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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 163 Research Studies DisplayedGanguli I, Mackwood MB, Yang CW
Racial differences in low value care among older adult Medicare patients in US health systems: retrospective cohort study.
The objective of this retrospective cohort study was to characterize racial differences in receipt of low-value care among older Medicare beneficiaries overall and within U.S. health systems. Medicare fee-for-service administrative data was used for Black and White Medicare patients who were at least 65 as of 2016. Findings showed that, of the 40 low value services examined, Black patients had a higher adjusted receipt of 9 services and lower receipt of 20 services than White patients. Differences were generally small and largely due to differential care within health systems, but the authors concluded that their findings suggested potential factors that researchers, policymakers, and health system leaders might investigate to improve health care quality and equity.
AHRQ-funded; HS024930.
Citation: Ganguli I, Mackwood MB, Yang CW .
Racial differences in low value care among older adult Medicare patients in US health systems: retrospective cohort study.
BMJ 2023 Oct 25; 383:e074908. doi: 10.1136/bmj-2023-074908..
Keywords: Elderly, Racial and Ethnic Minorities, Medicare, Health Systems
Thompson 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
McGarry BE, Mao Y, Nelson D
Hospital proximity and emergency department use among assisted living residents.
The purpose of this retrospective cohort study was to explore the association between the distance of assisted living (AL) communities to the nearest hospital and AL residents' rates of emergency department (ED) utilization. The researchers hypothesized that when access to an ED is a shorter distance, AL-to-ED transfers are more common, especially for non-emergency conditions. The study found that among 540,944 resident-years from 16,514 AL communities, the median distance to the closest hospital was 2.5 miles. After statistical adjustment, a doubling of distance to the closest hospital was related with 43.5 fewer ED treat-and-release visits per 1000 resident years and no significant difference in the rate of ED visits resulting in an inpatient admission. Among ED treat-and-release visits, a doubling of distance was related with a 3.0% decrease in visits classified as nonemergent, and a 1.6% decrease in visits classified as emergent, not primary care treatable.
AHRQ-funded; HS026893.
Citation: McGarry BE, Mao Y, Nelson D .
Hospital proximity and emergency department use among assisted living residents.
J Am Med Dir Assoc 2023 Sep; 24(9):1349-55.e.5. doi: 10.1016/j.jamda.2023.05.002..
Keywords: Emergency Department, Elderly, Long-Term Care, Medicare, Hospitals
Di M, Keeney T, Belanger E
Functional status and therapy for older adults with diffuse large B-cell lymphoma in nursing homes: a population-based study.
The purpose of this study was to describe the prevalence of functional and cognitive impairments, and relationships between impairments and treatment in older patients with diffuse large B cell lymphoma (DLBCL) receiving nursing home (NH) care. The study found that of the eligible 649 NH patients 45% received chemoimmunotherapy; among the recipients, 47% received multi-agent, anthracycline-containing regimens. Those patients in a NH were less likely to receive chemoimmunotherapy, had higher 30-day mortality, and poorer OS compared with community-dwelling patients. NH patients with severe functional (61%) or any cognitive impairment (48%) were less likely to receive chemoimmunotherapy.
AHRQ-funded; HS000011.
Citation: Di M, Keeney T, Belanger E .
Functional status and therapy for older adults with diffuse large B-cell lymphoma in nursing homes: a population-based study.
J Am Geriatr Soc 2023 Jul; 71(7):2239-49. doi: 10.1111/jgs.18302..
Keywords: Elderly, Nursing Homes, Medicare, Cancer, Treatments
Zhu JM, Meiselbach MK, Drake C C
Psychiatrist networks In Medicare Advantage plans are substantially narrower than in Medicaid and ACA Markets.
The authors used a novel data set that linked insurance network service areas, plans, and providers across Medicare Advantage, Medicaid managed care, and Affordable Care Act plan markets to compare psychiatrist network breadth; their purpose was to assess the percentage of providers in a given area considered in network for a plan. They found that nearly two-thirds of psychiatrist networks in Medicare Advantage contained fewer than 25 percent of providers in a network's service area. They concluded that these findings suggest a certain “narrowness” in psychiatrist networks in Medicare Advantage, which may disadvantage enrollees attempted to obtain mental health services.
