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https://www.readbyqxmd.com/read/28079673/differences-in-use-of-high-quality-and-low-quality-hospitals-among-working-age-individuals-by-insurance-type
#1
Ioana Popescu, Kevin C Heslin, Rosanna M Coffey, Raynard E Washington, Marguerite L Barrett, Lucy H Karnell, José J Escarce
BACKGROUND: Research suggests that individuals with Medicaid or no insurance receive fewer evidence-based treatments and have worse outcomes than those with private insurance for a broad range of conditions. These differences may be due to patients' receiving care in hospitals of different quality. RESEARCH DESIGN: We used the Healthcare Cost and Utilization Project State Inpatient Databases 2009-2010 data to identify patients aged 18-64 years with private insurance, Medicaid, or no insurance who were hospitalized with acute myocardial infarction, heart failure, pneumonia, stroke, or gastrointestinal hemorrhage...
February 2017: Medical Care
https://www.readbyqxmd.com/read/28062805/intravenous-thrombolysis-before-endovascular-therapy-for-large-vessel-strokes-can-lead-to-significantly-higher-hospital-costs-without-improving-outcomes
#2
Ansaar T Rai, SoHyun Boo, Chelsea Buseman, Amelia K Adcock, Abdul R Tarabishy, Maurice M Miller, Thomas D Roberts, Jennifer R Domico, Jeffrey S Carpenter
BACKGROUND: Limited efficacy of IV recombinant tissue plasminogen activator (rt-PA) for large vessel occlusions (LVO) raises doubts about its utility prior to endovascular therapy. PURPOSE: To compare outcomes and hospital costs for anterior circulation LVOs (middle cerebral artery, internal carotid artery terminus (ICA-T)) treated with either primary endovascular therapy alone (EV-Only) or bridging therapy (IV+EV)). METHODS: A single-center retrospective analysis was performed...
January 6, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28028150/cost-effectiveness-of-solitaire-stent-retriever-thrombectomy-for-acute-ischemic-stroke-results-from-the-swift-prime-trial-solitaire-with-the-intention-for-thrombectomy-as-primary-endovascular-treatment-for-acute-ischemic-stroke
#3
Theresa I Shireman, Kaijun Wang, Jeffrey L Saver, Mayank Goyal, Alain Bonafé, Hans-Christoph Diener, Elad I Levy, Vitor M Pereira, Gregory W Albers, Christophe Cognard, Werner Hacke, Olav Jansen, Tudor G Jovin, Heinrich P Mattle, Raul G Nogueira, Adnan H Siddiqui, Dileep R Yavagal, Thomas G Devlin, Demetrius K Lopes, Vivek K Reddy, Richard du Mesnil de Rochemont, Reza Jahan, Katherine A Vilain, John House, Jin-Moo Lee, David J Cohen
BACKGROUND AND PURPOSE: Clinical trials have demonstrated improved 90-day outcomes for patients with acute ischemic stroke treated with stent retriever thrombectomy plus tissue-type plasminogen activator (SST+tPA) compared with tPA. Previous studies suggested that this strategy may be cost-effective, but models were derived from pooled data and older assumptions. METHODS: In this prospective economic substudy conducted alongside the SWIFT-PRIME trial (Solitaire With the Intention for Thrombectomy as Primary Endovascular Treatment for Acute Ischemic Stroke), in-trial costs were measured for patients using detailed medical resource utilization and hospital billing data...
December 27, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27992350/alignment-free-self-calibrating-elbow-angles-measurement-using-inertial-sensors
#4
Philipp Muller, Marc-Andre Begin, Thomas Schauer, Thomas Seel
Due to their relative ease of handling and low cost, inertial measurement unit (IMU)-based joint angle measurements are used for a widespread range of applications. These include sports performance, gait analysis and rehabilitation (e.g. Parkinson's disease monitoring or post-stroke assessment). However, a major downside of current algorithms, recomposing human kinematics from IMU data, is that they require calibration motions and/or the careful alignment of the IMUs with respect to the body segments. In this article, we propose a new method, which is alignment-free and self-calibrating using arbitrary movements of the user and an initial zero reference arm pose...
