National Healthcare Quality and Disparities Report
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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 38 Research Studies DisplayedCooper LB, Lippmann SJ, Greiner MA
Use of mineralocorticoid receptor antagonists in patients with heart failure and comorbid diabetes mellitus or chronic kidney disease.
Perceived risks of hyperkalemia and acute renal insufficiency may limit use of mineralocorticoid receptor antagonist (MRA) therapy in patients with heart failure, especially those with diabetes mellitus or chronic kidney disease. In their study, the investigators found that among patients with heart failure and diabetes mellitus or chronic kidney disease, MRA use was associated with lower risk of all-cause readmission despite greater risk of hyperkalemia and acute renal insufficiency.
AHRQ-funded; HS021092.
Citation: Cooper LB, Lippmann SJ, Greiner MA .
Use of mineralocorticoid receptor antagonists in patients with heart failure and comorbid diabetes mellitus or chronic kidney disease.
J Am Heart Assoc 2017 Dec 23;6(12):pii: e006540. doi: 10.1161/jaha.117.006540..
Keywords: Cardiovascular Conditions, Chronic Conditions, Diabetes, Evidence-Based Practice, Heart Disease and Health, Kidney Disease and Health, Outcomes, Patient-Centered Outcomes Research, Registries
Ho V, Ross JS, Steiner CA
AHRQ Author: Steiner CA
A nationwide assessment of the association of smoking bans and cigarette taxes with hospitalizations for acute myocardial infarction, heart failure, and pneumonia.
No national study using complete hospitalization counts by area that accounts for contemporaneous controls including state cigarette taxes has been conducted. This study in 28 states found that smoking bans lowered pneumonia hospitalization rates for persons ages 60 to 74 years and higher cigarette taxes were associated with lower heart failure hospitalizations for all ages and fewer pneumonia hospitalizations for adults aged 60 to 74.
AHRQ-authored.
Citation: Ho V, Ross JS, Steiner CA .
A nationwide assessment of the association of smoking bans and cigarette taxes with hospitalizations for acute myocardial infarction, heart failure, and pneumonia.
Med Care Res Rev 2017 Dec;74(6):687-704. doi: 10.1177/1077558716668646.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Heart Disease and Health, Hospitalization, Pneumonia, Tobacco Use
Prochaska MT, Hohmann SF, Modes M
Trends in troponin-only testing for AMI in academic teaching hospitals and the impact of Choosing Wisely(R).
This study examined the variation in cardiac biomarker testing and the effect of the Choosing Wisely(R) troponin-only recommendation for the diagnosis of acute myocardial infarction (AMI). It concluded that in institutions with low rates of troponin-only testing prior to the Choosing Wisely(R) recommendation, the recommendation was associated with a significant increase in the rate of troponin-only testing.
AHRQ-funded; HS023007.
Citation: Prochaska MT, Hohmann SF, Modes M .
Trends in troponin-only testing for AMI in academic teaching hospitals and the impact of Choosing Wisely(R).
J Hosp Med 2017 Dec;12(12):957-62. doi: 10.12788/jhm.2846.
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Keywords: Cardiovascular Conditions, Medication, Heart Disease and Health, Patient-Centered Outcomes Research
Masterson Creber R, Chen T, Wei C
Brief report: patient activation among urban hospitalized patients with heart failure.
The purpose of this study was to identify whether patient activation is associated with patient-reported health outcomes in an urban and racially diverse inpatient sample of patients with heart failure. The study concluded that patient activation can be easily measured in hospitalized patients with heart failure and is associated with clinically meaningful patient-reported health outcomes.
AHRQ-funded; HS021816.
Citation: Masterson Creber R, Chen T, Wei C .
Brief report: patient activation among urban hospitalized patients with heart failure.
J Card Fail 2017 Nov;23(11):817-20. doi: 10.1016/j.cardfail.2017.08.452..
Keywords: Heart Disease and Health, Hospitalization, Patient and Family Engagement, Patient Self-Management, Urban Health
Zeitler EP, Al-Khatib SM, Friedman DJ
Predicting appropriate shocks in patients with heart failure: patient level meta-analysis from SCD-HeFT and MADIT II.
The study authors sought to identify characteristics predictive of appropriate shocks in patients with a primary prevention implantable cardioverter defibrillator (ICD). In this meta-analysis of patient level data from Multicenter Automatic Defibrillator Implantation Trial II and Sudden Cardiac Death in Heart Failure Trial, higher NYHA class, lower LVEF, no beta-blocker therapy, and single chamber ICD (vs. dual chamber) were significant predictors of appropriate shocks.
AHRQ-funded; HS018505.