AHRQ-funded; HS000029.
Citation: Zhu JM, Meiselbach MK, Drake C C .
Psychiatrist networks In Medicare Advantage plans are substantially narrower than in Medicaid and ACA Markets.
Health Aff 2023 Jul; 42(7):909-18. doi: 10.1377/hlthaff.2022.01547..
Keywords: Elderly, Medicare, Behavioral Health, Access to Care
Arbaje AI, Woodman S, Keita Fakeye MB
Senior services in US hospitals and readmission risk or mortality among Medicare beneficiaries since the Affordable Care Act.
This study examined whether there was an association between readmission risk or mortality among Medicare beneficiaries and passage of the Affordable Care Act. The study updated the Senior Care Services Scale (SCSS) which describes hospital provision of older adult services before the passage of the Affordable Care Act. The authors conducted a retrospective cohort analysis of older adults ≥65 years (n = 1,416,669), admitted to 2570 US acute-care hospitals from 2014 to 2015. Outcomes were hospital readmission, or death, within 30 and 90 days of discharge. The updated SCSS included three service groups: Inpatient Specialty Care, Post-Acute Community Care, and Home Care and Hospice. Older adults admitted to high Inpatient-Specialty-Care-scoring hospitals had lower risk of death within 30 days, and 90 days. There was no significant association between the other two groups and study outcomes.
AHRQ-funded; HS022916.
Citation: Arbaje AI, Woodman S, Keita Fakeye MB .
Senior services in US hospitals and readmission risk or mortality among Medicare beneficiaries since the Affordable Care Act.
J Appl Gerontol 2023 Jul; 42(7):1424-32. doi: 10.1177/07334648231161925..
Keywords: Elderly, Hospitals, Hospital Readmissions, Medicare
Temkin-Greener H, Mao Y, McGarry B
Online customer reviews of assisted living communities: association with community, county, and state factors.
The authors explored online reviews as a possible source of information about assisted living communities and examined the association between the reviews and aspects of state regulation. They found lower odds of positive reviews in communities with greater proportions of Medicare/Medicaid residents; communities in micropolitan areas and in states with more direct care worker hours had greater odds of a high rating. They concluded that online reviews are a promising source of information about important aspects of satisfaction, particularly in care settings.
AHRQ-funded; HS026893.
Citation: Temkin-Greener H, Mao Y, McGarry B .
Online customer reviews of assisted living communities: association with community, county, and state factors.
J Am Med Dir Assoc 2023 Jun; 24(6):841-45.e3. doi: 10.1016/j.jamda.2023.02.007..
Keywords: Elderly, Provider Performance, Long-Term Care, Medicare
Mao Y, Li Y, McGarry B
Are online reviews of assisted living communities associated with patient-centered outcomes?
The purpose of this study was to explore the relationship between assisted living (AL) online quality review ratings and AL residents' home time. The researchers identified Medicare beneficiaries who entered AL communities in 2018, with the main outcome of resident home time in the year after AL admission. Additional outcomes were the percentage of time spent in emergency room, inpatient hospital, nursing home, and inpatient hospice. The study sample included 59,831 residents in 12,143 ALs. AL online Google reviews for 2013-2017 were linked to 2018-2019 Medicare data. AL average rating score and rating status were generated using Google reviews. The study found that from 2013 to 2017, ALs received an average rating of 4.1 on Google, with a standard deviation of 1.1. Each one-unit increase in the AL's average online rating was associated with an increase in residents' risk-adjusted home time by 0.33 percentage points. Residents in high-rated ALs had a 0.64 pp increase in home time compared with residents in ALs without ratings. Thet study concluded that higher online rating scores were positively associated with residents' home time, and a lack of ratings was related with decreased home time.
AHRQ-funded; HS026893.
Citation: Mao Y, Li Y, McGarry B .
Are online reviews of assisted living communities associated with patient-centered outcomes?
