National Healthcare Quality and Disparities Report
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- Adverse Events (1)
- Blood Thinners (1)
- (-) Cardiovascular Conditions (25)
- Data (2)
- Disparities (1)
- Elderly (9)
- Evidence-Based Practice (2)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (3)
- Healthcare Costs (6)
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- Outcomes (4)
- Palliative Care (1)
- Patient-Centered Outcomes Research (3)
- Patient Adherence/Compliance (1)
- Patient Safety (1)
- Payment (4)
- Pneumonia (3)
- Policy (1)
- Provider Performance (2)
- Quality of Care (2)
- Racial and Ethnic Minorities (1)
- Registries (3)
- Risk (3)
- Sex Factors (1)
- Surgery (4)
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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 25 of 25 Research Studies DisplayedThompson MP, Stewart JW, Hou H
Determinants and outcomes associated with skilled nursing facility use after coronary artery bypass grafting: a statewide experience.
The purpose of this study was to assess determinants and outcomes related with Skilled nursing facility (SNF) use after isolated coronary artery bypass grafting. The study sample included 8,614 patients, with an average age of 73.3 years. A skilled nursing facility (SNF) was used by 22.3% of patients within 90 days of discharge and ranged from 3.2% to 58.3% across the 33 hospitals. Patients utilizing SNFs had a greater likelihood of being female, older, non-White, with greater comorbidities, worse cardiovascular function, a perioperative morbidity, and longer hospital lengths of stay. Outcomes were significantly worse for users of SNFs, including higher rates of 90-day readmissions and ED visits and lower use of home health and rehabilitation services. Compared with non-SNF users, users of SNFs had a greater risk-adjusted hazard of mortality and had 2.7-percentage point greater 5-year mortality rate in a propensity-matched cohort of patients.
AHRQ-funded; HS027830.
Citation: Thompson MP, Stewart JW, Hou H .
Determinants and outcomes associated with skilled nursing facility use after coronary artery bypass grafting: a statewide experience.
Circ Cardiovasc Qual Outcomes 2023 Oct; 16(10):e009639. doi: 10.1161/circoutcomes.122.009639..
Keywords: Elderly, Nursing Homes, Heart Disease and Health, Cardiovascular Conditions, Medicare, Surgery
Likosky DS, Yang G, Zhang M
Interhospital variability in health care-associated infections and payments after durable ventricular assist device implant among Medicare beneficiaries.
The purpose of this study was to examine differences in durable ventricular assist device implantation infection rates and associated costs across hospitals. The researchers utilized clinical data for 8,688 patients who received primary durable ventricular assist devices from the Society of Thoracic Surgeons Interagency Registry for Mechanically Assisted Circulatory Support (Intermacs) hospitals (n = 120) and merged that data with post-implantation 90-day Medicare claims. The primary outcome included infections within 90 days of implantation and Medicare payments. The study found that 27.8% of patients developed 3982 identified infections. The median adjusted incidence of infections (per 100 patient-months) across hospitals was 14.3 and differed according to hospital. Total Medicare payments from implantation to 90 days were 9.0% more in high versus low infection tercile hospitals. The researchers concluded that health-care-associated infection rates post durable ventricular assist device implantation varied according to hospital and were associated with increased 90-day Medicare expenditures.
AHRQ-funded; HS026003.
Citation: Likosky DS, Yang G, Zhang M .
Interhospital variability in health care-associated infections and payments after durable ventricular assist device implant among Medicare beneficiaries.
J Thorac Cardiovasc Surg 2022 Nov;164(5):1561-68. doi: 10.1016/j.jtcvs.2021.04.074..
Keywords: Healthcare-Associated Infections (HAIs), Medical Devices, Medicare, Heart Disease and Health, Cardiovascular Conditions, Hospitals, Payment, Healthcare Costs
Kim KD, Funk RJ, Hou H
Association between care fragmentation and total spending after durable left ventricular device implant: a mediation analysis of health care-associated infections within a national Medicare-Society of Thoracic Surgeons INTERMACS linked dataset.
