Patient in hospital

Apples and oranges: 4 definitions of multiple chronic conditions and their relationship to 30-day rehospitalization

Apples and oranges: 4 definitions of multiple chronic conditions and their relationship to 30-day rehospitalization

In this study, Melissa Dattalo et al. used HIP's Chronic Conditions Warehouse data to examine the extent of agreement of 4 commonly used definitions of multiple chronic conditions (MCC) and compare each definition's ability to predict 30-day hospital readmissions. They found that MCC definitions should not be used interchangeably. The two definitions with the greatest agreement (Charlson Comorbidity Index and Chronic Condition Special Needs Plan) were also the best predictors of readmissions. 

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Surgeons operating on patient

Endovascular vs. open revascularization for peripheral arterial disease

Endovascular vs. open revascularization for peripheral arterial disease

The aim of this study by Dr. Jason Wiseman et al. was to determine whether endovascular or open revascularization provides an advantageous long-term approach to symptomatic peripheral artery disease. The authors used Chronic Conditions Warehouse Medicare data and found that an endovascular approach is associated with improved amputation-free survival over the long term with only a modest relative increased risk of subsequent intervention.

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Diabetic foot ulcer

The association between geographic density of infectious disease physicians and limb preservation in patients with diabetic foot ulcers

The association between geographic density of infectious disease physicians and limb preservation in patients with diabetic foot ulcers

Dr. Meghan Brennan et al. studied geographic density of infectious disease physicians to capture the effects of access to these providers on major amputation. Using Chronic Conditions Warehouse data for Medicare enrollees with diabetic foot ulcers, they found living in hospital referral regions with high geographic density of infectious disease physicians was associated with a reduced risk in major amputation after controlling for other factors. 

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Medicare enrollment

Difference in receipt of preventive services by race/ethnicity in Medicare Advantage plans: tracking the impact of P4P

Difference in receipt of preventive services by race/ethnicity in Medicare Advantage plans: tracking the impact of P4P

Daniel Jung et al. studied whether pay-for-performance (P4P) incentives have affected racial/ethnic disparities in Medicare Advantage plans. The authors studied data from the Medicare Health Outcomes Survey and found similar racial/ethnic differences in receipt of preventive healthcare before and after the introduction of P4P. 

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Using a microscope

The role of intraoperative assessment in the surgical management of ductal carcinoma in situ

The role of intraoperative assessment in the surgical management of ductal carcinoma in situ

This study by Dr. Marquita Decker et al. examined the relationship between intraoperative pathologic assessment and subsequent operations in patients with a diagnosis of ductal carcinoma in situ (DCIS). Using SEER-Medicare data, investigators found that the use of intraoperative frozen section or touch preparation during partial mastectomy did not result in a reduction in subsequent breast operations in women with DCIS.

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Mechanical ventilator

Trajectories and prognosis of patients who have prolonged mechanical ventilation after high-risk surgery

Trajectories and prognosis of patients who have prolonged mechanical ventilation after high-risk surgery

This retrospective cohort study of Medicare beneficiaries by Dr. Michael Nabozny et al. examined patterns of mortality and hospitalization for patients 66 and older who have major surgery with and without prolonged mechanical ventilation. The authors found those who received prolonged mechanical ventilation had higher 1-year mortality than those who did not. Patients who did not receive mechanical ventilation were more likely to be discharged home. 

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Doctors office

Does first-contact access to primary care differentially benefit those with certain personalities to receive preventive services?

Does first-contact access to primary care differentially benefit those with certain personalities to receive preventive services?

Dr. Nancy Pandhi and team used Wisconsin Longitudinal Study data to examine utilization of preventive care services in patients with certain personality characteristics. They found that certain personality characteristics, such as lower conscientiousness, lower agreeableness, and lower openness to new experience predicted receiving fewer of one or more preventive care services. For those with less agreeableness, improved first-contact access mitigated this effect. 

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IBD pills

Examining systemic steroid use in older inflammatory bowel disease patients using hurdle models

Examining systemic steroid use in older inflammatory bowel disease patients using hurdle models

This study by Sophia Johnson et al. sought to evaluate the relationship between patient characteristics and the frequency and duration of incident steroid use for inflammatory bowel disease. In a national Medicare sample, 21% of IBD patients without baseline steroid use used systemic steroids, despite general consensus that systemic steroid use should be limited. Odds of receiving systemic steroids were greater in patients that were younger, lived in rural areas, and receiving other agents. Available patient characteristics failed to predict longer steroid treatment duration. 

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Woman thinking

Association of anxiety and depression with hypertension control

Association of anxiety and depression with hypertension control

This study by Dr. Heather Johnson's team aimed to evaluate rates and predictors of incident hypertension control among patients with anxiety and/or depression compared to patients without either mental health diagnosis. The 4-year retrospective analysis included patients over the age of 18 with hypertension. Those with anxiety and/or depression demonstrated more primary care and specialty visits than those without either condition. Other association of hypertension control included female gender, absence of tobacco use, Medicaid use, and a higher Adjusted Clinical Group Risk Score.

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Doctor counseling patient

Visit patterns for severe mental illness with implementation of integrated care

Visit patterns for severe mental illness with implementation of integrated care

This retrospective cohort pilot study by Meghan Fondow et al. examined visit patterns for over 1,000 patients with severe mental illness using EHR data from two federally qualified health centers. During the intervention period of a model that integrated behavioral health services with primary care, there was a significant increase in the proportion of visits per month. After the intervention, this rate declined but remained above pre-intervention period.

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