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Specialty: General Medicine
Management: Medicare

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Total 23 results found since Jan 2013.

Retrospective cohort study investigating synergism of air pollution and corticosteroid exposure in promoting cardiovascular and thromboembolic events in older adults
Conclusion PM2.5 and systemic corticosteroid use were independently associated with increases in CTE hospitalisations. We also found evidence of significant additive interactions between the two exposures for HF and MI/ACSs suggesting synergy between these two exposures.
Source: BMJ Open - September 13, 2023 Category: General Medicine Authors: Josey, K., Nethery, R., Visaria, A., Bates, B., Gandhi, P., Parthasarathi, A., Rua, M., Robinson, D., Setoguchi, S. Tags: Open access, Epidemiology Source Type: research

Decreasing rates of cost-related medication non-adherence by age advancement among American generational cohorts 2004-2014: a longitudinal study
Conclusion The paradox of decreasing CRN rates, independent of disease burden, income and insurance status, suggests populations’ CRN behaviours change as Americans age, bearing implications to social policy.
Source: BMJ Open - May 6, 2022 Category: General Medicine Authors: Zhang, J., Bhaumik, D., Meltzer, D. Tags: Open access, Health economics Source Type: research

Disparities by sex in P2Y12 inhibitor therapy duration, or differences in the balance of ischaemic-benefit and bleeding-risk clinical outcomes in older women versus comparable men following acute myocardial infarction? A P2Y12 inhibitor new user retrospective cohort analysis of US Medicare claims data
Conclusions Risks for death/hospice and ischaemic events were lower among women still taking a P2Y12 inhibitor than comparable men, with no difference in bleeding risks. Shorter P2Y12 inhibitor durations in older women than comparable men observed between 12 and 24 months post-AMI may reflect a disparity that is not justified by differences in clinical need.
Source: BMJ Open - December 1, 2021 Category: General Medicine Authors: Hickson, R. P., Kucharska-Newton, A. M., Rodgers, J. E., Sleath, B. L., Fang, G. Tags: Open access, Cardiovascular medicine Source Type: research

Association Between Thrombolytic Door-to-Needle Times and Ischemic Stroke Outcomes
This cohort study estimates associations between intravenous tissue plasminogen activator (tPA) door-to-needle times of less than 4.5 hours for acute ischemic stroke and 1-year mortality or readmission among Medicare beneficiaries aged 65 years or older.
Source: JAMA - June 2, 2020 Category: General Medicine Source Type: research

Race/Ethnicity and Sex-Related Differences in Direct Oral Anticoagulant Initiation in Newly Diagnosed Atrial Fibrillation: A Retrospective Study of Medicare Data.
CONCLUSION: In a national cohort of Medicare beneficiaries with newly-diagnosed AF, overall oral anticoagulant initiation was lower in blacks and women, with no difference observed by Hispanic ethnicity. Among oral anticoagulant initiators, blacks were less likely to initiate novel DOACs, with no differences identified by Hispanic ethnicity or sex. Identifying modifiable causes of treatment disparities is needed to improve quality of care for all patients with AF. PMID: 32035755 [PubMed - as supplied by publisher]
Source: Journal of the National Medical Association - February 10, 2020 Category: General Medicine Tags: J Natl Med Assoc Source Type: research

Prevalence and Payments for Traumatic Injury vs Common Acute Diseases in Medicare Beneficiaries
This study uses Medicare Parts A and B claims data to compare hospitalizations for and spending on traumatic injury vs heart failure, pneumonia, stroke, and acute myocardial infarction in older adults between 2008 and 2014.
Source: JAMA - June 4, 2019 Category: General Medicine Source Type: research

Comparative stroke, bleeding, and mortality risks in older Medicare patients treated with oral anticoagulants for nonvalvular atrial fibrillation
Non-vitamin K antagonist oral anticoagulants (NOACs) are alternatives to warfarin in patients with nonvalvular atrial fibrillation. Randomized trials compared NOACs to warfarin, but none have compared individual NOACs against each other for safety and effectiveness.
Source: The American Journal of Medicine - January 9, 2019 Category: General Medicine Authors: David J. Graham, Elande Baro, Rongmei Zhang, Jiemin Liao, Michael Wernecke, Marsha E. Reichman, Mao Hu, Onyekachukwu Illoh, Yuqin Wei, Margie R. Goulding, Yoganand Chillarige, Mary Ross Southworth, Thomas E. MaCurdy, Jeffrey A. Kelman Tags: Clinical Research Study Source Type: research