The purpose of this study was to examine the relationship between care fragmentation and total spending for durable left ventricular assisted device (LVAD) implant, and whether this relationship is mediated by infections. The researchers developed a measure of care fragmentation based on the number of shared medical professionals providing care to 4,987 Medicare beneficiaries undergoing LVAD implantation. The study found that the indirect effect of care fragmentation, through infections, was positive and statistically significant. The researchers concluded that higher care fragmentation associated with durable LVAD implantation is related with a greater incidence of infections and higher Medicare beneficiary payments.
AHRQ-funded; HS026003.
Citation: Kim KD, Funk RJ, Hou H .
Association between care fragmentation and total spending after durable left ventricular device implant: a mediation analysis of health care-associated infections within a national Medicare-Society of Thoracic Surgeons INTERMACS linked dataset.
Circ Cardiovasc Qual Outcomes 2022 Sep;15(9):e008592. doi: 10.1161/circoutcomes.121.008592..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Healthcare Costs, Healthcare-Associated Infections (HAIs), Medicare, Medical Devices, Healthcare Delivery
Groeneveld PW, Yang L, Segal AG
The effects of market competition on cardiologists' adoption of transcatheter aortic valve replacement.
This study examined the effects of market competition and unique regulations on cardiologists’ adoption of transcatheter aortic valve replacement (TAVR). This new technology was introduced around 2012. This retrospective cohort study looked at physician group practices (n=5116) from May 2012 through December 2014. Medicare claim data was used to indicate first usage. The Herfindahl-Hirschman Index was used to show that every 1000 point increase was associated with a 26% relative increase in the rate of TAVR adoption. This was most true in concentrated markets, and adoption of TAVR was favored by physician groups with greater market power.
AHRQ-funded; HS023615.
Citation: Groeneveld PW, Yang L, Segal AG .
The effects of market competition on cardiologists' adoption of transcatheter aortic valve replacement.
Med Care 2020 Nov;58(11):996-1003. doi: 10.1097/mlr.0000000000001391..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Surgery, Medicare
Khera R, Kondamudi N, Zhong L
Temporal trends in heart failure incidence among Medicare
This retrospective, national cohort study looked at temporal trends in heart failure (HF) incidence among Medicare beneficiaries from 2011 to 2016. There had been a decline in claims during that time period. Five percent of all fee-for-service Medicare beneficiaries with no prior HF diagnosis were followed up from 2011-2016. Annual trends were examined in HF incidence among groups with and without primary HF risk factors (hypertension, diabetes, and obesity) and predisposing cardiovascular conditions (acute myocardial infarction (MI) and atrial fibrillation (AF). Of the approximately 1.8 million Medicare beneficiaries at risk for HF, 249,832 had a new diagnosis of HF. The prevalence of all 5 risk factors had increased during the 5-year study period. There was a relative decline in HF incidence among beneficiaries with primary HF risk factors, but incidence increased among individuals with acute MI and AF.
AHRQ-funded; HS022418.
Citation: Khera R, Kondamudi N, Zhong L .
Temporal trends in heart failure incidence among Medicare
JAMA Netw Open 2020 Oct;3(10):e2022190. doi: 10.1001/jamanetworkopen.2020.22190.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Medicare, Risk, Elderly, Mortality
Wang Y, Eldridge N, Metersky ML
AHRQ Author: Eldridge N, Rodrick D
Association between Medicare expenditures and adverse events for patients with acute myocardial infarction, heart failure, or pneumonia in the United States.
The purpose of this study was to evaluate whether hospital-specific adverse event rates were associated with hospital-specific risk-standardized 30-day episode-of-care Medicare expenditures for fee-for-service patients discharged with acute myocardial infarction (AMI), heart failure (HF), or pneumonia. Investigators concluded that hospitals with high adverse event rates were more likely to have high 30-day episode-of-care Medicare expenditures for patients discharged with AMI, HF, or pneumonia.
AHRQ-authored; AHRQ-funded; 290201200003C.
Citation: Wang Y, Eldridge N, Metersky ML .
Association between Medicare expenditures and adverse events for patients with acute myocardial infarction, heart failure, or pneumonia in the United States.
JAMA Netw Open 2020 Apr;3(4):e202142. doi: 10.1001/jamanetworkopen.2020.2142..
