2023
Association of Neighborhood-Level Marginalization With Health Care Use and Clinical Outcomes Following Hospital Discharge in Patients Who Underwent Coronary Catheterization for Acute Myocardial Infarction in a Single-Payer Health Care System
Akioyamen L, Abdel-Qadir H, Han L, Sud M, Mistry N, Alter D, Atzema C, Austin P, Bhatia R, Booth G, Dhalla I, Ha A, Jackevicius C, Kapral M, Krumholz H, Lee D, McNaughton C, Roifman I, Schull M, Sivaswamy A, Tu K, Udell J, Wijeysundera H, Ko D. Association of Neighborhood-Level Marginalization With Health Care Use and Clinical Outcomes Following Hospital Discharge in Patients Who Underwent Coronary Catheterization for Acute Myocardial Infarction in a Single-Payer Health Care System. Circulation Cardiovascular Quality And Outcomes 2023, 16: e010063. PMID: 38050754, DOI: 10.1161/circoutcomes.123.010063.Peer-Reviewed Original ResearchMeSH KeywordsAftercareAgedCardiac CatheterizationFemaleHealth Services AccessibilityHospitalsHumansMaleMyocardial InfarctionOntarioPatient DischargeConceptsAcute myocardial infarctionMyocardial infarctionHealth care systemHospital dischargeClinical outcomesSocioeconomic statusFirst acute myocardial infarctionProportional hazards regression modelsCare systemSecondary prevention medicationsWorse clinical outcomesHealth service usePopulation-based studyPrimary care physiciansHealth care useHazards regression modelsGreater long-term riskPrescription medication useSingle-payer health care systemUniversal health care systemLong-term riskLow socioeconomic statusCause mortalityDays postdischargePrevention medications
2021
Prevalence of Dyslipidemia and Availability of Lipid-Lowering Medications Among Primary Health Care Settings in China
Lu Y, Zhang H, Lu J, Ding Q, Li X, Wang X, Sun D, Tan L, Mu L, Liu J, Feng F, Yang H, Zhao H, Schulz WL, Krumholz HM, Pan X, Li J, Huang C, Dong Z, Jiang B, Guo Z, Zhang Y, Sun J, Liu Y, Ren Z, Meng Y, Wang Z, Xi Y, Xing L, Tian Y, Liu J, Fu Y, Liu T, Sun W, Yan S, Jin L, Zheng Y, Wang J, Yan J, Xu X, Chen Y, Xing X, Zhang L, Zhong W, Fang X, Zhu L, Xu Y, Guo X, Xu C, Zhou G, Fan L, Qi M, Zhu S, Qi J, Li J, Yin L, Liu Q, Geng Q, Feng Y, Wang J, Wen H, Han X, Liu P, Ding X, Xu J, Deng Y, He J, Liu G, Jiang C, Zha S, Yang C, Bai G, Yu Y, Tashi Z, Qiu L, Hu Z, He H, Zhang J, Zhou M, Li X, Zhao J, Ma S, Ma Y, Huang Y, Zhang Y, Li F, Shen J. Prevalence of Dyslipidemia and Availability of Lipid-Lowering Medications Among Primary Health Care Settings in China. JAMA Network Open 2021, 4: e2127573. PMID: 34586366, PMCID: PMC8482054, DOI: 10.1001/jamanetworkopen.2021.27573.Peer-Reviewed Original ResearchConceptsAtherosclerotic cardiovascular diseaseLipid-lowering medicationsPrimary care institutionsPrevalence of dyslipidemiaControl of dyslipidemiaLipoprotein cholesterolCare institutionsControl rateFemale sexCardiovascular diseaseMAIN OUTCOMEHigh riskNonstatin lipid-lowering drugsHigh-density lipoprotein cholesterolLow-density lipoprotein cholesterolPrimary health care settingsMajor public health problemLipid lowering medicationsMillion Persons ProjectOverall control rateLDL-C levelsLipid-lowering drugsCross-sectional studyPublic health problemHealth care settingsTrends in Differences in Health Status and Health Care Access and Affordability by Race and Ethnicity in the United States, 1999-2018
