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https://www.readbyqxmd.com/read/28334230/guided-bayesian-imputation-to-adjust-for-confounding-when-combining-heterogeneous-data-sources-in-comparative-effectiveness-research
#1
Joseph Antonelli, Corwin Zigler, Francesca Dominici
In comparative effectiveness research, we are often interested in the estimation of an average causal effect from large observational data (the main study). Often this data does not measure all the necessary confounders. In many occasions, an extensive set of additional covariates is measured for a smaller and non-representative population (the validation study). In this setting, standard approaches for missing data imputation might not be adequate due to the large number of missing covariates in the main data relative to the smaller sample size of the validation data...
March 3, 2017: Biostatistics
https://www.readbyqxmd.com/read/28333918/21-gene-recurrence-score-testing-among-medicare-beneficiaries-with-breast-cancer-in-2010-2013
#2
Julie A Lynch, Brygida Berse, Nicole Coomer, John Kautter
PURPOSE: We evaluated national patient-level utilization of the 21-gene recurrence score (21-gene RS) test among Medicare beneficiaries with breast cancer. We analyzed clinical, demographic, and regional factors that predict testing. METHODS: Using 2010-2013 Medicare claims, we conducted a retrospective study of breast cancer patients. The outcome variable was whether the patient underwent testing. Independent variables expected to predict testing were age, gender, race, Medicaid status, clinical characteristics, and hospital referral region (HRR)...
March 23, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/28333869/macra-a-new-age-for-physician-payments
#3
Kent Kwasind Huston
The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 introduced a new system of physician payments in the United States. This legislation and the complex rules written to enact the law intend to force a shift away from volume-based payments and into so called value-based payments. Physicians and other clinicians will be graded via quality and cost metrics and payments will be adjusted based on performance. Robust use of certified electronic health records is required under MACRA. Physicians will follow one of two payment reform tracks known as the Merit-Based Incentive Payment System (MIPS) and the Alternative Payment Model (APM) pathways...
April 2017: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/28333786/the-bundled-care-disruption
#4
Carol Anne Boston-Fleischhauer
The new administration and Congress will wrestle with the Affordable Care Act and options. In the meantime, several reimbursement programs designed to disrupt current approaches to patient care delivery continue, including the Centers for Medicare & Medicaid Services bundled payment program. Chief nurse executives must prepare to advance processes and care models that align with bundled payments and the broader ambition to eliminate care variation.
April 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/28333761/race-ethnicity-health-insurance-and-mortality-in-older-survivors-of-critical-illness
#5
Matthew R Baldwin, Jessica L Sell, Nina Heyden, Azka Javaid, David A Berlin, Wendy C Gonzalez, Peter B Bach, Mathew S Maurer, Gina S Lovasi, David J Lederer
OBJECTIVES: To determine whether minority race or ethnicity is associated with mortality and mediated by health insurance coverage among older (≥ 65 yr old) survivors of critical illness. DESIGN: A retrospective cohort study. SETTING: Two New York City academic medical centers. PATIENTS: A total of 1,947 consecutive white (1,107), black (361), and Hispanic (479) older adults who had their first medical-ICU admission from 2006 through 2009 and survived to hospital discharge...
March 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28333708/cost-effectiveness-of-antihypertensive-medication-exploring-race-and-sex-differences-using-data-from-the-reasons-for-geographic-and-racial-differences-in-stroke-study
#6
Gabriel S Tajeu, Stephen Mennemeyer, Nir Menachemi, Robert Weech-Maldonado, Meredith Kilgore
BACKGROUND: Antihypertensive medication decreases risk of cardiovascular disease (CVD) events in adults with hypertension. Although black adults have higher prevalence of hypertension and worse CVD outcomes compared with whites, limited attention has been given to the cost-effectiveness of antihypertensive medication for blacks. OBJECTIVE: To compare the cost-effectiveness of antihypertensive medication treatment versus no-treatment in white and black adults. RESEARCH DESIGN: We constructed a State Transition Model to assess the costs and quality-adjusted life-years (QALYs) associated with either antihypertensive medication treatment or no-treatment using data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study and published literature...
