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https://www.readbyqxmd.com/read/29352596/thirty-day-readmissions-following-parathyroidectomy-evidence-from-the-national-readmissions-database-2013-2014
#1
Adam M Kravietz, Jessica L Buicko, Joshua P Parreco, Michael A Lopez, Robert A Kozol
PURPOSE: Parathyroidectomy is one of the most common procedures performed in the United States, and are increasingly being performed safely in the outpatient setting. However, complications from surgery can be life-threatening, and thus an understanding of who may be at risk is essential. We analyzed and compared the risk factors for patients readmitted within 30 days following inpatient parathyroidectomy for primary or secondary hyperparathyroidism. MATERIALS AND METHODS: We reviewed the National Readmissions Database from 2013 to 2014 for patients who received inpatient parathyroidectomy for primary or secondary hyperparathyroidism...
January 10, 2018: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/29351776/readmission-rates-in-not-for-profit-vs-proprietary-hospitals-before-and-after-the-hospital-readmission-reduction-program-implementation
#2
Lauren E Birmingham, Willie H Oglesby
BACKGROUND: The Patient Protection and Affordable Care Act established the Hospital Readmission Reduction Program (HRRP) to penalize hospitals with excessive 30-day hospital readmissions of Medicare enrollees for specific conditions. This policy was aimed at increasing the quality of care delivered to patients and decreasing the amount of money paid for potentially preventable hospital readmissions. While it has been established that the number of 30-day hospital readmissions decreased after program implementation, it is unknown whether this effect occurred equally between not-for-profit and proprietary hospitals...
January 19, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29351137/early-response-to-warfarin-initiation-and-the-risk-of-venous-thromboembolism-after-total-joint-arthroplasty
#3
Adam I Edelstein, Clara Terzaghi, Brandon Nudelman, Charles Qin, Mary Kwasny, David W Manning
BACKGROUND: Venous thromboembolism chemoprophylaxis with warfarin is common after total joint arthroplasty. Early response to warfarin initiation has been theorized to engender a transient increase in the risk of venous thromboembolism. We hypothesized that a rapid rise in the international normalized ratio is a risk factor for venous thromboembolism after total joint arthroplasty. METHODS: This study was a retrospective analysis of Medicare patients undergoing elective total joint arthroplasty who were given nomogram-dosed warfarin for venous thromboembolism prophylaxis...
January 18, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29351136/trends-and-variability-in-the-use-of-total-shoulder-arthroplasty-for-medicare-patients
#4
Benjamin Zmistowski, Eric M Padegimas, Michael Howley, Joseph Abboud, Gerald Williams, Surena Namdari
INTRODUCTION: As policies are implemented to encourage high-quality care, it is important to identify any persistent limitations to the uniform delivery of anatomic and reverse total shoulder arthroplasty (TSA). The study's goal was to assess current TSA use and identify predictors of geographic variability. METHODS: We used data from 2012 through 2014 that was obtained from public Medicare databases to identify the case volume, locations, and names of surgeons performing >10 TSAs annually...
January 18, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29350507/hospital-participation-in-meaningful-use-and-racial-disparities-in-readmissions
#5
Mark Aaron Unruh, Hye Young Jung, Rainu Kaushal, Joshua R Vest
OBJECTIVES: To measure the impact of hospital participation in Meaningful Use (MU) on disparities in 30-day readmissions associated with race. STUDY DESIGN: A retrospective cohort study that compared the likelihood of 30-day readmission for Medicare beneficiaries discharged from hospitals participating in Stage 1 of MU with the likelihood of readmission for beneficiaries concurrently discharged from hospitals that were not participating in the initiative. METHODS: Inpatient claims for 2,414,205 Medicare beneficiaries from Florida, New York, and Washington State were used as the primary data source...
January 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/29347984/the-effects-of-state-rules-on-opioid-prescribing-in-indiana
#6
Morhaf Al Achkar, Shaun Grannis, Debra Revere, Palmer MacKie, Meredith Howard, Sumedha Gupta
BACKGROUND: Prescription opioids have been linked to over half of the 28,000 opioid overdose deaths in 2014. High rates of prescription opioid non-medical use have continued despite nearly all states implementing large-scale prescription drug monitoring programs (PDMP), which points to the need to examine the impact of state PDMP's on curbing inappropriate opioid prescribing. In the short-term, PDMPs have been associated with short-term prescribing declines. Yet little is known about how such policies differentially impact patient subgroups or are interpreted by prescribing providers...
January 18, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29346522/serious-fall-injury-history-and-adverse-health-outcomes-after-initiating-hemodialysis-among-older-u-s-adults
#7
C Barrett Bowling, Rasheeda Hall, Anjali Khakharia, Harold A Franch, Laura C Plantinga
Background: Although older adults with pre-dialysis chronic kidney disease (CKD) are at higher risk for falls, the prognostic significance of a serious fall injury prior to dialysis initiation has not been well described in the end-stage renal disease population. Methods: We examined the association between a serious fall injury in the year prior to starting hemodialysis and adverse health outcomes in the year following dialysis initiation using a retrospective cohort study of U...