Citation: Zeitler EP, Al-Khatib SM, Friedman DJ .
Predicting appropriate shocks in patients with heart failure: patient level meta-analysis from SCD-HeFT and MADIT II.
J Cardiovasc Electrophysiol 2017 Nov;28(11):1345-51. doi: 10.1111/jce.13307.
Keywords: Comparative Effectiveness, Heart Disease and Health, Medical Devices, Medical Devices, Risk
Zullo AR, Sharmin S, Lee Y
Secondary prevention medication use after myocardial infarction in U.S. nursing home residents.
This study evaluated new use of secondary prevention medications after acute myocardial infarction (AMI) in NH residents who were previously nonusers and to evaluate what factors were associated with use. More than one-third of older NH residents in the United States do not have any secondary prevention medications initiated after AMI, with fewer medications initiated in older residents; women; and those with, DNR orders, poor physical function, and cognitive impairment.
AHRQ-funded; HS022998.
Citation: Zullo AR, Sharmin S, Lee Y .
Secondary prevention medication use after myocardial infarction in U.S. nursing home residents.
J Am Geriatr Soc 2017 Nov;65(11):2397-404. doi: 10.1111/jgs.15144.
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Keywords: Elderly, Medication, Heart Disease and Health, Nursing Homes, Prevention
Bucholz EM, Strait KM, Dreyer RP
Sex differences in young patients with acute myocardial infarction: a VIRGO study analysis.
This study sought to compare young women and men at the time of acute myocardial infarction (AMI) on six domains of demographic and clinical factors in order to determine whether they have distinct profiles. The authors concluded that young women with AMI represent a distinct, higher-risk population that is different from young men.
AHRQ-funded; HS023000.
Citation: Bucholz EM, Strait KM, Dreyer RP .
Sex differences in young patients with acute myocardial infarction: a VIRGO study analysis.
Eur Heart J Acute Cardiovasc Care 2017 Oct;6(7):610-22. doi: 10.1177/2048872616661847..
Keywords: Heart Disease and Health, Patient-Centered Outcomes Research, Risk, Sex Factors
Amin AP, Bach RG, Caruso ML
Association of variation in contrast volume with acute kidney injury in patients undergoing percutaneous coronary intervention.
The purpose of this study was to examine the national variation in acute kidney injury (AKI) incidence and contrast use among US physicians and the variation's association with patients' risk of developing AKI after percutaneous coronary intervention (PCI). This cross-sectional study used the American College of Cardiology National Cardiovascular Data Registry (NCDR) CathPCI Registry to identify in-hospital care for percutaneous coronary intervention (PCI) in the United States.
AHRQ-funded; HS022481.
Citation: Amin AP, Bach RG, Caruso ML .
Association of variation in contrast volume with acute kidney injury in patients undergoing percutaneous coronary intervention.
JAMA Cardiol 2017 Sep;2(9):1007-12. doi: 10.1001/jamacardio.2017.2156..
Keywords: Adverse Events, Kidney Disease and Health, Cardiovascular Conditions, Patient Safety, Heart Disease and Health, Practice Patterns
Schelbert EB, Fridman Y, Wong TC
Temporal relation between myocardial fibrosis and heart failure with preserved ejection fraction: association with baseline disease severity and subsequent outcome.
The purpose of this observational cohort study was to investigate whether myocardial fibrosis was similarly prevalent both in those with heart failure with preserved ejection fraction (HFpEF) and those at risk for HFpEF, similarly associating with disease severity and outcomes. The investigators concluded that among myriad changes occurring during the apparent evolution of HFpEF where elevated BNP was prevalent, myocardial fibrosis was similarly prevalent in those with or at risk for HFpEF.
AHRQ-funded; HS019461.
Citation: Schelbert EB, Fridman Y, Wong TC .
Temporal relation between myocardial fibrosis and heart failure with preserved ejection fraction: association with baseline disease severity and subsequent outcome.
JAMA Cardiol 2017 Sep;2(9):995-1006. doi: 10.1001/jamacardio.2017.2511..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Heart Disease and Health
Handley MA, Quan J, Chao MT
Use of complementary health approaches among diverse primary care patients with type 2 diabetes and association with cardiometabolic outcomes: from the SF Bay Collaborative Research Network (SF Bay CRN).
The purpose of this study is to describe use of complementary health approaches (CHAs) among patients with type 2 diabetes, and independent associations between CHA use and Hemoglobin A1c (A1C) and lower-density lipoprotein (LDL) cholesterol. The study concluded that CHA use is common among patients with type 2 diabetes and may be associated with poor cardiometabolic control and medication adherence.