J Am Geriatr Soc 2023 May; 71(5):1505-14. doi: 10.1111/jgs.18192..
Keywords: Elderly, Long-Term Care, Patient-Centered Healthcare, Nursing Homes, Provider Performance, Medicare, Medicaid
Growdon ME, Gan S, Yaffe K
New psychotropic medication use among Medicare beneficiaries with dementia after hospital discharge.
Hospital stays often trigger behavioral shifts in people with dementia (PWD), potentially leading to the prescription of psychotropic drugs despite their limited effectiveness and potential for harmful side-effects. The purpose of this study was to ascertain the prevalence of new psychotropic drug prescriptions in PWD living in the community after their discharge from the hospital, and within these new users, the percentage who continued their use for an extended duration. The researchers conducted a retrospective cohort study, utilizing a random selection of Medicare claims from 2017. The study included PWD hospital patients who were 68 years or older and covered by traditional and Part D Medicare. The primary outcome was the event of prescribing at the time of discharge psychotropic drugs including antipsychotics, sedative-hypnotics, antiepileptics, and antidepressants. The initiation was characterized as new prescriptions (from classes not utilized in the 180 days preceding admission) filled within a week of discharge from the hospital or skilled nursing facility. Extended use was defined as the percentage of new users who continued to refill the newly prescribed medications for more than 90 days post-discharge. The study population consisted of 117,022 hospitalized PWD with an average age of 81 years, with 63% being female. The study found that prior to admission, 63% were already using at least one psychotropic drug; 10% were using drugs from three or more psychotropic classes. These classes included antidepressants (44% pre-admission), antiepileptics (29%), sedative-hypnotics (21%), and antipsychotics (11%). The percentage of PWD discharged with new psychotropic prescriptions ranged from 1.9% (antipsychotics) to 2.9% (antiepileptics); 6.6% had at least one new class initiated. Among these new users, prolonged use varied from 36% (sedative-hypnotics) to 63% (antidepressants); across drug classes, prolonged use was observed in 51%. Factors associated with the initiation of new psychotropics included duration of hospital stay and delirium.
AHRQ-funded; HS026383.
Citation: Growdon ME, Gan S, Yaffe K .
New psychotropic medication use among Medicare beneficiaries with dementia after hospital discharge.
J Am Geriatr Soc 2023 Apr; 71(4):1134-44. doi: 10.1111/jgs.18161..
Keywords: Elderly, Medication, Medicare, Dementia, Neurological Disorders, Hospitalization
Anderson TS, Marcantonio ER, McCarthy EP
Association of diagnosed dementia with post-discharge mortality and readmission among hospitalized Medicare beneficiaries.
The purpose of this retrospective cohort study was to examine whether patients with dementia have a higher risk of adverse outcomes post-discharge. The researchers included Medicare beneficiaries hospitalized in 2016 and evaluated the co-primary outcomes of mortality and readmission within 30 days of hospital discharge. The final cohort included 1,089,109 hospitalizations of which 19.3% were of patients with diagnosed dementia and 886,411 were of patients without dementia. The study found that at 30 days following discharge, 5.7% of patients with dementia had died compared to 3.1% of patients without dementia. At 30 days following discharge, 17.7% of patients with dementia had been readmitted compared to 13.1% of patients without dementia. Patients with dementia who were discharged to the community had an increased likelihood of being readmitted than those who were discharged to nursing facilities, and, when readmitted, had an increased likelihood of dying during the readmission. The study concluded that diagnosed dementia was related with a substantially increased risk of mortality and a modestly increased risk of readmission within 30 days of discharge.
AHRQ-funded; HS026215.
Citation: Anderson TS, Marcantonio ER, McCarthy EP .
Association of diagnosed dementia with post-discharge mortality and readmission among hospitalized Medicare beneficiaries.
J Gen Intern Med 2022 Dec;37(16):4062-70. doi: 10.1007/s11606-022-07549-7..
Keywords: Dementia, Neurological Disorders, Medicare, Elderly, Hospital Readmissions, Mortality
Temkin-Greener H, Mao Y, McGarry B
Health care use and outcomes in assisted living communities: race, ethnicity, and dual eligibility.
