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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
551 to 575 of 576 Research Studies DisplayedKumamaru H, Judd SE, Curtis JR
Validity of claims-based stroke algorithms in contemporary Medicare data: reasons for geographic and racial differences in stroke (REGARDS) study linked with medicare claims.
The researchers assessed the validity of diagnostic coding algorithms for identifying stroke in the Medicare population by linking data from the REasons for Geographic And Racial Differences in Stroke (REGARDS) Study to Medicare claims. They found that claims-based algorithms to identify stroke in a contemporary Medicare cohort had high positive predictive value and specificity, supporting their use as outcomes for etiologic and comparative effectiveness studies in similar populations.
AHRQ-funded; HS017731; HS018517.
Citation: Kumamaru H, Judd SE, Curtis JR .
Validity of claims-based stroke algorithms in contemporary Medicare data: reasons for geographic and racial differences in stroke (REGARDS) study linked with medicare claims.
Circ Cardiovasc Qual Outcomes 2014 Jul;7(4):611-9. doi: 10.1161/circoutcomes.113.000743..
Keywords: Stroke, Medicare, Comparative Effectiveness, Outcomes
Zhang Y, Zhou C, Baik SH
A simple change to the Medicare Part D low-income subsidy program could save $5 billion.
The authors used an intelligent reassignment algorithm and 2008-09 Medicare Part D drug use and spending data to match enrollees to available Part D plans according to their medication needs. They found that such a reassignment approach, compared to the current approach, could have saved the federal government over $5 billion in 2009.
AHRQ-funded; HS018657.
Citation: Zhang Y, Zhou C, Baik SH .
A simple change to the Medicare Part D low-income subsidy program could save $5 billion.
Health Aff 2014 Jun;33(6):940-5. doi: 10.1377/hlthaff.2013.1083.
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Keywords: Healthcare Costs, Low-Income, Medicare, Medication
Tong L, Ahn C, Symanski E
Effects of newly developed chemotherapy regimens, comorbidities, chemotherapy-related toxicities on the changing patterns of the leading causes of death in elderly patients with colorectal cancer.
This study examined the effects of newly developed chemotherapy regimens, comorbidities, and chemotherapy-related toxicities on the changing patterns of the leading causes of death in elderly patients with colorectal cancer (CRC). It found that the risks of CRC-specific death decreased with diagnostic time periods only in chemotherapy recipients.
AHRQ-funded; HS018956
Citation: Tong L, Ahn C, Symanski E .
Effects of newly developed chemotherapy regimens, comorbidities, chemotherapy-related toxicities on the changing patterns of the leading causes of death in elderly patients with colorectal cancer.
Ann Oncol. 2014 Jun;25(6):1234-42. doi: 10.1093/annonc/mdu131..
Keywords: Elderly, Mortality, Treatments, Medicare
Rocke DJ, Beumer HW, Taylor DH, Jr.
Physician and patient and caregiver health attitudes and their effect on Medicare resource allocation for patients with advanced cancer.
The investigators sought to determine how baseline attitudes toward quality vs quantity of life affect end-of-life resource allocation. They found that, compared with patients and caregivers, otolaryngology-head and neck surgery (OHNS) physician allocations differed significantly in all 15 benefit categories except home care. They concluded that understanding the effect of baseline attitudes is important for effective end-of-life discussions.
AHRQ-funded; HS018360.
Citation: Rocke DJ, Beumer HW, Taylor DH, Jr. .
Physician and patient and caregiver health attitudes and their effect on Medicare resource allocation for patients with advanced cancer.
JAMA Otolaryngol Head Neck Surg 2014 Jun;140(6):497-503. doi: 10.1001/jamaoto.2014.494.
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Keywords: Cancer, Caregiving, Medicare, Palliative Care, Provider: Physician, Quality of Life
Setoguchi SR, Warner Stevenson L, Stewart GC
Influence of healthy candidate bias in assessing clinical effectiveness for implantable cardioverter-defibrillators: cohort study of older patients with heart failure.
This study assessed the potential contribution of unmeasured general health status to patient selection in assessments of implantable cardioverter-defibrillator (ICD) therapy. In a group of heart failure patients, those who received ICD therapy were younger and had lower ejection fraction and more cardiac admissions to hospital but fewer non-cardiac admissions. The lower risks of measured outcomes likely reflect unmeasured differences in comorbidity and frailty.
