2023
Variation in Risk‐Standardized Acute Admission Rates Among Patients With Heart Failure in Accountable Care Organizations: Implications for Quality Measurement
Chuzi S, Lindenauer P, Faridi K, Priya A, Pekow P, D'Aunno T, Mazor K, Stefan M, Spatz E, Gilstrap L, Werner R, Lagu T. Variation in Risk‐Standardized Acute Admission Rates Among Patients With Heart Failure in Accountable Care Organizations: Implications for Quality Measurement. Journal Of The American Heart Association 2023, 12: e029758. PMID: 37345796, PMCID: PMC10356066, DOI: 10.1161/jaha.122.029758.Peer-Reviewed Original ResearchConceptsAcute admission ratesHeart failureMedicare Shared Savings Program Accountable Care OrganizationsAccountable care organizationsAdmission ratesMost ACOsPrimary care providersPerformance categoriesCare organizationsACO characteristicsHealth care qualityAdmission riskBlack beneficiariesCare providersMedicare feeService beneficiariesConclusions AdmissionCare qualityPatientsAdmissionHospital affiliationACO structureFuture studiesLower proportionFailureAdjustment for Social Risk Factors in a Measure of Clinician Quality Assessing Acute Admissions for Patients With Multiple Chronic Conditions
Lipska K, Altaf F, Barthel A, Spatz E, Lin Z, Herrin J, Bernheim S, Drye E. Adjustment for Social Risk Factors in a Measure of Clinician Quality Assessing Acute Admissions for Patients With Multiple Chronic Conditions. JAMA Health Forum 2023, 4: e230081. PMID: 36897581, DOI: 10.1001/jamahealthforum.2023.0081.Peer-Reviewed Original ResearchConceptsMultiple chronic conditionsSocial risk factorsMedicare-Medicaid dual eligibilityRisk factorsChronic conditionsSocioeconomic status indexMeasure scoresAcute admissionsCohort studyDual eligibilityHealthcare ResearchDual-eligible patientsRetrospective cohort studyUnplanned hospital admissionsRisk of hospitalizationArea Health Resource FileService beneficiaries 65 yearsBeneficiaries 65 yearsRisk factor adjustmentStatus indexMedicare administrative claimsHospital admissionOutcome measuresAdministrative claimsMAIN OUTCOME
2019
Persistent 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
Association of the Overall Well-being of a Population With Health Care Spending for People 65 Years of Age or Older
Riley C, Roy B, Herrin J, Spatz ES, Arora A, Kell KP, Rula EY, Krumholz HM. Association of the Overall Well-being of a Population With Health Care Spending for People 65 Years of Age or Older. JAMA Network Open 2018, 1: e182136. PMID: 30646154, PMCID: PMC6324481, DOI: 10.1001/jamanetworkopen.2018.2136.Peer-Reviewed Original ResearchConceptsMedicare FFS beneficiariesPeople 65 yearsHealth care spendingFFS beneficiariesCare spendingPopulation-based cross-sectional studyLower health care spendingHealth care system capacityCross-sectional studyHealth care systemPopulation levelPayment modelsCare payment modelsHighest quintileInverse associationStudy interventionMAIN OUTCOMEMedicare feeMedicare beneficiariesUS national studyOverall healthMedian household incomeBeing IndexCare systemDemographic characteristicsAssociation of the US Department of Justice Investigation of Implantable Cardioverter-Defibrillators and Devices Not Meeting the Medicare National Coverage Determination, 2007-2015
Desai NR, Bourdillon PM, Parzynski CS, Brindis RG, Spatz ES, Masters C, Minges KE, Peterson P, Masoudi FA, Oetgen WJ, Buxton A, Zipes DP, Curtis JP. Association of the US Department of Justice Investigation of Implantable Cardioverter-Defibrillators and Devices Not Meeting the Medicare National Coverage Determination, 2007-2015. JAMA 2018, 320: 63-71. PMID: 29971398, PMCID: PMC6583049, DOI: 10.1001/jama.2018.8151.Peer-Reviewed Original ResearchConceptsPrimary prevention ICDsNon-Medicare beneficiariesAbsolute decreaseNational Cardiovascular Data Registry ICD RegistrySerial cross-sectional analysisStudy periodImplantable cardioverter defibrillatorRelative decreaseCross-sectional analysisProportion of devicesInitial ICDICD RegistryPrimary preventionCardioverter defibrillatorMAIN OUTCOMEMedicare beneficiariesUS hospitalsHospital groupHospitalICDMore rapid decreasesModest decreaseDepartmentMedicareUS DepartmentDefining Multiple Chronic Conditions for Quality Measurement
