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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/28065768/ventricular-septal-defect-complicating-st-elevation-myocardial-infarctions-a-call-for-action
#2
Vikas Singh, Alex P Rodriguez, Parth Bhatt, Carlos E Alfonso, Rahul Sakhuja, Igor F Palacios, Ignacio Inglessis-Azuaje, Mauricio G Cohen, Sammy Elmariah, William W O'Neill
BACKGROUND: Ventricular septal defect is a lethal complication after an acute myocardial infarction which have become infrequent with the advent of reperfusion strategies however; they remain a major contributor to mortality. METHODS: We identified patients using the ICD-9CM procedure codes from the Nationwide Inpatient Sample between the years 2001 and 2013. A multivariate hierarchical logistic regression model was used to identify significant predictors of in-hospital mortality...
January 5, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28065240/endovascular-repair-for-acute-type-b-aortic-dissection
#3
Wei Ye, Chang-Wei Liu, Xiao-Jun Song, Yong-Jun Li, Bao Liu, Yue-Hong Zheng, Rong Zeng
Objective To report experience and result of endovascular repair for acute type B aortic dissection (ATBD). Methods Totally 125 ATBD patients receiving endovascular repair with stent-graft were enrolled in this study. Demographic data,operation details,perioperative findings,and follow-up results were retrospectively analyzed. Results All the 125 patients were successfully implanted with 135 stent-grafts. Thirteen cases were covered left subclavian artery,16 cases underwent left subclavian artery revascularization,and 10 cases underwent visceral artery revascularization...
December 20, 2016: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28038725/long-term-clinical-outcomes-according-to-previous-manifestations-of-atherosclerotic-disease-from-the-fast-mi-2010-registry
#4
Etienne Puymirat, Nadia Aissaoui, Gilles Lemesle, Yves Cottin, Pierre Coste, François Schiele, Jean Ferrières, Tabassome Simon, Nicolas Danchin
The prognosis of patients with acute myocardial infarction (AMI) has notably improved in the past 20 years. Using the French Registry of ST-Elevation and Non-ST-elevation Myocardial Infarction (FAST-MI) 2010 registry, we investigated whether previous manifestations of atherosclerotic disease (i.e., previous MI, or a history of any form of atherosclerotic disease) are at truly increased risk compared with those in whom AMI is the first manifestation of the disease. FAST-MI 2010 is a nationwide French registry including 3,079 patients with AMI, among whom 1,062 patients had a history of cardiovascular atherosclerotic disease and 498 patients had a history of MI...
December 2, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27998897/antithrombotic-stewardship-a-multidisciplinary-team-approach-towards-improving-antithrombotic-therapy-outcomes-during-and-after-hospitalisation-a-study-protocol
#5
Albert R Dreijer, Marieke J H A Kruip, Jeroen Diepstraten, Suzanne Polinder, Rolf Brouwer, Frank W G Leebeek, Arnold G Vulto, Patricia M L A van den Bemt
INTRODUCTION: Antithrombotic therapy carries high risks for patient safety. Antithrombotics belong to the top 5 medications involved in potentially preventable hospital admissions related to medication. To provide a standard for antithrombotic therapy and stress the importance of providing optimal care to patients on antithrombotic therapy, the Landelijke Standaard Ketenzorg Antistolling (LSKA; Dutch guideline on integrated antithrombotic care) was drafted. However, the mere publication of this guideline does not guarantee its implementation...
December 20, 2016: BMJ Open
https://www.readbyqxmd.com/read/27979043/switching-of-adenosine-diphosphate-receptor-inhibitor-after-hospital-discharge-among-myocardial-infarction-patients-insights-from-the-treatment-with-adenosine-diphosphate-receptor-inhibitors-longitudinal-assessment-of-treatment-patterns-and-events-after-acute
#6
Marjorie E Zettler, Eric D Peterson, Lisa A McCoy, Mark B Effron, Kevin J Anstrom, Timothy D Henry, Brian A Baker, John C Messenger, David J Cohen, Tracy Y Wang
: The reasons for postdischarge adenosine diphosphate receptor inhibitor (ADPri) switching among patients with myocardial infarction (MI) are unclear. We sought to describe the incidence and patterns of postdischarge ADPri switching among patients with acute MI treated with percutaneous coronary intervention. METHODS: We used TRANSLATE-ACS (2010-2012) data to assess postdischarge ADPri switching among 8,672 MI patients discharged after percutaneous coronary intervention who remained on ADPri therapy 1 year post-MI...
