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https://www.readbyqxmd.com/read/28904655/assessment-of-potentially-preventable-hospitalizations-in-the-regional-hospital-of-saint-louis-senegal
#1
Abdoul Aziz Ndiaye, Mouhameth Bakhoum, Alioune Badara Tall, Ndeye Fatou Ngom-Gueye, Mohamed Sidy Seck, Boubacar Gueye, Awa Diop-Ba, Awa Gaye, Gallo Papa Sow, Lamine Gueye, Anta Tal-Dia
INTRODUCTION: The "potentially preventable hospitalizations (PPH)'' are hospital admissions that could have been avoided through effective primary care given at the appropriate time. Non-communicable diseases (NCDs), causes of PPH, are the leading cause of death worldwide with significant socioeconomic consequences especially in developing countries. This study aimed to assess the burden of potentially preventable hospitalizations in the St. Louis regional hospital. METHODS: This was a descriptive cross-sectional study...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28889824/differences-in-clinical-outcomes-and-cost-between-complex-and-simple-arterial-switches
#2
Eric R Griffiths, Nelangi M Pinto, Aaron W Eckhauser, Ragheed Al-Dulaimi, Angela P Presson, David K Bailly, Phillip T Burch
BACKGROUND: This study evaluates the morbidity, mortality, and cost differences between patients who underwent either a simple or a complex arterial switch operation. METHODS: A retrospective study of patients undergoing an arterial switch operation at a single institution was performed. Simple cases were defined as patients with d-transposition of the great arteries with usual coronary anatomy or circumflex artery originating from the right with either intact ventricular septum or ventricular septal defect...
September 11, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28882333/trends-and-outcomes-of-aortic-valve-replacement-in-patients-with-end-stage-renal-disease-on-hemodialysis
#3
Sami Aljohani, Fahad Alqahtani, Ahmad Almustafa, Khaled Boobes, Sujal Modi, Mohamad Alkhouli
Hemodialysis (HD) patients with aortic stenosis are less likely to undergo aortic valve replacement (AVR) due to their excess perioperative mortality. We aimed to evaluate contemporary utilization and outcomes of combined and isolated AVR in HD patients. The Nationwide Inpatient Sample was used to identify 142,046 patients who underwent AVR in 2005 to 2014, of whom 2,264 (1.6%) were on HD. Crude and adjusted in-hospital outcomes and costs were assessed in unmatched and propensity-matched cohorts of HD and non-HD patients, respectively...
August 4, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28865979/comparison-of-30-day-readmission-rates-and-risk-factors-between-carotid-artery-stenting-and-endarterectomy
#4
Hanaa Dakour Aridi, Satinderjit Locham, Besma Nejim, Mahmoud B Malas
OBJECTIVE: The aim of this study was to analyze the rates, reasons, and risk factors of 30-day readmission, both planned and unplanned, after carotid revascularization as well as to evaluate major outcomes associated with those readmissions. METHODS: Using the Premier Healthcare database, we retrospectively identified patients undergoing carotid endarterectomy (CEA) and carotid artery stenting (CAS) between 2009 and 2015. The primary outcome was 30-day all-cause readmission...
August 30, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28841249/assessing-physician-knowledge-regarding-indications-for-a-primary-prevention-implantable-defibrillator-and-potential-barriers-for-referral
#5
Rochelle Bernier, Satish R Raj, Dat Tran, Lucy Reyes, Michel Sauve, Glen L Sumner, Derek V Exner, Roopinder K Sandhu
BACKGROUND: Although there is clear evidence to demonstrate that primary prevention implantable defibrillators (ICDs) reduce mortality in high-risk patients, ICDs are underutilized. Limited data exist assessing referring physicians' knowledge about guideline indications and attitudes towards ICDs, which may influence decision for referral. METHODS AND RESULTS: The Arrhythmia Working Group from the Alberta Cardiovascular and Stroke Strategic Clinical Network developed a web-based survey consisting of case scenarios regarding primary prevention ICD indications and a list of barriers for referral to aid in the design of a complex device care pathway...