January 16, 2018: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/29346472/a-revised-estimate-of-costs-associated-with-routine-preoperative-testing-in-medicare-cataract-patients-with-a-procedure-specific-indicator
#8
Catherine L Chen, Theodore H Clay, Stephen McLeod, Han-Ying Peggy Chang, Adrian W Gelb, R Adams Dudley
Importance: Routine preoperative medical testing is not recommended for patients undergoing low-risk surgery, but testing is common before surgery. A 30-day preoperative testing window is conventionally used for study purposes; however, the extent of routine testing that occurs prior to that point is unknown. Objective: To improve on existing cost estimates by identifying all routine preoperative testing that takes place after the decision is made to perform cataract surgery...
January 18, 2018: JAMA Ophthalmology
https://www.readbyqxmd.com/read/29345890/how-medicare-could-provide-dental-vision-and-hearing-care-for-beneficiaries
#9
Amber Willink, Cathy Shoen, Karen Davis
Issue: The Medicare program specifically excludes coverage of dental, vision, and hearing services. As a result, many beneficiaries do not receive necessary care. Those that do are subject to high out-of-pocket costs. Goal: Examine gaps in access to dental, vision, and hearing services for Medicare beneficiaries and design a voluntary dental, vision, and hearing benefit plan with cost estimates. Methods: Uses the Medicare Current Beneficiary Survey, Cost and Use File, 2012, with population and costs projected to 2016 values...
January 1, 2018: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/29345750/mobility-trajectories-at-the-end-of-life-comparing-clinical-condition-and-latent-class-approaches
#10
June R Lunney, Steven M Albert, Robert Boudreau, Diane Ives, Suzanne Satterfield, Anne B Newman, Tamara Harris
OBJECTIVES: To assess mobility disability trajectories before death in a large sample of very old adults using two analytical approaches to determine how well they corresponded. DESIGN: Decedent sample from the Health, Aging and Body Composition (Health ABC) Study. Data were collected between 1997 and 2015. SETTING: Pittsburgh, Pennsylvania, and Memphis, Tennessee. PARTICIPANTS: Individuals randomly selected from well-functioning white Medicare beneficiaries and all black community residents meeting age criteria (70-79) (N = 3,075)...
January 18, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29342379/elimination-of-cost-sharing-for-screening-mammography-in-medicare-advantage-plans
#11
Amal N Trivedi, Bryan Leyva, Yoojin Lee, Orestis A Panagiotou, Issa J Dahabreh
BACKGROUND: The Affordable Care Act (ACA) required most insurers and the Medicare program to eliminate cost sharing for screening mammography. METHODS: We conducted a difference-in-differences study of biennial screening mammography among 15,085 women 65 to 74 years of age in 24 Medicare Advantage plans that eliminated cost sharing to provide full coverage for screening mammography, as compared with 52,035 women in 48 matched control plans that had and maintained full coverage...
January 18, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29342070/an-evaluation-of-industry-relationships-among-contributors-to-aaos-clinical-practice-guidelines-and-appropriate-use-criteria
#12
Jake X Checketts, Courtney Cook, Matt Vassar
BACKGROUND: A long-standing relationship between orthopaedic surgeons and industry has made financial conflicts of interest a concerning issue. Research supports that financial conflicts of interest can influence both medical research and clinical practice. Financial conflicts of interest may also influence clinical practice guideline recommendations and their corresponding appropriate use criteria. Because of the influential nature of these guidelines, it is imperative that care be taken to minimize bias during guideline development...
January 17, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29342019/hot-spotting-as-a-strategy-to-identify-high-cost-surgical-populations
#13
Sarah P Shubeck, Jyothi R Thumma, Justin B Dimick, Hari Nathan
OBJECTIVE: The aim of this study was to determine the feasibility of "hot spotting" in elective surgical populations. BACKGROUND: Prospective identification of high-cost patients, known as "hot spotting," is well developed in medical populations, but has not been performed in surgical populations. Population-based management of surgical expenditures requires identification of high-cost surgical patients to allow for effective implementation of cost-saving strategies...
January 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29340564/changes-in-health-care-use-associated-with-the-introduction-of-hospital-global-budgets-in-maryland
#14
Eric T Roberts, J Michael McWilliams, Laura A Hatfield, Sule Gerovich, Michael E Chernew, Lauren G Gilstrap, Ateev Mehrotra
Importance: In 2014, the State of Maryland placed the majority of its hospitals under all-payer global budgets for inpatient, hospital outpatient, and emergency department care. Goals of the program included reducing unnecessary hospital utilization and encouraging greater use of primary care. Objective: To compare changes in hospital and primary care use through the first 2 years of Maryland's hospital global budget program among fee-for-service Medicare beneficiaries in Maryland vs matched control areas...
