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AHRQ Research Studies Date
Topics
- Arthritis (1)
- Comparative Effectiveness (1)
- Depression (1)
- (-) Elderly (20)
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- Pneumonia (1)
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- Provider: Pharmacist (1)
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- Rural Health (1)
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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
1 to 20 of 20 Research Studies DisplayedJohnson SL, Palta M, Bartels CM
Examining systemic steroid use in older inflammatory bowel disease patients using hurdle models: a cohort study.
In order to evaluate the relationship between patient characteristics and the frequency and duration of incident steroid use, the researchers applied a 2-part hurdle model to Medicare data. Their study identified differences in predictors of frequency and duration of medication use and suggests the utility of two-part models to examine drug utilization patterns.
AHRQ-funded; HS022786.
Citation: Johnson SL, Palta M, Bartels CM .
Examining systemic steroid use in older inflammatory bowel disease patients using hurdle models: a cohort study.
BMC Pharmacol Toxicol 2015 Dec 8;16:34. doi: 10.1186/s40360-015-0034-9..
Keywords: Elderly, Medicare, Medication
Yun H, Xie F, Delzell E
The comparative effectiveness of biologics among older adults and disabled rheumatoid arthritis patients in the Medicare population.
Older and disabled rheumatoid arthritis (RA) patients are often not present in large numbers in clinical trials or registries. Using a novel, claims-based clinical effectiveness algorithm with the potential to compare the effectiveness of different biologics among this population using large administrative databases, researchers found that abatacept, adalimumab and etanercept are more effective than infliximab among RA patients initiating biologics.
AHRQ-funded; HS021694; HS023009; HS018517.
Citation: Yun H, Xie F, Delzell E .
The comparative effectiveness of biologics among older adults and disabled rheumatoid arthritis patients in the Medicare population.
Br J Clin Pharmacol 2015 Dec;80(6):1447-57. doi: 10.1111/bcp.12709.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Elderly, Arthritis, Medicare
Sanghavi P, Jena Newhouse, JP
Outcomes of basic versus advanced life support for out-of-hospital medical emergencies.
The researchers compared outcomes after advanced life support (ALS) and basic life support (BLS) in out-of-hospital medical emergencies. They found that advanced life support is associated with substantially higher mortality for several acute medical emergencies than BLS.
AHRQ-funded; HS022798.
Citation: Sanghavi P, Jena Newhouse, JP .
Outcomes of basic versus advanced life support for out-of-hospital medical emergencies.
Ann Intern Med 2015 Nov 3;163(9):681-90. doi: 10.7326/m15-0557..
Keywords: Elderly, Medicare, Emergency Medical Services (EMS), Outcomes
Pfoh E, Mojtabai R, Bailey J
Impact of Medicare annual wellness visits on uptake of depression screening.
This study assessed whether patients with an initial annual wellness visit (AWV) were more likely to be screened for depression than those with a primary care visit. Fifteen percent of patients with non-AWVs and 10 percent of patients with AWVs received depression screening. After accounting for clustering, there was no statistically significant difference in depression screening by visit type.
AHRQ-funded; HS000029.
Citation: Pfoh E, Mojtabai R, Bailey J .
Impact of Medicare annual wellness visits on uptake of depression screening.
Psychiatr Serv 2015 Nov;66(11):1207-12. doi: 10.1176/appi.ps.201400524.
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Keywords: Depression, Screening, Medicare, Elderly, Primary Care
Ndumele CD, Sommers BD, Trivedi AN
The ACA's 65th birthday challenge: moving from Medicaid to Medicare.
Following the Affordable Care Act’s coverage expansion, many newly-insured older enrollees will lose Medicaid coverage on their 65th birthday and transition from Medicaid to Medicare as their primary insurer. This article discusses the transition in primary health insurance coverage that includes changes to benefits, patient cost-sharing, and provider reimbursement, which could have profound consequences on the use of health services and associated health outcomes for low-income seniors.
AHRQ-funded; HS021291.
Citation: Ndumele CD, Sommers BD, Trivedi AN .
The ACA's 65th birthday challenge: moving from Medicaid to Medicare.
J Gen Intern Med 2015 Nov;30(11):1704-6. doi: 10.1007/s11606-015-3328-0..
