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Condition: Stroke
Education: Study
Management: Medicaid

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Total 178 results found since Jan 2013.

Patterns of Emergency Medical Services Use and Its Association With Timely Stroke Treatment: Findings From Get With the Guidelines-Stroke Original Articles
Conclusions— Although EMS use is independently associated with more rapid evaluation and treatment of stroke, more than one third of stroke patients fail to use EMSs. Interventions aimed at increasing EMS activation should target populations at risk, particularly younger patients and those of minority race and ethnicity.
Source: Circulation: Cardiovascular Quality and Outcomes - May 21, 2013 Category: Cardiology Authors: Ekundayo, O. J., Saver, J. L., Fonarow, G. C., Schwamm, L. H., Xian, Y., Zhao, X., Hernandez, A. F., Peterson, E. D., Cheng, E. M. Tags: Emergency treatment of Stroke Original Articles Source Type: research

Long-Term Outcomes After Invasive Management for Older Patients With Non-ST-Segment Elevation Myocardial Infarction Original Articles
Conclusions— Older patients with non–ST-segment elevation MI with significant coronary disease face high long-term risks for mortality and nonfatal cardiovascular outcomes after early catheterization that differ by type of revascularization procedure performed. These findings can help guide the design of studies evaluating long-term therapies among elderly post-MI patients.
Source: Circulation: Cardiovascular Quality and Outcomes - May 21, 2013 Category: Cardiology Authors: Roe, M. T., Li, S., Thomas, L., Wang, T. Y., Alexander, K. P., Ohman, E. M., Peterson, E. D. Tags: Catheter-based coronary interventions: stents, Acute coronary syndromes, Acute myocardial infarction Original Articles Source Type: research

Incidence and prevalence of treated epilepsy among poor health and low-income Americans
Conclusions: The Medicaid population has a high incidence and prevalence of epilepsy, in an order of magnitude greater than that reported in the US general population. This indigent population carries a disproportionate amount of the epilepsy burden and deserves more attention for its health care needs and support services.
Source: Neurology - May 20, 2013 Category: Neurology Authors: Kaiboriboon, K., Bakaki, P. M., Lhatoo, S. D., Koroukian, S. Tags: Cohort studies, Prevalence studies, Incidence studies, All Epilepsy/Seizures ARTICLE Source Type: research

Abstract 150: Resource Utilization Patterns and Outcomes Among Acute Coronary Syndrome Patients: Findings From a Multi-Payer Analysis Poster Session II
Conclusion: These findings suggest that many patients with ACS do not receive appropriate recommended antithrombotic prophylaxis, and opportunities exist to improve therapy. Increased use of software tools such as AQuA may support enhanced education efforts aimed at improving adherence to guidelines and quality of care.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Lang, K., Bozkaya, D., Patel, A. A., Macomson, B., Crivera, C., Owens, G., Mody, S. Tags: Poster Session II Source Type: research

Abstract 237: Anticoagulant Use For the Prevention of Stroke in Patients with Atrial Fibrillation: Findings From a Multi-Payer Analysis Poster Session II
Conclusions: Many AF patients in selected commercial, Medicare-eligible, and Medicaid populations, including those at high risk of stroke, do not receive appropriate thromboprophylaxis, as recommended by treatment guidelines. Increased use of the analyzer and similar software may support enhanced education efforts aimed at improving adherence to guidelines and quality of care.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Lang, K., Bozkaya, D., Patel, A. A., Macomson, B., Nelson, W., Owens, G., Mody, S. Tags: Poster Session II Source Type: research

The current national criteria for carotid artery stenting overestimate its efficacy in patients who are symptomatic and at high risk
In this study, we stratified patients who underwent CAS or CEA by CMS high-risk criteria and symptom status and examined their 30-day outcomes.Methods: A nonrandomized, retrospective cohort study was performed by chart review of all patients undergoing CEA or CAS from January 1, 2005, to December 31, 2010, at our institution. Demographic data and data pertaining to the presence or absence of high-risk factors were collected. Patients were stratified using symptom status and high-risk status as variables, and 30-day adverse events (stroke, death, myocardial infarction [MI]) were compared.Results: A total of 271 patients und...
Source: Journal of Vascular Surgery - April 8, 2013 Category: Surgery Authors: Shunsuke Yoshida, Rodney P. Bensley, Julia D. Glaser, Christoph S. Nabzdyk, Allen D. Hamdan, Mark C. Wyers, Elliot L. Chaikof, Marc L. Schermerhorn Tags: Clinical research studies Source Type: research

Clinical correlates of obesity in an inner-city adult medicine clinic.
In conclusion, obesity was associated with many diseases, as well as with healthcare utilization, unemployment and disability in this predominantly minority inner-city population. PMID: 23691735 [PubMed - in process]
Source: Connecticut Medicine - April 1, 2013 Category: Journals (General) Authors: Yassir S, Chopra R, Roush G Tags: Conn Med Source Type: research