The purpose of this study was to examine the type and quality of care received in residential long-term care setting by racial/ ethnic minorities or residents eligible for dual Medicare and Medicaid. With 2018 Medicare data, the researchers identified 255,564 fee-for-service Medicare beneficiaries over the age of 55 who were living in 24,108 assisted living facilities across the United States and evaluated the relationship between race/ethnicity and dual status with emergency room use, inpatient hospital admission, 30-day readmission, and placement in a nursing home. The study found variations within and across assisted living facilities for racial/ethnic minority and dual residents, suggesting that outcome disparities are the most significant by dual eligibility status instead of only race/ ethnicity. The researchers concluded that these results can be used to inform and guide future research, as well as healthcare providers and policy makers.
AHRQ-funded; HS026893.
Citation: Temkin-Greener H, Mao Y, McGarry B .
Health care use and outcomes in assisted living communities: race, ethnicity, and dual eligibility.
Med Care Res Rev 2022 Aug;79(4):500-10. doi: 10.1177/10775587211050189..
Keywords: Elderly, Racial and Ethnic Minorities, Long-Term Care, Medicare
Chao GF, Chhabra KR, Yang J
Bariatric surgery in Medicare patients: examining safety and healthcare utilization in the disabled and elderly.
The purpose of this study was to compare safety and healthcare use after sleeve gastrectomy versus Roux-en-Y gastric bypass in a national Medicare cohort. The researchers analyzed Medicare claims from 2012-2017 for 30,105 bariatric surgery patients receiving benefits due to age or disability and compared all outcomes between sleeve and bypass for each benefit group at 30 days, 1 year, and 3 years. The study found that among the disabled patients (n = 21,595), sleeve gastrectomy was associated with lower 3-year ED utilization, complications, reinterventions, rehospitalizations, and mortality. Cumulative expenditures were $46,277 after sleeve gastrectomy and $48,211 after gastric bypass. Among the elderly (n = 8510), sleeve was associated with lower 3-year ED utilization, complications, reinterventions, and rehospitalizations. Expenditures were $38,632 after sleeve gastrectomy and $39,270 after gastric bypass. Procedure treatment effect significantly differed by benefit group for paraesophageal hernia repair, revision, and mortality. The study concluded that healthcare utilization benefits of sleeve over bypass are maintained across Medicare elderly populations and Medicare disabled subpopulations.
AHRQ-funded; HS025778.
Citation: Chao GF, Chhabra KR, Yang J .
Bariatric surgery in Medicare patients: examining safety and healthcare utilization in the disabled and elderly.
Ann Surg 2022 Jul 1;276(1):133-39. doi: 10.1097/sla.0000000000004526..
Keywords: Obesity: Weight Management, Obesity, Surgery, Medicare, Elderly, Disabilities
Wang J, Mao Y, McGarry B
Post-acute care transitions and outcomes among Medicare beneficiaries in assisted living communities.
This study examined the post-acute care transitions among assisted living (AL) residents and their association with outcomes in the first 30 and 60 days after hospital discharge. Findings showed that the most common post-acute care referral was to skilled nursing facilities (SNF), followed by home without home health care (HHC), home with HHC, and others. Compared to discharge home without HHC, discharge to SNF was associated with a lower likelihood of ED visits and hospital readmissions, and higher likelihood of long-stay nursing home placement and mortality. Discharge home with HHC was associated with a higher likelihood of hospital readmissions and a lower likelihood of long-stay nursing home placement than discharge home without HHC. The results were similar within the first 30 days and 60 days after hospital discharge.
AHRQ-funded; HS026893.
Citation: Wang J, Mao Y, McGarry B .
Post-acute care transitions and outcomes among Medicare beneficiaries in assisted living communities.
J Am Geriatr Soc 2022 May;70(5):1429-41. doi: 10.1111/jgs.17669..
Keywords: Elderly, Medicare, Nursing Homes, Long-Term Care
Tucher E, Keeney T, Bélanger E
Leveraging survey and claims data to identify high-need Medicare beneficiaries in the National Health and Aging Trends Study.
