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Stroke utilization cost

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https://www.readbyqxmd.com/read/28536168/psychiatric-hospitalization-increases-short-term-risk-of-stroke
#1
Jonah P Zuflacht, Yuefan Shao, Ian M Kronish, Donald Edmondson, Mitchell S V Elkind, Hooman Kamel, Amelia K Boehme, Joshua Z Willey
BACKGROUND AND PURPOSE: Recent evidence suggests that psychological distress, including the symptoms of psychiatric illness, may acutely increase the risk of stroke. However, existing studies are limited by small sample sizes, inherent recall bias, and poorly defined criteria for what constitutes psychological distress. METHODS: We analyzed administrative data from the Healthcare Cost and Utilization Project for the state of California from 2007 to 2009 using a case-crossover design...
May 23, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28527586/gastrointestinal-bowel-obstruction-in-acute-ischemic-stroke-incidence-risk-factors-and-outcomes-in-a-u-s-nationwide-analysis-of-3-998-667-hospitalizations
#2
Kavelin Rumalla, Ashwath S Kumar, Manoj K Mittal
OBJECTIVE: The prognosis from acute ischemic stroke (AIS) is worsened by poststroke medical complications. The incidence, risk factors, and outcomes of gastrointestinal bowel obstruction (GIBO) in AIS are not known. METHODS: We queried the Nationwide Inpatient Sample (2002-2011) to identify all patients with a primary diagnosis of AIS and subsets with and without a secondary diagnosis of GIBO without hernia. Multivariable analysis was utilized to identify risk factors for GIBO in AIS patients and the association between GIBO, in-hospital complications, and outcomes...
May 17, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28516331/burden-of-herpes-simplex-virus-encephalitis-in-the-united-states
#3
S Modi, Abhimanyu Mahajan, D Dharaiya, P Varelas, P Mitsias
Herpes simplex virus encephalitis (HSVE) is a disease of public health concern, but its burden on the healthcare of United States has not been adequately assessed recently. We aimed to define the incidence, complications and outcomes of HSVE in the recent decade by analyzing data from a nationally representative database. Healthcare Cost and Utilization Project databases were utilized to identify patients with primary discharge diagnosis of HSVE. Annual hospitalization rate was estimated and several preselected inpatient complications were identified...
May 17, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28501349/potential-health-impact-and-cost-effectiveness-of-drug-therapy-for-prehypertension
#4
Tao Chen, Dahai Yu, Victoria Cornelius, Rui Qin, Yamei Cai, Zhixin Jiang, Zhanzheng Zhao
BACKGROUND: Studies have reported that pharmacologic interventions with candesartan or ramipril could reduce the risk of hypertension among prehypertensive subjects free of clinical cardiovascular disease (CVD), however, the cost-effectiveness and long-term cardiovascular risk of drug treatment among these population is unclear. METHOD: A Markov state-transition model was developed to simulate a hypothetical cohort of Chinese adults with high-range prehypertension (130-139/85-89mmHg) but without CVD...
May 5, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28497642/estimating-lifetime-medical-costs-from-censored-claims-data
#5
Jing-Shiang Hwang, Tsuey-Hwa Hu, Lukas Jyuhn-Hsiarn Lee, Jung-Der Wang
Claims databases consisting of routinely collected longitudinal records of medical expenditures are increasingly utilized for estimating expected medical costs of patients with a specific condition. Survival data of the patients of interest are usually highly censored, and observed expenditures are incomplete. In this study, we propose a survival-adjusted estimator for estimating mean lifetime costs, which integrates the product of the survival function and the mean cost function over the lifetime horizon. The survival function is estimated by a new algorithm of rolling extrapolation, aided by external information of age- and sex-matched referents simulated from national vital statistics...