Keywords: Adverse Events, Patient Safety, Heart Disease and Health, Cardiovascular Conditions, Pneumonia, Medicare, Healthcare Costs
Goldstone AB, Chiu P, Baiocchi M
Interfacility transfer of Medicare beneficiaries with acute type a aortic dissection and regionalization of care in the United States.
Researchers investigated the hypothesis that regionalizing care at high-volume hospitals for acute type A aortic dissections will lower mortality. Operative mortality and long-term survival were compared for Medicare beneficiaries diagnosed with an acute type A aortic dissection who were transferred versus not transferred, underwent surgery at high-volume versus low-volume hospitals, and were rerouted versus not rerouted to a high-volume hospital for treatment. The researchers found that, despite delaying surgery, a regionalization policy that transfers patients to high-volume hospitals was associated with a 7.2% absolute risk reduction in operative mortality. They recommended that policymakers evaluate the feasibility and benefits of regionalizing the surgical treatment of acute type A aortic dissection in the United States.
AHRQ-funded; HS022192.
Citation: Goldstone AB, Chiu P, Baiocchi M .
Interfacility transfer of Medicare beneficiaries with acute type a aortic dissection and regionalization of care in the United States.
Circulation 2019 Oct 8;140(15):1239-50. doi: 10.1161/circulationaha.118.038867..
Keywords: Transitions of Care, Medicare, Heart Disease and Health, Cardiovascular Conditions, Patient-Centered Outcomes Research, Risk, Evidence-Based Practice, Mortality, Hospitals
Kundi H, Popma JJ, Valsdottir LR
The value of claims-based nontraditional risk factors in predicting long-term mortality after MitraClip procedure.
The goals of this study were to identify nontraditional risk factors coded in administrative claims data and to evaluate their ability to improve prediction of long-term mortality in patients undergoing percutaneous mitral valve repair. Patients undergoing transcatheter mitral valve repair using MitraClip implantation were identified among Medicare fee-for-service beneficiaries; researchers used nested Cox regression models to identify claims codes predictive of long-term mortality. Four groups of variables were introduced: cardiac, noncardiac, and nontraditional risk factors, and presentation characteristics. The authors conclude that risk-prediction models, which include nontraditional risk factors as identified in claims data, can be used to predict long-term mortality risk more accurately in patients who have undergone MitraClip procedures.
AHRQ-funded; HS024520.
Citation: Kundi H, Popma JJ, Valsdottir LR .
The value of claims-based nontraditional risk factors in predicting long-term mortality after MitraClip procedure.
Can J Cardiol 2018 Dec;34(12):1648-54. doi: 10.1016/j.cjca.2018.10.002..
Keywords: Cardiovascular Conditions, Elderly, Mortality, Heart Disease and Health, Medicare, Risk, Surgery
Sukul D, Ryan AM, Yan P
Cardiologist participation in accountable care organizations and changes in spending and quality for Medicare patients with cardiovascular disease.
Despite widespread adoption of Medicare accountable care organizations (ACOs), healthcare spending reductions have been modest. This may relate to variable participation in ACOs by specialist physicians, who disproportionately drive spending. In this study, the investigators analyzed national Medicare data to examine whether specialist participation in Medicare ACOs was associated with changes in healthcare spending and clinical quality.
AHRQ-funded; HS024728; HS025615; HS024525.
Citation: Sukul D, Ryan AM, Yan P .
Cardiologist participation in accountable care organizations and changes in spending and quality for Medicare patients with cardiovascular disease.
Circ Cardiovasc Qual Outcomes 2019 Sep;12(9):e005438. doi: 10.1161/circoutcomes.118.005438..
Keywords: Cardiovascular Conditions, Healthcare Costs, Heart Disease and Health, Medicare, Quality of Care
Blecker S, Herrin J, Li L
Trends in hospital readmission of Medicare-covered patients with heart failure.
This study sought to compare trends in Medicare risk-adjusted, 30-day readmissions following principal heart failure (HF) hospitalizations and other hospitalizations with HF. The investigators found that patients with HF are often hospitalized for other causes, and these hospitalizations have high readmission rates. Policy changes led to decreases in readmission rates for both principal and secondary HF hospitalizations. Readmission rates in both groups remained high, suggesting that initiatives targeting all hospitalized patients with HF continue to be warranted.
