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https://www.readbyqxmd.com/read/29155982/economic-and-survival-burden-of-dysphagia-among-inpatients-in-the-united-states
#1
D A Patel, S Krishnaswami, E Steger, E Conover, M F Vaezi, M R Ciucci, D O Francis
The inpatient burden of dysphagia has primarily been evaluated in patients with stroke. It is unclear whether dysphagia, irrespective of cause, is associated with worse clinical outcomes and higher costs compared to inpatients with similar demographic, hospital, and clinical characteristics without dysphagia. The aim of this study is to assess how a dysphagia diagnosis affects length of hospital stay (LOS), costs, discharge disposition, and in-hospital mortality among adult US inpatients. Annual and overall dysphagia prevalence, LOS, hospital charges, inpatient care costs, discharge disposition, and in-hospital mortality were measured using the AHRQ Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (2009-2013)...
November 16, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29155848/an-electronic-health-record-based-model-predicts-statin-adherence-ldl-cholesterol-and-cardiovascular-disease-in-the-united-states-military-health-system
#2
Joseph E Lucas, Taylor C Bazemore, Celan Alo, Patrick B Monahan, Deepak Voora
HMG-CoA reductase inhibitors (or "statins") are important and commonly used medications to lower cholesterol and prevent cardiovascular disease. Nearly half of patients stop taking statin medications one year after they are prescribed leading to higher cholesterol, increased cardiovascular risk, and costs due to excess hospitalizations. Identifying which patients are at highest risk for not adhering to long-term statin therapy is an important step towards individualizing interventions to improve adherence. Electronic health records (EHR) are an increasingly common source of data that are challenging to analyze but have potential for generating more accurate predictions of disease risk...
2017: PloS One
https://www.readbyqxmd.com/read/29154813/one-year-outcomes-of-prasugrel-versus-ticagrelor-in-acute-myocardial-infarction-treated-with-primary-angioplasty-the-prague-18-study
#3
Zuzana Motovska, Ota Hlinomaz, Petr Kala, Milan Hromadka, Jiri Knot, Ivo Varvarovsky, Jaroslav Dusek, Jiri Jarkovsky, Roman Miklik, Richard Rokyta, Frantisek Tousek, Petra Kramarikova, Michal Svoboda, Bohumil Majtan, Stanislav Simek, Marian Branny, Jan Mrozek, Pavel Cervinka, Jiri Ostransky, Petr Widimsky
BACKGROUND: Early outcomes of patients in the PRAGUE-18 study did not find any significant differences between two potent P2Y12 inhibitors. OBJECTIVE: The one-year follow-up of the PRAGUE-18 study focused on (1) a comparison of efficacy and safety between prasugrel and ticagrelor, and (2) on the risk of major ischemic events related to an economically motivated post-discharge switch to clopidogrel. METHODS: A total of 1,230 patients with acute myocardial infarction (MI) treated with primary PCI were randomized to prasugrel or ticagrelor with an intended treatment duration of 12 months...
November 9, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29153122/age-specific-cost-effectiveness-of-using-intravenous-recombinant-tissue-plasminogen-activator-for-treating-acute-ischemic-stroke
#4
Heesoo Joo, Guijing Wang, Mary G George
INTRODUCTION: Studies have demonstrated that intravenous recombinant tissue plasminogen activator (IV rtPA) is a cost-effective treatment for acute ischemic stroke. Age-specific cost effectiveness has not been well examined. This study estimated age-specific incremental cost-effectiveness ratios (ICERs) of IV rtPA treatment versus no IV rtPA. METHODS: A Markov model was developed to examine the economic impact of IV rtPA over a 20-year time horizon on four age groups (18-44, 45-64, 65-80, and ≥81 years) from the U...
December 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29152607/use-of-post-acute-care-after-hospital-discharge-in-urban-and-rural-hospitals
#5
Robert E Burke, Christine D Jones, Eric A Coleman, Jason R Falvey, Jennifer E Stevens-Lapsley, Adit A Ginde
Objectives: Geographic variation in the use of post-acute care (PAC - skilled nursing facility and home health care) after hospital discharge is substantial, but reasons for this remain largely unexplored. PAC use in urban hospitals compared to rural hospitals may be one key contributor. We aimed to describe PAC use, explore substitution of one type of PAC for another, and identify how PAC use varies by diagnosis in urban and rural settings. Study Design: Secondary analysis of the 2012 National Inpatient Sample including adult discharges to PAC after a hospitalization...