Mahajan S, Caraballo C, Lu Y, Valero-Elizondo J, Massey D, Annapureddy AR, Roy B, Riley C, Murugiah K, Onuma O, Nunez-Smith M, Forman HP, Nasir K, Herrin J, Krumholz HM. Trends in Differences in Health Status and Health Care Access and Affordability by Race and Ethnicity in the United States, 1999-2018. JAMA 2021, 326: 637-648. PMID: 34402830, PMCID: PMC8371573, DOI: 10.1001/jama.2021.9907.Peer-Reviewed Original ResearchConceptsHealth care accessFair health statusSelf-reported health statusCare accessHealth statusWhite individualsEthnic differencesLatino/HispanicNational Health Interview Survey dataSerial cross-sectional studySelf-reported functional limitationsBlack individualsHealth Interview Survey dataLow incomeCross-sectional studyCross-sectional survey studyInterview Survey dataSelf-reported raceSelf-report measuresMAIN OUTCOMEUS adultsFunctional limitationsPercentage of peopleSignificant decreaseAdults
2020
Regulation of Cardiovascular Therapies During the COVID-19 Public Health Emergency
Vaduganathan M, Butler J, Krumholz HM, Itchhaporia D, Stecker EC, Bhatt DL. Regulation of Cardiovascular Therapies During the COVID-19 Public Health Emergency. Journal Of The American College Of Cardiology 2020, 76: 2517-2521. PMID: 33213730, PMCID: PMC7669239, DOI: 10.1016/j.jacc.2020.09.594.Peer-Reviewed Original ResearchCardiovascular DiseasesCOVID-19EmergenciesHealth Services AccessibilityHumansPublic HealthUnited StatesUnited States Food and Drug AdministrationEvaluation of STEMI Regionalization on Access, Treatment, and Outcomes Among Adults Living in Nonminority and Minority Communities
Hsia RY, Krumholz H, Shen YC. Evaluation of STEMI Regionalization on Access, Treatment, and Outcomes Among Adults Living in Nonminority and Minority Communities. JAMA Network Open 2020, 3: e2025874. PMID: 33196809, PMCID: PMC7670311, DOI: 10.1001/jamanetworkopen.2020.25874.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBlack or African AmericanCaliforniaCause of DeathCohort StudiesFemaleHealth Services AccessibilityHealthcare DisparitiesHispanic or LatinoHospitalizationHumansMaleMiddle AgedMinority GroupsMortalityNon-Randomized Controlled Trials as TopicPercutaneous Coronary InterventionRegional Medical ProgramsResidence CharacteristicsST Elevation Myocardial InfarctionTime-to-TreatmentWhite PeopleConceptsST-segment elevation myocardial infarctionElevation myocardial infarctionPercutaneous coronary interventionPCI-capable hospitalsZip codesNon-Hispanic whitesPatient's countyCause mortalityCohort studyCoronary interventionPCI hospitalsPCI treatmentWhite patientsCapable hospitalsMyocardial infarctionTop tertileInpatient dataMAIN OUTCOMEPatientsSTEMI regionalizationSmall improvementHospitalPotential mechanismsSame dayHispanic populationUnscheduled Care Access in the United States-A Tale of Two Emergency Departments
Venkatesh AK, Greenwood-Ericksen MB, Mei H, Rothenberg C, Lin Z, Krumholz HM. Unscheduled Care Access in the United States-A Tale of Two Emergency Departments. The American Journal Of Emergency Medicine 2020, 45: 374-377. PMID: 33143957, PMCID: PMC8076339, DOI: 10.1016/j.ajem.2020.08.095.Peer-Reviewed Original ResearchMeSH KeywordsAgedEmergency Service, HospitalFemaleHealth Services AccessibilityHumansMaleMedicareRural PopulationUnited StatesUrban PopulationUtilization ReviewConceptsHospital referral regionsED visit ratesEmergency departmentCare ratesVisit ratesMedicare Chronic Conditions WarehouseHospital-based emergency departmentsRole of EDsChronic Conditions WarehouseProportion of beneficiariesDartmouth Atlas hospital referral regionHealthcare delivery systemED utilizationED visitsED useUnscheduled careReferral regionsUrban zip codesCare accessMedicare beneficiariesCare needsCare deliveryOffice settingCare capabilitiesDisproportionate barriersAvailability of Telemedicine Services Across Hospitals in the United States in 2018: A Cross-sectional Study
