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https://www.readbyqxmd.com/read/28239867/inpatient-cost-analysis-for-treatment-of-myasthenia-gravis
#1
Jacklyn O Omorodion, Jesse M Pines, Henry J Kaminski
INTRODUCTION: We explored trends in U.S. inpatient costs of care over a 10-year period. METHODS: We compared myasthenia gravis (MG) to multiple sclerosis (MS) and overall U.S. hospital admissions using the Agency for Healthcare Research and Quality Nationwide Inpatient Sample database for 2003-2013. RESULTS: Total costs of MG inpatient care rose 13-fold from 2003-2013. This was accounted for by a >6-fold increase in discharges and a >2-fold increase in cost per discharge...
February 27, 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/28239010/antiretroviral-therapy-racial-disparities-among-publicly-insured-californians-with-hiv
#2
Raphael J Landovitz, Katherine A Desmond, Arleen A Leibowitz
Only 43% of Americans with HIV are virally suppressed; the rate is lower for African Americans, even among insured populations. This study uses 2010 Medicare and Medicaid data for HIV-positive Californians to examine how antiretroviral treatment (ART) relates to patient and provider characteristics. Logistic regressions isolated the effect of race/ethnicity on receipt of ART. Over 90% of the full sample received any ART. Nearly 80% of ART users received a recommended combination for at least half the year; half had a recommended combination for 90% of the year...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28237627/utilization-of-preoperative-endoscopic-ultrasound-for-pancreatic-adenocarcinoma
#3
Ryan K Schmocker, David J Vanness, Caprice C Greenberg, Jeff A Havlena, Noelle K LoConte, Jennifer M Weiss, Heather B Neuman, Glen Leverson, Maureen A Smith, Emily R Winslow
BACKGROUND: Endoscopic ultrasound (EUS) is used for pancreatic adenocarcinoma staging and obtaining a tissue diagnosis. The objective was to determine patterns of preoperative EUS and the impact on downstream treatment. METHODS: The Surveillance, Epidemiology, and End Results (SEER) Medicare-linked database was used to identify patients with pancreatic adenocarcinoma. The staging period was the first staging procedure within 6 months of surgery until surgery. Logistic regression was used to determine factors associated with preoperative EUS...
February 22, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28237424/downstream-imaging-utilization-after-emergency%C3%A2-department-ultrasound-interpreted-by%C3%A2-radiologists%C3%A2-versus-nonradiologists-a-medicare-claims-based-study
#4
Bibb Allen, L Van Carrol, Danny R Hughes, Jennifer Hemingway, Richard Duszak, Andrew B Rosenkrantz
OBJECTIVE: To study differences in imaging utilization downstream to initial emergency department (ED) ultrasound examinations interpreted by radiologists versus nonradiologists. METHODS: Using 5% Medicare Research Identifiable Files from 2009 to 2014, we identified episodes where the place of service was "emergency room hospital" and the patient also underwent an ultrasound examination. We determined whether the initial ultrasound was interpreted by a radiologist or nonradiologist and then summed all additional imaging events occurring within 7, 14, and 30 days of each initial ED ultrasound...
February 17, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28237388/using-administrative-data-to-look-at-changes-in-the-level-and-distribution-of-out-of-pocket-medical-expenditure-an-example-using-medicare-data-from-australia
#5
Xinyang Hua, Guido Erreygers, John Chalmers, Tracey-Lea Laba, Philip Clarke
OBJECTIVES: Australia's universal health insurance system Medicare generates very large amounts of data on out-of-pocket expenditure (OOPE), but only highly aggregated statistics are routinely published. Our primary purpose is to develop indices from the Medicare administrative data to quantify changes in the level and distribution of OOPE on out-of-hospital medical services over time. METHODS: Data were obtained from the Australian Hypertension and Absolute Risk Study, which involved patients aged 55 years and over (n=2653)...
February 22, 2017: Health Policy
https://www.readbyqxmd.com/read/28237242/early-results-of-lung-cancer-screening-and-radiation-dose-assessment-by-low-dose-ct-at-a-community-hospital
#6
Corbin D Jacobs, Mary Ellen Jafari
BACKGROUND: The National Lung Screening Trial showed a reduction in overall and cancer-specific mortality for patients screened with low-dose computed tomography (LDCT) versus chest radiograph. Some question whether this can be achieved in community healthcare settings. Our aim was to analyze lung cancer screening outcomes and administered radiation dose using LDCT scans at a community hospital. PATIENTS AND METHODS: We retrospectively reviewed the records of 680 patients who underwent LDCT between June 2014 and December 2015, and who met Centers for Medicare and Medicaid Services lung cancer screening criteria: asymptomatic, aged 55 to 77 years, smoked within the last 15 years, and ≥ 30 pack-year history...