CMS Requirements for Mandatory Shared Decision Making for Cardiac Procedures and Other Tests
This Viewpoint discusses Centers for Medicare& Medicaid Services (CMS) policies requiring physicians to engage patients in shared decision making prior to implantation of an implantable cardioverter-defibrillator, lung cancer screening, and left atrial appendage closure for stroke prevention in atrial fibrillation, and argues that better guidance is needed if the requirements are to promote meaningful shared decisions.
Source: JAMA - Journal of the American Medical Association - June 4, 2018 Category: General Medicine Source Type: research

The Rural Inpatient Mortality Study: Does Urban-Rural County Classification Predict Hospital Mortality in California?
CONCLUSION: Hospitals in medium-sized metro counties are associated with unfavorable Medicare mortality ratings, but current methods to assign mortality ratings may hinder fair comparisons. Patient transfers from rural locations to regional medical centers may contribute to these results, a potential factor that future research should examine. PMID: 29616911 [PubMed - in process]
Source: The Permanente journal - April 6, 2018 Category: General Medicine Tags: Perm J Source Type: research

Trends in Carotid Revascularization Procedures
To the Editor In a study of Medicare beneficiaries during 1999-2014, 30-day ischemic stroke or death rates after carotid endarterectomy improved (from 4.4% in 1999-2000 to 3.1% in 2013-2014), as did all-cause mortality (from 1.6% to 1.1%). In contrast, 30-day ischemic stroke or death rates after carotid artery stenting did not differ between the beginning and the end of the study period (7.0% in 1999-2000 and 7.0% in 2013-2014) and neither did all-cause mortality (4.7% in 1999-2000 and 4.8% in 2013-2014). Importantly, 30-day ischemic stroke or death rates after carotid artery stenting were higher than those recommended by ...
Source: JAMA - January 16, 2018 Category: General Medicine Source Type: research

Trends in Carotid Revascularization Procedures —Reply
In Reply Dr Hussain and colleagues point out interesting comparisons in carotid revascularization trends in Ontario, Canada, and in the US Medicare population, including similar 30-day stroke or death outcomes after carotid endarterectomy and stenting. We agree that differing reimbursement policies in the United States and Canada may account for differing patterns of carotid stenting after 2006. A noted difference is the lower receipt of procedures among symptomatic patients in the United States vs Ontario. However, such variation is expected because the approach to asymptomatic treatment has been shown to vary among Western countries.
Source: JAMA - January 16, 2018 Category: General Medicine Source Type: research

Stroke Administrative Severity Index: using administrative data for 30-day poststroke outcomes prediction.
CONCLUSION: The SASI model and score provide important tools to control for stroke severity at time of hospital discharge. It can be used as a risk-adjustment variable in administrative data analyses to measure postdischarge outcomes. PMID: 29057660 [PubMed - as supplied by publisher]
Source: Journal of Comparative Effectiveness Research - October 25, 2017 Category: General Medicine Tags: J Comp Eff Res Source Type: research

Hospital Discharge Disposition of Stroke Patients in Tennessee.
CONCLUSIONS: Our investigation revealed that the hospital discharge disposition pattern of patients with stroke in Tennessee was associated with the key patient characteristics of selected demographics, clinical indicators, and insurance status. These analyses resulted in the development of an easy-to-use predictive tool for early determination of hospital discharge disposition status. PMID: 28863224 [PubMed - in process]
Source: Southern Medical Journal - September 3, 2017 Category: General Medicine Tags: South Med J Source Type: research

1 in 4 Medicare Patients Uses Blood Pressure Meds Incorrectly
TUESDAY, Sept. 13, 2016 -- Nearly 5 million Medicare prescription drug enrollees aren ' t taking their blood pressure medication as directed, increasing their risk of heart attack and stroke, a new U.S. study found. An analysis of 18.5 million...
Source: Drugs.com - Daily MedNews - September 13, 2016 Category: Journals (General) Source Type: news

Antithrombotic use and bleeding risk in patients with atrial fibrillation: findings from a multipayer analysis.
CONCLUSION: Levels of thromboprophylaxis for high-risk AF patients in real-world data differ significantly from current medical guidelines for stroke prevention. PMID: 26690040 [PubMed - as supplied by publisher]
Source: Journal of Comparative Effectiveness Research - December 23, 2015 Category: Journals (General) Tags: J Comp Eff Res Source Type: research