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Hierarchical Condition Category

Scott Martin Vouri, Margaret A Olsen, Daniel Theodoro, Seth A Strope
BACKGROUND: The prevalence and difference in likely indications of urinary catheterization (UC) in treated-and-released emergency department (ED) visits between men and women are currently unknown. METHODS: This was a cross-sectional analysis using the 2013 National Emergency Department Sample for all treated-and-released visits in persons aged ≥18 years. The prevalence of conditions associated with UC visits in men and women were identified. A hierarchical ranking was used to categorize diagnosis codes identified during ED visits into clinically meaningful categories to assess conditions for UC...
April 11, 2017: American Journal of Infection Control
Jove H Graham, Robert J Sanchez, Joseph J Saseen, Usha G Mallya, Mary P Panaccio, Michael A Evans
BACKGROUND: Although statins are considered safe and effective, they have been associated with statin intolerance (SI) in clinical and observational studies. OBJECTIVE: The objective of this study was to describe the clinical and economic consequences of SI through comparison of an SI cohort of patients with matched controls. METHODS: This study used data extracted from an integrated health system's electronic health records from 2008 to 2014...
January 2017: Journal of Clinical Lipidology
Aloke K Mandal, Gene K Tagomori, Randell V Felix, Scott C Howell
OBJECTIVES: In Medicare Advantage (MA) with its CMS Hierarchical Condition Categories (CMS-HCC) payment model, CMS reimburses private plans (Medicare Advantage Organizations [MAOs]) with prospective, monthly, health-based or risk-adjusted, capitated payments. The effect of this payment methodology on healthcare delivery remains debatable. How value-based contracting generates cost efficiencies and improves clinical outcomes in MA is studied. STUDY DESIGN: A difference in contracting arrangements between an MAO and 2 provider groups facilitated an intervention-control, preintervention-postintervention, difference-in-differences approach among statistically similar, elderly, community-dwelling MA enrollees within one metropolitan statistical area...
February 1, 2017: American Journal of Managed Care
M C Obonsawin, J Carlisle, C J Patterson, K Black, K M Davidson, N Masson
BACKGROUND: Biases in beliefs about the self are associated with psychopathology and depressive and anxious mood, but it is not clear if both negative and positive beliefs are associated with depression or anxiety. We examined these relationships in people who present with a wide range of depressive and anxious mood across diagnostic categories. METHODS: We probed positive and negative beliefs about the self with a task in which 74 female participants with either affective disorder (depression and/or anxiety), borderline personality disorder or no psychiatric history indicated the degree to which 60 self-related words was "like them" or "not like them"...
January 21, 2017: Comprehensive Psychiatry
Le Yu, Hao Bin Wu, Xiong Wen David Lou
The rational design and synthesis of hollow structured functional materials are of great significance as both fundamental challenges in materials science and practical solutions for efficient energy utilization in modern society. The unique structural features of hollow functional materials bring outstanding electrochemical properties for both energy storage and electrocatalysis. However, conventional templating methods are normally less efficient in constructing hollow structures with desirable compositions and architectures...
January 27, 2017: Accounts of Chemical Research
Amit Kumar, Amol Karmarkar, Brian Downer, Amit Vashist, Deepak Adhikari, Soham Al Snih, Kenneth Ottenbacher
OBJECTIVE: Compare the performances of comorbidity indices: Charlson, Elixhauser, and the Centers for Medicare & Medicaid Services (CMS) risk adjustment model Hierarchical Condition Category (HCC), in predicting post-acute discharge settings and hospital readmission for patients after joint replacement. METHODS: Retrospective study of Medicare beneficiaries with total knee replacement (TKR) or total hip replacement (THR) discharged from hospitals in 2009-2011 (N=607,349)...
January 24, 2017: Arthritis Care & Research
Joanna F Dipnall, Julie A Pasco, Michael Berk, Lana J Williams, Seetal Dodd, Felice N Jacka, Denny Meyer
BACKGROUND: Depression is commonly comorbid with many other somatic diseases and symptoms. Identification of individuals in clusters with comorbid symptoms may reveal new pathophysiological mechanisms and treatment targets. The aim of this research was to combine machine-learning (ML) algorithms with traditional regression techniques by utilising self-reported medical symptoms to identify and describe clusters of individuals with increased rates of depression from a large cross-sectional community based population epidemiological study...
