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https://www.readbyqxmd.com/read/28924623/the-effectiveness-of-pharmacist-provided-telephonic-medication-therapy-management-on-emergency-department-utilization-in-home-health-patients
#1
Stephanie A Gernant, Margie E Snyder, Heather Jaynes, Jason M Sutherland, Alan J Zillich
BACKGROUND: Preventable emergency department (ED) use may be targeted with interventions for improving the medication use process, as medication misadventures and non-adherence frequently cause preventable ED utilization. One intervention that could prevent ED visits is Medication Therapy Management (MTM). OBJECTIVE: To evaluate the effectiveness of a telephonic medication therapy management (MTM) service on reducing emergency department utilization within a Medicare insured home health population...
October 1, 2016: Journal of Pharmacy Technology: JPT: Official Publication of the Association of Pharmacy Technicians
https://www.readbyqxmd.com/read/28921379/time-trends-in-utilization-of-g-csf-prophylaxis-and-risk-of-febrile-neutropenia-in-a-medicare-population-receiving-adjuvant-chemotherapy-for-early-stage-breast-cancer
#2
Ravi K Goyal, Spiros Tzivelekis, Kenneth J Rothman, Sean D Candrilli, James A Kaye
PURPOSE: The purpose of this study is to assess temporal trends in the use of granulocyte colony-stimulating factor (G-CSF) prophylaxis and risk of febrile neutropenia (FN) among older women receiving adjuvant chemotherapy for early-stage breast cancer. METHODS: Women aged ≥ 66 years with diagnosis of early-stage breast cancer who initiated selected adjuvant chemotherapy regimens were identified using the SEER-Medicare data from 2002 to 2012. Adjusted, calendar-year-specific proportions were estimated for use of G-CSF primary prophylaxis (PP) and secondary prophylaxis and FN risk in the first and the second/subsequent cycles during the first course of chemotherapy, using logistic regression models...
September 18, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28903802/can-national-healthcare-associated-infections-hais-data-differentiate-hospitals-in-the-united-states
#3
Max Masnick, Daniel J Morgan, John D Sorkin, Mark D Macek, Jessica P Brown, Penny Rheingans, Anthony D Harris
OBJECTIVE To determine whether patients using the Centers for Medicare and Medicaid Services (CMS) Hospital Compare website (http://medicare.gov/hospitalcompare) can use nationally reported healthcare-associated infection (HAI) data to differentiate hospitals. DESIGN Secondary analysis of publicly available HAI data for calendar year 2013. METHODS We assessed the availability of HAI data for geographically proximate hospitals (ie, hospitals within the same referral region) and then analyzed these data to determine whether they are useful to differentiate hospitals...
October 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28902882/risk-of-myeloid-neoplasms-after-radiotherapy-among-older-women-with-localized-breast-cancer-a-population-based-study
#4
Amer M Zeidan, Jessica B Long, Rong Wang, Xin Hu, James B Yu, Scott F Huntington, Gregory A Abel, Sarah S Mougalian, Nikolai A Podoltsev, Steven D Gore, Cary P Gross, Xiaomei Ma, Amy J Davidoff
BACKGROUND: There are inconsistent and limited data regarding the risk of myeloid neoplasms (MN) among breast cancer survivors who received radiotherapy (RT) in the absence of chemotherapy. Concern about subsequent MN might influence the decision to use adjuvant RT for women with localized disease. As patients with therapy-related MN have generally poor outcomes, the presumption of subsequent MN being therapy-related could affect treatment recommendations. METHODS: We used the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database to study older women with in-situ or stage 1-3 breast cancer diagnosed 2001-2009 who received surgery...
2017: PloS One
https://www.readbyqxmd.com/read/28888408/atrial-fibrillation-and-stent-selection-bare-metal-vs-drug-eluting-from-medicare-claims
#5
Greg Dadekian, Aaron V Kaplan, Chiang-Hua Chang, Nancy E Morden
In treating coronary artery disease, many factors influence the choice of bare metal stent (BMS) or drug-eluting stent (DES), including bleed risk and suitability for prolonged dual antiplatelet therapy. Atrial fibrillation (AF) further complicates this choice, due to common use of anticoagulation. We examined stent selection in the United States by AF status and across academic medical centers (AMCs) to explore how cardiologists are managing this complex choice. Using a 100% Medicare denominator file and associated claims (2008 to 2012), we identified patients over age 65 receiving inpatient coronary artery stents...
