2020
Association Between Sociodemographic Determinants and Disparities in Stroke Symptom Awareness Among US Young Adults
Mszar R, Mahajan S, Valero-Elizondo J, Yahya T, Sharma R, Grandhi GR, Khera R, Virani SS, Lichtman J, Khan SU, Cainzos-Achirica M, Vahidy FS, Krumholz HM, Nasir K. Association Between Sociodemographic Determinants and Disparities in Stroke Symptom Awareness Among US Young Adults. Stroke 2020, 51: 3552-3561. PMID: 33100188, DOI: 10.1161/strokeaha.120.031137.Peer-Reviewed Original ResearchConceptsNational Health Interview SurveyCommon stroke symptomsStroke symptomsHealth Interview SurveyYoung adultsUS young adultsSymptom awarenessFocused public health interventionsInterview SurveyStroke symptom awarenessHigh-risk characteristicsPublic health interventionsArms/legsCertain sociodemographic subgroupsLow education levelStroke incidenceSevere headacheSingle symptomStudy populationTimely diagnosisHigher oddsStroke rateHispanic ethnicityGeneral populationSociodemographic determinantsStroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic
Jasne AS, Chojecka P, Maran I, Mageid R, Eldokmak M, Zhang Q, Nystrom K, Vlieks K, Askenase M, Petersen N, Falcone GJ, Wira CR, Lleva P, Zeevi N, Narula R, Amin H, Navaratnam D, Loomis C, Hwang DY, Schindler J, Hebert R, Matouk C, Krumholz HM, Spudich S, Sheth KN, Sansing LH, Sharma R. Stroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic. Stroke 2020, 51: 2664-2673. PMID: 32755347, PMCID: PMC7446978, DOI: 10.1161/str.0000000000000347.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBetacoronavirusBrain IschemiaCohort StudiesComorbidityConnecticutCoronary Artery DiseaseCoronavirus InfectionsCOVID-19DyslipidemiasEmergency Medical ServicesEthnicityFemaleHumansHypertensionIncomeInsurance, HealthIntracranial HemorrhagesMaleMedically UninsuredMiddle AgedOutcome and Process Assessment, Health CarePandemicsPneumonia, ViralRetrospective StudiesSARS-CoV-2Severity of Illness IndexStrokeSubstance-Related DisordersTelemedicineThrombectomyThrombolytic TherapyTime-to-TreatmentConceptsComprehensive stroke centerStroke codePatient characteristicsStroke severityStroke code patientsHistory of hypertensionStroke-like symptomsCoronary artery diseaseCoronavirus disease 2019 (COVID-19) pandemicPatient-level dataLower median household incomePublic health initiativesDisease 2019 pandemicCOVID-19 pandemicRace/ethnicityCode patientsHospital presentationPublic health insuranceRankin ScaleStroke centersArtery diseaseReperfusion timeStroke symptomsEarly outcomesConnecticut hospitalsBurden and Consequences of Financial Hardship From Medical Bills Among Nonelderly Adults With Diabetes Mellitus in the United States
Caraballo C, Valero-Elizondo J, Khera R, Mahajan S, Grandhi GR, Virani SS, Mszar R, Krumholz HM, Nasir K. Burden and Consequences of Financial Hardship From Medical Bills Among Nonelderly Adults With Diabetes Mellitus in the United States. Circulation Cardiovascular Quality And Outcomes 2020, 13: e006139. PMID: 32069093, DOI: 10.1161/circoutcomes.119.006139.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge FactorsBlack or African AmericanComorbidityCost of IllnessCross-Sectional StudiesDiabetes MellitusFemaleFinancing, PersonalFood SupplyHealth Care CostsHealth Care SurveysHealth ExpendituresHealth Services AccessibilityHumansIncomeMaleMedically UninsuredMiddle AgedPatient ComplianceRisk AssessmentRisk FactorsUnited StatesYoung AdultConceptsDiabetes mellitusMedical billsHigher oddsMedical careNational Health Interview Survey dataHealth Interview Survey dataCost-related medication nonadherenceHigher comorbidity burdenCost-related nonadherenceSelf-reported diagnosisNon-Hispanic blacksInterview Survey dataFinancial hardshipMedication nonadherenceMean ageNonmedical needsHigh prevalenceMellitusMultivariate analysisPocket expenditureFood insecurityNonadherenceHigh financial distressPatientsAdults
2019
Association Between Insurance Status and Access to Hospital Care in Emergency Department Disposition
Venkatesh AK, Chou SC, Li SX, Choi J, Ross JS, D’Onofrio G, Krumholz HM, Dharmarajan K. Association Between Insurance Status and Access to Hospital Care in Emergency Department Disposition. JAMA Internal Medicine 2019, 179: 686-693. PMID: 30933243, PMCID: PMC6503571, DOI: 10.1001/jamainternmed.2019.0037.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAsthmaCritical CareCross-Sectional StudiesDatabases, FactualEmergency Service, HospitalFemaleHealth Services AccessibilityHospitalizationHumansInsurance CoverageInsurance, HealthLung DiseasesMaleMedicaidMedically UninsuredMiddle AgedPatient DischargePatient TransferPneumoniaPulmonary Disease, Chronic ObstructiveUnited StatesConceptsNational Emergency Department SampleEmergency Department SampleCommon medical conditionsUninsured patientsCritical care capabilitiesED dischargeED visitsED transfersPulmonary diseaseCare capabilitiesInsurance statusHigher oddsMedicaid beneficiariesMedical conditionsChronic obstructive pulmonary diseaseAcute pulmonary diseaseEmergency department transfersAdult ED visitsHospital admission ratesObstructive pulmonary diseaseEmergency department dispositionPatient insurance statusPatient case mixHospital ownership statusIntensive care capabilities