Keywords: Health Insurance, Medicare, Elderly, Low-Income
Singh S, Lin YL, Nattinger AB
Variation in readmission rates by emergency departments and emergency department providers caring for patients after discharge.
This study of Texas acute-care hospitals and ED facilities has found that the risk of readmission varies by ED provider caring for patients after discharge. A large part of this variation is explained by the ED facility in which the ED providers practice. Thus, ED provider practices patterns and ED facility systems of care may be a target for interventions to reduce readmissions.
AHRQ-funded; HS022134.
Citation: Singh S, Lin YL, Nattinger AB .
Variation in readmission rates by emergency departments and emergency department providers caring for patients after discharge.
J Hosp Med 2015 Nov;10(11):705-10. doi: 10.1002/jhm.2407.
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Keywords: Emergency Department, Elderly, Hospital Discharge, Hospital Readmissions, Medicare
Toth M, Holmes M, Van Houtven C
Rural Medicare beneficiaries have fewer follow-up visits and greater emergency department use postdischarge.
This study tested whether rural Medicare beneficiaries have a lower likelihood of follow-up care and greater likelihood of a readmission and ED visit within 30 days postdischarge, compared with urban beneficiaries. The results provide evidence of lower quality postdischarge care for Medicare beneficiaries in rural settings.
AHRQ-funded; HS000032.
Citation: Toth M, Holmes M, Van Houtven C .
Rural Medicare beneficiaries have fewer follow-up visits and greater emergency department use postdischarge.
Med Care 2015 Sep;53(9):800-8. doi: 10.1097/mlr.0000000000000401..
Keywords: Rural Health, Elderly, Medicare, Hospital Readmissions, Emergency Department, Hospital Discharge
Gill LE, Bartels SJ, Batsis JA
Weight management in older adults.
This overview highlights the challenges and implications of measuring adiposity in older adults and the dangers and benefits of weight loss in this population and provides an overview of the new Medicare Obesity Benefit. In addition, it provide a summary of outcomes from successful weight loss interventions for older adults and discuss implications for advancing clinical practice.
AHRQ-funded; HS0217695.
Citation: Gill LE, Bartels SJ, Batsis JA .
Weight management in older adults.
Curr Obes Rep 2015 Sep;4(3):379-88. doi: 10.1007/s13679-015-0161-z.
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Keywords: Elderly, Obesity: Weight Management, Obesity, Medicare
Carey K
Measuring the hospital length of stay/readmission cost trade-off under a bundled payment mechanism.
This paper investigates the relationship between length of stay and readmission within 30 days of discharge from an acute care hospitalization. It found that the cost of an additional day of stay was offset by expected cost savings from an avoided readmission in the range of 15 to 65 percent.
AHRQ-funded; HS020995.
Citation: Carey K .
Measuring the hospital length of stay/readmission cost trade-off under a bundled payment mechanism.
Health Econ 2015 Jul;24(7):790-802. doi: 10.1002/hec.3061..
Keywords: Hospital Readmissions, Hospitalization, Elderly, Hospital Discharge, Medicare
Suskind AM, Clemens JQ, Zhang Y
Physician use of sacral neuromodulation among Medicare beneficiaries with overactive bladder and urinary retention.
This study identified physician-level factors associated with high rates of sacral neuromodulation testing. It found that, over time, physicians are testing more patients but are not implanting more devices. Additionally, there is an inverse relationship between rates of device testing and implantation, suggesting opportunities to improve efficiency and resource utilization.
AHRQ-funded; HS018726.
Citation: Suskind AM, Clemens JQ, Zhang Y .
Physician use of sacral neuromodulation among Medicare beneficiaries with overactive bladder and urinary retention.
Urology 2015 Jul;86(1):30-4. doi: 10.1016/j.urology.2015.04.003..
Keywords: Elderly, Medicare, Treatments, Women
Briesacher BA, Madden JM, Zhang F
Did Medicare Part D affect national trends in health outcomes or hospitalizations? A time-series analysis.
The researchers examined changes in health outcomes and medical services in the Medicare population after implementation of Medicare Part D. They found that 5 years after implementation, and contrary to previous reports, there was no evidence of Part D's effect on a range of population-level health indicators among Medicare enrollees. Further, there was no clear evidence of gains in medical care efficiencies.
