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https://www.readbyqxmd.com/read/29231837/the-primary-health-care-system-in-china
#1
REVIEW
Xi Li, Jiapeng Lu, Shuang Hu, K K Cheng, Jan De Maeseneer, Qingyue Meng, Elias Mossialos, Dong Roman Xu, Winnie Yip, Hongzhao Zhang, Harlan M Krumholz, Lixin Jiang, Shengshou Hu
China has made remarkable progress in strengthening its primary health-care system. Nevertheless, the system still faces challenges in structural characteristics, incentives and policies, and quality of care, all of which diminish its preparedness to care for a fifth of the world's population, which is ageing and which has a growing prevalence of chronic non-communicable disease. These challenges include inadequate education and qualifications of its workforce, ageing and turnover of village doctors, fragmented health information technology systems, a paucity of digital data on everyday clinical practice, financial subsidies and incentives that do not encourage cost savings and good performance, insurance policies that hamper the efficiency of care delivery, an insufficient quality measurement and improvement system, and poor performance in the control of risk factors (such as hypertension and diabetes)...
December 9, 2017: Lancet
https://www.readbyqxmd.com/read/29221982/hypothermic-cardiopulmonary-bypass-weaning-and-prolonged-postoperative-rewarming-in-a-patient-with-intraoperative-oxygenator-thrombosis
#2
Ian Grant, Max Breidenstein, Ana Parsee, Charles Krumholz, Jacob Martin
No abstract text is available yet for this article.
September 14, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29206052/risk-trajectories-of-readmission-and-death-in-the-first-year-following-hospitalization-for-copd
#3
Peter K Lindenauer, Kumar Dharmarajan, Li Qin, Zhenqui Lin, Andrea S Gershon, Harlan M Krumholz
Rationale Characterizing the dynamic nature of post-hospital risk in COPD is needed to provide counseling and plan clinical services. Objectives To analyze risk of readmission and death among Medicare beneficiaries >=65 years following discharge for COPD, and to determine the association between ventilator support and risk trajectory. Methods We computed daily absolute risks of hospital readmission and death for one year after discharge for COPD, stratified by ventilator support. We determined the time required for risks to decline 50% from maximum daily values after discharge; and for daily risks to plateau...
December 5, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29183077/adherence-to-methodological-standards-in-research-using-the-national-inpatient-sample
#4
Rohan Khera, Suveen Angraal, Tyler Couch, John W Welsh, Brahmajee K Nallamothu, Saket Girotra, Paul S Chan, Harlan M Krumholz
Importance: Publicly available data sets hold much potential, but their unique design may require specific analytic approaches. Objective: To determine adherence to appropriate research practices for a frequently used large public database, the National Inpatient Sample (NIS) of the Agency for Healthcare Research and Quality (AHRQ). Design, Setting, and Participants: In this observational study of the 1082 studies published using the NIS from January 2015 through December 2016, a representative sample of 120 studies was systematically evaluated for adherence to practices required by AHRQ for the design and conduct of research using the NIS...
November 28, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29169478/2017-roadmap-for-innovation-acc%C3%A2-health-policy-statement-on-healthcare-transformation-in-the-era%C3%A2-of-digital-health-big-data-and%C3%A2-precision-health-a-report-of-the-american-college-of-cardiology-task-force-on-health-policy-statements-and-systems-of-care
#5
Sanjeev P Bhavnani, Kapil Parakh, Ashish Atreja, Regina Druz, Garth N Graham, Salim S Hayek, Harlan M Krumholz, Thomas M Maddox, Maulik D Majmudar, John S Rumsfeld, Bimal R Shah
No abstract text is available yet for this article.
November 28, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29164250/consequences-of-reductions-in-hospital-readmissions-reply
#6
LETTER
Kumar Dharmarajan, Harlan M Krumholz
No abstract text is available yet for this article.
