• Filter By:
• Specialty
• Source
• Condition
• Cancer
• Infectious Disease
• Drug
• Training
• Management
• Procedure
• Therapy
• Vaccine
• Nutrition
• Country

Are Treatment Preferences of Those Who Died Ever Heard?: The Lack of Documentation of Preferences in a State-Wide Cohort of Patients Who Died Following Ischemic Stroke (S47.004)
CONCLUSIONS: Among a representative sample of California patients who died within 30 days after an ischemic stroke, less than half had documented discussions about LSI. The new Medicare policy could serve as an additional barrier to increasing communication about preferences, as physicians may fear that these discussions would lead to withdrawal of LSI, increased 30-day mortality, and thus misleading estimates of the hospital’s quality of care. Study Supported by:California OSHPD, RWJCSPDisclosure: Dr. Robinson has nothing to disclose. Dr. Vickrey has received personal compensation for activities with EMD Serono as a...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Robinson, M., Vickrey, B., Holloway, R., Chong, K., Williams, L., Parikh, P., Leng, M., Zingmond, D. Tags: Cerebrovascular Disease and Interventional Neurology Source Type: research

Comparative Risk of Ischemic Stroke Among Users of Clopidogrel Together With Individual Proton Pump Inhibitors Clinical Sciences
Conclusions— PPIs of interest did not increase the rate of ischemic stroke among clopidogrel users when compared with pantoprazole, a PPI thought to be devoid of the potential to interact with clopidogrel.
Source: Stroke - February 23, 2015 Category: Neurology Authors: Leonard, C. E., Bilker, W. B., Brensinger, C. M., Flockhart, D. A., Freeman, C. P., Kasner, S. E., Kimmel, S. E., Hennessy, S. Tags: Platelet function inhibitors, Acute Cerebral Infarction, Acute Stroke Syndromes, Antiplatelets, Epidemiology Clinical Sciences Source Type: research

Centers for Medicare and Medicaid Services Medicare Data and Stroke Research: Goldmine or Landmine? Topical Reviews
Source: Stroke - January 26, 2015 Category: Neurology Authors: Lichtman, J. H., Leifheit-Limson, E. C., Goldstein, L. B. Tags: Health policy and outcome research, Acute Cerebral Hemorrhage, Acute Cerebral Infarction Topical Reviews Source Type: research

Carotid Stenting—Why Treating an Artery May Not Treat the Patient
In this issue of JAMA Neurology, Jalbert and colleagues present the results of a detailed analysis of Centers for Medicare & Medicaid Services (CMS) administrative data on patients with carotid artery stenosis treated with carotid artery stenting. Their well-written manuscript and timely study included more than 22 000 patients treated and followed up between 2000 and 2009. They analyzed periprocedural complications (defined as stroke, transient ischemic attack [TIA], myocardial infarction [MI], and death within 30 days), as well as long-term stroke and mortality. Important variables that were analyzed included the degre...
Source: JAMA Neurology - January 12, 2015 Category: Neurology Source Type: research

Outcomes After Carotid Artery Stenting in Medicare Beneficiaries, 2005 to 2009
Conclusions and RelevanceCompeting risks may limit the benefits of CAS in certain Medicare beneficiaries, particularly among older and symptomatic patients who have higher periprocedural and long-term mortality risks. The generalizability of trials like the SAPPHIRE or CREST to the Medicare population may be limited, underscoring the need to evaluate real-world effectiveness of carotid stenosis treatments.
Source: JAMA Neurology - January 12, 2015 Category: Neurology Source Type: research

Disparities in Accessibility of Certified Primary Stroke Centers Clinical Sciences
Conclusions— There are significant geographic disparities in access to PSCs. Access is limited in nonurban areas. Despite the higher burden of cerebrovascular disease in stroke belt states, access to care is lower in these areas. Selecting demographic and healthcare factors is strongly associated with access to care in smaller cities, but not in other areas, including major cities.
Source: Stroke - October 27, 2014 Category: Neurology Authors: Mullen, M. T., Wiebe, D. J., Bowman, A., Wolff, C. S., Albright, K. C., Roy, J., Balcer, L. J., Branas, C. C., Carr, B. G. Tags: Health policy and outcome research, Emergency treatment of Stroke Clinical Sciences Source Type: research