AHRQ-funded; HS022882; HS023683.
Citation: Blecker S, Herrin J, Li L .
Trends in hospital readmission of Medicare-covered patients with heart failure.
J Am Coll Cardiol 2019 Mar 12;73(9):1004-12. doi: 10.1016/j.jacc.2018.12.040..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Hospital Readmissions, Hospitalization, Medicare, Policy
Huckfeldt P, Escarce J, Sood N
Thirty-day postdischarge mortality among black and white patients 65 years and older in the Medicare Hospital Readmissions Reduction Program.
The goal of this cohort study was to determine whether short-term mortality rates increased among black and white adults 65 years and older after initiation of the Medicare Hospital Readmissions Reduction Program (HRRP) and whether trends differed by race. Using an interrupted time-series analysis, the researchers found that short-term post-discharge mortality did not appear to increase for black patients under the HRRP, suggesting that certain value-based payment policies can be implemented without harming black populations. However, mortality seemed to increase for white patients with heart failure; this situation warrants investigation.
AHRQ-funded; HS025394.
Citation: Huckfeldt P, Escarce J, Sood N .
Thirty-day postdischarge mortality among black and white patients 65 years and older in the Medicare Hospital Readmissions Reduction Program.
JAMA Netw Open 2019 Mar;2(3):e190634. doi: 10.1001/jamanetworkopen.2019.0634..
Keywords: Medicare, Elderly, Mortality, Heart Disease and Health, Cardiovascular Conditions, Hospital Discharge
Doll JA, Hellkamp AS, Thomas L
The association of pre- and posthospital medication adherence in myocardial infarction patients.
Nonadherence to optimal medical therapy following myocardial infarction (MI) is associated with adverse clinical outcomes such as stent thrombosis, recurrent cardiovascular events, and death. Whether adherence to medications prior to MI predicts post-MI medication adherence is unknown. In this study, the investigators assessed adherence to P2Y12 inhibitors and statins before and after admission for MI among 8,147 MI patients who had Medicare insurance with Part D prescription coverage.
AHRQ-funded; HS021092.
Citation: Doll JA, Hellkamp AS, Thomas L .
The association of pre- and posthospital medication adherence in myocardial infarction patients.
Am Heart J 2019 Feb;208:74-80. doi: 10.1016/j.ahj.2018.11.004..
Keywords: Cardiovascular Conditions, Elderly, Heart Disease and Health, Medicare, Medication, Patient Adherence/Compliance
Meddings J, Smith SN, Hofer TP
Mixed messages to consumers from Medicare: Hospital Compare grades versus value-based payment penalty.
This study examined the discrepancy of ratings with hospitals with low readmission grades for heart failure (HF) and acute myocardial infarction (AMI) on the Hospital Compare website, yet received penalties for excessive readmissions under the hospital Readmissions Reduction Program. A retrospective data analysis was conducted of 2956 hospitals that had publicly reported HF grades on Hospital Compare. Of those, 92% were graded as “no different” than the national rate for HD readmissions, yet included 48.6% that were scored as having excessive HF admissions and 87% received an overall readmission penalty. Of the 120 hospitals graded as “better”, none were scored as having excessive HF readmissions and 50% were penalized. There were similar results for AMI.
AHRQ-funded; HS018334; HS019767.
Citation: Meddings J, Smith SN, Hofer TP .
Mixed messages to consumers from Medicare: Hospital Compare grades versus value-based payment penalty.
Am J Manag Care 2018 Dec;24(12):e399-e403..
Keywords: Medicare, Hospital Readmissions, Heart Disease and Health, Hospitals, Quality of Care, Cardiovascular Conditions, Provider Performance, Payment
Huckfeldt P, Escarce J, Wilcock A
HF mortality trends under Medicare readmissions reduction program at penalized and nonpenalized hospitals.
After announcement and implementation of the Medicare Hospital Readmissions Reduction Program (HRRP), 30-day readmissions declined rapidly among seniors with heart failure (HF) while 30-day mortality rose. This raised questions about whether the policy was responsible, because lower HF readmission rates have historically been associated with higher mortality. In this study, the investigators compared trends in heart failure (HF) mortality at penalized and nonpenalized hospitals nationally.