Drye EE, Altaf FK, Lipska KJ, Spatz ES, Montague JA, Bao H, Parzynski CS, Ross JS, Bernheim SM, Krumholz HM, Lin Z. Defining Multiple Chronic Conditions for Quality Measurement. Medical Care 2018, 56: 193-201. PMID: 29271820, DOI: 10.1097/mlr.0000000000000853.Peer-Reviewed Original ResearchConceptsMultiple chronic conditionsChronic conditionsMedicare feeService beneficiariesMedicare Chronic Conditions WarehouseMCC cohortBroad cohortChronic Conditions WarehouseRisk-standardized ratesNational quality measuresUnplanned admissionsFinal cohortTotal admissionsAdmission riskAccountable care organizationsAdmission ratesOutcome measuresAdmissionCohortCohort conditionCare organizationsPatientsStakeholder inputNarrow cohortBeneficiaries
2017
Outcomes after observation stays among older adult Medicare beneficiaries in the USA: retrospective cohort study
Dharmarajan K, Qin L, Bierlein M, Choi JES, Lin Z, Desai NR, Spatz ES, Krumholz HM, Venkatesh AK. Outcomes after observation stays among older adult Medicare beneficiaries in the USA: retrospective cohort study. The BMJ 2017, 357: j2616. PMID: 28634181, PMCID: PMC5476173, DOI: 10.1136/bmj.j2616.Peer-Reviewed Original ResearchIdentification of Emergency Department Visits in Medicare Administrative Claims: Approaches and Implications
Venkatesh AK, Mei H, Kocher KE, Granovsky M, Obermeyer Z, Spatz E, Rothenberg C, Krumholz H, Lin Z. Identification of Emergency Department Visits in Medicare Administrative Claims: Approaches and Implications. Academic Emergency Medicine 2017, 24: 422-431. PMID: 27864915, PMCID: PMC5905698, DOI: 10.1111/acem.13140.Peer-Reviewed Original ResearchConceptsED visitsEmergency department visitsClaims-based definitionED visitationAdministrative claimsDepartment visitsClaims dataAdministrative claims data setsHealthcare resource utilizationMore ED visitsAcute care practiceAdministrative claims dataQuality improvement interventionsEmergency care researchMedicare administrative claimsClaims data setsED useCritical careED servicesMedicare feeMedicare dataCare practicesService beneficiariesImprovement interventionsProvider definitions
2016
Risk-standardized Acute Admission Rates Among Patients With Diabetes and Heart Failure as a Measure of Quality of Accountable Care Organizations
Spatz ES, Lipska KJ, Dai Y, Bao H, Lin Z, Parzynski CS, Altaf FK, Joyce EK, Montague JA, Ross JS, Bernheim SM, Krumholz HM, Drye EE. Risk-standardized Acute Admission Rates Among Patients With Diabetes and Heart Failure as a Measure of Quality of Accountable Care Organizations. Medical Care 2016, 54: 528-537. PMID: 26918404, PMCID: PMC5356461, DOI: 10.1097/mlr.0000000000000518.Peer-Reviewed Original ResearchConceptsHeart failure measuresAccountable care organizationsAcute admission ratesHeart failureAdmission ratesNational ratesUnplanned hospital admissionsHeart failure cohortRisk-adjustment variablesPopulation-based measuresCare organizationsOutcome measure developmentIntraclass correlation coefficientHospital admissionDiabetes measuresFailure cohortChronic conditionsMedicare feeDiabetesService beneficiariesPatientsMeet criteriaMeasures of qualitySocioeconomic statusPerformance categories
2015
Trends in Short- and Long-Term Outcomes for Takotsubo Cardiomyopathy Among Medicare Fee-for-Service Beneficiaries, 2007 to 2012