May 12, 2017: Health Economics
https://www.readbyqxmd.com/read/28483774/observed-cost-and-variations-in-short-term-cost-effectiveness-of-therapy-for-ischemic-stroke-in-interventional-management-of-stroke-ims-iii
#6
Kit N Simpson, Annie N Simpson, Patrick D Mauldin, Yuko Y Palesch, Sharon D Yeatts, Dawn Kleindorfer, Thomas A Tomsick, Lydia D Foster, Andrew M Demchuk, Pooja Khatri, Michael D Hill, Edward C Jauch, Tudor G Jovin, Bernard Yan, Rüdiger von Kummer, Carlos A Molina, Mayank Goyal, Wouter J Schonewille, Mikael Mazighi, Stefan T Engelter, Craig Anderson, Judith Spilker, Janice Carrozzella, Karla J Ryckborst, L Scott Janis, Joseph P Broderick
BACKGROUND: Examination of linked data on patient outcomes and cost of care may help identify areas where stroke care can be improved. We report on the association between variations in stroke severity, patient outcomes, cost, and treatment patterns observed over the acute hospital stay and through the 12-month follow-up for subjects receiving endovascular therapy compared to intravenous tissue plasminogen activator alone in the IMS (Interventional Management of Stroke) III Trial. METHODS AND RESULTS: Prospective data collected for a prespecified economic analysis of the trial were used...
May 8, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28476121/menopausal-hormone-therapy-a-systematic-review-of-cost-effectiveness-evaluations
#7
Louiza S Velentzis, Usha Salagame, Karen Canfell
BACKGROUND: Several evaluations of the cost-effectiveness (CE) of menopausal hormone therapy (MHT) have been reported. The aim of this study was to systematically and critically review economic evaluations of MHT since 2002, after the Women's Health Initiative (WHI) trial results on MHT were published. METHODS: The inclusion criteria for the review were: CE analyses of MHT versus no treatment, published from 2002-2016, in healthy women, which included both symptom relief outcomes and a range of longer term health outcomes (breast cancer, coronary heart disease, stroke, fractures and colorectal cancer)...
May 5, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28465771/clinical-characteristics-and-unmet-need-among-patients-with-atherosclerotic-cardiovascular-disease-stratified-by-statin-use
#8
Qing Huang, Michael Grabner, Robert J Sanchez, Vincent J Willey, Mark J Cziraky, Swetha R Palli, Thomas P Power
BACKGROUND: The American College of Cardiology (ACC)/American Heart Association (AHA) 2013 guidelines for blood cholesterol treatment recommend high-intensity statins for adults with atherosclerotic cardiovascular disease (ASCVD). Currently, little is known about the real-world patient characteristics of ASCVD, as well as the clinical and economic consequences of different treatment options for this disease. OBJECTIVES: To compare the demographic, clinical, and economic characteristics of patients with clinical ASCVD who started therapy with high-intensity statins, low-/moderate-intensity statins, or no statins in usual-care settings based on data primarily before the release of the ACC/AHA 2013 guidelines...
November 2016: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28460856/longterm-prognosis-of-low-risk-women-presenting-to-the-emergency-department-with-chest-pain
#9
Moneer Eddin, Sandhya Venugopal, Brittany Chatterton, Angela Thinda, Ezra A Amsterdam
BACKGROUND: Prognosis of low risk women presenting to the emergency department with chest pain has not been clarified. We assessed early and longterm outcomes of such patients and determined the need for predischarge testing METHODS: Retrospective assessment of consecutive low risk women presenting to the ED with chest pain evaluated in a chest pain unit (CPU). Criteria of low risk: age ≤51 yr, no history of cardiovascular disease, diabetes or smoking, negative initial electrocardiogram (ECG), and cardiac troponin...
April 28, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28431633/greater-healthcare-utilization-and-costs-among-black-persons-compared-to-white-persons-with-aphasia-in-the-north-carolina-stroke-belt
#10
Charles Ellis, Rose Y Hardy, Richard C Lindrooth
PURPOSE: To examine racial differences in healthcare utilization and costs for persons with aphasia (PWA) being treated in acute care hospitals in North Carolina (NC). METHODS: NC Healthcare Cost and Utilization Project State Inpatient Database (HCUP-SID) data from 2011-2012 were analyzed to examine healthcare utilization and costs of care for stroke patients with aphasia. Analyses emphasized length of stay, charges and cost of general hospital services. Generalized linear models (GLM) were constructed to determine the impact of demographic characteristics, stroke/illness severity, and observed hospital characteristics on utilization and costs...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28426345/economic-evaluation-of-ezetimibe-treatment-in-combination-with-statin-therapy-in-the-united-states
#11
Glenn M Davies, Ami Vyas, Carl A Baxter
AIMS: This study assessed the cost-effectiveness of ezetimibe with statin therapy versus statin monotherapy from a United States (US) payer perspective, assuming the impending patent expiration of ezetimibe. METHODS: A Markov-like economic model consisting of 28 distinct health states was used. Model population data were obtained from US linked claims and electronic medical records, with inclusion criteria based on diagnostic guidelines. Inputs came from recent clinical trials, meta-analyses, and cost-effectiveness analyses...
