National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
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- Adverse Events (1)
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- Comparative Effectiveness (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 8 of 8 Research Studies DisplayedGroeneveld 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
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
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
Zullo MD, Gathright EC, Dolansky MA
Influence of depression on utilization of cardiac rehabilitation postmyocardial infarction: A study of 158 991 Medicare beneficiaries.
The purpose of this study was to examine the association between depression diagnosis and participation in cardiac rehabilitation (CR) in a large sample of Medicare beneficiaries with recent myocardial infarction (MI). It concluded that diagnosis of depression in Medicare beneficiaries was strongly associated with attending CR and attending more sessions of CR compared with those without depression. Depression is not a barrier to CR participation after MI in Medicare beneficiaries.
AHRQ-funded; HS019795.
Citation: Zullo MD, Gathright EC, Dolansky MA .
Influence of depression on utilization of cardiac rehabilitation postmyocardial infarction: A study of 158 991 Medicare beneficiaries.
J Cardiopulm Rehabil Prev 2017 Jan;37(1):22-29. doi: 10.1097/hcr.0000000000000222.
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Keywords: Heart Disease and Health, Depression, Medicare, Patient Adherence/Compliance, Comparative Effectiveness