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https://www.readbyqxmd.com/read/29035618/impact-of-intensity-modulated-radiotherapy-on-health-care-costs-of-patients-with-anal-squamous-cell-carcinoma
#1
Alexander L Chin, Erqi L Pollom, Yushen Qian, Albert C Koong, Daniel T Chang
PURPOSE: Drivers of variation in the cost of care after chemoradiotherapy for the management of anal squamous cell carcinoma (SCC) have not been fully elucidated. We sought to characterize the direct and indirect impact of radiotherapy modality on health care costs among patients with anal SCC. PATIENTS AND METHODS: A retrospective cohort study was performed using the 2014 linkage of the SEER-Medicare database. We identified 1,025 patients with anal SCC diagnosed between 2001 and 2011 and treated with chemoradiotherapy...
October 16, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29034792/medical-resource-utilization-and-costs-for-total-hip-arthroplasty-benchmarking-an-anterior-approach-technique-in-the-medicare-population
#2
Atul F Kamath, Abhishek S Chitnis, Chantal Holy, Jason Lerner, Brian Curtin, Steve Lochow, Charles DeCook, Joel M Matta
AIMS: The anterior approach (AA) for total hip arthroplasty (THA) is associated with more rapid recovery when compared to traditional approaches. The purpose of this study was to benchmark healthcare resource utilization and costs for patients with THA via AA relative to matched patients. MATERIALS AND METHODS: We queried Medicare claims data (2012-2014) to identify patients who received THA via an AA from experienced surgeons, and matched these patients to a control cohort (all THA approaches)...
October 15, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/29033594/cost-effectiveness-analysis-of-intravenous-ferumoxytol-for-the-treatment-of-iron-deficiency-anemia-in-adult-patients-with-non-dialysis-dependent-chronic-kidney-disease-in-the-usa
#3
Naomi V Dahl, Robert F Kaper, William E Strauss, Frank A Corvino, Marko Zivkovic
OBJECTIVE: Ferumoxytol has demonstrated superior efficacy compared with oral iron in treating iron deficiency anemia in chronic kidney disease (CKD) patients. However, an economic evaluation of ferumoxytol has not been conducted. The aim of this study was to analyze the cost-effectiveness of treating iron deficiency anemia in adult non-dialysis-dependent CKD patients with ferumoxytol as compared with oral iron, alone or in combination with erythropoietin-stimulating agents (ESAs). METHODS: A decision analytic model compared health outcomes and costs associated with 5-week outpatient treatment of adult non-dialysis-dependent CKD patients with ferumoxytol or oral iron, each as monotherapy or in combination with ESAs in the USA...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/29033460/mortality-and-morbidity-in-the-21-st-century
#4
Anne Case, Angus Deaton
We build on and extend the findings in Case and Deaton (2015) on increases in mortality and morbidity among white non-Hispanic Americans in midlife since the turn of the century. Increases in all-cause mortality continued unabated to 2015, with additional increases in drug overdoses, suicides, and alcohol-related liver mortality, particularly among those with a high-school degree or less. The decline in mortality from heart disease has slowed and, most recently, stopped, and this combined with the three other causes is responsible for the increase in all-cause mortality...
2017: Brookings Papers on Economic Activity
https://www.readbyqxmd.com/read/29029585/refinement-of-the-affordable-care-act-a-progressive-perspective
#5
Olveen Carrasquillo, Michael Mueller
The Affordable Care Act (ACA) was the most significant expansion of health coverage since Medicare and Medicaid were enacted. The law resulted in approximately 13-20 million uninsured persons gaining coverage. Despite these gains, the ACA has numerous shortcomings. For progressives, the ACA was a unique opportunity to provide access to high-quality, comprehensive, equitable health coverage to all persons living in the United States. Using this perspective as our framework, in this review we highlight some of the limitations of the ACA and potential areas for refinement...