AHRQ-funded; HS024284.
Citation: Huckfeldt P, Escarce J, Wilcock A .
HF mortality trends under Medicare readmissions reduction program at penalized and nonpenalized hospitals.
J Am Coll Cardiol 2018 Nov 13;72(20):2539-40. doi: 10.1016/j.jacc.2018.08.2174..
Keywords: Mortality, Heart Disease and Health, Cardiovascular Conditions, Hospital Readmissions, Medicare, Hospitals, Provider Performance, Payment
Desai NR, Ott LS, George EJ
Variation in and hospital characteristics associated with the value of care for Medicare beneficiaries with acute myocardial infarction, heart failure, and pneumonia.
The objectives of this study were to investigate the association between hospital-level 30-day risk-standardized mortality rates (RSMRs) and 30-day risk-standardized payments (RSPs) for acute myocardial infarction (AMI), heart failure (HF), and pneumonia (PNA); to characterize patterns of value in care; and to identify hospital characteristics associated with high-value care (defined by having lower than median RSMRs and RSPs).
AHRQ-funded; HS023000.
Citation: Desai NR, Ott LS, George EJ .
Variation in and hospital characteristics associated with the value of care for Medicare beneficiaries with acute myocardial infarction, heart failure, and pneumonia.
JAMA Netw Open 2018 Oct 5;1(6):e183519. doi: 10.1001/jamanetworkopen.2018.3519..
Keywords: Cardiovascular Conditions, Elderly, Hospitalization, Hospitals, Heart Disease and Health, Inpatient Care, Medicare, Mortality, Pneumonia
Rymer JA, Chen AY, Thomas L
Advanced practice provider versus physician-only outpatient follow-up after acute myocardial infarction.
This study examines the prevalence of using advanced practice providers (APPs) for care following myocardial infarction as opposed to physicians due to physician shortages and reimbursement changes. Outpatient cardiology or primary care visits within 90 days of MI among 29,477 Medicare-insured patients aged 65 or older from 364 hospitals were examined from data in the Acute Coronary Treatment Intervention Outcomes Network Registry. Medicare adherence, all-cause readmission risk, mortality, and major adverse cardiovascular events were compared for patients seen by APPs versus physicians only. Patients seen by APPs were more likely to have diabetes mellitus, heart failure, be discharged to a nursing facility, and had more outpatient visits. There was no differences in the factors listed between patients seen by APPs or physicians. Patients seen by APPs were in more need of frequent monitoring and were more likely to have other chronic conditions leading to higher risk of post-MI complications.
AHRQ-funded; HS021092.
Citation: Rymer JA, Chen AY, Thomas L .
Advanced practice provider versus physician-only outpatient follow-up after acute myocardial infarction.
J Am Heart Assoc 2018 Sep 4;7(17):e008481. doi: 10.1161/jaha.117.008481..
Keywords: Cardiovascular Conditions, Elderly, Heart Disease and Health, Medicare, Outcomes, Patient-Centered Outcomes Research, Registries
Thompson MP, Cabrera L, Strobel RJ
Association between postoperative pneumonia and 90-day episode payments and outcomes among Medicare beneficiaries undergoing cardiac surgery.
Postoperative pneumonia is the most common healthcare-associated infection in cardiac surgical patients, yet their impact across a 90-day episode of care remains unknown. The objective of this study was to examine the relationship between pneumonia and 90-day episode payments and outcomes among Medicare beneficiaries undergoing cardiac surgery. The investigators concluded that postoperative pneumonia was associated with significantly higher 90-day episode payments and inferior outcomes at the patient and hospital level.
AHRQ-funded; HS022535.
Citation: Thompson MP, Cabrera L, Strobel RJ .
Association between postoperative pneumonia and 90-day episode payments and outcomes among Medicare beneficiaries undergoing cardiac surgery.
Circ Cardiovasc Qual Outcomes 2018 Sep;11(9):e004818. doi: 10.1161/circoutcomes.118.004818..
