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Condition: Ischemic Stroke
Management: Medicaid

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Total 65 results found since Jan 2013.

Ethnic Comparison of 30-Day Potentially Preventable Readmissions After Stroke in Hawaii Clinical Sciences
Conclusions— In Hawaii, Chinese may have a higher risk of 30-day PPR after stroke compared with whites. However, this seems to be driven by the high number of repeated PPR within the Chinese ethnic group.
Source: Stroke - September 25, 2016 Category: Neurology Authors: Nakagawa, K., Ahn, H. J., Taira, D. A., Miyamura, J., Sentell, T. L. Tags: Race and Ethnicity, Complications, Quality and Outcomes, Cerebrovascular Disease/Stroke Clinical Sciences 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

Incorporating Stroke Severity Into Hospital Measures of 30-Day Mortality After Ischemic Stroke Hospitalization Clinical Sciences
Conclusions—We developed 3 quality measures that demonstrate better discrimination than the Centers for Medicare & Medicaid Services’ existing stroke mortality measure, adjust for stroke severity, and could be implemented in a variety of settings.
Source: Stroke - October 23, 2017 Category: Neurology Authors: Jennifer Schwartz, Yongfei Wang, Li Qin, Lee H. Schwamm, Gregg C. Fonarow, Nicole Cormier, Karen Dorsey, Robert L. McNamara, Lisa G. Suter, Harlan M. Krumholz, Susannah M. Bernheim Tags: Health Services, Mortality/Survival, Quality and Outcomes, Ischemic Stroke Original Contributions 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

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

African Americans Are Less Likely to Be Adherent to Statins After Ischemic Stroke: An Analysis of Medicare Beneficiaries Following Hospital Discharge (I2.006)
Conclusions: African Americans may not be obtaining the recurrent stroke prevention therapy provided by statins, possibly contributing to the higher rate of recurrent stroke in this population.Disclosure: Dr. Albright has nothing to disclose. Dr. Blackburn has nothing to disclose. Dr. Zhao has nothing to disclose. Dr. Beasley has nothing to disclose. Dr. Limdi has nothing to disclose. Dr. Howard has nothing to disclose. Dr. Muntner has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Albright, K., Blackburn, J., Zhao, H., Beasley, T., Limdi, N., Howard, V., Muntner, P. Tags: Stroke in the Elderly and Young: Challenges for the Next Decade Data Blitz Presentations Source Type: research

African Americans Are Less Likely to Be Adherent to Statins After Ischemic Stroke: An Analysis of Medicare Beneficiaries Following Hospital Discharge (S4.003)
Conclusions: African Americans may not be obtaining the recurrent stroke prevention therapy provided by statins, possibly contributing to the higher rate of recurrent stroke in this population.Disclosure: Dr. Albright has nothing to disclose. Dr. Blackburn has nothing to disclose. Dr. Zhao has nothing to disclose. Dr. Beasley has nothing to disclose. Dr. Limdi has nothing to disclose. Dr. Howard has nothing to disclose. Dr. Muntner has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Albright, K., Blackburn, J., Zhao, H., Beasley, T., Limdi, N., Howard, V., Muntner, P. Tags: Health Disparities and Sex Differences in Stroke 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

Early transition to comfort measures only in acute stroke patients: Analysis from the Get With The Guidelines-Stroke registry
Conclusions: Early CMO was utilized in about 5% of stroke patients, being more common in ICH and SAH than IS. Early CMO use varies widely between hospitals and is influenced by patient and hospital characteristics.
Source: Neurology Clinical Practice - June 12, 2017 Category: Neurology Authors: Prabhakaran, S., Cox, M., Lytle, B., Schulte, P. J., Xian, Y., Zahuranec, D., Smith, E. E., Reeves, M., Fonarow, G. C., Schwamm, L. H. Tags: All Cerebrovascular disease/Stroke, Palliative care Research Source Type: research