January 16, 2018: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29340562/medicare-spending-and-potential-savings-on-brand-name-drugs-with-available-generic-substitutes-excluded-by-2-large-pharmacy-benefit-managers-2012-through-2015
#15
Alexander C Egilman, Joshua D Wallach, Joseph S Ross, Sanket S Dhruva
No abstract text is available yet for this article.
January 16, 2018: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29339011/facilitators-and-barriers-to-healthy-pregnancy-spacing-among-medicaid-beneficiaries-findings-from-the-national-strong-start-initiative
#16
Caitlin Cross-Barnet, Brigette Courtot, Ian Hill, Sarah Benatar, Morgan Cheeks, Jenny Markell
BACKGROUND: Closely spaced, unintended pregnancies are common among Medicaid beneficiaries and create avoidable risks for women and infants, including preterm birth. The Strong Start for Mothers and Newborns Initiative, a program of the Center for Medicare and Medicaid Innovation, intended to prevent preterm birth through psychosocially based enhanced prenatal care in maternity care homes, group prenatal care, and birth centers. Comprehensive care offers the opportunity for education and family planning to promote healthy pregnancy spacing...
January 12, 2018: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/29337636/new-onset-cardiovascular-morbidity-in-older-adults-with-stage-i-to-iii-colorectal-cancer
#17
Kelly M Kenzik, Courtney Balentine, Joshua Richman, Meredith Kilgore, Smita Bhatia, Grant R Williams
Purpose We sought to determine the long-term risk of cardiovascular disease (CVD)-stroke and myocardial infarction-and congestive heart failure (CHF) in older patients with colorectal cancer, as well as to understand the roles that preexisting comorbidities and cancer therapy play in increasing this risk. Patients and Methods We evaluated individuals from the SEER-Medicare database with incident stage I to III colorectal cancer at age older than 65 years between January 1, 2000, and December 31, 2011 (n = 72,408) and compared these patients with a matched cohort of Medicare patients without cancer (n = 72,408)...
January 16, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29336858/are-ceramic-bearings-becoming-cost-effective-for-all-patients
#18
Steven M Kurtz, Edmund C Lau, Doruk Baykal, Susan M Odum, Bryan D Springer, Thomas K Fehring
BACKGROUND: The purpose of this study is to analyze whether the cost for ceramic-on-polyethylene (C-PE) and ceramic-on-ceramic (COC) bearings used in primary total hip arthroplasty (THA) was changing over time, and if the cost differential between ceramic bearings and metal-on-polyethylene (M-PE) bearings was approaching the previously published tipping point for cost-effectiveness of $325. METHODS: A total of 245,077 elderly Medicare patients (65+) who underwent primary THA between 2010 and 2015 were identified from the United States Medicare 100% national administrative hospital claims database...
December 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29336600/current-clinical-practice-patterns-of-self-identified-interventional-radiologists
#19
Patricia Balthazar, C Matthew Hawkins, Arvind Vijayasarathi, Thomas W Loehfelm, Richard Duszak
OBJECTIVE: The purpose of this study was to assess patterns of procedural, clinical evaluation and management (E/M), and diagnostic imaging services rendered by self-identified interventional radiologists (IRs) across the United States. MATERIALS AND METHODS: Recent Medicare Physician and Other Supplier Public Use and Physician Compare national downloadable files were linked. IRs were defined as physicians self-identifying interventional radiology as their primary specialty on Medicare claims or as a specialty during Medicare enrollment...
January 16, 2018: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29336432/increased-mortality-rates-with-prolonged-corticosteroid-therapy-when-compared-with-antitumor-necrosis-factor-%C3%AE-directed-therapy-for-inflammatory-bowel-disease
#20
James D Lewis, Frank I Scott, Colleen M Brensinger, Jason A Roy, Mark T Osterman, Ronac Mamtani, Meenakshi Bewtra, Lang Chen, Huifeng Yun, Fenglong Xie, Jeffrey R Curtis
OBJECTIVES: Crohn's disease (CD) and ulcerative colitis (UC) are inflammatory bowel diseases (IBD) that compromise quality of life and may increase mortality. This study compared the mortality risk with prolonged corticosteroid use vs. antitumor necrosis factor-α (anti-TNF) drugs in IBD. METHODS: A retrospective cohort study was conducted among Medicaid and Medicare beneficiaries from 2001 to 2013 with IBD prescribed either >3,000 mg of prednisone or equivalent within a 12-month period or new initiation of anti-TNF therapy, each treated as time-updating exposures...
January 16, 2018: American Journal of Gastroenterology
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