Jain S, Khera R, Lin Z, Ross JS, Krumholz HM. Availability of Telemedicine Services Across Hospitals in the United States in 2018: A Cross-sectional Study. Annals Of Internal Medicine 2020, 173: m20-1201. PMID: 32353106, PMCID: PMC7212823, DOI: 10.7326/m20-1201.Peer-Reviewed Original ResearchMeSH KeywordsCross-Sectional StudiesHealth Services AccessibilityHospitalsHumansTelemedicineUnited StatesBurden 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 capabilitiesPersistent geographic variations in availability and quality of nursing home care in the United States: 1996 to 2016
Wang Y, Zhang Q, Spatz ES, Gao Y, Eckenrode S, Johnson F, Ho SY, Hu S, Xing C, Krumholz HM. Persistent geographic variations in availability and quality of nursing home care in the United States: 1996 to 2016. BMC Geriatrics 2019, 19: 103. PMID: 30975076, PMCID: PMC6460800, DOI: 10.1186/s12877-019-1117-z.Peer-Reviewed Original Research
2018
Time to hospital arrival among patients with acute myocardial infarction in China: a report from China PEACE prospective study
Guan W, Venkatesh AK, Bai X, Xuan S, Li J, Li X, Zhang H, Zheng X, Masoudi FA, Spertus JA, Krumholz HM, Jiang L. Time to hospital arrival among patients with acute myocardial infarction in China: a report from China PEACE prospective study. European Heart Journal - Quality Of Care And Clinical Outcomes 2018, 5: 63-71. PMID: 29878087, PMCID: PMC6307335, DOI: 10.1093/ehjqcco/qcy022.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionHospital arrivalSymptom onsetMyocardial infarctionMedical insuranceLower household incomeRural medical insuranceChest discomfortChest painIndex hospitalizationMedian timeMultivariable analysisAMI symptomsProspective studyAssociated FactorsPatients' perceptionsCare seekingAMI hospitalizationPatientsSymptomsHousehold incomeAMI studyHospitalizationInfarctionAverage timeGeographical Health Priority Areas For Older Americans
Krumholz HM, Normand ST, Wang Y. Geographical Health Priority Areas For Older Americans. Health Affairs 2018, 37: 104-110. PMID: 29309217, DOI: 10.1377/hlthaff.2017.0744.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overGeography, MedicalHealth PrioritiesHealth Services AccessibilityHealthcare DisparitiesHumansMedicareMortalityUnited StatesConceptsHealth priority areasMortality rateHigher adjusted mortality ratesRisk-standardized mortality ratesAdjusted mortality rateHealth careUnique Medicare beneficiariesMedicare beneficiariesUS populationHealth disparitiesOlder adultsStudy periodGeographic disparitiesOlder AmericansCarePercentDisparitiesPriority areasWide disparity
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
2016
Access to Evidence-Based Statins in Low-Cost Generic Drug Programs
Jackevicius CA, Choi K, Krumholz HM. Access to Evidence-Based Statins in Low-Cost Generic Drug Programs. Circulation Cardiovascular Quality And Outcomes 2016, 9: 785-787. PMID: 27803089, DOI: 10.1161/circoutcomes.116.002985.Peer-Reviewed Original ResearchSex Differences in Financial Barriers and the Relationship to Recovery After Acute Myocardial Infarction
Beckman AL, Bucholz EM, Zhang W, Xu X, Dreyer RP, Strait KM, Spertus JA, Krumholz HM, Spatz ES. Sex Differences in Financial Barriers and the Relationship to Recovery After Acute Myocardial Infarction. Journal Of The American Heart Association 2016, 5: e003923. PMID: 27742618, PMCID: PMC5121496, DOI: 10.1161/jaha.116.003923.Peer-Reviewed Original ResearchMeSH KeywordsAdultAftercareDepressionDrug CostsFemaleHealth Services AccessibilityHumansIncomeLinear ModelsMaleMedication AdherenceMiddle AgedMultivariate AnalysisMyocardial InfarctionPatient Health QuestionnaireProspective StudiesRecovery of FunctionSex FactorsSocioeconomic FactorsSpainUnited StatesConceptsAcute myocardial infarctionMyocardial infarctionFinancial barriersHealth status 12 monthsYoung adultsPost-AMI outcomesYear post-AMIYoung AMI patientsMultivariable linear regression modelsGreater depressive symptomatologyMental functional statusSex differencesClinical characteristicsYounger patientsAMI patientsPost-AMIFunctional statusWorse outcomesBaseline healthPsychosocial statusOutcomes 1Depressive symptomatologyPatientsMore womenHealth careHealthcare Disparities Affecting Americans in the US Territories: A Century-Old Dilemma