March 2017: Am J Accountable Care
https://www.readbyqxmd.com/read/29129364/diabetes-control-decreases-morbidity-and-mortality-after-carotid-endarterectomy
#6
Matthew S Parr, Viktor Y Dombrovskiy, Khanjan H Nagarsheth, Randy Shafritz, Saum A Rahimi
BACKGROUND: Single-institution studies have demonstrated a negative effect of diabetes mellitus on outcomes after carotid endarterectomy (CEA). The aim of this study was to compare patients with explicitly controlled and uncontrolled diabetes at the population level. METHODS: Using the National Inpatient Sample 2006-2013, we selected patients undergoing CEA. Rates of stroke, myocardial infarction (MI), and hospital mortality, as well as duration of stay and cost were compared among patients with uncontrolled diabetes (UCDM), well-controlled diabetes (WCDM), and those without diabetes (NDM)...
November 9, 2017: Surgery
https://www.readbyqxmd.com/read/29127194/dump-the-pump-manual-aspiration-thrombectomy-mat-with-a-syringe-is-technically-effective-expeditious-and-cost-efficient
#7
Bradley A Gross, Ashutosh P Jadhav, Tudor G Jovin, Brian Thomas Jankowitz
INTRODUCTION: Syringe aspiration for manual aspiration thrombectomy (MAT) is a cost- and time-efficient alternative to an aspiration pump with likely similar efficacy. It is counterintuitive to expect the pump to perform better than direct vacuum with a syringe, as the pump must deliver vacuum additionally through a canister and meters of tubing. OBJECTIVE: To present in vitro and clinical results of MAT with a syringe. METHODS: An in vitro analysis was performed comparing vacuum pressures generated by syringe aspiration and with pump aspiration...
November 10, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29126415/cost-of-illness-of-atrial-fibrillation-a-nationwide-study-of-societal-impact
#8
Søren Paaske Johnsen, Lene Worsaae Dalby, Tomas Täckström, Jens Olsen, Anina Fraschke
BACKGROUND: The prevalence of atrial fibrillation is increasing rapidly; however, to date, population-based data are lacking on the attributable cost of illness of atrial fibrillation from a societal perspective, including both direct and indirect costs. METHODS: The study was an incidence-based cost-of-illness study based on national registries covering the entire population of Denmark. We identified all patients with a first-time hospital diagnosis of atrial fibrillation between 2001 and 2012...
November 10, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29122466/novel-algorithm-to-help-identify-stroke-mimics
#9
Nadeem Israr Khan, Shilpa Chaku, Christina Goehl, Laura Endris, Georgia Mueller-Luckey, Fazeel M Siddiqui
BACKGROUND: Stroke is a major cause of disability in the United States. A portion of patients presenting with stroke-like symptoms in the emergency room who receive tissue plasminogen activator (tPA) do not end up having a true stroke, leading to unnecessary health-care costs. The aim of our study is to identify those patients who have a high likelihood of experiencing a stroke mimic using a novel stroke mimic score and to identify a cutoff point with a high specificity of ruling in stroke mimics...
November 6, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29118795/cost-analysis-of-the-addition-of-hyperacute-magnetic-resonance-imaging-for-selection-of-patients-for-endovascular-stroke-therapy
#10
Seby John, Nicolas R Thompson, Terry Lesko, Nancy Papesh, Nancy Obuchowski, Dan Tomic, Dolora Wisco, Zeshaun Khawaja, Ken Uchino, Shumei Man, Esteban Cheng-Ching, Gabor Toth, Thomas Masaryk, Paul Ruggieri, Michael Modic, Muhammad Shazam Hussain
Background and Purpose: Patient selection is important to determine the best candidates for endovascular stroke therapy. In application of a hyperacute magnetic resonance imaging (MRI) protocol for patient selection, we have shown decreased utilization with improved outcomes. A cost analysis comparing the pre- and post-MRI protocol time periods was performed to determine if the previous findings translated into cost opportunities. Materials and Methods: We retrospectively identified individuals considered for endovascular stroke therapy from January 2008 to August 2012 who were ≤8 h from stroke symptoms onset...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29107164/subarachnoid-hemorrhage-and-readmissions-national-rates-causes-risk-factors-and-outcomes-in-16-001-hospitalized-patients
#11
Kavelin Rumalla, Kyle A Smith, Paul M Arnold, Manoj K Mittal
INTRODUCTION: The acute complications of aneurysmal subarachnoid hemorrhage (aSAH) often lead to readmissions, which are linked to hospital reimbursement. The national rates, causes, risk factors, and outcomes associated with 30-day and 90-day readmission following aSAH have not previously been reported. METHODS: The Nationwide Readmissions Database was queried from January through September 2013 for all patients (age ≥ 18) with a diagnosis of aSAH. Data points included demographics, comorbidities, complications, and discharge outcomes...