October 13, 2017: Annual Review of Medicine
https://www.readbyqxmd.com/read/29027893/hospital-acquired-conditions-predictors-and-implications-for-outcomes-following-spine-tumor-resection
#6
Nikita Lakomkin, Constantinos G Hadjipanayis
OBJECTIVE Hospital-acquired conditions (HACs) significantly compromise patient safety, and have been identified by the Centers for Medicare and Medicaid Services as events that will be associated with penalties for surgeons. The mitigation of HACs must be an important consideration during the postoperative management of patients undergoing spine tumor resection. The purpose of this study was to identify the risk factors for HACs and to characterize the relationship between HACs and other postoperative adverse events following spine tumor resection...
October 13, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29025270/design-of-a-randomized-clinical-trial-of-a-colorectal-cancer-screening-decision-aid-to-promote-appropriate-screening-in-community-dwelling-older-adults
#7
Christine E Kistler, Carol Golin, Carolyn Morris, Alexandra F Dalton, Russell P Harris, Rowena Dolor, Renée M Ferrari, Noel T Brewer, Carmen L Lewis
BACKGROUND: Appropriate colorectal cancer screening in older adults should be aligned with the likelihood of net benefit. In general, patient decision aids improve knowledge and values clarity, but in older adults, they may also help patients identify their individual likelihood of benefit and foster individualized decision-making. We report on the design of a randomized clinical trial to understand the effects of a patient decision aid on appropriate colorectal cancer screening. This report includes a description of the baseline characteristics of participants...
August 1, 2017: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/29024708/nationwide-quality-of-hospice-care-findings-from-the-centers-for-medicare-medicaid-services-cms-hospice-quality-reporting-program-hqrp
#8
Nan Tracy Zheng, Qinghua Li, Laura C Hanson, Kathryn L Wessell, Natalie Chong, Noha Sherif, Ila H Broyles, Jennifer Frank, M Alexis Kirk, Carol R Schwartz, Alan F Levitt, Franziska Rokoske
BACKGROUND: With increasing use of the Medicare hospice benefit, policymakers recognize the need for quality measurement to assure that terminally ill patients receive high quality care and have the information they need when selecting a hospice. Towards these goals, CMS has been collecting standardized patient-level quality data via the Hospice Item Set (HIS) since July 1, 2014. OBJECTIVES: This article presents a first look at the national hospice HIS quality data...
October 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29024046/traumatic-brain-injury-in-the-prodromal-period-of-parkinson-disease-a-large-epidemiological-study-using-medicare-data
#9
Alejandra Camacho-Soto, Mark N Warden, Susan Searles Nielsen, Amber Salter, David L Brody, Heidi Prather, Brad A Racette
OBJECTIVE: Studies suggest a greater risk of Parkinson disease (PD) after traumatic brain injury (TBI), but it is possible that the risk of TBI is greater in the prodromal period of PD. We aimed to examine the time-to-TBI in PD patients in their prodromal period compared to population-based controls. METHODS: We identified 89,790 incident PD cases and 118,095 comparable controls > 65 years of age in 2009 using Medicare claims data. Using data from the preceding five years, we compared time-to-TBI in PD patients in their prodromal period to controls...
October 10, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/29023259/personal-and-professional-characteristics-of-u-s-dual-boarded-critical-care-cardiologists-in-2015
#10
Daniel M Blumenthal, Bassem Mikhael, Patrick R Lawler, Robert W Yeh, Joshua P Metlay, David M Dudzinski
OBJECTIVES: Evaluate the characteristics of U.S. physicians who are board certified in cardiology and critical care medicine ("dual-boarded cardiologists"). DESIGN: Retrospective cross-sectional study using a comprehensive database of licensed U.S. physicians linked to Medicare claims. SETTING: The United States. SUBJECTS: Dual-boarded cardiologists. MEASUREMENTS AND MAIN RESULTS: We used a comprehensive physician database to identify all physicians who were board certified in cardiology and critical care medicine before July 2015...