February 2, 2017: Clinical Lung Cancer
https://www.readbyqxmd.com/read/28230457/comparative-effectiveness-of-rapid-acting-insulins-in-adults-with-diabetes
#7
Patrick N Racsa, Yunus Meah, Jeffrey J Ellis, Kimberly R Saverno
BACKGROUND: Although there are a variety of insulin products and new delivery modalities available, the absence of direct clinical and economic comparisons can make treatment planning and formulary decision making difficult. Direct comparisons between insulin aspart and insulin lispro from a large heterogeneous population are not available. OBJECTIVE: To assess differences in clinical outcomes, medication adherence, utilization, and total health care costs between aspart and lispro and vial versus pen modalities for administering these short-acting insulin analogs...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230454/adherence-persistence-and-health-care-costs-for-patients-receiving-dipeptidyl-peptidase-4-inhibitors
#8
Karen L Rascati, Karen Worley, Yunus Meah, Damian Everhart
BACKGROUND: The dipeptidyl peptidase-4 (DPP-4) inhibitors are among the newer, yet more established, classes of diabetes medications. OBJECTIVE: To compare adherence, persistence, and health care costs among patients taking DPP-4 inhibitors. METHODS: Claims were extracted from Humana Medicare Advantage Prescription Drug (MAPD) or commercial plans for patients aged > 18 years with ≥ 1 prescription filled for a DPP-4 inhibitor between July 1, 2011, and March 31, 2013...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230451/positive-medication-changes-resulting-from-comprehensive-and-noncomprehensive-medication-reviews-in-a-medicare-part-d-population
#9
Allison Buhl, Jill Augustine, Ann M Taylor, Rose Martin, Terri L Warholak
BACKGROUND: Health care organizations face the challenge of reducing costs while improving health outcomes. Currently, more than 39 million seniors are enrolled in a Medicare Part D prescription benefit plan, many of whom also qualify for medication therapy management (MTM) services. MTM programs provide valuable services designed to prevent or resolve medication-related problems (MRPs). Two core components of all MTM programs include comprehensive medication reviews (CMRs) with followup interventions and focused non-CMR interventions...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230447/effect-of-medicaid-policy-changes-on-medication-adherence-differences-by-baseline-adherence
#10
Krutika Amin, Joel F Farley, Matthew L Maciejewski, Marisa E Domino
BACKGROUND: In 2001, the North Carolina (NC) Medicaid program reduced the number of days prescription supply that enrollees could fill from 100 days to 34 days and increased copayments for brand-name medications. Previous work has shown that a change in these policies led to a decrease in medication adherence from 2.9 to 8.0 percentage points in specific populations with chronic conditions. Studies have also shown that days supply limits and copayment increases have heterogeneous effects based on enrollees' baseline characteristics, including baseline adherence...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28229485/osteoporosis-related-health-services-utilization-following-first-hip-fracture-among-a-cohort-of-privately-insured-women-in-the-united-states-2008-2014-an-observational-study
#11
Catherine W Gillespie, Pamela E Morin
Timely identification and treatment of osteoporosis following hip fracture is recommended to mitigate future fracture risk, yet prior work has demonstrated a disconnect between evidence-based recommendations and real-world implementation. We sought to describe contemporary patterns of osteoporosis screening and initiation of pharmacotherapy following hip fracture based on medical and pharmacy claims in the OptumLabs™ Data Warehouse. From a national sample, we identified 8349 women aged 50+ years enrolled in private commercial or Medicare Advantage plans with no prior history of osteoporosis diagnosis, osteoporosis pharmacotherapy, or hip fracture who experienced a hip fracture between 2008 and 2013...
February 23, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28225746/atypical-antipsychotics-and-the-risk-of-falls-and-fractures-among-older-adults-an-emulation-analysis-and-an-evaluation-of-additional-confounding-control-strategies
#12
Darmendra Ramcharran, Hong Qiu, Martijn J Schuemie, Patrick B Ryan
PURPOSE: The aim of this study was to investigate the risk of falls and fractures among older adults receiving atypical antipsychotics. METHODS: An emulation analysis of a previously published study was performed using the US Truven MarketScan Medicare Supplemental database (MDCR). In addition, modified analyses were implemented to evaluate alternative confounding control strategies that (1) included all covariates used to fit propensity score models in outcome models and (2) required patients to have a mental health condition diagnosis and a health care visit within 90 days prior to the index date...
April 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28224943/medicare-telehealth-services-and-nephrology-policies-for-eligibility-and-payment
#13
REVIEW
Stephanie Frilling
The criteria for Medicare payment of telehealth nephrology services, and all other Medicare telehealth services, are set forth in section 1834(m) of the Social Security Act. There are just over 80 professional physician or practitioner services that may be furnished via telehealth and paid under Medicare Part B, when an interactive audio and video telecommunication system that permits real-time communication between a beneficiary at the originating site and the physician or practitioner at the distant site substitutes for an in-person encounter...
