2023
Insurance-Based Disparities in Stroke Center Access in California: A Network Science Approach
Zachrison K, Hsia R, Schwamm L, Yan Z, Samuels-Kalow M, Reeves M, Camargo C, Onnela J. Insurance-Based Disparities in Stroke Center Access in California: A Network Science Approach. Circulation Cardiovascular Quality And Outcomes 2023, 16: e009868. PMID: 37746725, PMCID: PMC10592016, DOI: 10.1161/circoutcomes.122.009868.Peer-Reviewed Original ResearchConceptsInsurance-based disparitiesStroke centersEmergency departmentHospital clustersInitial emergency departmentIschemic stroke admissionsHospital emergency departmentClusters of hospitalsLogistic regression modelsStroke admissionsUninsured patientsPatient insuranceLower oddsPatientsLess strokeCenter accessOddsCenter transferHospitalLikelihood of transferInsurance groupsRegression modelsLower proportionDepartmentAssociation
2021
Associations of Medicaid Expansion With Access to Care, Severity, and Outcomes for Acute Ischemic Stroke
McGee B, Seagraves K, Smith E, Xian Y, Zhang S, Alhanti B, Matsouaka R, Reeves M, Schwamm L, Fonarow G. Associations of Medicaid Expansion With Access to Care, Severity, and Outcomes for Acute Ischemic Stroke. Circulation Cardiovascular Quality And Outcomes 2021, 14: e007940. PMID: 34587752, DOI: 10.1161/circoutcomes.121.007940.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeLow-income cohortSkilled nursing facilitiesIschemic strokeMedicaid expansionStroke admissionsNonexpansion statesNursing facilitiesLow-income US populationHigh stroke burdenPrimary stroke preventionOdds of dischargeIschemic stroke admissionsExpansion statesSeverity of presentationLevel of disabilityReceipt of rehabilitationHealth insurance statusHealth insurance coverageHospital mortalityUninsured hospitalizationsStroke preventionDischarge dispositionStroke burdenStroke outcome
2016
Renal Dysfunction Is Associated With Poststroke Discharge Disposition and In-Hospital Mortality
El Husseini N, Fonarow G, Smith E, Ju C, Schwamm L, Hernandez A, Schulte P, Xian Y, Goldstein L. Renal Dysfunction Is Associated With Poststroke Discharge Disposition and In-Hospital Mortality. Stroke 2016, 48: 327-334. PMID: 28034963, PMCID: PMC5268130, DOI: 10.1161/strokeaha.116.014601.Peer-Reviewed Original ResearchConceptsHospital mortalityDischarge dispositionEGFR 15Renal dysfunctionEGFR levelsMultivariable Cox proportional hazards modelsRenal Disease Study equationCox proportional hazards modelAcute ischemic strokeIn-Hospital MortalityIschemic stroke patientsGlomerular filtration rateModification of DietShort-term outcomesNinth Revision codesProportional hazards modelDemographic factorsGuidelines-StrokeCohort studyEGFR 30EGFR 45Ischemic strokeFrequent comorbiditiesTotal cohortStroke patientsImpact of Insurance Status on Outcomes and Use of Rehabilitation Services in Acute Ischemic Stroke: Findings From Get With The Guidelines‐Stroke
Medford‐Davis L, Fonarow G, Bhatt D, Xu H, Smith E, Suter R, Peterson E, Xian Y, Matsouaka R, Schwamm L. Impact of Insurance Status on Outcomes and Use of Rehabilitation Services in Acute Ischemic Stroke: Findings From Get With The Guidelines‐Stroke. Journal Of The American Heart Association 2016, 5: e004282. PMID: 27930356, PMCID: PMC5210352, DOI: 10.1161/jaha.116.004282.Peer-Reviewed Original ResearchMeSH KeywordsAgedAmbulancesAnticholesteremic AgentsAntihypertensive AgentsBrain IschemiaDiabetes MellitusFemaleGuideline AdherenceHospital MortalityHumansHypercholesterolemiaHypertensionHypoglycemic AgentsInsurance CoverageInsurance, HealthLogistic ModelsMaleMedicaidMedically UninsuredMedicareMiddle AgedMultivariate