2015
An Administrative Claims Measure of Payments Made for Medicare Patients for a 30-Day Episode of Care for Acute Myocardial Infarction
Kim N, Bernheim SM, Ott LS, Han L, Spivack SB, Xu X, Volpe M, Liu A, Krumholz HM. An Administrative Claims Measure of Payments Made for Medicare Patients for a 30-Day Episode of Care for Acute Myocardial Infarction. Medical Care 2015, 53: 542-549. PMID: 25970575, DOI: 10.1097/mlr.0000000000000361.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial infarctionICD-9 codes 410Administrative Claims MeasurePatients 65 yearsDate of admissionClaims-based measuresIntraclass correlation coefficient scoreIntraclass correlation coefficientValue of careHigh-value careClinical variablesDischarge diagnosisMedicare patientsMedicare claimsClinical careAMI episodeAMI hospitalizationCare costsCode 410HospitalizationMedicaid ServicesHospitalClaims measuresCarePatients need safer hospitals, every day of the week
Dharmarajan K, Kim N, Krumholz HM. Patients need safer hospitals, every day of the week. The BMJ 2015, 350: h1826. PMID: 25877669, DOI: 10.1136/bmj.h1826.Peer-Reviewed Original ResearchIntravenous Fluids in Acute Decompensated Heart Failure
Bikdeli B, Strait KM, Dharmarajan K, Li SX, Mody P, Partovian C, Coca SG, Kim N, Horwitz LI, Testani JM, Krumholz HM. Intravenous Fluids in Acute Decompensated Heart Failure. JACC Heart Failure 2015, 3: 127-133. PMID: 25660836, PMCID: PMC4438991, DOI: 10.1016/j.jchf.2014.09.007.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overCohort StudiesDatabases, FactualFemaleFluid TherapyHeart FailureHospital MortalityHospitalizationHumansInfusions, IntravenousIntensive Care UnitsIntubation, IntratrachealIsotonic SolutionsMaleMiddle AgedRenal Replacement TherapyRetrospective StudiesRinger's SolutionSaline Solution, HypertonicSodium Potassium Chloride Symporter InhibitorsUnited StatesYoung AdultConceptsAcute decompensated heart failureDecompensated heart failureHeart failureIntravenous fluidsRetrospective cohort studyCritical care admissionRenal replacement therapyDays of hospitalizationProportion of hospitalizationsHalf-normal salineWarrants further investigationOnly diureticsCare admissionHospital deathHospital outcomesCohort studyLoop diureticsPatient groupReplacement therapyWorse outcomesNormal salineInpatient careMedian volumePatientsHospitalization
2014
Payments for Acute Myocardial Infarction Episodes-of-Care Initiated at Hospitals With and Without Interventional Capabilities
Ben-Josef G, Ott LS, Spivack SB, Wang C, Ross JS, Shah SJ, Curtis JP, Kim N, Krumholz HM, Bernheim SM. Payments for Acute Myocardial Infarction Episodes-of-Care Initiated at Hospitals With and Without Interventional Capabilities. Circulation Cardiovascular Quality And Outcomes 2014, 7: 882-888. PMID: 25387777, DOI: 10.1161/circoutcomes.114.000927.Peer-Reviewed Original ResearchConceptsNon-PCI hospitalsCoronary artery bypass graft ratesPCI hospitalsAcute myocardial infarctionMyocardial infarctionPercutaneous coronary intervention capabilityAcute myocardial infarction admissionsLower revascularization ratesPrincipal discharge diagnosisTreatment of patientsMyocardial infarction admissionsHigh rateMyocardial infarction episodeGraft ratePCI capabilityPCI useIndex admissionRevascularization ratesClinical characteristicsPatient demographicsDays postadmissionDischarge diagnosisMedicare patientsCare proceduresMedicare feeTrends in Aortic Dissection Hospitalizations, Interventions, and Outcomes Among Medicare Beneficiaries in the United States, 2000–2011
Mody PS, Wang Y, Geirsson A, Kim N, Desai MM, Gupta A, Dodson JA, Krumholz HM. Trends in Aortic Dissection Hospitalizations, Interventions, and Outcomes Among Medicare Beneficiaries in the United States, 2000–2011. Circulation Cardiovascular Quality And Outcomes 2014, 7: 920-928. PMID: 25336626, PMCID: PMC4380171, DOI: 10.1161/circoutcomes.114.001140.Peer-Reviewed Original ResearchRelationship Between Universal Health Outcome Priorities and Willingness to Take Medication for Primary Prevention of Myocardial Infarction