December 14, 2016: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/27979962/healthcare-resource-utilization-and-clinical-outcomes-associated-with-acute-care-and-inpatient-rehabilitation-of-stroke-patients-in-japan
#5
Kyoko Murata, Shiro Hinotsu, Nobutake Sadamasa, Kazumichi Yoshida, Yamagata Sen, Shoji Asari, Susumu Miyamoto, Koji Kawakami
OBJECTIVE: To investigate healthcare resource utilization and changes in functional status in stroke patients during hospitalization in an acute hospital and a rehabilitation hospital. DESIGN: Retrospective cohort study. SETTING: One acute and one rehabilitation hospital in Japan. PARTICIPANTS: Patients who were admitted to the acute hospital due to stroke onset and then transferred to the rehabilitation hospital (n = 263, 56% male, age 70 ± 12 years)...
December 15, 2016: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/27972333/cost-utility-of-in-ambulance-telemedicine-for-stroke-patients
#6
A Valenzuela Espinoza, S Devos, R Van Hooff, M Fobelets, A Dupont, R Brouns, K Putman
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27967275/velocity-oxygen-uptake-and-metabolic-cost-of-pull-kick-and-whole-body-swimming
#7
Kirstin S Morris, Mark A Osborne, Megan E Shephard, David G Jenkins, Tina L Skinner
PURPOSE: The contributions of the limbs to velocity and metabolic parameters in front-crawl swimming at different intensities have not been identified with the consideration of both stroke and kick rate. Consequently, velocity, oxygen uptake (V̇O2) and metabolic cost of swimming with the whole body (swim), the upper-limbs only (pull) and lower-limbs only (kick) were compared with stroke and kick rate controlled. METHODS: Twenty elite swimmers completed six 200m trials; two swim, two pull and two kick...
December 14, 2016: International Journal of Sports Physiology and Performance
https://www.readbyqxmd.com/read/27928866/semi-automatic-software-based-detection-of-atrial-fibrillation-in-acute-ischaemic-stroke-and-transient-ischaemic-attack
#8
M N Nickelsen, A Snoer, A M Ali, T Wienecke
BACKGROUND AND PURPOSE: Paroxysmal atrial fibrillation (PAF) is often asymptomatic and increases the risk of ischaemic stroke. Detection of PAF is challenging but crucial because a change of treatment decreases the risk of ischaemic stroke. Post-stroke investigations recommend at least 24-h continuous cardiac rhythm monitoring. Extended monitoring detects more PAF but is limited by costs due to manual analysis. Interpretive software might be a reasonable screening tool. The aim was to validate the performance and utility of Pathfinder SL software compared to manual analysis...
February 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/27926449/the-role-of-dopamine-in-the-pathophysiology-and-treatment-of-apathy
#9
T T-J Chong, M Husain
Disorders of diminished motivation, such as apathy, are common and prevalent across a wide range of medical conditions, including Parkinson's disease, Alzheimer's dementia, stroke, depression, and schizophrenia. Such disorders have a significant impact on morbidity and quality of life, yet their management lacks consensus and remains unsatisfactory. Here, we review laboratory and clinical evidence for the use of dopaminergic therapies in the treatment of apathy. Dopamine is a key neurotransmitter that regulates motivated decision making in humans and other species...
2016: Progress in Brain Research
https://www.readbyqxmd.com/read/27922910/impact-of-medicare-s-nonpayment-program-on-hospital-acquired-conditions
#10
Caroline P Thirukumaran, Laurent G Glance, Helena Temkin-Greener, Meredith B Rosenthal, Yue Li
BACKGROUND: Medicare's Nonpayment Program of 2008 (hereafter called Program) withholds hospital reimbursement for costs related to hospital-acquired conditions (HACs). Little is known whether a hospital's Medicare patient load [quantified by the hospital's Medicare utilization ratio (MUR), which is the proportion of inpatient days financed by Medicare] influences its response to the Program. OBJECTIVE: To determine whether the Program was associated with changes in HAC incidence, and whether this association varies across hospitals with differential Medicare patient load...