Impact of State Medicaid Coverage on Utilization of Inpatient Rehabilitation Facilities Among Patients With Stroke Brief Reports
Conclusions— State Medicaid coverage of IRFs is associated with IRF utilization among stroke patients with Medicaid. Given the increasing stroke incidence among the working age and Medicaid expansion under the Affordable Care Act, careful attention to state Medicaid policy for poststroke rehabilitation and analysis of its effects on stroke outcome disparities are warranted.
Source: Stroke - July 28, 2014 Category: Neurology Authors: Skolarus, L. E., Burke, J. F., Morgenstern, L. B., Meurer, W. J., Adelman, E. E., Kerber, K. A., Callaghan, B. C., Lisabeth, L. D. Tags: Health policy and outcome research Brief Reports Source Type: research

Episode-based care for stroke: Can neurologists play a leading role?
In this issue of Neurology® Clinical Practice, Dr. Michael Dobbs argues that episode-based care, which would encompass acute and longer-term associated care, is a likely candidate model of reimbursement for stroke.1 Physicians may be familiar with other bundled payment formats, particularly the diagnosis-related groups used by the Centers for Medicare & Medicaid Services (CMS) for determining inpatient care reimbursement to hospitals under Medicare part A.2 Episode-based care would have the advantages of looking at recurrent care and utilization events up to 1 year following the initial treatment and would be a bas...
Source: Nature Clinical Practice - June 9, 2014 Category: Neurology Authors: Ney, J. P. Tags: Medical care, Stroke prevention, Billing, Infarction Editorial Source Type: research

Stroke Outcomes Measures Must Be Appropriately Risk Adjusted to Ensure Quality Care of Patients: A Presidential Advisory From the American Heart Association/American Stroke Association AHA/ASA Presidential Advisory
This article details (1) why the Centers for Medicare & Medicaid Services acute ischemic stroke outcome measures in their present form may not provide adequate risk adjustment, (2) why the measures as currently designed may lead to inaccurate representation of hospital performance and have the potential for serious unintended consequences, (3) what activities the American Heart Association/American Stroke Association has engaged in to highlight these concerns to the Centers for Medicare & Medicaid Services and other interested parties, and (4) alternative approaches and opportunities that should be considered for m...
Source: Stroke - April 28, 2014 Category: Neurology Authors: Fonarow, G. C., Alberts, M. J., Broderick, J. P., Jauch, E. C., Kleindorfer, D. O., Saver, J. L., Solis, P., Suter, R., Schwamm, L. H. Tags: AHA Statements and Guidelines AHA/ASA Presidential Advisory Source Type: research

Medicare's New Two Midnight Rule for In-patient Status Admission Applied to Transient Ischemic Attack Patients Predicted by Hypertension History and Age (P6.275)
CONCLUSIONS:In our population of TIA patients, history of hypertension and age >70 years were the only baseline variables that significantly predicted LOS >2 days or 2 midnights. Our findings suggests that consideration of age and pre-existing hypertension may facilitate accurate prediction of patients who will exceed the 2 midnight Medicare rule and require in-patient admission versus observation status for TIA patients. Our findings require validation in a larger sample in a different population to determine generalizabilty.Study Supported by: Disclosure: Dr. Chavez-Keatts has nothing to disclose. Dr. Monlezun, ...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Chavez-Keatts, M., Monlezun, D., George, A., El Khoury, R., Martin-Schild, S. Tags: Cerebrovascular Disease and Interventional Neurology: Risk Factors Source Type: research