November 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29158421/urban-rural-comparisons-in-hospital-admission-treatments-and-outcomes-for-st-segment-elevation-myocardial-infarction-in-china-from-2001-to-2011-a-retrospective-analysis-from-the-china-peace-study-patient-centered-evaluative-assessment-of-cardiac-events
#7
Xi Li, Karthik Murugiah, Jing Li, Frederick A Masoudi, Paul S Chan, Shuang Hu, John A Spertus, Yongfei Wang, Nicholas S Downing, Harlan M Krumholz, Lixin Jiang
BACKGROUND: In response to urban-rural disparities in healthcare resources, China recently launched a healthcare reform with a focus on improving rural care during the past decade. However, nationally representative studies comparing medical care and patient outcomes between urban and rural areas in China during this period are not available. METHODS AND RESULTS: We created a nationally representative sample of patients in China admitted for ST-segment-elevation myocardial infarction in 2001, 2006, and 2011, using a 2-stage random sampling design in 2 urban and 3 rural strata...
November 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29148284/iodine-infused-aeration-for-hull-fouling-prevention-a-vessel-scale-study
#8
Natasha C Dickenson, Jason S Krumholz, Kelli Z Hunsucker, Michael Radicone
Biofouling is a significant economic and ecological problem, causing reduced vessel performance and increases in fuel consumption and emissions. Previous research has shown iodine vapor (I2)-infused aeration to be an environmentally friendly method for deterring the settlement of fouling organisms. An aeration system was deployed on a vessel with hull sections coated with two types of antifoulant coatings, Intersleek® 1100 (fouling-release) and Interspeed® BRA-640 (ablative copper biocide), as well as an inert epoxy barrier coating, to assess the effectiveness of aeration in conjunction with common marine coatings...
November 17, 2017: Biofouling
https://www.readbyqxmd.com/read/29133601/burden-of-catastrophic-health-expenditures-for-acute-myocardial-infarction-and-stroke-among-uninsured-in-the-united-states
#9
Rohan Khera, Jonathan C Hong, Anshul Saxena, Alejandro Arrieta, Salim S Virani, Ron Blankstein, James A de Lemos, Harlan M Krumholz, Khurram Nasir
Acute myocardial infarction (AMI) and stroke are unanticipated major healthcare events that require emergent and expensive care. Given the potential financial implications of AMI and stroke among uninsured patients, we sought to evaluate rates of catastrophic healthcare expenditures (CHEs), defined as expenses beyond financial means, in a period before the implementation of insurance expansion and protections in the Affordable Care Act.(1).
November 13, 2017: Circulation
https://www.readbyqxmd.com/read/29133522/systolic-blood-pressure-response-in-sprint-systolic-blood-pressure-intervention-trial-and-accord-action-to-control-cardiovascular-risk-in-diabetes-a-possible-explanation-for-discordant-trial-results
#10
Chenxi Huang, Sanket S Dhruva, Andreas C Coppi, Frederick Warner, Shu-Xia Li, Haiqun Lin, Khurram Nasir, Harlan M Krumholz
BACKGROUND: SPRINT (Systolic Blood Pressure Intervention Trial) and the ACCORD (Action to Control Cardiovascular Risk in Diabetes) blood pressure trial used similar interventions but produced discordant results. We investigated whether differences in systolic blood pressure (SBP) response contributed to the discordant trial results. METHODS AND RESULTS: We evaluated the distributions of SBP response during the first year for the intensive and standard treatment groups of SPRINT and ACCORD using growth mixture models...
November 13, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29106473/trends-in-acute-pericarditis-hospitalizations-and-outcomes-among-the-elderly-in-the-united-states-1999-2012
#11
Purav Mody, Behnood Bikdeli, Yun Wang, Massimo Imazio, Harlan M Krumholz
Aim: The elderly are at risk of pericarditis from conditions such as malignancy, renal disease and after cardiac surgery. However, the burden of pericarditis and especially long-term outcomes associated with pericarditis have not been described before among the elderly. Methods and results: We examined hospitalization rates; in-hospital, 30-day, and 1-year all-cause mortality rates; all-cause 30-day readmission rates; length of stay and healthcare expenditure for Medicare beneficiaries aged 65 years or older with a principal discharge diagnosis of pericarditis from 1999 to 2012...