March 22, 2017: Medical Care
https://www.readbyqxmd.com/read/28333571/screening-and-assessment-of-substance-use-in-hospice-care-examining-content-from-a-national-sample-of-psychosocial-assessments
#7
Paul Sacco, John G Cagle, Melissa L Moreland, Elizabeth A S Camlin
BACKGROUND: Quality of care provided by hospice and palliative care agencies depends on a thorough understanding of the patient, the family, their history, and current risk factors. It is therefore imperative for social workers and other providers in these settings to assess patients and caregivers for substance use disorders and potential for substance misuse. OBJECTIVE: We aimed to examine how hospice social workers in the United States screen and assess for alcohol and substance use and risk of medication diversion among patients and family caregivers...
March 23, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28330970/variation-in-family-experience-of-pediatric-inpatient-care-as-measured-by-child-hcahps
#8
Sara L Toomey, Marc N Elliott, Alan M Zaslavsky, David J Klein, Sifon Ndon, Shannon Hardy, Melody Wu, Mark A Schuster
BACKGROUND: Making national comparisons of family experience of inpatient pediatric care has been limited by the lack of a publicly available survey. The Agency for Healthcare Research and Quality and Centers for Medicare & Medicaid Services commissioned development of the Child Hospital Consumer Assessment of Healthcare Providers and Systems Survey to address this gap. Using Child Hospital Consumer Assessment of Healthcare Providers and Systems Survey, we measured performance of hospitals in a national field test...
March 22, 2017: Pediatrics
https://www.readbyqxmd.com/read/28330822/long-term-survival-of-patients-aged-80-years-or-older-treated-with-radical-prostatectomy-for-prostate-cancer
#9
P Dell'Oglio, E Zaffuto, K Boehm, V Trudeau, A Larcher, Z Tian, M Moschini, S F Shariat, M Graefen, F Saad, U Capitanio, A Briganti, F Montorsi, P I Karakiewicz
BACKGROUND: Radical prostatectomy (RP) is the gold standard for clinically localized prostate cancer (PCa) patients with life expectancy (LE) of at least 10 years. We examined long-term survival of men aged 80 years or older treated with RP and we attempted to identify criteria based on age and comorbidities that could predict survival of at least 10 years after RP, to identify those that might be considered for RP. PATIENTS AND METHODS: In Surveillance Epidemiology and End Results (SEER)-Medicare-linked database, we identified 234 octo- and nonagenarians with clinical T1, T2 or T3 PCa treated with RP between 1991 and 2009...
March 10, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28330751/reduction-in-heart-failure-hospitalizations-with-ambulatory-hemodynamic-monitoring-seen-in-clinical-trials-is-maintained-in-the-real-world
#10
Akshay S Desai, Arvind Bhimaraj, Rupinder Bharmi, Rita Jermyn, Kunjan Bhatt, David Shavelle, Margaret M Redfield, Robert Hull, Jamie A Pelzel, Kevin Davis, Nirav Dalal, Philip B Adamson, J Thomas Heywood
BACKGROUND: In the CHAMPION trial, heart failure hospitalization (HFH) rates were lower in patients managed with guidance from an implantable pulmonary artery pressure (PAP) sensor compared to usual care. OBJECTIVES: To examine the effectiveness of ambulatory hemodynamic monitoring in reducing HFH outside the clinical trial setting. METHODS: We conducted a retrospective cohort study using US Medicare claims data from patients undergoing PAP sensor implantation between 6/1/2014 and 12/31/2015...
