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https://www.readbyqxmd.com/read/28636843/hospital-inpatient-admissions-with-dehydration-and-or-malnutrition-in-medicare-beneficiaries-receiving-enteral-nutrition-a-cohort-study
#1
Rachel Drake, Audrey Ozols, William J Nadeau, Mary Jo Braid-Forbes
BACKGROUND: Enteral nutrition (EN) supports many older and disabled Americans. This study describes the frequency and cost of acute care hospitalization with dehydration and/or malnutrition of Medicare beneficiaries receiving EN, focusing on those receiving home EN. METHODS: Medicare 5% Standard Analytic Files were used to determine Medicare spending for EN supplies and the proportion and cost of beneficiaries receiving EN, specifically home EN, admitted to the hospital with dehydration and/or malnutrition...
June 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28636834/implementation-of-medical-homes-in-federally-qualified-health-centers
#2
Justin W Timbie, Claude M Setodji, Amii Kress, Tara A Lavelle, Mark W Friedberg, Peter J Mendel, Emily K Chen, Beverly A Weidmer, Christine Buttorff, Rosalie Malsberger, Mallika Kommareddi, Afshin Rastegar, Aaron Kofner, Lisa Hiatt, Ammarah Mahmud, Katherine Giuriceo, Katherine L Kahn
Background From 2011 through 2014, the Federally Qualified Health Center Advanced Primary Care Practice Demonstration provided care management fees and technical assistance to a nationwide sample of 503 federally qualified health centers to help them achieve the highest (level 3) medical-home recognition by the National Committee for Quality Assurance, a designation that requires the implementation of processes to improve access, continuity, and coordination. Methods We examined the achievement of medical-home recognition and used Medicare claims and beneficiary surveys to measure utilization of services, quality of care, patients' experiences, and Medicare expenditures in demonstration sites versus comparison sites...
June 21, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28636718/trends-and-outcomes-of-off-label-use-of-transcatheter-aortic-valve-replacement-insights-from-the-ncdr-sts-acc-tvt-registry
#3
Ravi S Hira, Sreekanth Vemulapalli, Zhuokai Li, James M McCabe, John S Rumsfeld, Samir R Kapadia, Mahboob Alam, Hani Jneid, Creighton Don, Mark Reisman, Salim S Virani, Neal S Kleiman
Importance: Transcatheter aortic valve replacement (TAVR) was approved by the US Food and Drug Administration for severe aortic stenosis in patients who cannot undergo surgery and for patients at high operative risk. Use of TAVR for off-label indications has not been previously reported. Objective: To evaluate patterns and adverse outcomes of off-label use of TAVR in US clinical practice. Design, Setting and Participants: Patients receiving commercially funded TAVR in the United States are included in the Transcatheter Valve Therapy Registry...
June 21, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28636200/functional-impairment-an-unmeasured-marker-of-medicare-costs-for-postacute-care-of-older-adults
#4
S Ryan Greysen, Irena Stijacic Cenzer, W John Boscardin, Kenneth E Covinsky
OBJECTIVES: To assess the effects of preadmission functional impairment on Medicare costs of postacute care up to 365 days after hospital discharge. DESIGN: Longitudinal cohort study. SETTING: Health and Retirement Study (HRS). PARTICIPANTS: Nationally representative sample of 16,673 Medicare hospitalizations of 8,559 community-dwelling older adults from 2000 to 2012. MEASUREMENTS: The main outcome was total Medicare costs in the year after hospital discharge, assessed according to Medicare claims data...
June 21, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28635981/patient-perceived-access-to-care-when-actively-seeking-treatment
#5
Zachary Pruitt, Susan Sportsman
PURPOSE/OBJECTIVES: To examine predictors of perceived access to care and reported barriers to care of patients with cancer actively seeking treatment.
. DESIGN: Retrospective secondary data analysis.
. SETTING: U.S. Medical Expenditure Panel Survey, a national survey with questions about healthcare coverage and access.