August 25, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28837458/early-lessons-on-bundled-payment-at-an-academic-medical-center
#6
Lindsay E Jubelt, Keith S Goldfeld, Saul B Blecker, Wei-Yi Chung, John A Bendo, Joseph A Bosco, Thomas J Errico, Anthony K Frempong-Boadu, Richard Iorio, James D Slover, Leora I Horwitz
INTRODUCTION: Orthopaedic care is shifting to alternative payment models. We examined whether New York University Langone Medical Center achieved savings under the Centers for Medicare and Medicaid Services Bundled Payments for Care Improvement initiative. METHODS: This study was a difference-in-differences study of Medicare fee-for-service patients hospitalized from April 2011 to June 2012 and October 2013 to December 2014 for lower extremity joint arthroplasty, cardiac valve procedures, or spine surgery (intervention groups), or for congestive heart failure, major bowel procedures, medical peripheral vascular disorders, medical noninfectious orthopaedic care, or stroke (control group)...
September 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28832680/predicting-the-length-of-hospital-stay-of-post-acute-care-patients-in-taiwan-using-the-chinese-version-of-the-continuity-assessment-record-and-evaluation-item-set
#7
Chen-Yu Hung, Wei-Ting Wu, Ke-Vin Chang, Tyng-Guey Wang, Der-Sheng Han
BACKGROUND: The Chinese version of the Continuity Assessment Record and Evaluation (CARE-C) item set was developed to facilitate the assessment of post-acute care (PAC) patients in Taiwan. Considering that the length of hospital stay (LOS) has a significant effect on the total healthcare cost, determining whether the CARE-C scores could predict the LOS of PAC patients is of great interest to the PAC providers. METHODS: This prospective trial included PAC patients with stroke or central nervous system injuries...
2017: PloS One
https://www.readbyqxmd.com/read/28807634/-severity-assessment-strategies-based-on-administrative-data-using-stroke-as-an-example
#8
Ingrid Schubert, Antje Hammer, Ingrid Köster
BACKGROUND AND OBJECTIVES: Information on disease severity is relevant for many studies with claims data in health service research, but only limited information is available in routine data. Stroke serves as an example, to analyse whether the combination of different information in claims data can provide insight into the severity of a disease. METHOD: As a first step, a literature search was conducted. Strategies to assess the severity of a disease by means of routine data were examined with regards and applicability to German sickness fund data...
August 11, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28801954/an-analysis-of-inpatient-pediatric-sickle-cell-disease-incidence-costs-and-outcomes
#9
Laura M Bou-Maroun, Fabien Meta, Curtis J Hanba, Andrew D Campbell, Gregory A Yanik
OBJECTIVE: To identify characteristics of pediatric sickle cell disease (SCD) hospitalizations and to examine admission demographics and medical expenditures. METHODS: Admissions with SCD were identified from the 2009 and 2012 releases of the Healthcare and Cost Utilization Project's Kids Inpatient Database. Disease-specific secondary diagnoses including acute chest syndrome (ACS), vaso-occlusive pain crisis (VOC), splenic sequestration, and stroke/transient ischemic attack were analyzed for patient and hospital demographics...
August 12, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28800179/short-term-outcomes-of-atrial-flutter-ablation
#10
Byomesh Tripathi, Shilpkumar Arora, Abhishek Mishra, Vishwa Reddy Kundoor, Sopan Lahewala, Varun Kumar, Mahek Shah, Dhairya Lakhani, Harshil Shah, Nilay V Patel, Nileshkumar J Patel, Mihir Dave, Abhishek Deshmukh, Sattur Sudhakar, Radha Gopalan
BACKGROUND: Understanding the factors associated with early readmissions following atrial flutter (AFL) ablation is critical to reduce the cost and improving the quality of life in AFL patients. METHOD: The study cohort was derived from the National readmission database 2013-14. International Classification of Diseases, 9th Revision (ICD-9-CM) diagnosis code 427.32 and procedure code 37.34 were used to identify AFL and catheter ablation respectively. The primary and secondary outcomes were 90-day readmission and complications including in-hospital mortality...
August 11, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28797241/hospital-treatment-costs-and-length-of-stay-associated-with-hypertension-and-multimorbidity-after-hemorrhagic-stroke
#11
Adrian V Specogna, Tanvir C Turin, Scott B Patten, Michael D Hill
BACKGROUND: Previous studies have identified various treatment and patient characteristics that may be associated with higher hospital cost after spontaneous intracerebral hemorrhage (ICH); a devastating type of stroke. Patient morbidity is perhaps the least understood of these cost-driving factors. We describe how hypertension and other patient morbidities affect length of stay, and hospital treatment costs after ICH using primary and simulated data. We also describe the relationship between cost and length of stay within these patients...