Insurance Status and Outcome after Intracerebral Hemorrhage: Findings from Get With The Guidelines-Stroke
Backgound: Few studies have examined associations among insurance status, treatment, and outcomes in patients hospitalized for intracerebral hemorrhage (ICH).Methods: Through retrospective analyses of the Get With The Guidelines (GWTG)-Stroke database, a national prospective stroke registry, from April 2003 to April 2011, we identified 95,986 nontransferred subjects hospitalized with ICH. Insurance status was categorized as Private/Other, Medicaid, Medicare, or None/Not Documented (ND). Associations between insurance status and in-hospital outcomes and quality of care measures were analyzed using patient- and hospital-spec...
Source: Journal of Stroke and Cerebrovascular Diseases - March 28, 2013 Category: Neurology Authors: Michael L. James, Maria V. Grau-Sepulveda, DaiWai M. Olson, Eric E. Smith, Adrian F. Hernandez, Eric D. Peterson, Lee H. Schwamm, Deepak L. Bhatt, Gregg C. Fonarow Tags: Original Articles Source Type: research

Accuracy of administrative data versus clinical data to evaluate carotid endarterectomy and carotid stenting
Conclusions: Administrative data are unreliable for determining symptom status, high-risk status, and perioperative stroke and should not be used to analyze CEA and CAS. NSQIP data do not adequately identify high-risk patients, but do accurately identify perioperative strokes and to a lesser degree, symptom status.
Source: Journal of Vascular Surgery - March 13, 2013 Category: Surgery Authors: Rodney P. Bensley, Shunsuke Yoshida, Ruby C. Lo, Margriet Fokkema, Allen D. Hamdan, Mark C. Wyers, Elliot L. Chaikof, Marc L. Schermerhorn Tags: Clinical research studies Source Type: research

The impact of Centers for Medicare and Medicaid Services high-risk criteria on outcome after carotid endarterectomy and carotid artery stenting in the SVS Vascular Registry
Objective: The Centers for Medicare and Medicaid Services (CMS) require high-risk (HR) criteria for carotid artery stenting (CAS) reimbursement. The impact of these criteria on outcomes after carotid endarterectomy (CEA) and CAS remains uncertain. Additionally, if these HR criteria are associated with more adverse events after CAS, then existing comparative effectiveness analysis of CEA vs CAS may be biased. We sought to elucidate this using data from the SVS Vascular Registry.Methods: We analyzed 10,107 patients undergoing CEA (6370) and CAS (3737), stratified by CMS HR criteria. The primary endpoint was composite death,...
Source: Journal of Vascular Surgery - February 13, 2013 Category: Surgery Authors: Marc L. Schermerhorn, Margriet Fokkema, Philip Goodney, Ellen D. Dillavou, Jeffrey Jim, Christopher T. Kenwood, Flora S. Siami, Rodney A. White, SVS Outcomes Committee Tags: Clinical research studies Source Type: research

National utilization patterns of warfarin use in older patients with atrial fibrillation: a population-based study of Medicare Part D beneficiaries
Source: Annals of Pharmacotherapy Area: Evidence > Medicines Management > References Background: Although warfarin therapy reduces stroke incidence in patients with atrial fibrillation (AF), the rate of warfarin use in this population remains low.  In 2008, the US Medicare Part D programme was expanded to pay for medications for Medicare enrollees. Objective: To examine rates and predictors of warfarin use in Medicare Part D beneficiaries with AF. Methods: This population-based retrospective cohort study used claims data from 41,447 Medicare beneficiaries aged 66 and older with at least 2 AF diagnoses in ...
Source: NeLM - Cardiovascular Medicine - January 24, 2013 Category: Cardiology Source Type: news

Age‐related treatment patterns in sickle cell disease patients and the associated sickle cell complications and healthcare costs
ConclusionsPatients transitioning to adult care received less transfusions and hydroxyurea, less ICT when eligible for chelation therapy, had higher healthcare costs and suffered from more frequent SCD related complications than pediatric patients. These findings highlight the changes in treatment patterns corresponding to transition to adult care. Pediatr Blood Cancer © 2013 Wiley Periodicals, Inc.
Source: Pediatric Blood and Cancer - January 17, 2013 Category: Cancer & Oncology Authors: Morey A. Blinder, Francis Vekeman, Medha Sasane, Alex Trahey, Carole Paley, Mei Sheng Duh Tags: Research Article Source Type: research

National utilization patterns of warfarin use in older patients with atrial fibrillation: a population-based study of medicare part d beneficiaries.
CONCLUSIONS: Warfarin use rates vary by patient characteristics and region, with higher rates among residents of the Midwest and among patients seen by cardiologists and PCPs. Preventing stroke-related disability in AF requires implementation of evidence-based initiatives to increase warfarin use. PMID: 23324508 [PubMed - in process]
Source: The Annals of Pharmacotherapy - January 1, 2013 Category: Drugs & Pharmacology Authors: Raji MA, Lowery M, Lin YL, Kuo YF, Baillargeon J, Goodwin JS Tags: Ann Pharmacother Source Type: research