AHRQ-funded; HS022561.
Citation: Handley MA, Quan J, Chao MT .
Use of complementary health approaches among diverse primary care patients with type 2 diabetes and association with cardiometabolic outcomes: from the SF Bay Collaborative Research Network (SF Bay CRN).
J Am Board Fam Med 2017 Sep-Oct;30(5):624-31. doi: 10.3122/jabfm.2017.05.170030..
Keywords: Heart Disease and Health, Complementary and Alternative Medicine, Diabetes, Outcomes, Patient Self-Management
Qian F, Zhong Y, Hannan EL
Long-term comparative effectiveness of Endeavor zotarolimus-eluting and everolimus-eluting stents in New York.
Endeavor zotarolimus-eluting stents (E-ZES) and everolimus-eluting stents (EES) as second-generation stents were approved for use in percutaneous coronary interventions (PCIs) in 2008. The researchers aimed to evaluate the long-term outcomes of E-ZES vs. EES. They concluded that compared with patients receiving EES, patients receiving E-ZES had a significantly higher rate of 6-year all-cause mortality.
AHRQ-funded; HS022289.
Citation: Qian F, Zhong Y, Hannan EL .
Long-term comparative effectiveness of Endeavor zotarolimus-eluting and everolimus-eluting stents in New York.
Int J Cardiol 2017 Aug 15;241:437-43. doi: 10.1016/j.ijcard.2017.03.095.
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Keywords: Cardiovascular Conditions, Comparative Effectiveness, Medication, Patient-Centered Outcomes Research, Heart Disease and Health
Sinha SS, Sjoding MW, Sukul D
Changes in primary noncardiac diagnoses over time among elderly cardiac intensive care unit patients in the United States.
This study examined changes in primary noncardiac diagnoses among elderly patients admitted to a cardiac intensive care unit (CICU) during the past decade. More than half of all elderly patients with a CICU stay across the United States now have primary noncardiac diagnoses at discharge. These patients receive different types of care and have worse outcomes than patients with primary cardiac diagnoses.
AHRQ-funded; HS020672.
Citation: Sinha SS, Sjoding MW, Sukul D .
Changes in primary noncardiac diagnoses over time among elderly cardiac intensive care unit patients in the United States.
Circ Cardiovasc Qual Outcomes 2017 Aug;10(8):e003616. doi: 10.1161/circoutcomes.117.003616.
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Keywords: Elderly, Heart Disease and Health, Intensive Care Unit (ICU), Outcomes, Respiratory Conditions
Murtaugh CM, Deb P, Zhu C
Reducing readmissions among heart failure patients discharged to home health care: effectiveness of early and intensive nursing services and early physician follow-up.
This study compared the effectiveness of two "treatments"-early, intensive home health nursing and physician follow-up within a week-versus less intense and later postacute care in reducing readmissions among heart failure patients discharged to home health care. Neither treatment by itself had a statistically significant effect on hospital readmission. In combination, however, they reduced the probability of readmission by roughly 8 percentage points.
AHRQ-funded; HS020257.
Citation: Murtaugh CM, Deb P, Zhu C .
Reducing readmissions among heart failure patients discharged to home health care: effectiveness of early and intensive nursing services and early physician follow-up.
Health Serv Res 2017 Aug;52(4):1445-72. doi: 10.1111/1475-6773.12537.
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Keywords: Comparative Effectiveness, Heart Disease and Health, Home Healthcare, Hospital Readmissions, Patient-Centered Outcomes Research
Bostwick D, Wolf S, Samsa G
Comparing the palliative care needs of those with cancer to those with common non-cancer serious illness.
Researchers compared functionality, advanced care planning, hospital admissions, prognosis, quality of life, pain, dyspnea, fatigue, and depression between patients with cancer and three non-cancer diagnoses-end-stage renal disease (ESRD), heart failure (HF), and chronic obstructive pulmonary disease (COPD). Patients with COPD, ESRD, and HF were less functional and more likely to be hospitalized at time of referral to palliative care than cancer patients.
AHRQ-funded; HS022763.
Citation: Bostwick D, Wolf S, Samsa G .
Comparing the palliative care needs of those with cancer to those with common non-cancer serious illness.
J Pain Symptom Manage 2017 Jun;53(6):1079-84.e1. doi: 10.1016/j.jpainsymman.2017.02.014.
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Keywords: Cancer, Respiratory Conditions, Kidney Disease and Health, Heart Disease and Health, Palliative Care
Valley TS, Sjoding MW, Ryan AM
Intensive care unit admission and survival among older patients with chronic obstructive pulmonary disease, heart failure, or myocardial infarction.