Keywords: Elderly, Surgery, Medicare, Cardiovascular Conditions, Heart Disease and Health, Pneumonia, Payment, Healthcare Costs, Outcomes, Healthcare-Associated Infections (HAIs), Health Insurance
Angraal S, Khera R, Wang Y
Sex and race differences in the utilization and outcomes of coronary artery bypass grafting among Medicare beneficiaries, 1999-2014.
The authors sought to evaluate how the use of coronary artery bypass grafting (CABG) and its outcomes have evolved in different sex and racial subgroups. Using Medicare data, they found that women and black patients had persistently higher CABG mortality than men and white patients, respectively, despite greater declines over the time period. The authors conclude that these findings indicate progress, but further progress is needed.
AHRQ-funded; HS023000.
Citation: Angraal S, Khera R, Wang Y .
Sex and race differences in the utilization and outcomes of coronary artery bypass grafting among Medicare beneficiaries, 1999-2014.
J Am Heart Assoc 2018 Jul 12;7(14). doi: 10.1161/jaha.118.009014..
Keywords: Cardiovascular Conditions, Elderly, Evidence-Based Practice, Heart Disease and Health, Healthcare Utilization, Medicare, Outcomes, Patient-Centered Outcomes Research, Racial and Ethnic Minorities, Sex Factors
Hollingsworth JM, Nallamothu BK, Yan P
Medicare accountable care organizations are not associated with reductions in the use of low-value coronary revascularization.
This study examined national Medicare data to determine whether or not Medicare accountable care organizations are associated with reductions in the use of low-value coronary revascularization. The investigators found no association between provider group participation in a Medicare ACO and use of low- or high-value coronary revascularization.
AHRQ-funded; HS024525; HS024728.
Citation: Hollingsworth JM, Nallamothu BK, Yan P .
Medicare accountable care organizations are not associated with reductions in the use of low-value coronary revascularization.
Circ Cardiovasc Qual Outcomes 2018 Jun;11(6):e004492. doi: 10.1161/circoutcomes.117.004492..
Keywords: Cardiovascular Conditions, Healthcare Utilization, Medicare, Heart Disease and Health
Liang Q, Ward S, Pagani FD
Linkage of Medicare records to the interagency registry of mechanically assisted circulatory support.
This study merged Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) records with CMS Medicare claims regarding adults receiving durable FDA-approved mechanical circulatory support devices (MCSDs) in order to investigate the uncertainty of penetrance of Medicare beneficiaries within INTERMACS. The results indicated that there was an annual increase in CMS and INTERMACS centers performing durable MCSD implants among adults from 2008 to 2013, but the CMS centers outnumbered the INTERMAC centers throughout this period. Representation within INTERMACS of MCSDs implanted in Medicare beneficiaries more than doubled in 2013. The authors conclude that ‘the vast majority’ of Medicare beneficiaries receiving MCSDs are increasingly captured in INTERMACS, and that contemporary studies in INTERMACS are therefore relevant and generalizable to the Medicare population.
AHRQ-funded; HS022535.
Citation: Liang Q, Ward S, Pagani FD .
Linkage of Medicare records to the interagency registry of mechanically assisted circulatory support.
Ann Thorac Surg 2018 May;105(5):1397-402. doi: 10.1016/j.athoracsur.2017.11.044..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Data, Medicare, Registries
Liang Q, Ward S, Pagani FD
Linkage of Medicare records to the interagency registry of mechanically assisted circulatory support.
This study merged Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) records with CMS Medicare claims regarding adults receiving durable FDA-approved mechanical circulatory support devices (MCSDs) in order to investigate the uncertainty of penetrance of Medicare beneficiaries within INTERMACS. The results indicated that there was an annual increase in CMS and INTERMACS centers performing durable MCSD implants among adults from 2008 to 2013, but the CMS centers outnumbered the INTERMAC centers throughout this period. Representation within INTERMACS of MCSDs implanted in Medicare beneficiaries more than doubled in 2013. The authors conclude that ‘the vast majority’ of Medicare beneficiaries receiving MCSDs are increasingly captured in INTERMACS, and that contemporary studies in INTERMACS are therefore relevant and generalizable to the Medicare population.
AHRQ-funded; HS022535.
Citation: Liang Q, Ward S, Pagani FD .