The purpose of this retrospective cohort study was to compare the performance of existing survey and claims-based definitions in identifying high-need (HN) Medicare population beneficiaries and predicting poor outcomes among a community-dwelling population. The researchers utilized Round 5 (2015) of the National Health and Aging Trends Study (NHATS) linked with Medicare claims and applied HN definitions from prior studies to the current study cohort. The study found that the percentage of NHATS respondents categorized as HN differed greatly across definitions. HN respondents had significantly higher mortality and hospitalization rates in 2016. The researchers report that although all the definitions utilized had good specificity, none were sufficiently accurate in their ability to predict outcomes in the following year.
AHRQ-funded; HS000011.
Citation: Tucher E, Keeney T, Bélanger E .
Leveraging survey and claims data to identify high-need Medicare beneficiaries in the National Health and Aging Trends Study.
J Am Geriatr Soc 2022 Feb; 70(2):522-30. doi: 10.1111/jgs.17517..
Keywords: Medicare, Elderly, Hospitalization
Wickwire EM, Bailey MD, Somers VK
CPAP adherence is associated with reduced inpatient utilization among older adult Medicare beneficiaries with pre-existing cardiovascular disease.
The purpose of this study was to examine the impact of adherence to continuous positive airway pressure (CPAP) therapy on health care utilization among a nationally representative and sample of older adults with multiple morbidities and pre-existing cardiovascular disease and subsequently diagnosed with obstructive sleep apnea in the United States. The investigators concluded that in this nationally representative sample of older Medicare beneficiaries with multiple morbidities and relative to low adherers, high adherers demonstrated reduced inpatient utilization.
AHRQ-funded; HS024560.
Citation: Wickwire EM, Bailey MD, Somers VK .
CPAP adherence is associated with reduced inpatient utilization among older adult Medicare beneficiaries with pre-existing cardiovascular disease.
J Clin Sleep Med 2022 Jan;18(1):39-45. doi: 10.5664/jcsm.9478..
Keywords: Elderly, Medicare, Sleep Problems, Cardiovascular Conditions, Patient Adherence/Compliance, Hospitalization, Healthcare Utilization, Respiratory Conditions
Cornelio N, McInerney MP, Mellor JM
Increasing Medicaid's stagnant asset test for people eligible for Medicare and Medicaid will help vulnerable seniors.
Researchers examined states' income and asset tests for full-benefit Medicaid during the period 2006-18 and examined how alternative asset tests would affect eligibility for community-dwelling Medicare beneficiaries ages sixty-five and older. They found that increasing asset limits would lessen restrictions on Medicaid eligibility that arise from stagnant asset tests, broadening eligibility for certain low-income Medicare beneficiaries and allowing them to retain higher, yet still modest, savings.
AHRQ-funded; HS025422; HS026727; HS027698.
Citation: Cornelio N, McInerney MP, Mellor JM .
Increasing Medicaid's stagnant asset test for people eligible for Medicare and Medicaid will help vulnerable seniors.
Health Affairs 2021 Dec;40(12):1943-52. doi: 10.1377/hlthaff.2021.00841..
Keywords: Elderly, Medicaid, Medicare, Low-Income, Vulnerable Populations
McInerney M, Mellor JM, Sabik LM. M, Mellor JM, Sabik LM
Welcome mats and on-ramps for older adults: the impact of the Affordable Care Act's Medicaid Expansions on Dual Enrollment in Medicare and Medicaid.
The authors examined whether Medicaid participation by low-income adults age 65 and up increased as a result of Medicaid expansions to working-age adults under the Affordable Care Act (ACA). Using American Community Survey data and state variation in ACA Medicaid expansions, they found that Medicaid expansions to working-age adults increased Medicaid participation among low-income older adults by 4.4 percent. They also found evidence of an “on-ramp” effect, which is an important mechanism behind welcome mat effects among some older adults.
AHRQ-funded; HS025422.
Citation: McInerney M, Mellor JM, Sabik LM. M, Mellor JM, Sabik LM .