2016: PloS One
Rafael Veras, Christopher Collins
In this paper we examine how the Minimum Description Length (MDL) principle can be used to efficiently select aggregated views of hierarchical datasets that feature a good balance between clutter and information. We present MDL formulae for generating uneven tree cuts tailored to treemap and sunburst diagrams, taking into account the available display space and information content of the data. We present the results of a proof-of-concept implementation. In addition, we demonstrate how such tree cuts can be used to enhance drill-down interaction in hierarchical visualizations by implementing our approach in an existing visualization tool...
January 2017: IEEE Transactions on Visualization and Computer Graphics
Marianne van Hage, Peter Schmid-Grendelmeier, Chrysanthi Skevaki, Mario Plebani, Walter Canonica, Jörg Kleine-Tebbe, Mats Nystrand, Mehrdad Jafari-Mamaghani, Thilo Jakob
BACKGROUND: After the re-introduction of ImmunoCAP® ISAC sIgE 112 on the market, we undertook a study to evaluate the performance of this multiplex-based immunoassay for IgE measurements to allergen components. METHODS: The study was carried out at 22 European and one South African site. Microarrays from different batches, eight specific IgE (sIgE) positive, three sIgE negative serum samples and a calibration sample were sent to participating laboratories where assays were performed according to the manufacturer's instructions...
March 1, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
Thomas M Achenbach
As the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) acknowledges, DSM diagnostic categories do not fit the real-world heterogeneity, comorbidity, and complexity of most mental health problems. Many efforts to develop and test evidence-based treatments also fail to take account of the heterogeneity, comorbidity, and complexity of problems seen in the community settings where most mental health services are rendered. Most community services cannot attain the treatment specificity and fidelity characterizing randomized controlled trials, which often yield larger therapeutic effects than when the tested treatments are tried in community services...
October 13, 2016: Journal of Clinical Child and Adolescent Psychology
Fabian Lenhard, Sarah Vigerland, Hedvig Engberg, Anna Hallberg, Hanna Thermaenius, Eva Serlachius
INTRODUCTION: Childhood Obsessive-Compulsive Disorder (OCD) is a prevalent and impairing condition that can be effectively treated with Cognitive Behavior Therapy (CBT). However, a majority of children and adolescents do not have access to CBT. Internet-delivered CBT (ICBT) has been suggested as a way to increase availability to effective psychological treatments. Yet, the research on ICBT in children and adolescents has been lagging behind significantly both when it comes to quantitative as well as qualitative studies...
2016: PloS One
Chad Ellimoottil, Andrew M Ryan, Hechuan Hou, James M Dupree, Brian Hallstrom, David C Miller
Importance: Under the Comprehensive Care for Joint Replacement (CJR) model, hospitals are held accountable for nearly all Medicare payments that occur during the initial hospitalization until 90 days after hospital discharge (ie, the episode of care). It is not known whether unrelated expenditures resulting from this "broad" definition of an episode of care will affect participating hospitals' average episode-of-care payments. Objective: To compare the CJR program's broad definition of an episode of care with a clinically narrow definition of an episode of care...
January 1, 2017: JAMA Surgery
Emiley Chang, Teague Ruder, Claude Setodji, Debra Saliba, Mark Hanson, David S Zingmond, Neil S Wenger, David A Ganz
BACKGROUND: Medicare Advantage (MA) enrollment is steadily growing, but little is known about the quality of nursing home (NH) care provided to MA enrollees compared to enrollees in traditional fee-for-service (FFS) Medicare. OBJECTIVES: To compare MA and FFS enrollees' quality of NH care. DESIGN: Cross-sectional. SETTING: US nursing homes. PARTICIPANTS: 2.17 million Medicare enrollees receiving care at an NH during 2011...
October 1, 2016: Journal of the American Medical Directors Association
Amit Kumar, Amol M Karmarkar, James E Graham, Linda Resnik, Alai Tan, Anne Deutsch, Kenneth J Ottenbacher
BACKGROUND: Information regarding the association of comorbidity indices with readmission risk for older adults receiving postacute care is limited. The purpose of this study was to compare the discriminatory ability of five comorbidity indices in predicting 30-day all-cause hospital readmission following discharge to the community from postacute inpatient rehabilitation facilities (IRF). METHODS: The sample included Medicare fee-for-service beneficiaries with stroke, lower extremity joint replacement, and fracture, discharged from IRF in 2011 (N = 75,582)...