Case SM, O'Leary J, Kim N, Tinetti ME, Fried TR. Relationship Between Universal Health Outcome Priorities and Willingness to Take Medication for Primary Prevention of Myocardial Infarction. Journal Of The American Geriatrics Society 2014, 62: 1753-1758. PMID: 25146885, PMCID: PMC4172520, DOI: 10.1111/jgs.12983.Peer-Reviewed Original ResearchConceptsMyocardial infarctionOutcome prioritiesPrimary preventionUniversal health outcomesFuture healthObservational cohort studyBurden of treatmentCommunity-dwelling adultsIndividual treatment decisionsSpecific clinical situationsNegative predictive valueQuality of lifeQuantity of lifeCohort studyTreatment decisionsMedicationsPredictive valueHealth outcomesClinical situationsSignificant associationOlder personsInfarctionMedication scenariosAdverse effectsPrevention“Phenotyping” Hospital Value of Care for Patients with Heart Failure
Xu X, Li S, Lin H, Normand S, Kim N, Ott LS, Lagu T, Duan M, Kroch EA, Krumholz HM. “Phenotyping” Hospital Value of Care for Patients with Heart Failure. Health Services Research 2014, 49: 2000-2016. PMID: 24974769, PMCID: PMC4254136, DOI: 10.1111/1475-6773.12197.Peer-Reviewed Original ResearchConceptsLower mortalityHeart failureHeart failure hospitalizationHospital mortality rateLonger hospital stayIntensive care unitDistinct joint trajectoriesValue of careFailure hospitalizationHospital stayCare unitClinical outcomesGroup of hospitalsHospital characteristicsHospital careHospital patternsSurgical proceduresMultinomial logistic regressionMortality rateHigh mortalityHospitalHospitalizationMortalityLogistic regressionHospital ValueHospital Variation in Noninvasive Positive Pressure Ventilation for Acute Decompensated Heart Failure
Kulkarni VT, Kim N, Dai Y, Dharmarajan K, Safavi KC, Bikdeli B, Lindenauer PK, Testani J, Dries DL, Krumholz HM. Hospital Variation in Noninvasive Positive Pressure Ventilation for Acute Decompensated Heart Failure. Circulation Heart Failure 2014, 7: 427-433. PMID: 24633829, PMCID: PMC4386575, DOI: 10.1161/circheartfailure.113.000698.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureNoninvasive positive pressure ventilationDecompensated heart failureRisk-standardized mortality ratesPositive pressure ventilationHeart failureIntubation rateMortality ratePressure ventilationUse of NPPVHospital risk-standardized mortality ratesHigher intubation rateHospital practice patternsHospital-level outcomesCross-sectional studyHierarchical logistic regression modelsLogistic regression modelsNIPPV useHospital variationSuch hospitalizationsPractice patternsHospitalizationHospitalQuartileBottom quartile
2013
Hospital readmission performance and patterns of readmission: retrospective cohort study of Medicare admissions
Dharmarajan K, Hsieh AF, Lin Z, Bueno H, Ross JS, Horwitz LI, Barreto-Filho JA, Kim N, Suter LG, Bernheim SM, Drye EE, Krumholz HM. Hospital readmission performance and patterns of readmission: retrospective cohort study of Medicare admissions. The BMJ 2013, 347: f6571. PMID: 24259033, PMCID: PMC3898430, DOI: 10.1136/bmj.f6571.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionRetrospective cohort studyReadmission diagnosesReadmission ratesHeart failureMyocardial infarctionCohort studySpecific diagnosisReadmission performanceHospital readmission performancePatterns of readmissionDay readmission rateRisk-standardized readmission ratesLow performing hospitalsHospital performanceHigh performing hospitalsReadmission timingDay readmissionHospital stayIndex admissionHospital dischargeReadmission patternsHospital admissionCommon diagnosisMedian timeTrends in Hospitalization Rates and Outcomes of Endocarditis Among Medicare Beneficiaries
Bikdeli B, Wang Y, Kim N, Desai MM, Quagliarello V, Krumholz HM. Trends in Hospitalization Rates and Outcomes of Endocarditis Among Medicare Beneficiaries. Journal Of The American College Of Cardiology 2013, 62: 2217-2226. PMID: 23994421, PMCID: PMC4335801, DOI: 10.1016/j.jacc.2013.07.071.Peer-Reviewed Original ResearchSpending more, doing more, or both? An alternative method for quantifying utilization during hospitalizations
Lagu T, Krumholz HM, Dharmarajan K, Partovian C, Kim N, Mody PS, Li S, Strait KM, Lindenauer PK. Spending more, doing more, or both? An alternative method for quantifying utilization during hospitalizations. Journal Of Hospital Medicine 2013, 8: 373-379. PMID: 23757115, PMCID: PMC4014449, DOI: 10.1002/jhm.2046.Peer-Reviewed Original ResearchDominance of Furosemide for Loop Diuretic Therapy in Heart Failure Time to Revisit the Alternatives?