October 11, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29021267/association-of-neighborhood-socioeconomic-context-with-participation-in-cardiac-rehabilitation
#11
Justin M Bachmann, Shi Huang, Deepak K Gupta, Loren Lipworth, Michael T Mumma, William J Blot, Elvis A Akwo, Sunil Kripalani, Mary A Whooley, Thomas J Wang, Matthew S Freiberg
BACKGROUND: Cardiac rehabilitation (CR) is underutilized in the United States, with fewer than 20% of eligible patients participating in CR programs. Individual socioeconomic status is associated with CR utilization, but data regarding neighborhood characteristics and CR are sparse. We investigated the association of neighborhood socioeconomic context with CR participation in the SCCS (Southern Community Cohort Study). METHODS AND RESULTS: The SCCS is a prospective cohort study of 84 569 adults in the southeastern United States from 2002 to 2009, 52 117 of whom have Medicare or Medicaid claims...
October 11, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29020905/the-incidence-and-multiplicity-rates-of-keratinocyte-cancers-in-australia
#12
Nirmala Pandeya, Catherine M Olsen, David C Whiteman
OBJECTIVES: To assess the incidence and multiplicity of keratinocyte cancers (basal cell carcinoma [BCC] and squamous cell carcinoma [SCC]) excised in Australia, and to examine variations by age, sex, state, and prior skin cancer history. DESIGN: Analysis of individual-level Medicare data for keratinocyte cancer treatments (identified by eight specific MBS item codes) during 2011-2014. Histological data from the QSkin prospective cohort study were analysed to estimate BCC and SCC incidence...
October 16, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/29020733/how-have-health-insurers-performed-financially-under-the-aca-market-rules
#13
Michael J McCue, Mark A Hall
Issue: The Affordable Care Act (ACA) transformed the market for individual health insurance, so it is not surprising that insurers' transition was not entirely smooth. Insurers, with no previous experience under these market conditions, were uncertain how to price their products. As a result, they incurred significant losses. Based on this experience, some insurers have decided to leave the ACA’s subsidized market, although others appear to be thriving. Goals: Examine the financial performance of health insurers selling through the ACA's marketplace exchanges in 2015--the market’s most difficult year to date...
October 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/29019079/pharmacotherapy-choice-is-associated-with-2-year-mortality-for-patients-with-heart-failure-and-reduced-ejection-fraction
#14
Nancy M Albert, Dana A Drzayich Antol, Richard W DeClue, Adrianne Waldman Casebeer, Yong Li, Stephen Stemkowski, Chun-Lan Chang
INTRODUCTION: Factors associated with mortality for patients with heart failure and reduced ejection fraction (HFrEF) are known; however, the association between initial pharmacotherapy (IPT) and mortality is unclear in real-world settings. METHODS: Using a retrospective design and claims database, 14,359 Medicare patients with HFrEF from August 2010 to July 2015 were identified. Index date was first HF claim. IPT was mono- or combo-angiotensin-converting enzyme inhibitor (ACEI), angiotensin II receptor blocker (ARB), beta-blocker (BB), hydralazine-nitrate (HN), and aldosterone antagonist (AA) within 1 year post-index...
October 10, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/29017802/big-data-and-total-hip-arthroplasty-how-do-large-databases-compare
#15
Nicholas A Bedard, Andrew J Pugely, Michael A McHugh, Nathan R Lux, Kevin J Bozic, John J Callaghan
BACKGROUND: Use of large databases for orthopedic research has become extremely popular in recent years. Each database varies in the methods used to capture data and the population it represents. The purpose of this study was to evaluate how these databases differed in reported demographics, comorbidities, and postoperative complications for primary total hip arthroplasty (THA) patients. METHODS: Primary THA patients were identified within National Surgical Quality Improvement Programs (NSQIP), Nationwide Inpatient Sample (NIS), Medicare Standard Analytic Files (MED), and Humana administrative claims database (HAC)...