Linkage of Medicare records to the interagency registry of mechanically assisted circulatory support.
Ann Thorac Surg 2018 May;105(5):1397-402. doi: 10.1016/j.athoracsur.2017.11.044..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Data, Medicare, Registries
Yim CK, Barron Y, Moore S
Hospice enrollment in patients with advanced heart failure decreases acute medical service utilization.
Patients with advanced heart failure (HF) enroll in hospice at low rates, and data on their acute medical service utilization after hospice enrollment is limited. This descriptive analysis of Medicare fee-for-service beneficiaries found that home health care Medicare beneficiaries with advanced HF who enrolled in hospice had lower acute medical service utilization after their enrollment.
AHRQ-funded; HS020257.
Citation: Yim CK, Barron Y, Moore S .
Hospice enrollment in patients with advanced heart failure decreases acute medical service utilization.
Circ Heart Fail 2017 Mar;10(3). doi: 10.1161/circheartfailure.116.003335.
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Keywords: Cardiovascular Conditions, Heart Disease and Health, Healthcare Utilization, Medicare, Palliative Care
Vaughan Sarrazin MS, Jones M, Mazur A
Cost of hospital admissions in Medicare patients with atrial fibrillation taking warfarin, dabigatran, or rivaroxaban.
The purpose of this study was to examine the impact of anticoagulant choice on inpatient costs in patients with nonvalvular atrial fibrillation (AF). Analysis used 3-way propensity matching to create groups from AF patients taking dabigatran, rivaroxaban, or warfarin, and were plausible candidates for all 3 anticoagulants. Predicted values from two models were multiplied together to estimate expected costs per patient-year. The study concludes from its data that patients with newly diagnosed AF taking 150 mg dabigatran or 20 mg rivaroxaban experience lower annual inpatient costs than patients taking warfarin, due to fewer hospital admissions for stroke, non-gastrointestinal-related hemorrhages, and heart failure events.
AHRQ-funded; HS023104.
Citation: Vaughan Sarrazin MS, Jones M, Mazur A .
Cost of hospital admissions in Medicare patients with atrial fibrillation taking warfarin, dabigatran, or rivaroxaban.
J Am Coll Cardiol 2017 Jan 24;69(3):360-62. doi: 10.1016/j.jacc.2016.11.023..
Keywords: Blood Thinners, Heart Disease and Health, Medication, Healthcare Costs, Medicare, Hospitalization, Cardiovascular Conditions
Dhruva SS, Desai NR, Karaca-Mandic P
Medicare formulary changes after the 2013 American College of Cardiology/American Heart Association Cholesterol Guideline.
This letter describes a study which examined the use of statins and non-statin medications at Medicare formularies before and after the 2013 American College of Cardiology/American Heart Association (ACC/AHA) cholesterol guideline was released. The study found that while many formularies did restrict nonstatin medications as per the new guidelines, many others did not.
AHRQ-funded; HS023000.
Citation: Dhruva SS, Desai NR, Karaca-Mandic P .
Medicare formulary changes after the 2013 American College of Cardiology/American Heart Association Cholesterol Guideline.
J Am Coll Cardiol 2017 Jan 17;69(2):244-46. doi: 10.1016/j.jacc.2016.10.053..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Guidelines, Medicare, Medication
Wallaert JB, Nolan BW, Stone DH
Physician specialty and variation in carotid revascularization technique selected for Medicare patients.
The researchers investigated whether the choice of carotid artery stenting (CAS) vs. carotid endarterectomy (CEA) varies as a function of treating physician specialty, which would result in regional variation in the relative use of these treatment types They found that the proportion of all carotid revascularization procedures performed as CAS varies markedly by geographic region, and regions with the highest proportion of cardiologists perform the most CAS procedures.
AHRQ-funded; HS021581.
Citation: Wallaert JB, Nolan BW, Stone DH .
Physician specialty and variation in carotid revascularization technique selected for Medicare patients.
J Vasc Surg 2016 Jan;63(1):89-97. doi: 10.1016/j.jvs.2015.08.068.
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Keywords: Heart Disease and Health, Medicare, Cardiovascular Conditions, Disparities, Outcomes