Using the Hendrich II inpatient fall risk screen to predict outpatient falls after ED visits
Using the Hendrich II inpatient fall risk screen to predict outpatient falls after ED visits
Dr. Brian Patterson et al. used electronic health record data to evaluate whether routinely collected Hendrich II fall scores can predict returns to the emergency department (ED) for falls within 6 months. The investigators found that using the score alone, the odds of returning to the ED for a fall in 6 months were 1.23 times as high for every 1-point increase in the Hendrich II score. When routinely collected data on other fall risk factors was combined with the fall risk score, the screening performed much better.
Can claims data algorithms identify the physician of record?
Can claims data algorithms identify the physician of record?
Eva DuGoff and co-authors investigated the agreement of primary care providers (PCPs) identified by claims algorithms and in EHR data. This study looked at Medicare fee-for-service beneficiaries with diabetes age 65+ and found agreement was higher for algorithms based on primary care visits. The algorithms perform less well among vulnerable populations and those experiencing fragmented care.
30-day readmission & mortality among Medicare beneficiaries discharged to SNFs after vascular surgery
30-day readmission & mortality among Medicare beneficiaries discharged to SNFs after vascular surgery
Using HIP Chronic Conditions Warehouse data, authors looked at readmissions among vascular surgery patients discharged to skilled nursing facilities (SNFs). They found 36% were readmitted or had died at 30 days. Predictors of readmission or death at 30 days included SNF for-profit status, number of hospitalizations in the previous year, comorbidities, emergency procedures, and complications.
Survival of sepsis survivors admitted to skilled nursing facilities
Survival of sepsis survivors admitted to skilled nursing facilities
Dr. William Ehlenbach et al. examined the cognitive and physical impairment among severe sepsis survivors discharged to a skilled nursing facility. Using the Chronic Conditions Warehouse 5% random national Medicare sample, they found discharge to a SNF was associated with shorter survival. Cognitive impairment and activities of daily living dependence were each strongly associated wtih shortened survival.
Validation of an instrument to assess barriers to care-seeking for accidental bowel leakage
Validation of an instrument to assess barriers to care-seeking for accidental bowel leakage
Despite the existence of effective, minimally invasive therapies for accidental bowel leakage, fewer than 30% of women with the condition seek care for it. To begin to understand the barriers to seeking care for ABL, Dr. Heidi Brown et al. developed a survey instrument and tested its vailidity by having adult women with ABL complete the survey electronically. Test-retest reliability for the instrument was excellent for all items, and factor extraction via oblique rotation resulted in a final instrument that contained 16 items in six domains.
Insurance Coverage for CT Colonography Screening: Impact on Overall Colorectal Cancer Screening Rates.
Insurance Coverage for CT Colonography Screening: Impact on Overall Colorectal Cancer Screening Rates.
Dr. Maureen Smith et al. compared colorectal cancer (CRC) screening rates for patients with and without insurance coverage for CT colonography. Using longitudinal electronic health record data, the investigators found that among patients who became due for CRC screening, there was a 48% greater likelihood of them getting screened by any method if they had insurance coverage for CT colonography when compared to those who did not have insurance coverage.
Using chief complaint in addition to diagnosis codes to identify falls in the ED
Using chief complaint in addition to diagnosis codes to identify falls in the ED
Dr. Brian Patterson et al. compared the incidence of falls in an emergency department cohort using ICD-9 codes and an expanded definition that included chief complaint. Of the falls evaluated in the retrospective electronic health record review, 80% met the ICD-9 definition of a fall-related visit and 61% met the chief-complaint definition. Nearly 20% were missed when applying the ICD-9 definition alone.
Barriers to seeking care for accidental bowel leakage: a qualitative study
Barriers to seeking care for accidental bowel leakage: a qualitative study
Dr. Heidi Brown et al. conducted focus groups and cognitive interviews with 39 women aged 46-85 to identify and describe the barriers to seeking care for accidental bowel leakage, a condition for which less than 30% of women who have it seek care. The investigators found 12 barriers to seeking care for accidental bowel leakage, such as lack of knowledge about the condition, lack of knowledge about treatment, fear of testing/treatment, and others, that fit into three overarching themes of (1) internalized self in relation to ABL: (2) perceptions about ABL and its treatments; and (3) interaction with the healthcare system. These barriers are similar to those described for urinary incontinence treatment, with the addition of lack of knowledge that ABL is a condition experienced by others.
Variation in the types of providers participating in breast cancer follow-up care
Variation in the types of providers participating in breast cancer follow-up care
Dr. Heather Neuman et al. aimed to describe the types of providers participating in early follow-up care of older breast cancer survivors. Using the SEER-Medicare database, investigators found 80% of follow-up care was with a medical oncologist, 46% with a surgeon, and 39% with a radiation oncologist after radiation treatment. Patients with larger tumor size, positive axillary nodes, estrogen receptor-positive status, and chemotherapy treatment were more llikely to have medical oncology follow-up.
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.