Comparability of Charges and Payments for Hospitalized Stroke (P2.130)
Conclusions: For profit organizations were more likely to submit higher charges, but collect less in payments, with higher comparability of billing, compared to non-profit organizations across all DRGs.Disclosure: Dr. Bulic has nothing to disclose. Dr. Kim-Tenser has nothing to disclose. Dr. He has nothing to disclose. Dr. Kazaryan has nothing to disclose. Dr. Cen has nothing to disclose. Dr. He has nothing to disclose. Dr. Mack has nothing to disclose. Dr. Sanossian has received personal compensation for activities with Boehringer-Ingelheim Pharmaceutical Inc.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Bulic, S., Kim, M., He, S., Kazaryan, S., Cen, S., He, S., Mack, W., Sanossian, N. Tags: Cerebrovascular Disease and Interventional Neurology: Evaluation, Cost, and Quality Source Type: research

Show or No-Show - That Is the Question: Lack of Outpatient Follow-up a After Acute Stroke. (P2.131)
CONCLUSION: Poor follow up rates were seen overall. Medicare, Medicaid, and self-pay patients were least likely to follow up. Patients discharged to inpatient rehabilitation or nursing facilities had a low follow-up rate, as did those patients living at a geographic distance from our facilities. Better education of the importance of follow-up prior to discharge is needed.Disclosure: Dr. Chaudhary has nothing to disclose. Dr. Lee has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Chaudhary, G., Lee, J. Tags: Cerebrovascular Disease and Interventional Neurology: Evaluation, Cost, and Quality Source Type: research

Medicare Coverage Increases Odds of In-Hospital Mortality but Lack of Insurance Increases Odds of Poor Functional Outcome by Modified Rankin Score (mRS) (P2.138)
CONCLUSIONS:Medicare patients have greater odds of in-hospital mortality compared to uninsured, private, and VA patients, though uninsured patients had the highest odds of poor functional outcome on discharge. Further studies are needed to determine whether coverage is a stronger predictor of admission or in-hospital variables to determine if the observed outcome differences are more associated with variance in admission or in-hospital care.Disclosure: Dr. Friedant has nothing to disclose. Dr. Monlezun, Jr has nothing to disclose. Dr. Baranwal has nothing to disclose. Dr. Valmoria has nothing to disclose. Dr. Shaban has no...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Friedant, A., Monlezun, D., Baranwal, P., Valmoria, M., Shaban, A., George, A., El Khoury, R., Martin-Schild, S. Tags: Cerebrovascular Disease and Interventional Neurology: Disparity Source Type: research

Uninsured Patients May Lack Diagnoses for Chronic Diseases That Are Known Stroke Risk Predictors (P2.140)
CONCLUSIONS:In our population, uninsured patients were significantly less likely to have risk factors for stroke based on past medical history. However, the same population had the higher prevalence of systolic hypertension and elevated LDL on admission and were not taking medications at home. Together, this suggests that uninsured patients may lack access to resources needed to diagnose and treat known chronic risk factors for stroke.Disclosure: Dr. Baranwal has nothing to disclose. Dr. Monlezun, Jr has nothing to disclose. Dr. Lanceta has nothing to disclose. Dr. Shaban has nothing to disclose. Dr. George has received re...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Baranwal, P., Monlezun, D., Lanceta, J., Shaban, A., George, A., Martin-Schild, S., El Khoury, R. Tags: Cerebrovascular Disease and Interventional Neurology: Disparity Source Type: research

Factors Associated With 30-Day Readmission Rate Among Stroke Patients From 2009-2012 At Two Tertiary Level Hospitals In Metro Portland Area (P3.090)
CONCLUSIONS:Elderly patients with stroke with shorter length of stay who are discharged home are at the highest risk for getting readmitted within 30 days. These subgroups could be targeted for interventions in preventing 30 day readmission. These findings should be validated in larger studies.Disclosure: Dr. Kansara has nothing to disclose. Dr. Stuchiner has nothing to disclose. Dr. Baraban has nothing to disclose. Dr. Bhatt has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Kansara, A., Stuchiner, T., Baraban, E., Bhatt, A. Tags: Cerebrovascular Disease and Interventional Neurology: Clinical Management Source Type: research

Pages: 1  2  3  4