Welcome mats and on-ramps for older adults: the impact of the Affordable Care Act's Medicaid Expansions on Dual Enrollment in Medicare and Medicaid.
J Policy Anal Manage 2021 Win;40(1):12-41. doi: 10.1002/pam.22259..
Keywords: Elderly, Medicaid, Medicare, Low-Income, Health Insurance, Policy
Herb J, Staley BS, Roberson M
Use and disparities in parathyroidectomy for symptomatic primary hyperparathyroidism in the Medicare population.
The investigators’ objective was to determine national usage and disparities in parathyroidectomy for symptomatic primary hyperparathyroidism among insured older adults. Data was obtained using Medicare claims. They found that parathyroidectomy was underused and recommended that quality improvement efforts, rooted in equitable care, be undertaken to increase access to parathyroidectomy for this disease.
AHRQ-funded; HS000032.
Citation: Herb J, Staley BS, Roberson M .
Use and disparities in parathyroidectomy for symptomatic primary hyperparathyroidism in the Medicare population.
Surgery 2021 Nov;170(5):1376-82. doi: 10.1016/j.surg.2021.05.026..
Keywords: Elderly, Disparities, Medicare, Surgery, Racial and Ethnic Minorities
Luo Z, Gritz M, Connelly L
A survey of primary care practices on their use of the intensive behavioral therapy for obese Medicare patients.
The objective of this study was to fill the gap in knowledge on systematic differences between primary care practices (PCP) that do or do not provide intensive behavioral therapy (IBT) for obese Medicare patients. The investigators concluded that although the Centers for Medicare and Medicaid Services established payment codes for PCPs to deliver IBT for obesity in 2011, very few providers submitted fee-for-service claims for these services after almost 10 years.
AHRQ-funded; HS024843.
Citation: Luo Z, Gritz M, Connelly L .
A survey of primary care practices on their use of the intensive behavioral therapy for obese Medicare patients.
J Gen Intern Med 2021 Sep;36(9):2700-08. doi: 10.1007/s11606-021-06596-w..
Keywords: Primary Care, Obesity, Behavioral Health, Medicare, Elderly
Hua CL, Thomas KS, Bunker J
Changes in the agreement between the Minimum Data Set and hospital Medicare claims measures of dementia.
The objective of this study was to examine the agreement between a clinical Minimum Data Set measure of dementia and a diagnosis of dementia documented on a hospital claim across three points in time. A second objective was to examine the extent to which the agreement varied by age, sex, and race/ethnicity. Findings showed that hospital claims for patients aged 66–75 were less likely to be accurate than those for other age groups and suggests that physicians do not always look for signs of dementia in younger adults. Additionally, Asian patients were less likely to have a diagnosis of dementia documented during hospitalization, which could be related to language barriers between patients and clinicians.
AHRQ-funded; HS000011.
Citation: Hua CL, Thomas KS, Bunker J .
Changes in the agreement between the Minimum Data Set and hospital Medicare claims measures of dementia.
J Am Geriatr Soc 2021 Sep;69(9):2672-75. doi: 10.1111/jgs.17201..
Keywords: Elderly, Dementia, Neurological Disorders, Diagnostic Safety and Quality, Medicare
Hoffman GJ, U U, Bynum J
Alzheimer's disease and related dementias and episode spending under Medicare's Bundled Payment for Care Improvements Advanced (BPCI-A).
Investigators evaluated the prevalence of Alzheimer’s disease and related dementias (ADRD) across the episodes included in Medicare's Bundled Payments for Care Improvement Advanced (BPCI-A) program and the association between ADRD and 90-day spending among hospitals participating in the BPCI-A program. They found that ADRD is associated with higher episode spending, highlighting the importance of closely monitoring the experience of these patients under BPCI-A to ensure that they are receiving appropriate care. This is particularly important for episodes like sepsis and pneumonia that are common among patients with ADRD and also highly prevalent under BPCI-A.
AHRQ-funded; HS025838.
Citation: Hoffman GJ, U U, Bynum J .
Alzheimer's disease and related dementias and episode spending under Medicare's Bundled Payment for Care Improvements Advanced (BPCI-A).