December 5, 2016: Medical Care
https://www.readbyqxmd.com/read/27909482/the-cost-effectiveness-of-laa-exclusion
#11
REVIEW
Bahij Kreidieh, Moisés Rodríguez-Mañero, Sergio H Ibarra-Cortez, Paul Schurmann, Miguel Valderrábano
Left atrial appendage (LAA) exclusion strategies are increasingly utilized for stroke prevention in lieu of oral anticoagulants. Reductions in bleeding risk and long-term compliance issues bundled with comparable stroke prevention benefits have made these interventions increasingly attractive. Unfortunately, healthcare funding remains limited. Comparative cost economic analyses are therefore critical in optimizing resource allocation. In this review we seek to discourse the cost economics analysis of LAA exclusion over available therapeutic alternatives (warfarin and the new oral anticoagulants (NOACs))...
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27896982/predictive-modeling-of-hospital-readmission-rates-using-electronic-medical-record-wide-machine-learning-a-case-study-using-mount-sinai-heart-failure-cohort
#12
Khader Shameer, Kipp W Johnson, Alexandre Yahi, Riccardo Miotto, L I Li, Doran Ricks, Jebakumar Jebakaran, Patricia Kovatch, Partho P Sengupta, Sengupta Gelijns, Alan Moskovitz, Bruce Darrow, David L David, Andrew Kasarskis, Nicholas P Tatonetti, Sean Pinney, Joel T Dudley
Reduction of preventable hospital readmissions that result from chronic or acute conditions like stroke, heart failure, myocardial infarction and pneumonia remains a significant challenge for improving the outcomes and decreasing the cost of healthcare delivery in the United States. Patient readmission rates are relatively high for conditions like heart failure (HF) despite the implementation of high-quality healthcare delivery operation guidelines created by regulatory authorities. Multiple predictive models are currently available to evaluate potential 30-day readmission rates of patients...
2016: Pacific Symposium on Biocomputing
https://www.readbyqxmd.com/read/27896681/financial-impact-of-direct-acting-oral-anticoagulants-in-medicaid-budgetary-assessment-based-on-number-needed-to-treat
#13
Kathleen A Fairman, Lindsay E Davis, Courtney R Kruse, David A Sclar
BACKGROUND: Faced with rising healthcare costs, state Medicaid programs need short-term, easily calculated budgetary estimates for new drugs, accounting for medical cost offsets due to clinical advantages. OBJECTIVE: To estimate the budgetary impact of direct-acting oral anticoagulants (DOACs) compared with warfarin, an older, lower-cost vitamin K antagonist, on 12-month Medicaid expenditures for nonvalvular atrial fibrillation (NVAF) using number needed to treat (NNT)...
November 28, 2016: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/27879970/mortality-hospital-days-and-expenditures-attributable-to-ambient-air-pollution-from-particulate-matter-in-israel
#14
Gary M Ginsberg, Ehud Kaliner, Itamar Grotto
BACKGROUND: Worldwide, ambient air pollution accounts for around 3.7 million deaths annually. Measuring the burden of disease is important not just for advocacy but also is a first step towards carrying out a full cost-utility analysis in order to prioritise technological interventions that are available to reduce air pollution (and subsequent morbidity and mortality) from industrial, power generating and vehicular sources. METHODS: We calculated the average national exposure to particulate matter particles less than 2...
2016: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/27846641/prevalence-and-prognostic-implications-of-coronary-artery-calcification-in-low-risk-women-a-meta-analysis
#15
Maryam Kavousi, Chintan S Desai, Colby Ayers, Roger S Blumenthal, Matthew J Budoff, Amir-Abbas Mahabadi, M Arfan Ikram, Aad van der Lugt, Albert Hofman, Raimund Erbel, Amit Khera, Marie H Geisel, Karl-Heinz Jöckel, Nils Lehmann, Udo Hoffmann, Christopher J O'Donnell, Joseph M Massaro, Kiang Liu, Stefan Möhlenkamp, Hongyan Ning, Oscar H Franco, Philip Greenland
Importance: The role of coronary artery calcium (CAC) testing for guiding preventive strategies among women at low cardiovascular disease (CVD) risk based on the American College of Cardiology and American Heart Association CVD prevention guidelines is unclear. Objective: To assess the potential utility of CAC testing for CVD risk estimation and stratification among low-risk women. Design, Setting, and Participants: Women with 10-year atherosclerotic CVD (ASCVD) risk lower than 7...