The researchers estimated the relationship between ICU admission and outcomes for hospitalized patients with exacerbation of chronic obstructive pulmonary disease (COPD), exacerbation of heart failure (HF), or acute myocardial infarction (AMI). They found that ICU admission did not confer a survival benefit for patients with uncertain ICU needs hospitalized with COPD exacerbation, HF exacerbation, or AMI.
AHRQ-funded; HS020672.
Citation: Valley TS, Sjoding MW, Ryan AM .
Intensive care unit admission and survival among older patients with chronic obstructive pulmonary disease, heart failure, or myocardial infarction.
Ann Am Thorac Soc 2017 Jun;14(6):943-51. doi: 10.1513/AnnalsATS.201611-847OC.
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Keywords: Intensive Care Unit (ICU), Respiratory Conditions, Heart Disease and Health, Outcomes
Barlow SE, Turer CB
Lipid screening and treatment practices conflict with conflicting recommendations: where do we go from here?
This article comments on a 2017 study by de Ferranti, et al., published in the Journal of Pediatrics, which reported results from a survey of US pediatricians’ knowledge and implementation of child and adolescent cholesterol screening and treatment guidelines.
AHRQ-funded; HS022418.
Citation: Barlow SE, Turer CB .
Lipid screening and treatment practices conflict with conflicting recommendations: where do we go from here?
J Pediatr 2017 Jun;185:16-18. doi: 10.1016/j.jpeds.2017.02.041..
Keywords: Children/Adolescents, Heart Disease and Health, Decision Making, Guidelines
Parikh KS, Lippmann SJ, Greiner M
Scope of sacubitril/valsartan eligibility after heart failure hospitalization: findings from the GWTG-HF Registry (Get With The Guidelines-Heart Failure).
Researchers used the Get With The Guidelines-Heart Failure (GWTG-HF) registry to characterize patients’ eligibility and potential barriers for sacubitril/valsartan initiation. The GWTG-HF registry was established by the American Heart Association to improve adherence to quality of care guidelines for patients hospitalized with heart failure. The FDA has approved sacubitril/valsartan for patients with heart failure with reduced ejection fraction (HFrEF); however, FDA labeling is broader than the trial entry criteria, and the scope of potential sacubitril/valsartan use in HFrEF is not well understood. Findings suggest that discharge from hospitalization from acute heart failure may be an opportunity for re-evaluating medications, including potentially switching the patient from ACEI/ARB, or starting sacubitril/valsartan.
AHRQ-funded; HS021092.
Citation: Parikh KS, Lippmann SJ, Greiner M .
Scope of sacubitril/valsartan eligibility after heart failure hospitalization: findings from the GWTG-HF Registry (Get With The Guidelines-Heart Failure).
Circulation 2017 May 23;135(21):2077-80. doi: 10.1161/circulationaha.117.027773..
Keywords: Cardiovascular Conditions, Guidelines, Heart Disease and Health, Hospitalization, Medication, Registries
Desai NR, Giugliano RP, Wasserman SM
Association between circulating baseline proprotein convertase subtilisin kexin type 9 levels and efficacy of evolocumab.
Levels of proprotein convertase subtilisin kexin type 9 (PCSK9) vary markedly across the population and are influenced by genetic and nongenetic factors. Evolocumab is a fully human, monoclonal antibody against PCSK9 that reduces low-density lipoprotein cholesterol (LDL-C) levels by 55% to 75%. The purpose of this study was to characterize variability in PCSK9 levels and determine whether the LDL-C level reduction achieved with evolocumab differed based on PCSK9 levels.
AHRQ-funded; HS023000.
Citation: Desai NR, Giugliano RP, Wasserman SM .
Association between circulating baseline proprotein convertase subtilisin kexin type 9 levels and efficacy of evolocumab.
JAMA Cardiol 2017 May;2(5):556-60. doi: 10.1001/jamacardio.2016.5395..
Keywords: Heart Disease and Health
Adedinsewo D, Xu J, Agasthi P
Effect of digoxin use among Medicaid enrollees with atrial fibrillation.
The study’s goal was to examine risk factors for hospitalizations and mortality with digoxin use in a diverse real-world atrial fibrillation patient population and evaluate racial differences. It found an overall increased risk of hospitalizations and mortality with digoxin use. No racial/ethnic differences in outcomes were observed.
AHRQ-funded; HS022444.
Citation: Adedinsewo D, Xu J, Agasthi P .
Effect of digoxin use among Medicaid enrollees with atrial fibrillation.
Circ Arrhythm Electrophysiol 2017 May;10(5):e004573. doi: 10.1161/circep.116.004573.