AHRQ-funded; 29020050016I; HS017731
Citation: Setoguchi SR, Warner Stevenson L, Stewart GC .
Influence of healthy candidate bias in assessing clinical effectiveness for implantable cardioverter-defibrillators: cohort study of older patients with heart failure.
BMJ. 2014 May 8;348:g2866. doi: 10.1136/bmj.g2866..
Keywords: Medical Devices, Outcomes, Registries, Heart Disease and Health, Medicare
Hays RD, Berman LJ, Kanter MH
Evaluating the psychometric properties of the CAHPS Patient-Centered Medical Home survey.
This study surveyed Medicare beneficiaries to evaluate the reliability and validity of a new five-item care coordination measure. The composite score had a strong unique association with the CAHPS global rating of health care, after controlling for the CAHPS core composite scores.
AHRQ-funded; HS016980
Citation: Hays RD, Berman LJ, Kanter MH .
Evaluating the psychometric properties of the CAHPS Patient-Centered Medical Home survey.
Clin Ther. 2014 May;36(5):689-696.e1. doi: 10.1016/j.clinthera.2014.04.004..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Medicare, Patient Experience, Patient-Centered Healthcare
McGarry BE, Strawderman RL, Li Y
Lower Hispanic participation in Medicare Part D may reflect program barriers.
This study found that Hispanics were 35 percent less likely than non-Hispanic whites to have Medicare Part D coverage. This difference may be driven by ethnic disparities among those eligible for the low-income Part D subsidy but not automatically enrolled in it.
AHRQ-funded; HS00044
Citation: McGarry BE, Strawderman RL, Li Y .
Lower Hispanic participation in Medicare Part D may reflect program barriers.
Health Aff. 2014 May;33(5):856-62. doi: 10.1377/hlthaff.2013.0671..
Keywords: Medicare, Disparities, Racial and Ethnic Minorities, Low-Income, Healthcare Costs
Setoguchi S, Zhu Y, Jalbert JJ
Validity of deterministic record linkage using multiple indirect personal identifiers: linking a large registry to claims data.
The researchers compared the validity of several deterministic record linkage methods with multiple indirect identifiers by using data from the Centers for Medicare and Medicaid Services (CMS) implantable cardioverter-defibrillator (ICD) registry and administrative Medicare inpatient claims data. Linkage rules using 2 or 3 indirect, patient-level identifiers and hospital ID produced linkages with sensitivity of 95% and specificity of 98% compared with a gold standard linkage rule.
AHRQ-funded; 29020050016I; HS017731.
Citation: Setoguchi S, Zhu Y, Jalbert JJ .
Validity of deterministic record linkage using multiple indirect personal identifiers: linking a large registry to claims data.
Circ Cardiovasc Qual Outcomes 2014 May;7(3):475-80. doi: 10.1161/circoutcomes.113.000294..
Keywords: Medical Devices, Medicare, Registries, Data, Inpatient Care
Thacker EL, Muntner P, Zhao H
Claims-based algorithms for identifying Medicare beneficiaries at high estimated risk for coronary heart disease events: a cross-sectional study.
The researchers sought to develop claims-based algorithms to identify individuals at high risk for coronary artery disease (CHD) and to identify low-density lipoprotein (LDL) cholesterol among statin users at high risk for CHD events. They found that despite low sensitivity, the high predictive value of their algorithm for high risk for CHD events supports the use of claims to identify Medicare beneficiaries at high risk for CHD events.
AHRQ-funded; HS018517
Citation: Thacker EL, Muntner P, Zhao H .
Claims-based algorithms for identifying Medicare beneficiaries at high estimated risk for coronary heart disease events: a cross-sectional study.
BMC Health Serv Res. 2014 Apr 29;14:195. doi: 10.1186/1472-6963-14-195..
Keywords: Comparative Effectiveness, Medicare, Risk, Cardiovascular Conditions, Chronic Conditions
Martin BI, Lurie JD, Tosteson AN
Indications for spine surgery: validation of an administrative coding algorithm to classify degenerative diagnoses.
The Spine Patient Outcomes Research Trial (SPORT) provided a unique opportunity to examine the validity of a claims-based algorithm for grouping patients by surgical indication. SPORT enrolled patients for lumbar disc herniation, spinal stenosis, and degenerative spondylolisthesis. The researchers found that their claims-based hierarchical coding algorithm of spine-related medical encounters correctly classified more than 90 percent of Medicare patients into their respective SPORT cohorts.