November 22, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27846007/carotid-intima-media-thickness-as-a-cardiovascular-risk-factor-and-imaging-pathway-of-atherosclerosis
#16
Osmar Antonio Centurión
Assessment of carotid intima-media thickness (IMT) has emerged as a simple and noninvasive technique for measuring atherosclerotic burden. Although serum biomarkers have been linked to the risk of developing atherosclerosis, carotid IMT has the theoretical advantage of directly visualizing a final consequence of the disease itself, namely atherosclerosis in the vessel wall. The current widespread application of carotid IMT measurements has been based on the validity, standardization, and reproducibility of the measurement and the evidence that an increased carotid IMT can be regarded as an attractive biomarker of atherosclerosis and of increased cardiovascular risk, potentially useful as a therapeutic target in those at increased cardiovascular risk...
December 2016: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/27822477/left-atrial-enlargement-on-transthoracic-echocardiography-predicts-left-atrial-thrombus-on-transesophageal-echocardiography-in-ischemic-stroke-patients
#17
James Anaissie, Dominique Monlezun, A Seelochan, James E Siegler, Maria Chavez-Keatts, Jonathan Tiu, Denise Pineda, Alexander George, Amir Shaban, Nidal Abi Rafeh, Laurie Schluter, Sheryl Martin-Schild, Ramy El Khoury
Background. Transesophageal echocardiogram (TEE) is superior to transthoracic echocardiogram (TTE) in detecting left atrial thrombus (LAT), a risk factor for stroke, but is costly and invasive, carrying a higher risk for complications. Aims. To determine the utility of using left atrial enlargement (LAE) on TTE to predict LAT on TEE. Methods. AIS patients who presented in 06/2008-7/2013 and underwent both TTE and TEE were identified from our prospective stroke registry. Analysis consisted of multivariate logistic regression with propensity score adjustment and receiver operating characteristic (ROC) area under the curve (AUC) analyses...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27810149/diabetes-mellitus-with-chronic-complications-in-relation-to-carotid-endarterectomy-and-carotid-artery-stenting-outcomes
#18
Oluwole Adegbala, Kimberly D Martin, David Otuada, Tomi Akinyemiju
BACKGROUND: Carotid endarterectomy and carotid artery stenting are effective treatment procedures for carotid artery stenosis. Although diabetes mellitus is highly prevalent among patients undergoing these revascularization procedures, few studies have examined their impact on periprocedural outcomes. OBJECTIVES: The study aimed to determine whether perioperative outcomes among patients undergoing carotid artery stenting and carotid endarterectomy varied depending on the presence of diabetes with or without chronic complications...
January 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27771008/cost-effectiveness-of-non-vitamin-k-antagonist-oral-anticoagulants-for-stroke-prevention-in-patients-with-atrial-fibrillation-at-high-risk-of-bleeding-and-normal-kidney-function
#19
Inmaculada Hernandez, Kenneth J Smith, Yuting Zhang
INTRODUCTION: The comparative cost-effectiveness of all oral anticoagulants approved up to date has not been evaluated from the US perspective. The objective of this study was to compare the cost-effectiveness of edoxaban 60mg, apixaban 5mg, dabigatran 150mg, dabigatran 110mg, rivaroxaban 20mg and warfarin in stroke prevention in atrial fibrillation patients at high-risk of bleeding (defined as HAS-BLED score≥3). MATERIALS AND METHODS: We constructed a Markov state-transition model to evaluate lifetime costs and quality-adjusted life years (QALYs) with each of the six treatments from the perspective of US third-party payers...
October 15, 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27760870/increasing-comorbidity-and-health-services-utilization-in-older-adults-with-prior-stroke
#20
Andrea Gruneir, Lauren E Griffith, Kathryn Fisher, Dilzayn Panjwani, Sima Gandhi, Li Sheng, Chris Patterson, Amiram Gafni, Jenny Ploeg, Maureen Markle-Reid
OBJECTIVE: To characterize comorbid chronic conditions, describe health services use, and estimate health care costs among community-dwelling older adults with prior stroke. METHODS: This is a retrospective cohort study using administrative data from Ontario, Canada. We identified all community-dwelling individuals aged 66 and over on April 1, 2008 (baseline), who had experienced a stroke at least 6 months prior. We estimated the prevalence of 14 comorbid conditions at baseline; we captured all physician visits, emergency department visits, hospital admissions, home care contacts, and associated costs over 5 years stratifying by number of comorbid conditions...
November 15, 2016: Neurology
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