August 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28885293/surgeon-reimbursement-relative-to-hospital-payments-for-spinal-fusion-trends-from-10-year-medicare-analysis
#6
Nikhil Jain, Frank M Phillips, Adam L Shimer, Safdar N Khan
STUDY DESIGN: Retrospective, economic analysis OBJECTIVE.: To analyze the trend in hospital charge and payment adjusted to corresponding surgeon charge and payment for cervical and lumbar fusions in a Medicare sample population from 2005-2014. SUMMARY OF BACKGROUND DATA: Previous studies have reported trends and variation in hospital charges and payments for spinal fusion, but none have incorporated surgeon data in analysis. Knowledge of the fiscal relationship between hospitals and surgeons over time will be important for stakeholders as we move toward bundled payments...
September 6, 2017: Spine
https://www.readbyqxmd.com/read/28885288/early-effects-of-medicare-s-bundled-payment-for-care-improvement-bpci-program-for-lumbar-fusion
#7
Brook I Martin, Jon D Lurie, Farrokh R Farrokhi, Kevin J McGuire, Sohail K Mirza
STUDY DESIGN: Retrospective analysis of Medicare claims linked to hospital participation in the Center for Medicare and Medicaid Innovation's episode-based Bundled Payment for Care Improvement (BPCI) program for lumbar fusion. OBJECTIVES: To describe the early effects of BPCI participation for lumbar fusion on 90-day reimbursement, procedure volume, reoperation, and readmission. SUMMARY OF BACKGROUND DATA: Initiated on January 1st, 2013, BPCI's voluntary bundle payment program provides a predetermined payment for services related to a Diagnosis Related Group-defined "triggering event" over a defined time period...
September 6, 2017: Spine
https://www.readbyqxmd.com/read/28866828/association-of-the-severity-of-diabetes-related-complications-with-stage-of-breast-cancer-at-diagnosis-among-elderly-women-with-pre-existing-diabetes
#8
Ebtihag O Alenzi, S Suresh Madhavan, Xi Tan
PURPOSE: This study assessed the association between the severity of diabetes complications using diabetes complications severity index (DCSI) and stage of breast cancer (BC) at diagnosis among elderly women with pre-existing diabetes and incident BC. METHODS: Using Surveillance, Epidemiology and End Results-Medicare data, we identified women with incident BC during 2004-2011 and pre-existing diabetes (N = 7729). Chi-square tests were used to test for group differences in stage of BC at diagnosis...
September 2, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28863353/predicting-3-year-mortality-and-admission-to-acute-care-hospitals-skilled-nursing-facilities-and-long-term-care-facilities-in-medicare-beneficiaries
#9
Jibby E Kurichi, Hillary R Bogner, Joel E Streim, Dawei Xie, Pui L Kwong, Debra Saliba, Sean Hennessy
PURPOSE: The ability to predict mortality and admission to acute care hospitals, skilled nursing facilities (SNFs), and long-term care (LTC) facilities in the elderly and how it varies by activity of daily living (ADL) and instrumental ADL (IADL) status could be useful in measuring the success or failure of economic, social, or health policies aimed at disability prevention and management. We sought to derive and assess the predictive performance of rules to predict 3-year mortality and admission to acute care hospitals, SNFs, and LTC facilities among Medicare beneficiaries with differing ADL and IADL functioning levels...