Preventable Readmissions Within 30 Days of Ischemic Stroke Among Medicare Beneficiaries Clinical Sciences
Conclusions— On the basis of Agency for Healthcare Research and Quality Prevention Quality Indicators, we found that a small proportion of readmissions after ischemic stroke were classified as preventable. Although other causes of readmissions not reflected in the Agency for Healthcare Research and Quality measures could also be avoidable, hospital-level programs intended to reduce all-cause readmissions and costs should target high-risk patients.
Source: Stroke - November 25, 2013 Category: Neurology Authors: Lichtman, J. H., Leifheit-Limson, E. C., Jones, S. B., Wang, Y., Goldstein, L. B. Tags: Clinical Sciences Source Type: research

Socioeconomic Disparities in the Utilization of Mechanical Thrombectomy for Acute Ischemic Stroke
We examined the utilization rates of mechanical thrombectomy by race/ethnicity (white, black, Hispanic, and Asian/Pacific Islander), income quartile (first, second to third, and fourth), and insurance status (Medicare, Medicaid, self-pay, and private). We also studied thrombectomy utilization rates at hospitals that performed thrombectomy.Results: From 2006 to 2010, 2,087,017 patients were hospitalized with a primary diagnosis of acute ischemic stroke; 8946 patients (.4%) received mechanical thrombectomy. Compared with white patients, black patients had significantly lower rates of overall mechanical thrombectomy utilizati...
Source: Journal of Stroke and Cerebrovascular Diseases - October 10, 2013 Category: Neurology Authors: Waleed Brinjikji, Alejandro A. Rabinstein, Harry J. Cloft Tags: Original Articles Source Type: research

Fragmentation of Care and the Use of Head Computed Tomography in Patients With Ischemic Stroke Original Articles
Conclusions— Rates of high-intensity CT use for patients with ischemic stroke reflect wide practice patterns across regions and races. Medicare expenditures parallel these disparities. Fragmentation of care is associated with high-intensity CT use.
Source: Circulation: Cardiovascular Quality and Outcomes - May 20, 2014 Category: Cardiology Authors: Bekelis, K., Roberts, D. W., Zhou, W., Skinner, J. S. Tags: Acute Cerebral Infarction, Computerized tomography and Magnetic Resonance Imaging, Pathology of Stroke Original Articles Source Type: research

Cost of Alteplase Has More Than Doubled Over the Past Decade Brief Report
Conclusions—We found a striking increase in the cost of alteplase over the last decade, with a 100 mg vial now with a CMS payment of ≈$6400, a>100% increase over 10 years. During the same time frame, the DRG base payment to hospitals increased by only 8%, and alteplase cost increased from 27% of the payment in 2006 to 53% in 2013. Researchers and stroke physicians should be aware of these changes in drug costs and their impact on cost-effectiveness analyses.
Source: Stroke - June 26, 2017 Category: Neurology Authors: Dawn Kleindorfer, Joseph Broderick, Bart Demaerschalk, Jeffrey Saver Tags: Cost-Effectiveness, Ischemic Stroke Brief Reports Source Type: research

National Institutes of Health Stroke Scale Correlates Well with Initial Intracerebral Hemorrhage Volume
The US Centers for Medicare and Medicaid Services (CMS) currently publicly reports hospital-quality, risk-adjusted mortality measure for ischemic stroke but not intracerebral hemorrhage (ICH). The NIHSS, which is captured in CMS administrative claims data, is a candidate metric for use in ICH risk adjustment and has been shown to predict clinical outcome with accuracy similar to the ICH Score. Correlation between early NIHSS and initial ICH volume would further support use of the NIHSS for ICH risk adjustment.
Source: Journal of Stroke and Cerebrovascular Diseases - February 10, 2022 Category: Neurology Authors: Salman Farooq, Kristina Shkirkova, Pablo Villablanca, Nerses Sanossian, David S. Liebeskind, Sidney Starkman, Gilda Avila, Latisha Sharma, May Kim-Tenser, Suzie Gasparian, Marc Eckstein, Robin Conwit, Scott Hamilton, Jeffrey L. Saver Tags: Original Article Source Type: research

Emergency Medical Services Utilization for Acute Stroke Care: Analysis of the Paul Coverdell National Acute Stroke Program, 2014-2019.
CONCLUSIONS: Strategies to help increase stroke awareness and utilization of EMS among those with symptoms of stroke should be considered in order to help improve stroke outcomes. PMID: 33464940 [PubMed - as supplied by publisher]
Source: Prehospital Emergency Care - January 21, 2021 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research