January 2017: American Heart Journal
https://www.readbyqxmd.com/read/27973617/quantifying-geographic-variation-in-health-care-outcomes-in-the-united-states-before-and-after-risk-adjustment
#7
Barry L Rosenberg, Joshua A Kellar, Anna Labno, David H M Matheson, Michael Ringel, Paige VonAchen, Richard I Lesser, Yue Li, Justin B Dimick, Atul A Gawande, Stefan H Larsson, Hamilton Moses
BACKGROUND: Despite numerous studies of geographic variation in healthcare cost and utilization at the local, regional, and state levels across the U.S., a comprehensive characterization of geographic variation in outcomes has not been published. Our objective was to quantify variation in US health outcomes in an all-payer population before and after risk-adjustment. METHODS AND FINDINGS: We used information from 16 independent data sources, including 22 million all-payer inpatient admissions from the Healthcare Cost and Utilization Project (which covers regions where 50% of the U...
2016: PloS One
https://www.readbyqxmd.com/read/27970506/which-costs-matter-costs-included-in-economic-evaluation-and-their-impact-on-decision-uncertainty-the-example-of-acute-myocardial-infarction
#8
J R Lomas, M Asaria, L Bojke, G Richardson, S Walker
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/27968888/health-insurance-and-quality-and-efficiency-of-medical-care-for-patients-with-acute-myocardial-infraction-in-tertiary-hospitals-in-shanxi-china-a-retrospective-study
#9
Xiao Jun Lin, Hong Bing Tao, Miao Cai, Zhao Hui Cheng, Man Li Wang, Chang Xu, Hai Feng Lin, Li Jin
BACKGROUND: Previous studies have shown that health insurance type affects patient outcomes, but empirical research on the effect of health insurance on quality and efficiency of care in China is scarce. This study aimed to determine whether there are health insurance-related differences in hospital care for acute myocardial infraction. METHODS: Patients with a principal diagnosis of acute myocardial infraction were identified from inpatient discharge records of 27 tertiary hospitals in Shanxi, China from September 1, 2013, to October 31, 2014...
October 2016: Lancet
https://www.readbyqxmd.com/read/27951551/what-is-the-best-dialysis-therapy-in-developed-and-developing-countries-peritoneal-dialysis-and-or-hemodialysis-the-trend-in-korea
#10
Yong-Lim Kim
In Korea, peritoneal dialysis (PD) penetration peaked around 2005 at 23%, after which it declined and has remained at 10.5%. Two factors possibly explain the decrease: more favorable physician incentives to perform hemodialysis (HD) and disincentives for private clinics to perform PD, even though they account for a large percentage of dialysis centers in Korea. Early referral to nephrologists has been shown to be associated with better survival and lower medical costs than late referral, highlighting a possible role for systemic intervention to encourage early referrals...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27934084/highly-sensitive-and-quick-detection-of-acute-myocardial-infarction-biomarkers-using-in2o3-nanoribbon-biosensors-fabricated-using-shadow-masks
#11
Qingzhou Liu, Noppadol Aroonyadet, Yan Song, Xiaoli Wang, Xuan Cao, Yihang Liu, Sen Cong, Fanqi Wu, Mark E Thompson, Chongwu Zhou
We demonstrate a scalable and facile lithography-free method for fabricating highly uniform and sensitive In2O3 nanoribbon biosensor arrays. Fabrication with shadow masks as the patterning method instead of conventional lithography provides low-cost, time-efficient, and high-throughput In2O3 nanoribbon biosensors without photoresist contamination. Combined with electronic enzyme-linked immunosorbent assay for signal amplification, the In2O3 nanoribbon biosensor arrays are optimized for early, quick, and quantitative detection of cardiac biomarkers in diagnosis of acute myocardial infarction (AMI)...
November 22, 2016: ACS Nano
https://www.readbyqxmd.com/read/27924429/cyp2c19-lof-and-gof-guided-antiplatelet-therapy-in-patients-with-acute-coronary-syndrome-a-cost-effectiveness-analysis
#12
Minghuan Jiang, Joyce H S You
PURPOSE: This study aimed to examine the cost-effectiveness of CYP2C19 loss-of-function and gain-of-function allele guided (LOF/GOF-guided) antiplatelet therapy in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). METHODS: A life-long decision-analytic model was designed to simulate outcomes of three strategies: universal clopidogrel (75 mg daily), universal alternative P2Y12 inhibitor (prasugrel 10 mg daily or ticagrelor 90 mg twice daily), and LOF/GOF-guided therapy (LOF/GOF allele carriers receiving alternative P2Y12 inhibitor, wild-type patients receiving clopidogrel)...
December 7, 2016: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/27923390/the-rapid-ctca-trial-rapid-assessment-of-potential-ischaemic-heart-disease-with-ctca-a-multicentre-parallel-group-randomised-trial-to-compare-early-computerised-tomography-coronary-angiography-versus-standard-care-in-patients-presenting-with-suspected-or-confirmed
#13
Alasdair J Gray, Carl Roobottom, Jason E Smith, Steve Goodacre, Katherine Oatey, Rachel O'Brien, Robert F Storey, Lumine Na, Steff C Lewis, Praveen Thokala, David E Newby
BACKGROUND: Emergency department attendances with chest pain requiring assessment for acute coronary syndrome (ACS) are a major global health issue. Standard assessment includes history, examination, electrocardiogram (ECG) and serial troponin testing. Computerised tomography coronary angiography (CTCA) enables additional anatomical assessment of patients for coronary artery disease (CAD) but has only been studied in very low-risk patients. This trial aims to investigate the effect of early CTCA upon interventions, event rates and health care costs in patients with suspected/confirmed ACS who are at intermediate risk...