October 26, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29105583/the-economic-cost-of-stroke-associated-pneumonia-in-a-uk-setting
#12
A N Ali, J Howe, A Majid, J Redgrave, S Pownall, A H Abdelhafiz
Introduction Stroke-associated pneumonia (SAP) is common, however, data on the economic impact of SAP are scarce. This study aimed to prospectively evaluate the impact of SAP on acute stroke care costs in a UK setting. Methods Prospective cohort study of 213 consecutive patients with stroke (196 ischemic, 17 hemorrhagic) was admitted to a UK hospital over 1 year. Socio demographic and clinical characteristics were recorded along with all treatments and rehabilitation activity. Patients were classified as having SAP if they fulfilled criteria for "probable" or "definite" respiratory tract infection according to the Centres for Disease Control and Prevention definition, within the first seven days following stroke...
November 4, 2017: Topics in Stroke Rehabilitation
https://www.readbyqxmd.com/read/29105528/cost-effectiveness-analysis-of-tissue-plasminogen-activator-in-acute-ischemic-stroke-in-iran
#13
Asrin Amiri, Reza Goudarzi, Mohammadreza Amiresmaili, Farhad Iranmanesh
AIMS: Tissue plasminogen activator (tPA) is used to treat acute ischemic stroke up to 4.5 hours after symptom onset. Its cost-effectiveness in developing countries is not specified yet. This study aimed to study cost-effectiveness of tPA in Iran. METHODS: This is a cost-effectiveness analysis from the perspective of the third party payer to compare IV tPA with no tPA of ischemic stroke. A Markov model with a lifetime horizon was used to analyze the costs and outcomes...
November 5, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/29082335/atrial-fibrillation-trial-to-evaluate-real-world-procedures-for-their-utility-in-helping-to-lower-stroke-events-after-pulse-study-protocol-for-a-randomized-controlled-trial
#14
Tsung-Ta Hsieh, Meng Lee, Wen-Yi Huang, Sung-Chun Tang, Sheng-Feng Sung, Kuo-Husan Chang, Jiann-Der Lee, Tsong-Hai Lee, Yung-Sung Huang, Jiann-Shing Jeng, Chang-Min Chung, Yi-Ling Wu, Bruce Ovbiagele
BACKGROUND: Enhancing detection of undiagnosed atrial fibrillation (AF) in hospitalized patients with a recent ischemic stroke is important because of the treatment implications; especially since presence of paroxysmal AF may not be picked up in a single 12-lead electrocardiogram (ECG) test. While several trials have shown improved detection of AF with prolonged ECG monitoring, this strategy is associated with relatively high cost, labor intensity, and patient inconvenience, thereby making it challenging to routinely implement in all hospitals...
June 2017: Contemporary Clinical Trials Communications
https://www.readbyqxmd.com/read/29078803/profile-of-stroke-patients-treated-at-a-rehabilitation-centre-in-bangladesh
#15
Firoz Ahmed Mamin, Muhammad Shahidul Islam, Farjana Sharmin Rumana, Farhana Faruqui
OBJECTIVE: Stroke is the leading cause of death and disability in Bangladesh. Rehabilitation services have not yet been integrated into the Bangladesh health system. Only a few non-governmental organisations provide rehabilitation for stroke patients. The demographic profile of these patients has not yet been established. The aim of this study was to identify and evaluate the socio-demographic data, risk factors, place of primary management and cost of stroke for those who attended rehabilitation at the Centre for the Rehabilitation of the Paralysed (CRP), Bangladesh...
