurance-payer-status-and-household-income-are-associated-with-outcomes-after-primary-total-hip-arthroplasty
#19
Jasvinder A Singh, John D Cleveland
Our objective was to examine if Medicaid/Medicare health insurance and household income were associated with poorer outcomes after primary total hip arthroplasty (THA). We used multivariable-adjusted Cox regression analyses to assess whether insurance payer type and household income were independently associated with health care utilization outcomes or complications post-THA in a cohort of hospital discharges from the 1998-2014 US National Inpatient Sample, adjusting for demographics, underlying diagnosis for THA, medical comorbidity, and hospital characteristics...
May 3, 2018: Clinical Rheumatology
https://www.readbyqxmd.com/read/29720303/the-medicare-part-d-season-begins-again
#20
Paul Baldwin
No abstract text is available yet for this article.
March 1, 2018: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
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