December 7, 2016: Trials
https://www.readbyqxmd.com/read/27922910/impact-of-medicare-s-nonpayment-program-on-hospital-acquired-conditions
#14
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/27899069/gastric-dilatation-and-intestinal-obstruction-mimicking-acute-coronary-syndrome-with-dynamic-electrocardiographic-changes
#15
H M M T B Herath, Anne Thushara Matthias, B S D P Keragala, W A E Udeshika, Aruna Kulatunga
BACKGROUND: ST elevation myocardial infarction is a medical emergency and the electrocardiogram is a part of the mainstay in the initial diagnosis. A variety of non-cardiac conditions have been known to mimic the electrocardiographic changes seen in acute coronary syndrome. We present a patient presenting with acute partial intestinal obstruction causing gastric distension and intestinal dilatation who also had dynamic electrocardiographic changes, mimicking anterior ST elevation myocardial infarction...
November 29, 2016: BMC Cardiovascular Disorders
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
#16
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/27886815/antiplatelet-therapy-for-secondary-prevention-after-acute-myocardial-infarction
#17
REVIEW
Ilaria Cavallari, Marc P Bonaca
Patients with prior myocardial infarction (MI) are at long-term heightened risk for recurrent ischemic events. Several large randomized controlled trials have demonstrated the benefit of more intensive antiplatelet strategies for long-term secondary prevention of cardiovascular death, recurrent MI, and stroke in patients with a history of MI at a cost of increased bleeding. The bleeding risk associated with long-term intensive antiplatelet strategies requires careful patient selection and involvement of patients in shared decision making regarding risks and benefits of therapy...
January 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27881255/cost-effectiveness-analysis-of-ticagrelor-and-prasugrel-for-the-treatment-of-acute-coronary-syndrome
#18
Ying Jiao Zhao, Ai Leng Khoo, Liang Lin, Monica Teng, Tuck Seng Wu, Mark Y Chan, Boon Peng Lim
BACKGROUND: In the management of Asian patients with acute coronary syndrome (ACS), the comparative cost-effectiveness of ticagrelor and prasugrel, referenced to generic clopidogrel, is unknown. OBJECTIVE: To assess the cost-effectiveness of ticagrelor and prasugrel as compared with generic clopidogrel in patients with ACS in Singapore. METHODS: A Markov model simulating a typical cohort of 62-year-old patients with ACS was constructed from a patient's perspective over a lifetime horizon...
May 2016: Value in Health Regional Issues
https://www.readbyqxmd.com/read/27861446/preoperative-renal-insufficiency-underreporting-and-association-with-readmission-and-major-postoperative-morbidity-in-an-academic-medical-center
#19
Jeanna D Blitz, Marny H Shoham, Yixin Fang, Venod Narine, Neeraj Mehta, Beamy S Sharma, Paul Shekane, Samir Kendale
BACKGROUND: Making a formal diagnosis of chronic kidney disease (CKD) in the preoperative setting may be challenging because of lack of longitudinal data. We explored the predictive value of a single reduced preoperative estimated glomerular filtration rate (eGFR) value on adverse patient outcomes in the first 30 days after elective surgery. We compared the rate of major postoperative adverse events, including 30-day readmission rate, hospital length of stay, infection, acute kidney injury (AKI), and myocardial infarction across patients with declining preoperative eGFR values...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27848189/the-impact-of-disability-and-social-determinants-of-health-on-condition-specific-readmissions-beyond-medicare-risk-adjustments-a-cohort-study
#20
Jennifer Meddings, Heidi Reichert, Shawna N Smith, Theodore J Iwashyna, Kenneth M Langa, Timothy P Hofer, Laurence F McMahon
BACKGROUND: Readmission rates after pneumonia, heart failure, and acute myocardial infarction hospitalizations are risk-adjusted for age, gender, and medical comorbidities and used to penalize hospitals. OBJECTIVE: To assess the impact of disability and social determinants of health on condition-specific readmissions beyond current risk adjustment. DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study of Medicare patients using 1) linked Health and Retirement Study-Medicare claims data (HRS-CMS) and 2) Healthcare Cost and Utilization Project State Inpatient Databases (Florida, Washington) linked with ZIP Code-level measures from the Census American Community Survey (ACS-HCUP)...
November 15, 2016: Journal of General Internal Medicine
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