August 10, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28795348/all-cause-stroke-and-bleed-specific-healthcare-costs-comparison-among-patients-with-non-valvular-atrial-fibrillation-nvaf-newly-treated-with-dabigatran-or-warfarin
#12
Adrienne M Gilligan, Pranav Gandhi, Xue Song, Cheng Wang, Caroline Henriques, Stephen Sander, David M Smith
OBJECTIVE: Our objective was to compare all-cause and stroke- and bleed-specific healthcare costs among patients with non-valvular atrial fibrillation (NVAF) treated with dabigatran or warfarin. METHODS: Administrative claims data from the MarketScan(®) Databases for 2009-2014 were used. Patients with NVAF newly treated with dabigatran were matched 1:1 to those treated with warfarin. All-cause and stroke- and bleed-specific costs per patient per month (PPPM) ($US, year 2015 values) up to a 12-month follow-up period were analyzed...
August 9, 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/28783225/meta-analysis-of-the-costs-of-carotid-artery-stenting-and-carotid-endarterectomy
#13
REVIEW
E E de Vries, V G M Baldew, H M den Ruijter, G J de Borst
BACKGROUND: Carotid artery stenting (CAS) is currently associated with an increased risk of 30-day stroke compared with carotid endarterectomy (CEA), whereas both interventions seem equally durable beyond the periprocedural period. Although the clinical outcomes continue to be scrutinized, there are few data summarizing the costs of both techniques. METHODS: A systematic search was conducted in MEDLINE, Embase and Cochrane databases in August 2016 identifying articles comparing the costs or cost-effectiveness of CAS and CEA in patients with carotid artery stenosis...
September 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28768644/age-and-sex-disparities-in-discharge-statin-prescribing-in-the-stroke-belt-evidence-from-the-reasons-for-geographic-and-racial-differences-in-stroke-study
#14
Karen C Albright, Virginia J Howard, George Howard, Paul Muntner, Vera Bittner, Monika M Safford, Amelia K Boehme, J David Rhodes, T Mark Beasley, Suzanne E Judd, Leslie A McClure, Nita Limdi, Justin Blackburn
BACKGROUND: Stroke is a costly and debilitating disease that disproportionately affects blacks. Despite the efficacy of statins, evidence suggests racial disparities may exist in statin prescribing. METHODS AND RESULTS: We analyzed discharge medications for participants hospitalized for an ischemic stroke during follow-up of the REGARDS (Reasons for Geographic and Racial Differences in Stroke) study. Medications on admission and discharge were abstracted from medical records...
August 2, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28766370/predictors-for-total-hospital-and-cardiology-cost-claims-among-patients-with-atrial-fibrillation-initiating-dabigatran-or-acenocoumarol-in-the-netherlands
#15
M S Jacobs, M W J van Leent, R G Tieleman, F G A Jansman, Q Cao, M J Postma, M van Hulst
AIMS: The prevalence of atrial fibrillation (AF) has increased over the past years due to aging of the population, and health care costs associated with AF reflect a significant financial burden. The aim of this study was to explore predictors for the real-world AF-related in-hospital costs in patients that recently initiated anticoagulation with acenocoumarol or dabigatran. METHODS: Predictors for claimed total hospital care costs and cardiology costs in AF patients were explored by using hospital financial claims data from propensity score matched patient groups in a large Dutch community hospital...
August 2, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28750695/cost-effectiveness-of-long-term%C3%A2-ticagrelor-in-patients-with-prior-myocardial-infarction-results-from-the-pegasus-timi-54-trial
#16
RANDOMIZED CONTROLLED TRIAL
Elizabeth A Magnuson, Haiyan Li, Kaijun Wang, Katherine Vilain, Ali Shafiq, Marc P Bonaca, Deepak L Bhatt, Marc Cohen, Philippe Gabriel Steg, Robert F Storey, Eugene Braunwald, Marc S Sabatine, David J Cohen
BACKGROUND: In patients with a myocardial infarction (MI) 1 to 3 years earlier, treatment with ticagrelor + low-dose aspirin (ASA) reduces the risk of cardiovascular (CV) death, MI, or stroke compared with low-dose aspirin alone, but at an increased risk of major bleeding. OBJECTIVES: The authors evaluated cost-effectiveness of ticagrelor + low-dose ASA in patients with prior MI within the prior 3 years. METHODS: The authors performed a prospective economic substudy alongside the PEGASUS-TIMI 54 (Prevention of Cardiovascular Events in Patients With Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin-Thrombolysis In Myocardial Infarction 54) trial, which randomized 21,162 patients to ASA alone, ticagrelor 60 mg twice daily + low-dose ASA, or ticagrelor 90 mg twice daily + low-dose ASA...