2018
National Trends in Nonstatin Use and Expenditures Among the US Adult Population From 2002 to 2013: Insights From Medical Expenditure Panel Survey
Salami JA, Warraich HJ, Valero‐Elizondo J, Spatz ES, Desai NR, Rana JS, Virani SS, Blankstein R, Khera A, Blaha MJ, Blumenthal RS, Katzen BT, Lloyd‐Jones D, Krumholz HM, Nasir K. National Trends in Nonstatin Use and Expenditures Among the US Adult Population From 2002 to 2013: Insights From Medical Expenditure Panel Survey. Journal Of The American Heart Association 2018, 7: e007132. PMID: 29358195, PMCID: PMC5850149, DOI: 10.1161/jaha.117.007132.Peer-Reviewed Original ResearchAdultAgedAtherosclerosisDatabases, FactualDrug CostsDrug PrescriptionsDyslipidemiasFemaleHealth Care SurveysHealth ExpendituresHealthcare DisparitiesHumansHydroxymethylglutaryl-CoA Reductase InhibitorsHypolipidemic AgentsLongitudinal StudiesMaleMedically UninsuredMiddle AgedPractice Patterns, Physicians'Racial GroupsRetrospective StudiesRisk FactorsSex FactorsSocioeconomic FactorsTime FactorsTreatment OutcomeUnited States
2017
Burden of Catastrophic Health Expenditures for Acute Myocardial Infarction and Stroke Among Uninsured in the United States
Khera R, Hong JC, Saxena A, Arrieta A, Virani SS, Blankstein R, de Lemos JA, Krumholz HM, Nasir K. Burden of Catastrophic Health Expenditures for Acute Myocardial Infarction and Stroke Among Uninsured in the United States. Circulation 2017, 137: 408-410. PMID: 29133601, PMCID: PMC5780190, DOI: 10.1161/circulationaha.117.030128.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultFemaleHealth Care CostsHealth ExpendituresHealth Services AccessibilityHospital ChargesHospital CostsHumansIncomeMaleMedically UninsuredMiddle AgedMyocardial InfarctionPatient Protection and Affordable Care ActProcess Assessment, Health CareStrokeTime FactorsUnited StatesYoung Adult
2015
Insurance and Prehospital Delay in Patients ≤55 Years With Acute Myocardial Infarction
Chen SI, Wang Y, Dreyer R, Strait KM, Spatz ES, Xu X, Smolderen KG, Desai NR, Lorenze NP, Lichtman JH, Spertus JA, D'Onofrio G, Bueno H, Masoudi FA, Krumholz HM. Insurance and Prehospital Delay in Patients ≤55 Years With Acute Myocardial Infarction. The American Journal Of Cardiology 2015, 116: 1827-1832. PMID: 26541907, PMCID: PMC5323057, DOI: 10.1016/j.amjcard.2015.09.018.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPrehospital delayInsurance statusMyocardial infarctionSpanish patientsGender differencesHealth care systemUS patientsProspective studyUS cohortUS womenPatientsUniversal insuranceCare systemWomenSignificant gender differencesInfarctionMenInsurance groupsHoursStatusAssociationLarge proportionDifferencesCohort
2012
Based On Key Measures, Care Quality For Medicare Enrollees At Safety-Net And Non-Safety-Net Hospitals Was Almost Equal
Ross JS, Bernheim SM, Lin Z, Drye EE, Chen J, Normand SL, Krumholz HM. Based On Key Measures, Care Quality For Medicare Enrollees At Safety-Net And Non-Safety-Net Hospitals Was Almost Equal. Health Affairs 2012, 31: 1739-1748. PMID: 22869652, PMCID: PMC3527010, DOI: 10.1377/hlthaff.2011.1028.Peer-Reviewed Original ResearchConceptsSafety-net hospitalNet hospitalReadmission ratesUrban hospitalHeart failure mortalityRisk-standardized ratesAcute myocardial infarctionIndicators of careService Medicare beneficiariesHeart failureClinical outcomesMyocardial infarctionWorse outcomesMedicare beneficiariesHospitalMedicare enrolleesHospital qualityCare qualityVulnerable populationsGreater financial strainOutcomesMortalityFinancial strainCareMore affluent populations
2010
Health Care Insurance, Financial Concerns in Accessing Care, and Delays to Hospital Presentation in Acute Myocardial Infarction
Smolderen KG, Spertus JA, Nallamothu BK, Krumholz HM, Tang F, Ross JS, Ting HH, Alexander KP, Rathore SS, Chan PS. Health Care Insurance, Financial Concerns in Accessing Care, and Delays to Hospital Presentation in Acute Myocardial Infarction. JAMA 2010, 303: 1392-1400. PMID: 20388895, PMCID: PMC3020978, DOI: 10.1001/jama.2010.409.Peer-Reviewed Original Research
2008
Influence of Patients’ Socioeconomic Status on Clinical Management Decisions: A Qualitative Study
Bernheim SM, Ross JS, Krumholz HM, Bradley EH. Influence of Patients’ Socioeconomic Status on Clinical Management Decisions: A Qualitative Study. The Annals Of Family Medicine 2008, 6: 53-59. PMID: 18195315, PMCID: PMC2203396, DOI: 10.1370/afm.749.Peer-Reviewed Original ResearchConceptsClinical management decisionsPatients' socioeconomic statusClinical managementSocioeconomic statusPatient sPatient outcomesPrimary care physiciansStandard of careInfluence of patientLow socioeconomic statusVaried practice settingsHealth care qualitySES influencesCare physiciansHispanic ethnicityPhysician perspectivesPractice settingsCare qualityPatientsPhysiciansPatient interestMinority racial backgroundsInterview guideFinancial strainOutcomes