AHRQ-funded; HS018405
Citation: Martin BI, Lurie JD, Tosteson AN .
Indications for spine surgery: validation of an administrative coding algorithm to classify degenerative diagnoses.
Spine. 2014 Apr 20;39(9):769-79. doi: 10.1097/brs.0000000000000275..
Keywords: Comparative Effectiveness, Surgery, Outcomes, Medicare
Chrischilles E, Schneider K, Wilwert J
Beyond comorbidity: expanding the definition and measurement of complexity among older adults using administrative claims data.
Studies of patients with multiple chronic conditions using claims data are often missing important determinants of treatments and outcomes, such as function status and disease severity. In this study, the investigators sought to identify and evaluate a class of function-related indicators (FRIs) from administrative claims data. The investigators concluded that claims data studies that include indicators of potentially diminished patient functional status better capture heterogeneity of patients with multiple chronic conditions.
AHRQ-funded; HS019440.
Citation: Chrischilles E, Schneider K, Wilwert J .
Beyond comorbidity: expanding the definition and measurement of complexity among older adults using administrative claims data.
Med Care 2014 Mar;52(Suppl 3):S75-S84. doi: 10.1097/mlr.0000000000000026..
Keywords: Elderly, Chronic Conditions, Medicare
Huckfeldt PJ, Sood N, Escarce JJ
Effects of Medicare payment reform: evidence from the home health interim and prospective payment systems.
The researchers contrasted the effects of two Medicare payment reforms for home health agencies: the interim payment system (IPS) and the prospective payment system (PPS). The 1997 IPS reform lowered payments for both fee-for-service and episode-based care, as predicted by their conceptual model. The PPS in 2000 raised average but lowered marginal payment.
AHRQ-funded; HS018541
Citation: Huckfeldt PJ, Sood N, Escarce JJ .
Effects of Medicare payment reform: evidence from the home health interim and prospective payment systems.
J Health Econ. 2014 Mar;34:1-18. doi: 10.1016/j.jhealeco.2013.11.005..
Keywords: Medicare, Healthcare Costs, Home Healthcare
Ottenbacher KJ, Karmarkar A, Graham JE
Thirty-day hospital readmission following discharge from postacute rehabilitation in fee-for-service Medicare patients.
This study sought to determine 30-day readmission rates and factors related to readmission for patients receiving postacute inpatient rehabilitation. It found that among postacute rehabilitation facilities providing services to Medicare fee-for-service beneficiaries, 30-day readmission rates ranged from 5.8 percent to 18.8 percent for selected impairment groups.
AHRQ-funded; HS022134.
Citation: Ottenbacher KJ, Karmarkar A, Graham JE .
Thirty-day hospital readmission following discharge from postacute rehabilitation in fee-for-service Medicare patients.
JAMA 2014 Feb 12;311(6):604-14. doi: 10.1001/jama.2014.8..
Keywords: Hospital Readmissions, Medicare, Rehabilitation, Elderly, Quality Indicators (QIs)
Erten MZ, Davidoff AJ, Zuckerman IH
AHRQ Author: Davidoff AJ
The effect of supplemental medical and prescription drug coverage on health care spending for Medicare beneficiaries with cancer.
The researchers examined whether patients with newly diagnosed cancer respond differently to supplemental coverage than the general Medicare population. They concluded that Medicare beneficiaries with cancer are less responsive to the presence and type of supplemental insurance than are beneficiaries without cancer. They recommended that policymakers consider welfare effects associated with coverage restrictions.
AHRQ-authored.
Citation: Erten MZ, Davidoff AJ, Zuckerman IH .
The effect of supplemental medical and prescription drug coverage on health care spending for Medicare beneficiaries with cancer.
Value Health 2014 Jan-Feb;17(1):15-21. doi: 10.1016/j.jval.2013.11.003.
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Keywords: Cancer, Health Insurance, Medicare, Medication
Bao Y, Ryan AM, Shao H
Generic initiation and antidepressant therapy adherence under Medicare Part D.
This study assessed the effects of initiating antidepressant treatment with a generic versus a branded prescription (generic initiation) on adherence to antidepressant therapy for the treatment of depression. It found that starting patients with generics had benefits for antidepressant adherence by lowering out-of-pocket costs for all patients and by mitigating the effect of the Part D coverage gap faced by patients not receiving low-income subsidies.