. SAMPLE: 1,170 adults with cancer actively seeking treatment.
. METHODS: A retrospective analysis of data...
May 1, 2017: Oncology Nursing Forum
https://www.readbyqxmd.com/read/28635549/a-missed-primary-care-appointment-correlates-with-a-subsequent-emergency-department-visit-among-children-with-asthma
#6
Colleen Marie McGovern, Margaret Redmond, Kimberly Arcoleo, David R Stukus
OBJECTIVE: Since the Affordable Care Act's implementation, emergency department (ED) visits have increased. Poor asthma control increases the risk of acute exacerbations and preventable ED visits. The Centers for Medicare and Medicaid Services support the reduction of preventable ED visits to reduce healthcare spending. Implementation of interventions to avoid preventable ED visits has become a priority for many healthcare systems yet little data exist examining children's missed asthma management primary care (PC) appointments and subsequent ED visits...
March 2, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28635338/risk-of-stroke-systemic-embolism-major-bleeding-and-associated-costs-in-non-valvular-atrial-fibrillation-patients-who-initiated-apixaban-dabigatran-or-rivaroxaban-compared-with-warfarin-in-the-united-states-medicare-population
#7
Alpesh Amin, Allison Keshishian, Jeffrey Trocio, Oluwaseyi Dina, Hannah Le, Lisa Rosenblatt, Xianchen Liu, Jack Mardekian, Qisu Zhang, Onur Baser, Lien Vo
OBJECTIVE: To compare the risk and cost of stroke/systemic embolism (SE) and major bleeding between each direct oral anticoagulant (DOAC) and warfarin among non-valvular atrial fibrillation (NVAF) patients. METHODS: Patients (≥65 years) initiating warfarin or DOACs (apixaban, rivaroxaban, and dabigatran) were selected from the Medicare database from 01/01/2013-12/31/2014. Patients initiating each DOAC were matched 1:1 to warfarin patients using propensity score matching to balance demographics and clinical characteristics...
June 21, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28635179/changing-trends-in-opioid-use-among-u-s-rheumatoid-arthritis-patients
#8
Jeffrey R Curtis, Fenglong Xie, Christian Smith, Kenneth G Saag, Lang Chen, Timothy Beukelman, Melissa Mannion, Huifeng Yun, Stefan Kertesz
Introduction Opioid prescribing recently has come under intense scrutiny. However, longitudinal patterns of opioid prescription receipt in a population-based cohort of patients who have chronic pain, such as those with rheumatoid arthritis (RA), have not been well characterized. Methods We identified a cohort of RA patients based on 2006-2014 Medicare data and evaluated longitudinal time trends in regular opioid use (>=3 filled prescriptions in each 12 month interval). A separate analysis in 2014 assessed rheumatologist-specific variability in regular opioid prescription for RA patients...
June 21, 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/28634181/outcomes-after-observation-stays-among-older-adult-medicare-beneficiaries-in-the-usa-retrospective-cohort-study
#9
Kumar Dharmarajan, Li Qin, Maggie Bierlein, Jennie E S Choi, Zhenqiu Lin, Nihar R Desai, Erica S Spatz, Harlan M Krumholz, Arjun K Venkatesh
Objective To characterize rates and trends over time of emergency department treatment-and-discharge stays, repeat observation stays, inpatient stays, any hospital revisit, and death within 30 days of discharge from observation stays.Design Retrospective cohort study.Setting 4750 hospitals in the USA.Participants Nationally representative sample of Medicare fee for service beneficiaries aged 65 or over discharged after 363 037 index observation stays, 2 540 000 index emergency department treatment-and-discharge stays, and 2 667 525 index inpatient stays from 2006-11...