November 2, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/29102087/availability-cost-and-prescription-patterns-of-antihypertensive-medications-in-primary-health-care-in-china-a-nationwide-cross-sectional-survey
#12
Meng Su, Qiuli Zhang, Xueke Bai, Chaoqun Wu, Yetong Li, Elias Mossialos, George A Mensah, Frederick A Masoudi, Jiapeng Lu, Xi Li, Sebastian Salas-Vega, Anwen Zhang, Yuan Lu, Khurram Nasir, Harlan M Krumholz, Lixin Jiang
BACKGROUND: Around 200 million adults in China have hypertension, but few are treated or achieve adequate control of their blood pressure. Available and affordable medications are important for successfully controlling hypertension, but little is known about current patterns of access to, and use of, antihypertensive medications in Chinese primary health care. METHODS: We used data from a nationwide cross-sectional survey (the China Patient-Centered Evaluative Assessment of Cardiac Events Million Persons Project primary health care survey), which was undertaken between November, 2016 and May, 2017, to assess the availability, cost, and prescription patterns of 62 antihypertensive medications at primary health-care sites across 31 Chinese provinces...
October 25, 2017: Lancet
https://www.readbyqxmd.com/read/29102084/prevalence-awareness-treatment-and-control-of-hypertension-in-china-data-from-1%C3%A2-7-million-adults-in-a-population-based-screening-study-china-peace-million-persons-project
#13
Jiapeng Lu, Yuan Lu, Xiaochen Wang, Xinyue Li, George C Linderman, Chaoqun Wu, Xiuyuan Cheng, Lin Mu, Haibo Zhang, Jiamin Liu, Meng Su, Hongyu Zhao, Erica S Spatz, John A Spertus, Frederick A Masoudi, Harlan M Krumholz, Lixin Jiang
BACKGROUND: Hypertension is common in China and its prevalence is rising, yet it remains inadequately controlled. Few studies have the capacity to characterise the epidemiology and management of hypertension across many heterogeneous subgroups. We did a study of the prevalence, awareness, treatment, and control of hypertension in China and assessed their variations across many subpopulations. METHODS: We made use of data generated in the China Patient-Centered Evaluative Assessment of Cardiac Events (PEACE) Million Persons Project from Sept 15, 2014, to June 20, 2017, a population-based screening project that enrolled around 1·7 million community-dwelling adults aged 35-75 years from all 31 provinces in mainland China...
November 5, 2017: Lancet
https://www.readbyqxmd.com/read/29049467/updated-cost-effectiveness-assessments-of-pcsk9-inhibitors-from-the-perspectives-of-the-health-system-and-private-payers-insights-derived-from-the-fourier-trial
#14
Alejandro Arrieta, Jonathan C Hong, Rohan Khera, Salim S Virani, Harlan M Krumholz, Khurram Nasir
Importance: Preliminary cost-effectiveness analyses of proprotein convertase subtilisin/kexin type 9 inhibitor (PCSK9i) were based on benefits estimated from reductions in low-density lipoprotein cholesterol that occurred in PCSK9i trials with variable results. The recent Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk (FOURIER) trial provides better information about the effectiveness of the drug. Objective: To use the trial results to determine the cost-effectiveness of a PCSK9i and statin treatment strategy compared with a statin alone strategy...
October 18, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29044398/trends-in-mortality-and-major-complications-for-patients-undergoing-coronary-artery-bypass-grafting-among-urban-teaching-hospitals-in-china-2004-to-2013
#15
Xin Yuan, Heng Zhang, Zhe Zheng, Chenfei Rao, Yan Zhao, Yun Wang, Harlan M Krumholz, Shengshou Hu
Aims: Although the number of hospitals performing cardiac surgery has increased rapidly in China, information regarding the trends in coronary artery bypass grafting (CABG) outcomes remains unknown. Methods and results: We used data from the Chinese Cardiac Surgery Registry, the largest registry system that accounts for nearly 50% of total annual CABG volume in China, to assess trends of in-hospital mortality and major complication rates for patients receiving isolated CABG in 102 urban teaching hospitals in China from 25 January 2004 through 31 December 2013 (except 2006 and 2009)...