Murugiah K, Wang Y, Desai NR, Spatz ES, Nuti SV, Dreyer RP, Krumholz HM. Trends in Short- and Long-Term Outcomes for Takotsubo Cardiomyopathy Among Medicare Fee-for-Service Beneficiaries, 2007 to 2012. JACC Heart Failure 2015, 4: 197-205. PMID: 26746377, PMCID: PMC5323042, DOI: 10.1016/j.jchf.2015.09.013.Peer-Reviewed Original ResearchConceptsLong-term outcomesReadmission ratesNonwhite patientsHospitalization ratesSecondary diagnosisMedicare feeYears of ageTakotsubo cardiomyopathyWorse outcomesWhite racePatientsService beneficiariesHospitalMortalityTime pointsOutcomesHospitalizationCohortDiagnosisRepresentative dataTakotsuboTTCReadmissionCardiomyopathyYearsComparative Effectiveness of CRT-D Versus Defibrillator Alone in HF Patients With Moderate-to-Severe Chronic Kidney Disease
Friedman DJ, Singh JP, Curtis JP, Tang WHW, Bao H, Spatz ES, Hernandez AF, Patel UD, Al-Khatib SM. Comparative Effectiveness of CRT-D Versus Defibrillator Alone in HF Patients With Moderate-to-Severe Chronic Kidney Disease. Journal Of The American College Of Cardiology 2015, 66: 2618-2629. PMID: 26670062, DOI: 10.1016/j.jacc.2015.09.097.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCardiac Resynchronization TherapyComorbidityComparative Effectiveness ResearchDefibrillators, ImplantableElectric CountershockFemaleGlomerular Filtration RateHeart FailureHospitalizationHumansMaleMedicareProportional Hazards ModelsRenal Insufficiency, ChronicSeverity of Illness IndexSurvival AnalysisTreatment OutcomeUnited StatesConceptsSevere chronic kidney diseaseChronic kidney diseaseCardiac resynchronization therapyCRT-eligible patientsHF hospitalizationKidney diseaseNational Cardiovascular Data Registry ICD RegistryUse of CRTComparative effectivenessInverse probability-weighted analysisReal-world comparative effectivenessEnd-stage renal diseaseCox proportional hazards modelCRT-D useHeart failure hospitalizationAcceptable complication rateDevice-related complicationsProportional hazards modelFine-Gray modelCKD classCKD stageFailure hospitalizationHF patientsPrimary endpointSecondary endpointsNational Trends in Hospital Readmission Rates among Medicare Fee-for-Service Survivors of Mitral Valve Surgery, 1999–2010
Dodson JA, Wang Y, Murugiah K, Dharmarajan K, Cooper Z, Hashim S, Nuti SV, Spatz E, Desai N, Krumholz HM. National Trends in Hospital Readmission Rates among Medicare Fee-for-Service Survivors of Mitral Valve Surgery, 1999–2010. PLOS ONE 2015, 10: e0132470. PMID: 26147225, PMCID: PMC4493110, DOI: 10.1371/journal.pone.0132470.Peer-Reviewed Original ResearchConceptsMitral valve surgeryLength of stayHospital LOSReadmission ratesHospital readmission ratesOlder patientsHospital readmissionMedicare feeMean hospital LOSSurvival rateProportional hazards regressionYears of ageValve surgeryHazards regressionService patientsWorse outcomesAge subgroupsPatientsOlder adultsSurvivorsNational trendsReadmissionModest declineWomenSubgroups
2014
Transfer Rates From Nonprocedure Hospitals After Initial Admission and Outcomes Among Elderly Patients With Acute Myocardial Infarction
Barreto-Filho JA, Wang Y, Rathore SS, Spatz ES, Ross JS, Curtis JP, Nallamothu BK, Normand SL, Krumholz HM. Transfer Rates From Nonprocedure Hospitals After Initial Admission and Outcomes Among Elderly Patients With Acute Myocardial Infarction. JAMA Internal Medicine 2014, 174: 213-222. PMID: 24296747, DOI: 10.1001/jamainternmed.2013.11944.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionCoronary artery bypass graft surgeryArtery bypass graft surgeryRisk-standardized mortality ratesBypass graft surgeryPercutaneous coronary interventionLength of stayMyocardial infarctionElderly patientsGraft surgeryRevascularization ratesCoronary interventionMortality rateLower risk-standardized mortality ratesRate of catheterizationHospital transfer ratesInvasive cardiac proceduresTransfer of patientsRisk-standardized mortalityHospital outcomesInitial admissionMedian lengthService patientsCardiac proceduresHospital differences