AHRQ-funded; HS018577
Citation: Briesacher BA, Madden JM, Zhang F .
Did Medicare Part D affect national trends in health outcomes or hospitalizations? A time-series analysis.
Ann Intern Med. 2015 Jun 16;162(12):825-33. doi: 10.7326/m14-0726..
Keywords: Hospitalization, Outcomes, Medicare, Health Status, Elderly
Kim N, Bernheim SM, Ott LS
An administrative claims measure of payments made for Medicare patients for a 30-day episode of care for acute myocardial infarction.
The authors developed a method for profiling hospitals by 30-day episode-of-care costs for acute myocardial infarction (AMI). Their final model included 30 variables and resulted in predictive ratios close to 1. When combined with quality measures, they think that their payment measure will help profile high-value care.
AHRQ-funded; HS016929.
Citation: Kim N, Bernheim SM, Ott LS .
An administrative claims measure of payments made for Medicare patients for a 30-day episode of care for acute myocardial infarction.
Med Care 2015 Jun;53(6):542-9. doi: 10.1097/mlr.0000000000000361.
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Keywords: Elderly, Payment, Medicare, Heart Disease and Health
Doucette WR, Pendergast JF, Zhang Y
Stimulating comprehensive medication reviews among Medicare Part D beneficiaries.
The authors assessed the impact of a patient engagement intervention utilizing the Medication User Self-Evaluation (MUSE) tool on the completion percentage of comprehensive medication reviews (CMRs) among Medicare Part D beneficiaries. They found that the estimated odds of having a CMR among those who received the MUSE intervention were 2 times that of their counterparts. They concluded that Part D plans could use the MUSE to engage targeted beneficiaries in using pharmacist-provided MTM services.
AHRQ-funded; HS018353.
Citation: Doucette WR, Pendergast JF, Zhang Y .
Stimulating comprehensive medication reviews among Medicare Part D beneficiaries.
Am J Manag Care 2015 Jun;21(6):e372-8.
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Keywords: Elderly, Medicare, Medication, Patient and Family Engagement, Provider: Pharmacist
Sjoding MW, Iwashyna TJ, Dimick JB
Gaming hospital-level pneumonia 30-day mortality and readmission measures by legitimate changes to diagnostic coding.
The researchers sought to determine the degree to which hospitals can game mortality or readmission measures and change their rankings by recoding patients with pneumonia. They concluded that hospitals can improve apparent pneumonia mortality and readmission rates by recoding pneumonia patients. Centers for Medicare and Medicaid Services should consider changes to their methods used to calculate hospital-level pneumonia outcome measures.
AHRQ-funded; HS020672.
Citation: Sjoding MW, Iwashyna TJ, Dimick JB .
Gaming hospital-level pneumonia 30-day mortality and readmission measures by legitimate changes to diagnostic coding.
Crit Care Med 2015 May;43(5):989-95. doi: 10.1097/ccm.0000000000000862..
Keywords: Elderly, Hospital Readmissions, Medicare, Mortality, Pneumonia, Quality Indicators (QIs)
Shah T, Churpek MM, Coca Perraillon M
Understanding why patients with COPD get readmitted: a large national study to delineate the Medicare population for the readmissions penalty expansion.
The Hospital Readmissions Reduction Program (HRRP) penalizes hospitals for 30-day readmissions and was extended to COPD in October 2014. The authors investigated readmission risk factors and reasons for readmission in order to guide hospitals in initiating programs to reduce COPD readmissions. They found that patients discharged home without home care were more likely to be readmitted for COPD than patients discharged to post-acute care, and those readmitted were more likely to be dually enrolled in Medicare and Medicaid, have a longer median length of stay, and have more comorbidities. They concluded that the addition of COPD to the readmissions penalty may further worsen the disproportionately high penalties seen in safety net hospitals.
AHRQ-funded; HS021877.
Citation: Shah T, Churpek MM, Coca Perraillon M .
Understanding why patients with COPD get readmitted: a large national study to delineate the Medicare population for the readmissions penalty expansion.
Chest 2015 May;147(5):1219-26. doi: 10.1378/chest.14-2181.