June 20, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28633782/factors-predicting-length-of-hospital-stay-and-extended-care-facility-admission-after-hindfoot-arthrodesis-procedures
#10
Jacob Deister, Brian G Cothern, Chad Williams, Andrew W Froehle, Richard T Laughlin
Delayed identification of patients requiring admission to extended care facilities (ECFs) can lead to greater healthcare costs through an increased length of hospital stay (LOHS). Previous studies of hip and knee arthroplasty identified factors associated with a likely discharge to an ECF. These issues have not been extensively studied for major hindfoot procedures. We conducted a retrospective review of 198 cases treated during a 3-year period to identify the risk factors for an extended LOHS and ECF admission after ankle arthrodesis, triple arthrodesis, pantalar arthrodesis, and subtalar arthrodesis...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28632589/emergency-department-visits-following-elective-total-hip-and-knee-replacement-surgery-identifying-gaps-in-continuity-of-care
#11
Micaela A Finnegan, Robyn Shaffer, Austin Remington, Jereen Kwong, Catherine Curtin, Tina Hernandez-Boussard
BACKGROUND: Major joint replacement surgical procedures are common, elective procedures with a care episode that includes both inpatient readmissions and postoperative emergency department (ED) visits. Inpatient readmissions are well studied; however, to our knowledge, little is known about ED visits following these procedures. We sought to characterize 30-day ED visits following a major joint replacement surgical procedure. METHODS: We used administrative records from California, Florida, and New York, from 2010 through 2012, to identify adults undergoing total knee and hip arthroplasty...
June 21, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28631720/contemporary-management-of-men-with-high-risk-localized-prostate-cancer-in-the-united-states
#12
A B Weiner, R S Matulewicz, E M Schaeffer, S L Liauw, J M Feinglass, S E Eggener
BACKGROUND: Surgery and radiation-based therapies are standard management options for men with clinically localized high-risk prostate cancer (PCa). Contemporary patterns of care are unknown. We hypothesize the use of surgery has steadily increased in more recent years. METHODS: Using the National Cancer Data Base for 2004-2013, all men diagnosed with high-risk localized PCa were identified using National Comprehensive Cancer Network criteria. Temporal trends in initial management were assessed...
June 20, 2017: Prostate Cancer and Prostatic Diseases
https://www.readbyqxmd.com/read/28629906/can-bundled-payments-be-successful-in-the-medicaid-population-for-primary-joint-arthroplasty
#13
P Maxwell Courtney, Tori Edmiston, Brian Batko, Brett R Levine
BACKGROUND: Although some bundled payment models have had success in total joint arthroplasty, concerns exist about access to care for higher cost patients who use more resources. The purpose of this study is to determine whether Medicaid patients have increased hospital costs and more resource utilization in a 90-day episode of care than Medicare or privately insured patients. METHODS: We retrospectively reviewed a consecutive series of 7268 primary hip and knee arthroplasty patients at a single institution...
May 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28629454/impact-of-pharmacy-channel-on-adherence-to-oral-oncolytics
#14
Michael Stokes, Carolina Reyes, Yu Xia, Veronica Alas, Hans-Peter Goertz, Luke Boulanger
BACKGROUND: Oral chemotherapy is increasingly prescribed to treat cancer. Despite its benefits, concerns have been raised regarding adherence to therapy. The study objective was to compare and measure adherence, persistence, and abandonment in patients filling prescriptions in traditional retail (TR) versus specialty pharmacy (SP) channels. METHODS: Using a retrospective cohort design, we selected newly treated patients aged ≥18 years with a prescription for erlotinib, capecitabine, or imatinib during 2007-2011 from a Medco population of both United States commercial and Medicare health plans...
June 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28628533/the-association-between-activity-limitation-stages-and-admission-to-facilities-providing-long-term-care-among-older-medicare-beneficiaries
#15
Jibby E Kurichi, Joel E Streim, Dawei Xie, Sean Hennessy, Ling Na, Debra Saliba, Qiang Pan, Pui L Kwong, Hillary R Bogner
OBJECTIVE: This study aimed to examine whether activity limitation stages are associated with admission to facilities providing long-term care (LTC). DESIGN: Cohort study using Medicare Current Beneficiary Survey data from the 2005-2009 entry panels. A total of 14,580 community-dwelling Medicare beneficiaries 65 years or older were included. Proportional subhazard models examined associations between activity limitation stages and time to first LTC admission, adjusting for baseline sociodemographics and health conditions...