August 1, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28737304/investigation-and-diagnostic-formulation-in-patients-admitted-with-transient-loss-of-consciousness
#17
R Briggs, T Coughlan, J Doherty, D R Collins, D O'Neill, S P Kennelly
Several commonly completed tests have low diagnostic yield in the setting of transient loss of consciousness (T-LOC). We estimated the use and cost of inappropriate investigations in patients admitted with T-LOC and assessed if these patients were given a definitive diagnosis for their presentation. We identified 80 consecutive patients admitted with T-LOC to a university teaching hospital. Eighty-eight percent (70/80) had a computerized topography (CT) brain scan and 49% (34/70) of these scans were inappropriate based on standard guidelines...
May 10, 2017: Irish Medical Journal
https://www.readbyqxmd.com/read/28737070/%C3%AE-blockers-on-discharge-from-acute-atrial-fibrillation-are-associated-with-decreased-mortality-and-lower-cerebrovascular-accidents-in-patients-with-heart-failure-and-reduced-ejection-fraction
#18
Charbel Abi Khalil, Mohammad Zubaid, Nidal Asaad, Wafa A Rashed, Adel Khalifa Hamad, Rajvir Singh, Jassim Al Suwaidi
The benefits of β-blockers in patients with heart failure (HF) with reduced ejection fraction (HFrEF) and atrial fibrillation (AF) are controversial. The Gulf Survey of Atrial Fibrillation Events was a prospective, multinational, observational registry of consecutive patients with AF recruited from the emergency department (ED). We studied the incidence of 6- and 12-month mortality, hospitalization for HF or AF, and stroke/transient ischemic attacks (TIAs) in patients with HFrEF, in relation to β-blockers on discharge from the ED or the subsequent hospital stay...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/28716983/systematic-review-of-the-cost-and-cost-effectiveness-of-rapid-endovascular-therapy-for-acute-ischemic-stroke
#19
Laura K Sevick, Sarah Ghali, Michael D Hill, Vishva Danthurebandara, Diane L Lorenzetti, Tom Noseworthy, Eldon Spackman, Fiona Clement
BACKGROUND AND PURPOSE: Rapid endovascular therapy (EVT) is an emerging treatment option for acute ischemic stroke. Several economic evaluations have been published examining the cost-effectiveness of EVT, and many international bodies are currently making adoption decisions. The objective of this study was to establish the cost-effectiveness of EVT for ischemic stroke patients and to synthesize all the publicly available economic literature. METHODS: A systematic review of the published literature was conducted to identify economic evaluations and cost analyses of EVT for acute ischemic stroke patients...
September 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28716014/the-comprehensive-post-acute-stroke-services-compass-study-design-and-methods-for-a-cluster-randomized-pragmatic-trial
#20
Pamela W Duncan, Cheryl D Bushnell, Wayne D Rosamond, Sara B Jones Berkeley, Sabina B Gesell, Ralph B D'Agostino, Walter T Ambrosius, Blair Barton-Percival, Janet Prvu Bettger, Sylvia W Coleman, Doyle M Cummings, Janet K Freburger, Jacqueline Halladay, Anna M Johnson, Anna M Kucharska-Newton, Gladys Lundy-Lamm, Barbara J Lutz, Laurie H Mettam, Amy M Pastva, Mysha E Sissine, Betsy Vetter
BACKGROUND: Patients discharged home after stroke face significant challenges managing residual neurological deficits, secondary prevention, and pre-existing chronic conditions. Post-discharge care is often fragmented leading to increased healthcare costs, readmissions, and sub-optimal utilization of rehabilitation and community services. The COMprehensive Post-Acute Stroke Services (COMPASS) Study is an ongoing cluster-randomized pragmatic trial to assess the effectiveness of a comprehensive, evidence-based, post-acute care model on patient-centered outcomes...
July 17, 2017: BMC Neurology
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