August 24, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28862960/selection-of-stent-type-in-patients-with-atrial-fibrillation-presenting-with-acute-myocardial-infarction-an-analysis-from-the-action-acute-coronary-treatment-and-intervention-outcomes-network-registry-get-with-the-guidelines
#10
Amit N Vora, Tracy Y Wang, Shuang Li, Karen Chiswell, Connie Hess, Renato D Lopes, Sunil V Rao, Eric D Peterson
BACKGROUND: Patients receiving oral anticoagulation in addition to dual-antiplatelet therapy are known to be at high risk for bleeding events; thus, the selection of a drug-eluting stent (DES) versus a bare metal stent (BMS) can have important implications for patients with atrial fibrillation (AF) presenting with acute myocardial infarction (MI). METHODS AND RESULTS: From the National Cardiovascular Data Registry ACTION (Acute Coronary Treatment and Intervention Outcomes Network) Registry-Get With the Guidelines, we identified 14 427 AF patients presenting with acute MI undergoing percutaneous coronary intervention from 2008 to 2014...
August 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28862479/cost-effectiveness-analysis-of-dabigatran-versus-rivaroxaban-for-stroke-prevention-in-patients-with-non-valvular-atrial-fibrillation-using-real-world-evidence-in-elderly-us-medicare-beneficiaries
#11
Siyang Peng, Kristen A Deger, Anastasia Ustyugova, Pranav Gandhi, Nan Qiao, Cheng Wang, Anuraag R Kansal
OBJECTIVE: Dabigatran and rivaroxaban have been approved by the US FDA to reduce the risk of stroke and systemic embolism in non-valvular atrial fibrillation (NVAF) patients. Newly published real-world evidence based on the US population found that elderly Medicare patients with NVAF treated with rivaroxaban experienced statistically significant increases in intracranial hemorrhage (ICH) and major extracranial bleeding, and statistically nonsignificant decreases in thromboembolic stroke and acute myocardial infarction (AMI) compared with dabigatran...
September 1, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28853238/herpes-zoster-as-a-risk-factor-for-incident-giant-cell-arteritis
#12
Bryant R England, Ted R Mikuls, Fenglong Xie, Shuo Yang, Lang Chen, Jeffrey R Curtis
OBJECTIVES: Histopathological studies have implicated herpes zoster (HZ) as a causative organism of giant cell arteritis (GCA). We assessed the epidemiologic association of HZ events with incident GCA. METHODS: We performed a retrospective cohort study utilizing two, large, independent US administrative datasets (Medicare 5% and Truven MarketScan) with eligible subjects having 12 months of continuous coverage, >50 years old, and without history of GCA or polymyalgia rheumatica...
August 29, 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/28844631/improving-value-in-total-hip-and-knee-arthroplasty-the-role-of-high-volume-hospitals
#13
P Maxwell Courtney, Nicholas B Frisch, Daniel D Bohl, Craig J Della Valle
BACKGROUND: Recent healthcare reform efforts have focused on improving the quality of total joint replacement care while reducing overall costs. The purpose of this study is to determine if higher volume centers have lower costs and better outcomes than lower volume hospitals. METHODS: We queried the Centers for Medicare and Medicaid Services (CMS) Inpatient Charge Data and identified 2702 hospitals that performed a total of 458,259 primary arthroplasty procedures in 2014...
August 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28841388/risk-of-alzheimer-s-disease-among-senior-medicare-beneficiaries-treated-with-androgen-deprivation-therapy-for-prostate-cancer
#14
Seo Hyon Baik, Fabricio Sampaio Peres Kury, Clement Joseph McDonald
Purpose To assess the relative risk of Alzheimer's disease (AD) among patients with prostate cancer who received androgen deprivation therapy (ADT), after adjustment for other cancer therapies. Methods Data from demographics, survival, diagnoses codes, procedure codes, and other information about beneficiaries age 67 years or older in the Medicare claims database was assessed to determine the unadjusted and adjusted risks of AD and of dementia from ADT. The prespecified survival analysis method was competing risk regression...