AnalysisOdds RatioPractice Guidelines as TopicSkilled Nursing FacilitiesStrokeStroke RehabilitationTime FactorsUnited StatesConceptsAcute ischemic strokeIschemic strokeInsurance statusHospital mortalityGuidelines-Stroke programIschemic stroke patientsMultivariable logistic regressionPatient insurance statusGovernment-sponsored insuranceSkilled nursing facilitiesGuidelines-StrokeInpatient rehabPostdischarge destinationHospital outcomesPatient demographicsSymptom onsetAcute treatmentControl medicationDiabetes mellitusStroke patientsHospital characteristicsUninsured patientsHigh cholesterolNursing facilitiesPreventative care
2015
Clinical Effectiveness of Statin Therapy After Ischemic Stroke: Primary Results From the Statin Therapeutic Area of the Patient‐Centered Research Into Outcomes Stroke Patients Prefer and Effectiveness Research (PROSPER) Study
O'Brien E, Greiner M, Xian Y, Fonarow G, Olson D, Schwamm L, Bhatt D, Smith E, Maisch L, Hannah D, Lindholm B, Peterson E, Pencina M, Hernandez A. Clinical Effectiveness of Statin Therapy After Ischemic Stroke: Primary Results From the Statin Therapeutic Area of the Patient‐Centered Research Into Outcomes Stroke Patients Prefer and Effectiveness Research (PROSPER) Study. Circulation 2015, 132: 1404-1413. PMID: 26246175, DOI: 10.1161/circulationaha.115.016183.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBrain IschemiaCardiovascular DiseasesDose-Response Relationship, DrugFemaleFollow-Up StudiesHospitalizationHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMedicaidMedical RecordsMedicarePatient DischargePatient Outcome AssessmentPatient ReadmissionRecurrenceRegistriesTreatment OutcomeUnited StatesConceptsMajor adverse cardiovascular eventsAdverse cardiovascular eventsStatin therapyTime of admissionCardiovascular eventsIschemic strokePatient prefersCause mortalityHemorrhagic strokeOlder ischemic stroke patientsGuidelines-Stroke registryHigh-intensity doseIschemic stroke patientsModerate-intensity statinsPatient-centered outcomesReal-world effectivenessYears of ageOutcomes Research InstituteEffectiveness researchCoprimary outcomesCardiovascular readmissionCause readmissionSecondary outcomesStroke patientsClinical effectiveness
2013
Insurance Status and Outcome after Intracerebral Hemorrhage: Findings from Get With The Guidelines-Stroke
James M, Grau-Sepulveda M, Olson D, Smith E, Hernandez A, Peterson E, Schwamm L, Bhatt D, Fonarow G. Insurance Status and Outcome after Intracerebral Hemorrhage: Findings from Get With The Guidelines-Stroke. Journal Of Stroke And Cerebrovascular Diseases 2013, 23: 283-292. PMID: 23537567, DOI: 10.1016/j.jstrokecerebrovasdis.2013.02.016.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCerebral HemorrhageChi-Square DistributionFemaleGuideline AdherenceHealth Services AccessibilityHealthcare DisparitiesHumansInsurance CoverageInsurance, HealthLogistic ModelsMaleMedicaidMedically UninsuredMedicareMiddle AgedMultivariate AnalysisOdds RatioPatient DischargePractice Guidelines as TopicPractice Patterns, Physicians'Private SectorQuality of Health CareRegistriesRetrospective StudiesRisk FactorsTreatment OutcomeUnited StatesConceptsInsurance statusIntracerebral hemorrhageCare measuresOdds ratioND groupHospital mortality rateProspective stroke registryPrivate insurance groupHigher mortality riskHigher odds ratioEvidence-based qualityInsurance groupsHospital-specific variablesGuidelines-StrokeHospital outcomesStroke RegistryDischarge destinationIndependent ambulationComorbid conditionsStroke databaseAdjusted analysisICH patientsFunctional statusCare indicatorsMedicare patients