April 20, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28400985/spanning-from-the-west-to-east-an-updated-review-on-endovascular-treatment-of-intracranial-atherosclerotic-disease
#12
REVIEW
Mohammed Hussain, Neil Datta, Zhe Cheng, David Dornbos, Asif Bashir, Ibrahim Sultan, Tapan Mehta, Faris Shweikeh, Paul Mazaris, Nora Lee, Amre Nouh, Xiaokun Geng, Yuchuan Ding
Ischemic stroke is a major cause of morbidity and mortality, incurring significant cost. Intracranial atherosclerotic disease (ICAD) accounts for 10-15% of ischemic stroke in Western societies, but is an underlying pathology in up to 54% of ischemic strokes in Asian populations. ICAD has largely been treated with medical management, although a few studies have examined outcomes following endovascular treatment. Our objective was to summarize the major trials that have been performed thus far in regard to the endovascular treatment of ICAD and to provide direction for future management of this disease process...
April 2017: Aging and Disease
https://www.readbyqxmd.com/read/28361110/patterns-of-care-and-outcomes-in-cardiovascular-disease-after-kidney-transplantation-in-the-united-states
#13
Amit K Mathur, Yu-Hui Chang, D Eric Steidley, Raymond Heilman, Narjeet Khurmi, Nabil Wasif, David Etzioni, Adyr A Moss
BACKGROUND: Cardiovascular disease (CVD) is an important driver of mortality after kidney transplantation. Its broader impact on posttransplant health care utilization in US hospitals is unknown. METHODS: We used administrative claims data from the Nationwide Inpatient Sample and the American Hospital Association Annual Survey to identify hospitalizations for kidney transplant patients with a cardiovascular diagnosis from 2005 to 2011. CVD hospitalizations were stratified by transplant hospital status to characterize patterns in inpatient health care utilization and outcomes...
February 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28318984/safety-and-efficacy-of-thrombectomy-in-acute-ischaemic-stroke-revascat-1-year-follow-up-of-a-randomised-open-label-trial
#14
RANDOMIZED CONTROLLED TRIAL
Antoni Dávalos, Erik Cobo, Carlos A Molina, Angel Chamorro, M Angeles de Miquel, Luis San Román, Joaquín Serena, Elena López-Cancio, Marc Ribó, Mónica Millán, Xabier Urra, Pere Cardona, Alejandro Tomasello, Carlos Castaño, Jordi Blasco, Lucía Aja, Marta Rubiera, Meritxell Gomis, Arturo Renú, Blanca Lara, Joan Martí-Fàbregas, Brian Jankowitz, Neus Cerdà, Tudor G Jovin
BACKGROUND: The REVASCAT trial and other studies have shown that the neurovascular thrombectomy improves outcomes at 90 days post stroke. However, whether the observed benefit is sustained in the long term remains unknown. We report the results of the prespecified 12-month analysis of the REVASCAT trial. METHODS: Patients with acute ischaemic stroke who could be treated within 8 h of symptom onset were randomly assigned to medical therapy (including intravenous alteplase when eligible) and neurovascular thrombectomy with Solitaire FR or medical therapy alone...
May 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28315744/cardiac-implantable-electronic-device-infections-who-is-at-greatest-risk
#15
Parijat Saurav Joy, Gagan Kumar, Jeanne E Poole, Barry London, Brian Olshansky
BACKGROUND: Cardiac implantable electronic device (CIED) infections are associated with hospitalization, mortality, increased costs, and adverse outcomes. OBJECTIVE: Determine the burden of infections for CIEDs based on device type, associated comorbidities, and clinical characteristics over a 12-year period. METHODS: Utilizing data from the National Inpatient Sample database for cases from 2000 through 2012, we identified procedures for device-related infection (DRI) using International Statistical Classification of Diseases and Related Health Problems, Ninth Revision, Clinical Modification (ICD-9-CM) codes for CIED removal with diagnosis codes for device-related infection or systemic infection...