March 9, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28329668/stevens-johnson-syndrome-and-toxic-epidermal-necrolysis-in-us-adults
#11
Derek Y Hsu
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening disorders. The incidences, mortality and cost of SJS and TEN in US adults are not well-characterized. We analyzed data from the 2009-2012 Nationwide Inpatient Sample, containing a representative 20% sample of all hospitalizations in the US. SJS, SJS/TEN and TEN were identified by a validated algorithm using ICD-9- CM codes. The mean incidences of SJS, SJS/TEN and TEN were 9.3, 1.6, and 1.9 per million people per year, respectively...
September 15, 2016: Dermatology Online Journal
https://www.readbyqxmd.com/read/28329652/the-inpatient-burden-of-psoriasis-a-nationwide-analysis
#12
Derek Y Hsu
Psoriasis is a chronic inflammatory skin disorder associated with substantial morbidity and mortality. Little is known about psoriasis in the inpatient setting. We sought to determine the inpatient burden of psoriasis in the US. We analyzed the 2002-2012 Nationwide Inpatient Sample, containing a representative 20% stratified sample of all hospitalizations in the US. Psoriasis was determined by a validated algorithm using ICD-9-CM codes. Demographics, inflation-adjusted cost, length of stay, comorbidities, and sex- adjusted mortality were analyzed using descriptive statistics and regression analysis...
September 15, 2016: Dermatology Online Journal
https://www.readbyqxmd.com/read/28329633/comorbidities-of-hospitalized-pemphigus-patients-in-the-united-states
#13
Derek Y Hsu Y Hsu
We sought to determine the comorbid health conditions and inpatient mortality associated with pemphigus in a U.S. inpatient cohort. The 2002-2012 Nationwide Inpatient Sample, which contains a representative 20% stratified sample of all inpatient hospitalizations in the US, was analyzed. Comorbidities were determined through ICD-9-CM codes. Survey weighted multivariate logistic regression models controlling for demographic factors were constructed to determine the association of pemphigus with various comorbidities...
September 15, 2016: Dermatology Online Journal
https://www.readbyqxmd.com/read/28329356/sleep-disturbances-and-risk-of-hospitalization-and-inpatient-days-among-older-women
#14
Misti L Paudel, Brent C Taylor, Tien N Vo, Allyson M Kats, John T Schousboe, Li-Yung Lui, Charles E McCulloch, Lisa Langsetmo, Sonia Ancoli-Israel, Susan Redline, Kristine Yaffe, Katie L Stone, Teresa A Hillier, Kristine E Ensrud
Study Objective: Determine the associations of sleep disturbances with hospitalization risk among older women. Methods: 1,827 women (mean age 83.6 years) participating in Study of Osteoporotic Fractures Year 16 (Y16) examination (2002-2004) linked with Medicare and/or HMO claims. At Y16 examination, sleep/wake parameters were measured by actigraphy (total sleep time [TST], sleep efficiency [SE], sleep latency [SL], and wake after sleep onset [WASO]) and subjective sleep measures (sleep quality [Pittsburgh Sleep Quality Index] and daytime sleepiness [Epworth Sleepiness Scale]) were assessed by questionnaire...
March 1, 2017: Sleep
https://www.readbyqxmd.com/read/28329352/costs-and-consequences-of-early-hospital-discharge-after-major-inpatient-surgery-in-older-adults
#15
Scott E Regenbogen, Anne H Cain-Nielsen, Edward C Norton, Lena M Chen, John D Birkmeyer, Jonathan S Skinner
Importance: As prospective payment transitions to bundled reimbursement, many US hospitals are implementing protocols to shorten hospitalization after major surgery. These efforts could have unintended consequences and increase overall surgical episode spending if they induce more frequent postdischarge care use or readmissions. Objective: To evaluate the association between early postoperative discharge practices and overall surgical episode spending and expenditures for postdischarge care use and readmissions...