Rodríguez-Vilá O, Nuti SV, Krumholz HM. Healthcare Disparities Affecting Americans in the US Territories: A Century-Old Dilemma. The American Journal Of Medicine 2016, 130: e39-e42. PMID: 27593609, DOI: 10.1016/j.amjmed.2016.07.036.Peer-Reviewed Original Research
2015
Standardized Data Collection Practices and the Racial/Ethnic Distribution of Hospitalized Patients
Chakkalakal RJ, Green JC, Krumholz HM, Nallamothu BK. Standardized Data Collection Practices and the Racial/Ethnic Distribution of Hospitalized Patients. Medical Care 2015, 53: 666-672. PMID: 26147864, PMCID: PMC4503513, DOI: 10.1097/mlr.0000000000000392.Peer-Reviewed Original ResearchMeSH KeywordsEthnicityHealth Services AccessibilityHealthcare DisparitiesHospitalizationHumansInpatientsMinority GroupsNew JerseyNew YorkQuality Indicators, Health CareRacial GroupsSocioeconomic Factors
2013
Regional Density of Cardiologists and Rates of Mortality for Acute Myocardial Infarction and Heart Failure
Kulkarni VT, Ross JS, Wang Y, Nallamothu BK, Spertus JA, Normand SL, Masoudi FA, Krumholz HM. Regional Density of Cardiologists and Rates of Mortality for Acute Myocardial Infarction and Heart Failure. Circulation Cardiovascular Quality And Outcomes 2013, 6: 352-359. PMID: 23680965, PMCID: PMC5323047, DOI: 10.1161/circoutcomes.113.000214.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCardiologyCohort StudiesFemaleHealth Services AccessibilityHealth Services Needs and DemandHealthcare DisparitiesHeart FailureHospitalizationHumansLinear ModelsLogistic ModelsMaleMedicareMyocardial InfarctionOdds RatioPhysiciansPneumoniaPrognosisResidence CharacteristicsRisk AssessmentRisk FactorsTime FactorsUnited StatesWorkforceConceptsAcute myocardial infarctionHeart failureHospital referral regionsMortality riskLowest quintileMyocardial infarctionReferral regionsMedicare administrative claims dataCharacteristics of patientsRisk of deathAdministrative claims dataHierarchical logistic regression modelsLogistic regression modelsRate of mortalityRegional densityHighest quintileNumber of cardiologistsWorse outcomesClaims dataPatientsPneumoniaCardiologistsHospitalizationAdmissionQuintile
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
2011
US Cardiologist Workforce From 1995 To 2007: Modest Growth, Lasting Geographic Maldistribution Especially In Rural Areas
Aneja S, Ross JS, Wang Y, Matsumoto M, Rodgers GP, Bernheim SM, Rathore SS, Krumholz HM. US Cardiologist Workforce From 1995 To 2007: Modest Growth, Lasting Geographic Maldistribution Especially In Rural Areas. Health Affairs 2011, 30: 2301-2309. PMID: 22147857, PMCID: PMC3332098, DOI: 10.1377/hlthaff.2011.0255.Peer-Reviewed Original ResearchMeSH KeywordsAgedCardiologyHealth Services AccessibilityHumansPhysiciansPrimary Health CareProfessional Practice LocationRegression AnalysisRural Health ServicesUnited StatesWorkforceConceptsPrimary care physiciansCare physiciansGeographic maldistributionChronic cardiovascular diseaseHospital referral regionsUse of telemedicineCardiology workforceNumber of cardiologistsTotal physician workforceCardiovascular diseaseCardiovascular careReferral regionsElderly populationUS populationTotal physiciansCardiologistsPhysiciansAge sixtyPhysician workforceDisadvantaged areasPercentRural areasPopulationDiseaseVariety of strategies