January 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28219452/stop-stroke-a-brief-report-on-door-to-needle-times-and-performance-after-implementing-an-acute-care-coordination-medical-application-and-implications-to-emergency-medical-services
#14
Robert Dickson, Adrian Nedelcut, Melissa McPeek Nedelcut
OBJECTIVE: The objective of this study was to evaluate the effect of the Stop Stroke (Pulsara; Bozeman, Montana USA) medical application on door-to-needle (DTN) time in patients presenting to the emergency department (ED) with an acute ischemic stroke (AIS). METHODS: This was a retrospective cohort study of the Good Shepherd Health System (Longview, Texas USA) stroke quality improvement dashboard for a 25-month period from February 2012 through February 2014. Data analysis includes all data from Center for Medicare and Medicaid Services (CMS; Baltimore, Maryland USA) reportable cases receiving Tissue Plasminogen Activator (TPA) for AIS during the study period...
February 21, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28217968/payer-type-and-low-value-care-comparing-choosing-wisely-services-across-commercial-and-medicare-populations
#15
Carrie H Colla, Nancy E Morden, Thomas D Sequist, Alexander J Mainor, Zhonghe Li, Meredith B Rosenthal
OBJECTIVE: To compare low-value health service use among commercially insured and Medicare populations and explore the influence of payer type on the provision of low-value care. DATA SOURCES: 2009-2011 national Medicare and commercial insurance administrative data. DESIGN: We created claims-based algorithms to measure seven Choosing Wisely-identified low-value services and examined the correlation between commercial and Medicare overuse overall and at the regional level...
February 19, 2017: Health Services Research
https://www.readbyqxmd.com/read/28214255/clinical-outcomes-and-90-day-costs-following-hemiarthroplasty-or-total-hip-arthroplasty-for-hip-fracture
#16
Christine I Nichols, Joshua G Vose, Ryan M Nunley
BACKGROUND: In the era of bundled payments, many hospitals are responsible for costs from admission through 90 days postdischarge. Although bundled episodes for hip fracture will have a separate target price for the bundle, little is known about the 90-day resource use burden for this patient population. METHODS: Using Medicare 100% Standard Analytic Files (2010-2014), we identified patients undergoing hemiarthroplasty or total hip arthroplasty (THA). Patients were aged 65 and older with admitting diagnosis of closed hip fracture, no concurrent fractures of the lower limb, and no history of hip surgery in the prior 12 months baseline...
January 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28214250/colorectal-cancer-screening-adherence-in-selected-disabilities-over-10-years
#17
Chelsea B Deroche, Suzanne W McDermott, Joshua R Mann, James W Hardin
INTRODUCTION: Colorectal cancer (CRC) is the second leading cause of cancer mortality in the U.S.; however, if the population aged 50 years or older received routine screening, approximately 60% of these deaths could be eliminated. This study investigates whether adults, aged 50-75 years, with one of three disabilities (blind/low vision [BLV], intellectual disability [ID], spinal cord injury [SCI]) receive CRC screening at rates equivalent to adults without the three disabilities, by accounting for combinations of recommended CRC screenings during a 10-year period (colonoscopy, sigmoidoscopy, fecal occult blood test)...
February 14, 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/28214235/effects-of-postacute-settings-on-readmission-rates-and-reasons-for%C3%A2-readmission-following-total-knee-arthroplasty
#18
Rodney Laine Welsh, James E Graham, Amol M Karmarkar, Natalie E Leland, Jacques G Baillargeon, Dana L Wild, Kenneth J Ottenbacher
OBJECTIVES: Examine the effects of postacute discharge setting on unplanned hospital readmissions following total knee arthroplasty (TKA) in older adults. DESIGN: Secondary analyses of 100% Medicare (inpatient) claims files. SETTING: Acute hospitals across the United States. PARTICIPANTS: Medicare fee-for-service beneficiaries ≥66 years of age who were discharged from an acute hospital following TKA in 2009-2011 (n = 608,031)...
February 14, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28210082/multitarget-stool-dna-tests-increases-colorectal-cancer-screening-among-previously-noncompliant-medicare-patients
#19
Mark Prince, Lynn Lester, Rupal Chiniwala, Barry Berger
AIM: To determine the uptake of noninvasive multitarget stool DNA (mt-sDNA) in a cohort of colorectal cancer (CRC) screening non-compliant average-risk Medicare patients. METHODS: This cross sectional primary care office-based study examined mt-sDNA uptake in routine clinical practice among 393 colorectal cancer screening non-compliant Medicare patients ages 50-85 ordered by 77 physicians in a multispecialty group practice (USMD Physician Services, Dallas, TX) from October, 2014-September, 2015...
January 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28208030/intensive-care-unit-admission-and-survival-among-older-patients-with-chronic-obstructive-pulmonary-disease-heart-failure-or-myocardial-infarction
#20
Thomas S Valley, Michael W Sjoding, Andrew M Ryan, Theodore J Iwashyna, Colin R Cooke
RATIONALE: Admission to an intensive care unit (ICU) may be beneficial to pneumonia patients with uncertain ICU needs; however, evidence regarding the association between ICU admission and mortality for other common conditions is largely unknown. OBJECTIVES: To estimate the relationship between ICU admission and outcomes for hospitalized patients with exacerbation of chronic obstructive pulmonary disease (COPD), exacerbation of heart failure (HF), or acute myocardial infarction (AMI)...
February 16, 2017: Annals of the American Thoracic Society
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