J Gen Intern Med 2021 Aug;36(8):2499-502. doi: 10.1007/s11606-020-06348-2..
Keywords: Elderly, Dementia, Medicare, Payment
Medbery RL, Fernandez FG, Kosinski AS
Costs associated with lobectomy for lung cancer: an analysis merging STS and Medicare data.
Researchers sought to identify underlying case mix factors that contribute to variability of 90-day costs of lobectomy for early-stage lung cancer. Using the Society of Thoracic Surgeons General Thoracic Surgery Database, they found that lobectomy is associated with substantial variability of episode-of-care costs. Variability is driven by patient demographic and clinical factors, hospital characteristics, and the occurrence and severity of complications.
AHRQ-funded; R01 HS022279.
Citation: Medbery RL, Fernandez FG, Kosinski AS .
Costs associated with lobectomy for lung cancer: an analysis merging STS and Medicare data.
Ann Thorac Surg 2021 Jun;111(6):1781-90. doi: 10.1016/j.athoracsur.2020.08.073..
Keywords: Cancer: Lung Cancer, Cancer, Healthcare Costs, Surgery, Elderly, Medicare
Smith JM, Lin H, Thomas-Hawkins C
Timing of home health care initiation and 30-day rehospitalizations among Medicare beneficiaries with diabetes by race and ethnicity.
Older adults with diabetes are at elevated risk of complications following hospitalization. Home health care services mitigate the risk of adverse events and facilitate a safe transition home. In the United States, when home health care services are prescribed, federal guidelines require they begin within two days of hospital discharge. This study examined the association between timing of home health care initiation and 30-day rehospitalization outcomes in a cohort of 786,734 Medicare beneficiaries following a diabetes-related index hospitalization admission during 2015.
AHRQ-funded; HS022406.
Citation: Smith JM, Lin H, Thomas-Hawkins C .
Timing of home health care initiation and 30-day rehospitalizations among Medicare beneficiaries with diabetes by race and ethnicity.
Int J Environ Res Public Health 2021 May 25;18(11). doi: 10.3390/ijerph18115623..
Keywords: Elderly, Home Healthcare, Hospital Readmissions, Medicare, Diabetes, Chronic Conditions, Racial and Ethnic Minorities
Mack DS, Baek J, Tjia J
Geographic variation of statin use among US nursing home residents with life-limiting illness.
The authors described regional variation in statin use among residents with life-limiting illness. Statin usage was determined by examination of Medicare Part D claims. Findings suggested extensive geographic variation in US statin prescribing across hospital referral regions, especially for those aged 76 years or older. This variation may reflect clinical uncertainty given the largely absent guidelines for statin use in nursing home residents.
AHRQ-funded; HS026840.
Citation: Mack DS, Baek J, Tjia J .
Geographic variation of statin use among US nursing home residents with life-limiting illness.
Med Care 2021 May;59(5):425-36. doi: 10.1097/mlr.0000000000001505..
Keywords: Elderly, Nursing Homes, Long-Term Care, Medicare, Practice Patterns
Hua CL, Cornell PY, Zimmerman S
Trends in serious mental illness in US assisted living compared to nursing homes and the community: 2007-2017.
This study examined trends in the prevalence of serious mental illness (SMI) in assisted living (AL) communities in the United States over time and in relationship to characteristics such as dual eligibility and health conditions. Using Medicare data, findings showed that the prevalence of SMI in AL increased by 54% from 2007 to 2017. Residents with SMI were more likely to be dually eligible for Medicare and Medicaid than residents without SMI. Approximately 10% of AL communities had over half of the sample's AL residents with SMI.
AHRQ-funded; HS000011.
Citation: Hua CL, Cornell PY, Zimmerman S .
Trends in serious mental illness in US assisted living compared to nursing homes and the community: 2007-2017.
Am J Geriatr Psychiatry 2021 May;29(5):434-44. doi: 10.1016/j.jagp.2020.09.011..
Keywords: Elderly, Behavioral Health, Nursing Homes, Long-Term Care, Medicare