AHRQ-funded; HS018546.
Citation: Bao Y, Ryan AM, Shao H .
Generic initiation and antidepressant therapy adherence under Medicare Part D.
Am J Manag Care 2013 Dec;19(12):989-98..
Keywords: Medication, Depression, Medicare, Patient Adherence/Compliance
Stuart B, Davidoff A, Erten M
AHRQ Author: Davidoff A
How Medicare Part D benefit phases affect adherence with evidence-based medications following acute myocardial infarction.
The authors assessed the impact of Medicare Part D benefit phases on adherence with evidence-based medications after hospitalization for an acute myocardial infarction (AMI). They found that as the Part D doughnut hole is gradually filled in by 2020, Medicare Part D enrollees with critical diseases such as AMI who rely heavily on brand name drugs are likely to exhibit modest increases in adherence, while those reliant on generic drugs are less likely to be affected.
AHRQ-authored.
Citation: Stuart B, Davidoff A, Erten M .
How Medicare Part D benefit phases affect adherence with evidence-based medications following acute myocardial infarction.
Health Serv Res 2013 Dec;48(6 Pt 1):1960-77. doi: 10.1111/1475-6773.12073.
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Keywords: Evidence-Based Practice, Medicare, Medication, Heart Disease and Health, Patient Adherence/Compliance
McGuire TG, Glazer J, Newhouse JP
AHRQ Author: Zuvekas SH
Integrating risk adjustment and enrollee premiums in health plan payment.
Paying health plans from two different sources such as risk-adjusted payments from a regulator and premiums charged to individual enrollees raises issues in payment design for both Medicare Advantage plans and the new State-run exchanges created by the Affordable Care Act. The primary purpose of this study is to demonstrate the versatility of least squares methods for risk adjustment in individual insurance markets with enrollee premiums.
AHRQ-authored
Citation: McGuire TG, Glazer J, Newhouse JP .
Integrating risk adjustment and enrollee premiums in health plan payment.
J Health Econ. 2013 Dec;32(6):1263-77. doi: 10.1016/j.jhealeco.2013.05.002..
Keywords: Healthcare Costs, Medical Expenditure Panel Survey (MEPS), Medicare
Zeidan AM, Gore SD, McNally DL
AHRQ Author: Davidoff AJ
Lenalidomide performance in the real world: patterns of use and effectiveness in a Medicare population with myelodysplastic syndromes.
The authors examined the use of lenalidomide in the Medicare population. They found that reductions in transfusion rates were overall consistent with data from clinical trials, and response rates were higher when ≥ 3 lenalidomide cycles were received.
AHRQ-authored.
Citation: Zeidan AM, Gore SD, McNally DL .
Lenalidomide performance in the real world: patterns of use and effectiveness in a Medicare population with myelodysplastic syndromes.
Cancer 2013 Nov 1;119(21):3870-8. doi: 10.1002/cncr.28298.
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Keywords: Comparative Effectiveness, Elderly, Medicare, Medication
Nicholas LH, Dimick JB
Bariatric surgery in minority patients before and after implementation of a centers of excellence program.
This study compared rates of bariatric surgery for minority Medicare vs. non-Medicare patients before and after the 2006 implementation of a national coverage decision (NCD) restricting Medicare patients to centers of excellence for bariatric surgery. It found that the proportion of nonwhite Medicare patients receiving this procedure dropped from 27.5 percent before the NCD to 25.9 percent afterwards.
AHRQ-funded; HS017765
Citation: Nicholas LH, Dimick JB .
Bariatric surgery in minority patients before and after implementation of a centers of excellence program.
JAMA. 2013 Oct 2;310(13):1399-400. doi: 10.1001/jama.2013.277915..
Keywords: Racial and Ethnic Minorities, Medicare, Healthcare Utilization, Obesity
Huckfeldt PJ, Sood NB, Romley JA
Medicare payment reform and provider entry and exit in the post-acute care market.
The researchers examined the impact of Medicare payment reform on the entry and exit of post-acute providers (home health agencies and skilled nursing facilities). They found that payment reforms reducing average and marginal payments reduced entries and increased exits from the market, with entries more likely to be affected.
AHRQ-funded; HS018541
Citation: Huckfeldt PJ, Sood NB, Romley JA .