August 25, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28838868/online-surgeon-ratings-and-outcomes-in-hernia-surgery-an-americas-hernia-society-quality-collaborative-analysis
#15
Ivy N Haskins, David M Krpata, Michael J Rosen, Arielle J Perez, Luciano Tastaldi, Robert S Butler, Steven Rosenblatt, Ajita S Prabhu
BACKGROUND: Online surgeon ratings are viewed as a measure of physician quality by some consumers. Nevertheless, the correlation between online surgeon ratings and surgeon quality metrics remains unknown. The purpose of this study was to investigate the association between online surgeon ratings and hernia-specific quality metrics. STUDY DESIGN: The Americas Hernia Society Quality Collaborative (AHSQC) is recognized by the Centers for Medicaid and Medicare as a Quality Clinical Data Registry (QCDR) that reports risk-adjusted quality metrics for hernia surgeons...
August 31, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28838094/the-obesity-paradox-extreme-obesity-and-long-term-outcomes-in-older-adults-with-st-segment-elevation-myocardial-infarction-results-from-the-ncdr
#16
Ian J Neeland, Sandeep R Das, DaJuanicia N Simon, Deborah B Diercks, Karen P Alexander, Tracy Y Wang, James A de Lemos
Aims: To investigate the obesity paradox and association of extreme obesity with long-term outcomes among older ST-segment elevation myocardial infarction (STEMI) patients. Methods and results: Nineteen thousand four hundred and ninety-nine patients ≥65 years with STEMI surviving to hospital discharge in NCDR ACTION Registry-GWTG linked to Centers for Medicare and Medicaid Services outcomes between 2007 and 2012 were stratified by body mass index (BMI) (kg/m2) into normal weight (18...
July 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28832865/drivers-of-payment-variation-in-90-day-coronary-artery-bypass-grafting-episodes
#17
Vinay Guduguntla, John D Syrjamaki, Chad Ellimoottil, David C Miller, Richard L Prager, Edward C Norton, Patricia Theurer, Donald S Likosky, James M Dupree
Importance: Coronary artery bypass grafting (CABG) is scheduled to become a mandatory Medicare bundled payment program in January 2018. A contemporary understanding of 90-day CABG episode payments and their drivers is necessary to inform health policy, hospital strategy, and clinical quality improvement activities. Furthermore, insight into current CABG payments and their variation is important for understanding the potential effects of bundled payment models in cardiac care. Objective: To examine CABG payment variation and its drivers...
August 23, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28830879/outcomes-associated-with-extraction-versus-capping-and-abandoning-pacing-and-defibrillator-leads
#18
Sean D Pokorney, Xiaojuan Mi, Robert K Lewis, Melissa Greiner, Laurence M Epstein, Roger G Carrillo, Emily P Zeitler, Sana M Al-Khatib, Donald D Hegland, Jonathan P Piccini
Background -Lead management is an increasingly important aspect of care in patients with cardiac implantable electronic devices (CIED); however, relatively little is known about long-term outcomes after capping and abandoning leads. Methods -Using the 5% Medicare sample, we identified patients with (1) de novo CIED implants between 1/1/2000 and 12/31/2013 and (2) a subsequent lead addition or extraction ≥12 months after the de novo implant. Patients who underwent extraction for infection were excluded. Using multivariable Cox proportional hazards models, cumulative incidence of all-cause mortality, device-related infection, device revision, and lead extraction at 1 and 5 years were compared for the extract versus the cap and abandon groups...
August 22, 2017: Circulation
https://www.readbyqxmd.com/read/28822996/examining-bias-in-studies-of-statin-treatment-and-survival-in-patients-with-cancer
#19
Louise Emilsson, Xabier García-Albéniz, Roger W Logan, Ellen C Caniglia, Mette Kalager, Miguel A Hernán
Importance: Patients with cancer who use statins appear to have a substantially better survival than nonusers in observational studies. However, this inverse association between statin use and mortality may be due to selection bias and immortal-time bias. Objective: To emulate a randomized trial of statin therapy initiation that is free of selection bias and immortal-time bias. Design, Setting, and Participants: We used observational data on 17 372 patients with cancer from the Surveillance, Epidemiology, and End Results (SEER)-Medicare database (2007-2009) with complete follow-up until 2011...
August 20, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28817299/how-do-medicare-advantage-beneficiary-payments-vary-with-tenure
#20
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
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