September 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29016707/minimal-clinical-impact-of-intraoperative-examination-of-sentinel-lymph-nodes-in-patients-with-ductal-carcinoma-in-situ-an-opportunity-for-improved-resource-utilization
#16
Eugene T Shin, Amy S Joehlin-Price, Doreen M Agnese, Debra L Zynger
Objectives: There is little information regarding sentinel lymph node (SLN) frozen-section examination in patients with a history of ductal carcinoma in situ (DCIS). We evaluated the usage, clinical impact, and pathology resources used for SLN cryosectioning in mastectomy cases with a DCIS history. Methods: Mastectomies with SLNs submitted from 2012 to 2013 at a tertiary care center were analyzed. Medicare reimbursement was used to estimate pathology health care expenditures of intraoperative frozen sections...
September 18, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/29016226/trajectories-of-injectable-cancer-drug-costs-after-launch-in-the-united-states
#17
Noa Gordon, Salomon M Stemmer, Dan Greenberg, Daniel A Goldstein
Purpose Cancer drug prices at launch have increased in recent years. It is unclear how individual drug prices change over time after launch and what market determinants influence these changes. We measured the price trajectories of a cohort of cancer drugs after their launch into the US market and assessed the influence of market structure on price changes. Methods We studied the changes in mean monthly costs for a cohort of 24 patented, injectable anticancer drugs that were approved by the US Food and Drug Administration between 1996 and 2012...
October 10, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28994106/safety-culture-and-mortality-after-acute-myocardial-infarction-a-study-of-medicare-beneficiaries-at-171-hospitals
#18
David M Shahian, Xiu Liu, Laura P Rossi, Elizabeth A Mort, Sharon-Lise T Normand
OBJECTIVES: To investigate the association between hospital safety culture and 30-day risk-adjusted mortality for Medicare patients with acute myocardial infarction (AMI) in a large, diverse hospital cohort. SUBJECTS: The final analytic cohort consisted of 19,357 Medicare AMI discharges (MedPAR data) linked to 257 AHRQ Hospital Survey on Patient Safety Culture surveys from 171 hospitals between 2008 and 2013. STUDY DESIGN: Observational, cross-sectional study using hierarchical logistic models to estimate the association between hospital safety scores and 30-day risk-adjusted patient mortality...
October 9, 2017: Health Services Research
https://www.readbyqxmd.com/read/28993075/call-to-action-aprns-in-u-s-nursing-homes-to-improve-care-and-reduce-costs
#19
Marilyn J Rantz, Nancy M Birtley, Marcia Flesner, Charles Crecelius, Cathy Murray
BACKGROUND: Centers for Medicare and Medicaid Innovation Center sponsored the initiative to reduce avoidable hospitalizations among nursing facility residents. PURPOSE: Missouri Quality Initiative (MOQI) designed inter-professional model in nursing homes with advanced practice registered nurses (APRNs). METHOD: MOQI APRN model was implemented for 4 years in 16 nursing homes in a metro area of the Midwest. Hospitalizations were reduced (40% all-cause, 58% potentially avoidable), emergency room visits (54% all-cause, 65% potentially avoidable), Medicare expenditures for hospitalizations (34% all-cause, 45% potentially avoidable), and Medicare expenditures for emergency room visits (50% all-cause, 60% potentially avoidable) for long-stay nursing home residents...
September 21, 2017: Nursing Outlook
https://www.readbyqxmd.com/read/28992343/serum-to-dialysate-potassium-gradient-and-its-association-with-short-term-outcomes-in-hemodialysis-patients
#20
Steven M Brunelli, David M Spiegel, Charles Du Mond, Nina Oestreicher, Wolfgang C Winkelmayer, Csaba P Kovesdy
Background: A high serum-to-dialysate potassium (K + ) gradient at the start of dialysis leads to rapid lowering of serum K + and may confer a greater risk of adverse events. Here, we examined the near-term association of K + gradient with clinical outcomes. Methods: This retrospective (2010-11) event-based study considered 830 741 patient-intervals, each defined by a pre-dialysis measurement of serum K + made among adult Medicare Parts A and B enrollees who received in-center hemodialysis on a Monday/Wednesday/Friday schedule at a large US dialysis organization...
August 19, 2017: Nephrology, Dialysis, Transplantation
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