February 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Rituparna Bhattacharya, Chan Shen, Amy B Wachholtz, Nilanjana Dwibedi, Usha Sambamoorthi
BACKGROUND: There are many studies in the literature on the association between depression treatment and health expenditures. However, there is a knowledge gap in examining this relationship taking into account coexisting chronic conditions among patients with diabetes. We aim to analyze the association between depression treatment and healthcare expenditures among adults with Type 2 Diabetes Mellitus (T2DM) and newly-diagnosed depression, with consideration of coexisting chronic physical conditions...
July 19, 2016: BMC Psychiatry
Carrie H Colla, Valerie A Lewis, Lee-Sien Kao, A James O'Malley, Chiang-Hua Chang, Elliott S Fisher
IMPORTANCE: Accountable care contracts hold physician groups financially responsible for the quality and cost of health care delivered to patients. Focusing on clinically vulnerable patients, those with serious conditions who are responsible for the greatest proportion of spending, may result in the largest effects on both patient outcomes and financial rewards for participating physician groups. OBJECTIVE: To estimate the effect of Medicare accountable care organization (ACO) contracts on spending and high-cost institutional use for all Medicare beneficiaries and for clinically vulnerable beneficiaries...
August 1, 2016: JAMA Internal Medicine
Mélodie Schmitz, Syaghalirwa N M Mandiki, Jessica Douxfils, Tamar Ziv, Arie Admon, Patrick Kestemont
UNLABELLED: Hyperosmotic stress has often been investigated from osmoregulation perspectives while the effects of such stress on the immune capacity remain largely unexplored. In this study, striped catfish were submitted to a gradual hyperosmotic stress (up to 20ppt), followed by an infection with a virulent strain of an intracellular bacteria, Edwardsiella ictaluri. Physiological parameters (plasma osmolarity, gill NaK ATPase) have been investigated. Moreover, a label free quantitative proteomics workflow was used to study how salinity affects the proteome of kidney of no infected and infected fish...
June 16, 2016: Journal of Proteomics
Amit Kumar, James E Graham, Linda Resnik, Amol M Karmarkar, Alai Tan, Anne Deutsch, Kenneth J Ottenbacher
OBJECTIVE: Compare 5 comorbidity indices to predict community discharge and functional status following post-acute rehabilitation. DESIGN: This was a retrospective study of Medicare beneficiaries with stroke, lower-extremity fracture, and joint replacement discharged from inpatient rehabilitation in 2011 (N = 105,275). Community discharge and self-care, mobility, and cognitive function were compared using the Charlson, Elixhauser, Tier, Functional Comorbidity, and Hierarchical Condition Category comorbidity indices...
December 2016: American Journal of Physical Medicine & Rehabilitation
Kadin Caines, Carla Shoff, David M Bott, Jesse M Pines
STUDY OBJECTIVE: Hospital-based emergency departments (EDs) are the gateway to hospital admissions for many Americans. Approximately half of all US hospital admissions originate from EDs, and more than 3 in 4 are among Medicare beneficiaries. Recent literature has demonstrated nearly 2-fold variation in both physician- and hospital-level ED admission rates. We study geographic variation at the county level in ED admission rates among Medicare fee-for-service beneficiaries. METHODS: Using the 100% population data from the Centers for Medicare & Medicaid Services (CMS), we analyzed beneficiaries continuously enrolled in Medicare fee-for-service Parts A and B who resided in the 50 states and the District of Columbia in 2012...
October 2016: Annals of Emergency Medicine
Yossy Machluf, Daniel Fink, Rivka Farkash, Ron Rotkopf, Avinoam Pirogovsky, Orna Tal, Tamar Shohat, Giora Weisz, Erez Ringler, David Dagan, Yoram Chaiter
The increasing prevalence of abnormal body mass index (BMI), mainly obesity, is becoming a significant public health problem. This cross-sectional study aimed to provide a comprehensive view of secular trends of BMI, and the associated socio-demographic variables and comorbidities among adolescents with abnormal BMI. Individuals of the study population were born mainly between 1970 and 1993, and were examined at 16 to 19 years of age during the years 1987 to 2010, at 1 conscription center in the northern district of Israel...
March 2016: Medicine (Baltimore)
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