October 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28960228/home-health-agency-performance-in-the-united-states-2011-15
#16
Yun Wang, Erica S Spatz, Maliha Tariq, Suveen Angraal, Harlan M Krumholz
OBJECTIVES: To evaluate home health agency quality performance. DESIGN: Observational study. SETTING: Home health agencies. PARTICIPANTS: All Medicare-certified agencies with at least 6 months of data from 2011 to 2015. MEASUREMENTS: Twenty-two quality indicators, five patient survey indicators, and their composite scores. RESULTS: The study included 11,462 Medicare-certified home health agencies that served 92...
September 27, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28954922/incorporating-stroke-severity-into-hospital-measures-of-30-day-mortality-after-ischemic-stroke-hospitalization
#17
Jennifer Schwartz, Yongfei Wang, Li Qin, Lee H Schwamm, Gregg C Fonarow, Nicole Cormier, Karen Dorsey, Robert L McNamara, Lisa G Suter, Harlan M Krumholz, Susannah M Bernheim
BACKGROUND AND PURPOSE: The Centers for Medicare & Medicaid Services publicly reports a hospital-level stroke mortality measure that lacks stroke severity risk adjustment. Our objective was to describe novel measures of stroke mortality suitable for public reporting that incorporate stroke severity into risk adjustment. METHODS: We linked data from the American Heart Association/American Stroke Association Get With The Guidelines-Stroke registry with Medicare fee-for-service claims data to develop the measures...
November 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28950309/are-non-st-segment-elevation-myocardial-infarctions-nstemi-missing-in-china
#18
Karthik Murugiah, Yongfei Wang, Sudhakar V Nuti, Xi Li, Jing Li, Xin Zheng, Nicholas S Downing, Nihar R Desai, Frederick A Masoudi, John A Spertus, Lixin Jiang, Harlan M Krumholz
Background: HASH(0x4992588) Methods and results: HASH(0x4992c18) Conclusions: HASH(0x49961a8) Clinical Trial Registration: HASH(0x4996a48)
July 27, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28935036/inferior-vena-cava-filters-to-prevent-pulmonary-embolism-systematic-review-and%C3%A2-meta-analysis
#19
REVIEW
Behnood Bikdeli, Saurav Chatterjee, Nihar R Desai, Ajay J Kirtane, Mayur M Desai, Michael B Bracken, Frederick A Spencer, Manuel Monreal, Samuel Z Goldhaber, Harlan M Krumholz
BACKGROUND: Inferior vena cava (IVC) filters are widely used for prevention of pulmonary embolism (PE). However, uncertainty persists about their efficacy and safety. OBJECTIVES: The authors conducted a systematic review and meta-analysis of the published reports on the efficacy and safety of IVC filters. METHODS: The authors searched PubMed, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov through October 3, 2016, for randomized controlled trials (RCTs) or prospective controlled observational studies of IVC filters versus none in patients at risk of PE...
September 26, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28922297/quality-of-care-in-the-united-states-territories-1999-2012
#20
Sudhakar V Nuti, Yun Wang, Frederick A Masoudi, Marcella Nunez-Smith, Sharon-Lise T Normand, Karthik Murugiah, Orlando Rodríguez-Vilá, Joseph S Ross, Harlan M Krumholz
BACKGROUND: Millions of Americans live in the US territories, but health outcomes and payments among Medicare beneficiaries in these territories are not well characterized. METHODS: Among Fee-for-Service Medicare beneficiaries aged 65 years and older hospitalized between 1999 and 2012 for acute myocardial infarction (AMI), heart failure (HF), and pneumonia, we compared hospitalization rates, patient outcomes, and inpatient payments in the territories and states...
September 15, 2017: Medical Care
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