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Keywords: Heart Disease and Health, Medication, Medicaid, Cardiovascular Conditions, Patient-Centered Outcomes Research
Jones CD, Bowles KH, Richard A
High-value home health care for patients with heart failure: an opportunity to optimize transitions from hospital to home.
Providing home health nursing and therapy could promote recovery in vulnerable HF patients with post-hospital syndrome and potentially reduce readmissions. The authors argue that understanding the characteristics of effective post-acute HHC for patients with HF will inform best practices, optimal outcomes for cost, and ultimately high-value care.
AHRQ-funded; HS024569.
Citation: Jones CD, Bowles KH, Richard A .
High-value home health care for patients with heart failure: an opportunity to optimize transitions from hospital to home.
Circ Cardiovasc Qual Outcomes 2017 May;10(5). doi: 10.1161/circoutcomes.117.003676.
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Keywords: Home Healthcare, Heart Disease and Health, Transitions of Care, Care Coordination, Medicare
Ritchey MD, Loustalot F, Wall HK
AHRQ Author: Steiner CA
Million Hearts: description of the national surveillance and modeling methodology used to monitor the number of cardiovascular events prevented during 2012-2016.
This study describes the national surveillance and modeling methodology developed to monitor achievement of the Million Hearts initiative's aim of preventing 1 million acute myocardial infarctions, strokes, and other related cardiovascular events during 2012-2016. The authors concluded that around 115 000 events were prevented during the initiative's first 2 years compared with what would have occurred had 2011 rates remained stable.
AHRQ-authored.
Citation: Ritchey MD, Loustalot F, Wall HK .
Million Hearts: description of the national surveillance and modeling methodology used to monitor the number of cardiovascular events prevented during 2012-2016.
J Am Heart Assoc 2017 May 2;6(5). doi: 10.1161/jaha.117.006021.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Prevention
Zullo AR, Lee Y, Daiello LA
Beta-blocker use in U.S. Nursing home residents after myocardial infarction: a national study.
This study evaluated how often beta-blockers were started after acute myocardial infarction (AMI) in nursing home (NH) residents who previously did not use these drugs and to evaluate which factors were associated with post-AMI use of beta-blockers. It found that almost half of older NH residents in the United States do not initiate a beta-blocker after AMI.
AHRQ-funded; HS022998.
Citation: Zullo AR, Lee Y, Daiello LA .
Beta-blocker use in U.S. Nursing home residents after myocardial infarction: a national study.
J Am Geriatr Soc 2017 Apr;65(4):754-62. doi: 10.1111/jgs.14671.
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Keywords: Elderly, Healthcare Utilization, Nursing Homes, Heart Disease and Health, Medication
Palamaner Subash Shantha G, Bhave PD, Girotra S
Sex-specific comparative effectiveness of oral anticoagulants in elderly patients with newly diagnosed atrial fibrillation.
This study assessed the sex-specific, comparative effectiveness of direct oral anticoagulants (rivaroxaban and dabigatran), compared to each other and to warfarin among patients with atrial fibrillation. It concluded that the reduced risk of ischemic stroke in patients taking rivaroxaban, compared with dabigatran and warfarin, seems to be limited to men, whereas the higher risk of bleeding seems to be limited to women.
AHRQ-funded; HS023104.
Citation: Palamaner Subash Shantha G, Bhave PD, Girotra S .
Sex-specific comparative effectiveness of oral anticoagulants in elderly patients with newly diagnosed atrial fibrillation.
Circ Cardiovasc Qual Outcomes 2017 Apr;10(4). doi: 10.1161/circoutcomes.116.003418.
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Keywords: Elderly, Heart Disease and Health, Blood Thinners, Medication, Comparative Effectiveness, Cardiovascular Conditions, Sex Factors, Patient-Centered Outcomes Research, Evidence-Based Practice
Masoudi FA, Curtis JP, Desai NR
PCI appropriateness in New York: if it makes it there, can it make it everywhere?
In this article, the authors discuss cardiovascular medicine in the United States, specifically percutaneous coronary intervention (PCI) procedures. They discuss New York’s experience with PCI. They assert that systematic examination of trends in utilization and characteristics of patients undergoing PCI in New York could provide important insights into these actions’ potential impact on clinical care.
AHRQ-funded; K12 HS023000.
Citation: Masoudi FA, Curtis JP, Desai NR .
PCI appropriateness in New York: if it makes it there, can it make it everywhere?
J Am Coll Cardiol 2017 Mar 14;69(10):1243-46. doi: 10.1016/j.jacc.2017.01.009..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Surgery
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