Medicare payment reform and provider entry and exit in the post-acute care market.
Health Serv Res. 2013 Oct;48(5):1557-80. doi: 10.1111/1475-6773.12059..
Keywords: Medicare, Critical Care, Healthcare Costs, Home Healthcare, Long-Term Care
Sheppard KD, Brown CJ, Hearld KR
Symptom burden predicts nursing home admissions among older adults.
Using a sample of community-dwelling Medicare beneficiaries in Alabama who were contacted by telephone every 6 months during an eight and a half-year study, researchers found that symptom burden is an independent risk factor for NH admission. The study suggests that symptom assessment and management may reduce NH utilization.
AHRQ-funded; HS013852
Citation: Sheppard KD, Brown CJ, Hearld KR .
Symptom burden predicts nursing home admissions among older adults.
J Pain Symptom Manage. 2013 Oct;46(4):591-7. doi: 10.1016/j.jpainsymman.2012.10...
Keywords: Medicare, Long-Term Care, Elderly, Nursing Homes, Healthcare Costs
O'Donnell BE, Schneider KM, Brooks JM
Standardizing Medicare payment information to support examining geographic variation in costs.
This paper describes a method for standardizing claim payments, and demonstrates the difference in actual versus standardized payments by geographic region. It found that without standardization of payments, certain areas of the country are mischaracterized as either high or low healthcare resource-consuming areas.
AHRQ-funded; HS019574; HS019440.
Citation: O'Donnell BE, Schneider KM, Brooks JM .
Standardizing Medicare payment information to support examining geographic variation in costs.
Medicare Medicaid Res Rev 2013 Sep 10;3(3). doi: 10.5600/mmrr.003.03.a06..
Keywords: Medicare, Healthcare Costs, Hospitalization, Hospitals
Suskind AM, Clemens JQ, Dunn RL
Effectiveness of mesh compared with nonmesh sling surgery in Medicare beneficiaries.
This study assessed the effectiveness of mesh compared to nonmesh slings in the surgical treatment of female incontinence. It found that overall rates of complications were similar for patients undergoing either mesh or nonmesh sling procedures. However, patients undergoing the nonmesh procedure were more likely to require a subsequent intervention for bladder outlet obstruction.
AHRQ-funded; HS018726.
Citation: Suskind AM, Clemens JQ, Dunn RL .
Effectiveness of mesh compared with nonmesh sling surgery in Medicare beneficiaries.
Obstet Gynecol. 2013 Sep;122(3):546-52. doi: 10.1097/AOG.0b013e31829e8543..
Keywords: Comparative Effectiveness, Elderly, Patient-Centered Outcomes Research, Surgery, Women, Outcomes, Medicare, Evidence-Based Practice
Beaubrun AC, Kanda E, Bond TC
Form CMS-2728 data versus erythropoietin claims data: implications for quality of care studies.
The purpose of this study was to compare predialysis erythropoietin-simulating agents (ESA) care reported on Form CMS-2728 with Medicare claims for ESA treatment submitted for patients 67 years and older at initiation of dialysis with Medicare as the primary payer. It found that the agreement between Form CMS-2728 and claims data is poor and discordant results are observed when comparing the use of these data sources to predict health outcomes.
AHRQ-funded; HS000032.
Citation: Beaubrun AC, Kanda E, Bond TC .
Form CMS-2728 data versus erythropoietin claims data: implications for quality of care studies.
Ren Fail 2013;35(3):320-6. doi: 10.3109/0886022x.2012.747967..
Keywords: Medicare, Data, Elderly, Quality of Care, Kidney Disease and Health
Henke RM, Maeda JL, Marder WD
AHRQ Author: Friedman BS, Wong HS
Medicare and commercial inpatient resource use: impact of hospital competition.
The authors examined the influence of hospital competition on small-area inpatient resource use by payer. Using HCUP data, they found that policies or incentives that promote or encourage competition in less competitive markets may reduce variation in resource use for both Medicare and private payers.
AHRQ-authored; AHRQ-funded; 290200600009C.
Citation: Henke RM, Maeda JL, Marder WD .
Medicare and commercial inpatient resource use: impact of hospital competition.
Am J Manag Care 2013 Jun;19(6):e238-48.
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Keywords: Healthcare Utilization, Healthcare Cost and Utilization Project (HCUP), Hospitals, Medicare