July 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28628393/early-national-dissemination-of-abiraterone-and-enzalutamide-for-advanced-prostate-cancer-in-medicare-part-d
#16
Megan E V Caram, Tudor Borza, Hye-Sung Min, Jennifer J Griggs, David C Miller, Brent K Hollenbeck, Bhramar Mukherjee, Ted A Skolarus
INTRODUCTION: Abiraterone and enzalutamide were approved by the Food and Drug Administration in 2011 and 2012 to treat men with metastatic castration-resistant prostate cancer (mCRPC). Most men with mCRPC are > 65 years of age and thus eligible for Medicare Part D. We conducted a study to better understand the early dissemination of these drugs across the United States using national Medicare Part D data. METHODS: We evaluated the number of prescriptions for abiraterone and enzalutamide by provider specialty and hospital referral region (HRR) using Medicare Part D and Dartmouth Atlas data...
June 19, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28626986/trends-in-sleep-studies-performed-for-medicare-beneficiaries
#17
Whitney Chiao, Megan L Durr
OBJECTIVES/HYPOTHESIS: To quantify trends and characteristics of sleep studies performed for Medicare beneficiaries in the United States. STUDY DESIGN: Retrospective longitudinal study of the Centers for Medicare and Medicaid Services' Part B National Summary Data and Medicare Provider Utilization and Payment Data from 2000 to 2014. METHODS: Sleep study data were analyzed according to type of study performed, total expenditure amount, provider specialty, and geographic location...
June 19, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28626508/rate-of-adverse-events-and-healthcare-costs-associated-with-the-topical-treatment-of-rosacea
#18
Todd Williamson, Rajesh Kamalakar, Augustina Ogbonnaya, Erin A Zagadailov, Michael Eaddy, Charlie Kreilick
BACKGROUND: Rosacea is a condition more common in women than in men, and in people aged ≥30 years than in younger patients. Adverse events associated with the use of topical medications for rosacea may lead to a lack of treatment adherence. Previous studies have reported low treatment adherence rates among patients with rosacea. OBJECTIVE: To describe the rate of treatment discontinuation resulting from adverse events and the associated healthcare costs among patients with rosacea who are receiving a topical medication...
May 2017: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28625702/national-trends-in-the-frequency-of-bladder-catheterization-and-physician-diagnosed-catheter-associated-urinary-tract-infections-results-from-the-medicare-patient-safety-monitoring-system
#19
Mark L Metersky, Noel Eldridge, Yun Wang, Eric M Mortensen, Jennifer Meddings
BACKGROUND: It is unclear if bladder catheterization and catheter-associated urinary tract infection (CAUTI) rates have changed since the implementation of public reporting in 2011. METHODS: We analyzed data from the Medicare Patient Safety Monitoring System, a national, chart abstraction-based surveillance system, for hospitalized adults with a principal discharge diagnosis of heart failure (HF), acute myocardial infarction (AMI), or pneumonia and patients who had undergone certain major surgeries...
June 15, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28625684/brand-medications-and-medicare-part-d-how-eye-care-providers-prescribing-patterns-influence-costs
#20
Paula Anne Newman-Casey, Maria A Woodward, Leslie M Niziol, Paul P Lee, Lindsey B De Lott
PURPOSE: To quantify costs of eye care providers' Medicare Part D prescribing patterns for ophthalmic medications and to estimate the potential savings of generic or therapeutic drug substitutions and price negotiation. DESIGN: Retrospective cross-sectional study. PARTICIPANTS: Eye care providers prescribing medications through Medicare Part D in 2013. METHODS: Medicare Part D 2013 prescriber public use file and summary file were used to calculate medication costs by physician specialty and drug...
June 16, 2017: Ophthalmology
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