March 16, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28282022/barriers-to-health-care-for-adults-with-multiple-chronic-conditions-united-states-2012-2015
#16
Brian W Ward
Data from the National Health Interview Survey •In 2015, the percentage of adults aged 18-64 who delayed or did not obtain needed medical care due to cost in the past 12 months was highest among those diagnosed with 2 or more of 10 selected chronic conditions (16.9%), and it was lowest among those with none of the selected conditions (8.5%). •The percentage of adults who delayed needed medical care for a non-cost reason in the past 12 months increased as the number of conditions increased. •The percentage of adults who had seen or talked to a health professional in the past 12 months increased as the number of conditions increased...
March 2017: NCHS Data Brief
https://www.readbyqxmd.com/read/28279725/modified-eversion-carotid-endarterectomy-mecea-analysis-of-clinical-and-financial-outcomes
#17
Scott E Musicant, Vincent J Guzzetta, Thomas T Terramani, Kristina L Greenwood, Wendy C Chiodo, Karen M Heaney, Shelley J Berthiaume
BACKGROUND: Several carotid endarterectomy techniques have been described, including conventional carotid endarterectomy (CCEA) performed with patch repair and eversion carotid endarterectomy (ECEA) performed with transection of the internal carotid artery. We describe our simplified technique of modified eversion carotid endarterectomy (mECEA) with longitudinal arteriotomy limited to the carotid bulb, without transection of the internal carotid artery and present our analysis of its safety, efficacy, and cost effectiveness...
March 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28272725/-comparison-of-the-cost-utility-of-direct-oral-anticoagulants-for-the-prevention-of-stroke-in-patients-with-atrial-fibrillation-in-spain
#18
M Monreal-Bosch, S Soulard, C Crespo, S Brand, A Kansal
INTRODUCTION: Apixaban, dabigatran and rivaroxaban are three new direct oral anticoagulants (DOACs) used in the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF) in Spain. AIM: To assess the relative cost-utility of the three DOACs compared with vitamin K antagonists. PATIENTS AND METHODS: A Markov model with 3-month cycles was used to simulate NVAF patients starting with treatment and followed up for their lifetime from the perspective of the National Health System...
March 16, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28247569/transcatheter-aortic-valve-implantation-in-the-united-states-predictors-of-early-hospital-discharge
#19
Sagar Mallikethi-Reddy, Emmanuel Akintoye, Tesfaye Telila, Rajeev Sudhakar, Kavyashri Jagadeesh, Alexandros Briasoulis, Melvyn Rubenfire, Luis Afonso, Cindy L Grines
BACKGROUND: There is a concerted push for adopting a minimalist strategy with emphasis on early hospital discharge for patients undergoing Transcatheter aortic valve implantation (TAVI). However, studies on discharge patterns and predictors of early discharge (≤3 days post-TAVI) are sparse, in the United States. METHODS: We analyzed using Healthcare Utilization Project, Nationwide Inpatient Sample database, 2011-2012. A total of 7321 TAVI procedures were identified...
April 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28243501/validation-of-olfactory-deficit-as-a-biomarker-of-alzheimer-disease
#20
Matthew R Woodward, Chaitanya V Amrutkar, Harshit C Shah, Ralph H B Benedict, Sanjanaa Rajakrishnan, Rachelle S Doody, Li Yan, Kinga Szigeti
BACKGROUND: We evaluated smell identification as a biomarker for Alzheimer disease (AD) by assessing its utility in differentiating normal aging from an amnestic disorder and determining its predictive value for conversion from amnestic mild cognitive impairment (aMCI) to AD. METHODS: Cross-sectional study (AD = 262, aMCI = 110, controls = 194) measuring smell identification (University of Pennsylvania Smell Identification Test [UPSIT]) and cognitive status was performed, as well as longitudinal analysis of aMCI participants (n = 96) with at least 1 year follow-up (mean 477...
February 2017: Neurology. Clinical Practice
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