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Keywords: Respiratory Conditions, Elderly, Medicare, Hospital Readmissions
Lund BC, Schroeder MC, Middendorff G
Effect of hospitalization on inappropriate prescribing in elderly Medicare beneficiaries.
This study sought to determine whether acute hospitalization is associated with a change in potentially inappropriate medication (PIM) use and whether use varies across geographic region. It found that despite intervention studies demonstrating up to 80% reduction in PIM use during acute hospitalization, a significant increase in PIM use was observed in a naturalistic setting in Medicare beneficiaries with acute myocardial acute myocardial infarction.
AHRQ-funded; HS018381.
Citation: Lund BC, Schroeder MC, Middendorff G .
Effect of hospitalization on inappropriate prescribing in elderly Medicare beneficiaries.
J Am Geriatr Soc 2015 Apr;63(4):699-707. doi: 10.1111/jgs.13318..
Keywords: Hospitalization, Medicare, Elderly, Medication
Riall TS, Adhikari D, Parmar AD
The risk paradox: use of elective cholecystectomy in older patients is independent of their risk of developing complications.
For older patients with newly diagnosed symptomatic gallstones, researchers calculated their 2-year risk of emergent gallstone-related hospitalization. They found that patients in the high-risk group were less likely to receive elective cholecystectomy than those in the low-risk group. The study used Texas Medicare data for 161,568 patients with an episode of symptomatic gallstones.
AHRQ-funded; HS022134
Citation: Riall TS, Adhikari D, Parmar AD .
The risk paradox: use of elective cholecystectomy in older patients is independent of their risk of developing complications.
J Am Coll Surg. 2015 Apr;220(4):682-90. doi: 10.1016/j.jamcollsurg.2014.12.012..
Keywords: Hospitalization, Elderly, Medicare, Surgery
Nishi SP, Zhang W, Kuo YF
Oxygen therapy use in older adults with chronic obstructive pulmonary disease.
The researchers examined national trends and factors associated with the use of oxygen therapy and sustained oxygen therapy in older adults with COPD between 2001 and 2010. They found an increase in oxygen therapy use but a decrease in sustained oxygen therapy in fee-for-service Medicare beneficiaries with COPD from 2001 to 2010.
AHRQ-funded; HS022134; HS020642.
Citation: Nishi SP, Zhang W, Kuo YF .
Oxygen therapy use in older adults with chronic obstructive pulmonary disease.
PLoS One 2015 Mar 18;10(3):e0120684. doi: 10.1371/journal.pone.0120684..
Keywords: Elderly, Medicare, Respiratory Conditions
Davidoff AJ, Hendrick FB, Zeidan AM
AHRQ Author: Davidoff AJ
Patient cost sharing and receipt of erythropoiesis-stimulating agents through Medicare part D.
This study examined use of erythropoiesis-stimulating agents (ESAs) to manage anemia in patients with myelodysplastic syndromes (MDS). It found that few patients with MDS received ESAs through Part D. OOP payments required under Part D were substantially higher than under Part B. Cost sharing, as reflected by low-income subsidy receipt, likely affected decisions to prescribe ESAs outside of the physician office.
AHRQ-authored.
Citation: Davidoff AJ, Hendrick FB, Zeidan AM .
Patient cost sharing and receipt of erythropoiesis-stimulating agents through Medicare part D.
J Oncol Pract 2015 Mar;11(2):e190-8. doi: 10.1200/jop.2014.001527..
Keywords: Elderly, Healthcare Costs, Medicare, Medication
Gabayan GZ, Sarkisian CA, Liang LJ
Predictors of admission after emergency department discharge in older adults.
The objective of this study was to identify the incidence and predictors of admissions to nonfederal California hospitals within 7 days of ED discharge of older Medicare beneficiaries. It found that five percent of older Medicare beneficiaries have a hospital inpatient admission after discharge from the ED, with chronic disease such as renal disease and heart failure being associated with the greatest odds of admission.
AHRQ-funded; HS18098.
Citation: Gabayan GZ, Sarkisian CA, Liang LJ .
Predictors of admission after emergency department discharge in older adults.
J Am Geriatr Soc 2015 Jan;63(1):39-45. doi: 10.1111/jgs.13185..
Keywords: Elderly, Emergency Department, Hospital Discharge, Hospital Readmissions, Medicare