March 22, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28329311/comparative-effectiveness-of-high-dose-versus-standard-dose-influenza-vaccines-among-us-medicare-beneficiaries-in-preventing-postinfluenza-deaths-during-2012-2013-and-2013-2014
#16
David K Shay, Yoganand Chillarige, Jeffrey Kelman, Richard A Forshee, Ivo M Foppa, Michael Wernecke, Yun Lu, Jill M Ferdinands, Arjun Iyengar, Alicia M Fry, Chris Worrall, Hector S Izurieta
Background.: Recipients of high-dose vs standard-dose influenza vaccines have fewer influenza illnesses. We evaluated the comparative effectiveness of high-dose vaccine in preventing postinfluenza deaths during 2012-2013 and 2013-2014, when influenza viruses and vaccines were similar. Methods.: We identified Medicare beneficiaries aged ≥65 years who received high-dose or standard-dose vaccines in community-located pharmacies offering both vaccines. The primary outcome was death in the 30 days following an inpatient or emergency department encounter listing an influenza International of Classification of Diseases, Ninth Revision, Clinical Modification code...
March 2, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28329251/factors-associated-with-accelerated-hospitalization-and-re-hospitalization-among-medicare-home-health-patients
#17
Matthew C Lohman, Emily A Scherer, Karen L Whiteman, Rebecca L Greenberg, Martha L Bruce
Background: Preventing hospitalizations and re-hospitalizations of older adults receiving Medicare home health (HH) services is a key goal for patients and care providers. This study aimed to identify factors related to greater risk of and earlier hospitalizations from HH, a key step in targeting preventive efforts. Methods: Data come from Medicare mandated start-of-care assessments from 87,780 HH patients served by 132 agencies in 32 states, collected from January 2013 to March 2015...
January 19, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28329147/a-claims-based-examination-of-health-care-costs-among-spouses-of-patients-with-alzheimer-s-disease
#18
Daniel M Gilden, Joanna M Kubisiak, Kristin Kahle-Wrobleski, Daniel E Ball, Lee Bowman
Background: Spouses of Alzheimer's disease patients (AD spouses) may experience substantial health effects associated with their partner's chronic cognitive and behavioral dysfunction. Studies examining associations between the medical experiences of AD spouses in the period before and after their partner's AD diagnosis are limited, particularly those which measure health care resource use and cost. Methods: AD patients were identified through multiple Medicare claims containing an AD diagnostic code...
March 16, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28329087/clinical-definitions-of-sarcopenia-and-risk-of-hospitalization-in-community-dwelling-older-men-the-osteoporotic-fractures-in-men-study
#19
Peggy M Cawthon, Li-Yung Lui, Brent C Taylor, Charles E McCulloch, Jane A Cauley, Jodi Lapidus, Eric Orwoll, Kristine E Ensrud
Background: The association between various definitions of sarcopenia and hospitalization has not been evaluated in community-dwelling older men. Methods: We used data from 1,516 participants at Visit 3 of the Osteoporotic Fractures in Men (MrOS) study who also had linked Medicare Fee-For-Service Claims data available. We examined the association between several sarcopenia definitions (International Working Group, European Working Group for Sarcopenia in Older Persons, Foundation for the NIH Sarcopenia Project, Baumgartner, and Newman) and hospitalization, using two-part ("hurdle") models, adjusted for age, clinical center, functional limitations, self-reported health, comorbidity, and cognitive function...
January 18, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28328305/development-and-implementation-of-online-training-modules-on-abuse-neglect-and-exploitation
#20
Farida K Ejaz, Miriam Rose, Georgia Anetzberger
Online training for care managers to identify, report, and prevent abuse, neglect, and exploitation was developed for a demonstration involving the dually eligible Medicare and Medicaid population. It was comprised of three modules covering background, screening, and reporting abuse. Of 453 enrollees, 273 completed at least one module and 212 completed all three. Pre- and post-training surveys for each module were used to examine changes in the proportion of correct answers for each question, using the related-samples Cochran's Q statistic...
March 22, 2017: Journal of Elder Abuse & Neglect
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