October 27, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29072961/reducing-smoking-in-the-us-federal-workforce-5-year-health-and-economic-impacts-from-improved-cardiovascular-disease-outcomes
#16
Garrett R Beeler Asay, David M Homa, Erin M Abramsohn, Xin Xu, Erin L O'Connor, Guijing Wang
OBJECTIVE: We estimated the reduction in number of hospitalizations for acute myocardial infarction and stroke as well as the associated health care costs resulting from reducing the number of smokers in the US federal workforce during a 5-year period. METHODS: We developed a 5-year spreadsheet-based cohort model with parameter values from past literature and analysis of national survey data. We obtained 2015 data on the federal workforce population from the US Office of Personnel Management and data on smoking prevalence among federal workers from the 2013-2015 National Health Interview Survey...
November 2017: Public Health Reports
https://www.readbyqxmd.com/read/29051816/eptifibatide-is-associated-with-significant-cost-savings-and-similar-clinical-outcomes-to-abciximab-when-used-during-primary-percutaneous-coronary-intervention-for-st-elevation-myocardial-infarction-an-observational-cohort-study-of-3863-patients
#17
K S Rathod, S Antoniou, P Avari, N Ding, P Wright, C Knight, A K Jain, A Mathur, E J Smith, R Weerackody, A Wragg, D A Jones
INTRODUCTION: Glycoprotein IIb/IIIa inhibitors are recommended by guidelines in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention. There are few studies directly comparing these agents. The aim of this study was to assess whether eptifibatide is a safe and cost-effective alternative to abciximab in the treatment of primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. METHODS: This was an observational cohort study of 3863 patients who received a GPIIb/IIIa inhibitor whilst undergoing primary percutaneous coronary intervention from 2007 to 2014...
January 2017: JRSM Cardiovascular Disease
https://www.readbyqxmd.com/read/29047304/real-world-comparison-of-all-cause-hospitalizations-hospitalizations-due-to-stroke-and-major-bleeding-and-costs-for-nonvalvular-atrial-fibrillation-patients-prescribed-oral-anticoagulants-in-a-us-health-plan
#18
Alpesh Amin, Allison Keshishian, Lien Vo, Qisu Zhang, Oluwaseyi Dina, Chad Patel, Kevin Odell, Jeffrey Trocio
AIMS: Compare the risk of all-cause hospitalization and hospitalizations due to stroke/systemic embolism (SE) and major bleeding as well as associated health care costs for nonvalvular atrial fibrillation (NVAF) patients initiating apixaban, dabigatran, rivaroxaban, or warfarin. MATERIALS AND METHODS: NVAF patients initiating apixaban, dabigatran, rivaroxaban, or warfarin were selected from the OptumInsight Research Database from 01JAN2013-30SEP2015. Propensity score matching (PSM) was performed between apixaban and each oral anticoagulant...
October 19, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/29033989/effectiveness-of-back-massage-on-sleep-pattern-among-patients-with-congestive-cardiac-failure
#19
Amol Sable, Thangaraj Sivabalan, Akshaya Narayan Shetti
BACKGROUND: Sleep plays an important role in congestive cardiac failure (CCF). Back massage reduces anxiety, discomfort, and physical suffering in CCF patients. Study objective is to assess sleep pattern in CCF patients before and after back massage. MATERIALS AND METHODS: A quasi-experimental study was conducted in Pravara Rural hospital, Loni, India over 4 months in 2016. Thirty CCF patients were included in the study with purposive sampling. Nurse investigator performed 20-min back massage thrice daily, 5 min for each step from the day of admission till discharge...
September 2017: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/29032237/hospital-charges-and-length-of-stay-following-radical-cystectomy-in-the-eras-era
#20
Alice Semerjian, Niv Milbar, Max Kates, Michael A Gorin, Hiten D Patel, Heather J Chalfin, Steven M Frank, Christopher L Wu, William W Yang, Deb Hobson, Lindsay Robertson, Elizabeth Wick, Mark P Schoenberg, Phillip M Pierorazio, Michael H Johnson, C J Stimson, Trinity J Bivalacqua
OBJECTIVE: To report our center's experience with Enhanced Recovery after Surgery (ERAS) pathway for radical cystectomy (RC), specifically evaluating complications, LOS, 30- and 90-day readmissions, and hospital charges. Pathways of this type have been shown to decrease length of stay (LOS) and post-operative ileus. However, concerns persist that ERAS is costly and increases readmissions. To date, limited studies have evaluated these concerns. MATERIALS AND METHODS: Our ERAS protocol was implemented for RC in December 2015...
October 12, 2017: Urology
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