Bikdeli B, Strait KM, Dharmarajan K, Partovian C, Coca SG, Kim N, Li SX, Testani JM, Khan U, Krumholz HM. Dominance of Furosemide for Loop Diuretic Therapy in Heart Failure Time to Revisit the Alternatives? Journal Of The American College Of Cardiology 2013, 61: 1549-1550. PMID: 23500272, PMCID: PMC4038646, DOI: 10.1016/j.jacc.2012.12.043.Peer-Reviewed Original ResearchTrends in Intracranial Stenting Among Medicare Beneficiaries in the United States, 2006–2010
Gupta A, Desai MM, Kim N, Bulsara KR, Wang Y, Krumholz HM. Trends in Intracranial Stenting Among Medicare Beneficiaries in the United States, 2006–2010. Journal Of The American Heart Association 2013, 2: e000084. PMID: 23588099, PMCID: PMC3647283, DOI: 10.1161/jaha.113.000084.Peer-Reviewed Original ResearchConceptsIntracranial stentingMortality rateService beneficiariesICD-9-CM procedure codesPrincipal discharge diagnosis codeOverall hospitalization rateDischarge diagnosis codesHumanitarian Device Exemption approvalAcute care hospitalsHumanitarian Device ExemptionCare hospitalIntracranial angioplastyHospitalization ratesICS useSubarachnoid hemorrhageDiagnosis codesOperative rateProcedure ratesMedicare feeMedicare beneficiariesInsufficient evidenceICS procedureDrug AdministrationCerebral aneurysmsMedicaid ServicesVariation Exists in Rates of Admission to Intensive Care Units for Heart Failure Patients Across Hospitals in the United States
Safavi KC, Dharmarajan K, Kim N, Strait KM, Li SX, Chen SI, Lagu T, Krumholz HM. Variation Exists in Rates of Admission to Intensive Care Units for Heart Failure Patients Across Hospitals in the United States. Circulation 2013, 127: 923-929. PMID: 23355624, PMCID: PMC3688061, DOI: 10.1161/circulationaha.112.001088.Peer-Reviewed Original ResearchConceptsIntensive care unitHeart failureRisk-standardized mortalityICU admissionICU useCare unitPatient outcomesCoronary intensive care unitMedical intensive care unitNoninvasive positive pressure ventilationSurgical intensive care unitTop quartileGreater ICU useOverall heart failureTop quartile hospitalsICU admission ratePercent of patientsPremier Perspective databaseHeart failure patientsPositive pressure ventilationRate of admissionHigh-cost settingsQuality of careHF admissionsICU daysDiagnoses and Timing of 30-Day Readmissions After Hospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia
Dharmarajan K, Hsieh AF, Lin Z, Bueno H, Ross JS, Horwitz LI, Barreto-Filho JA, Kim N, Bernheim SM, Suter LG, Drye EE, Krumholz HM. Diagnoses and Timing of 30-Day Readmissions After Hospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia. JAMA 2013, 309: 355-363. PMID: 23340637, PMCID: PMC3688083, DOI: 10.1001/jama.2012.216476.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionCommon readmission diagnosesAcute MI hospitalizationReadmission diagnosesDays of hospitalizationPatient demographic characteristicsHeart failureMyocardial infarctionHF hospitalizationReadmission timingPneumonia hospitalizationsMedian timeMI hospitalizationMedicare feeIndex HF hospitalizationIndex pneumonia hospitalizationProportion of patientsDemographic characteristicsService claims dataMI cohortPneumonia cohortHF cohortCondition categoriesHospitalizationReadmission
2012
Antiretroviral Adherence Among Rural Compared to Urban Veterans with HIV Infection in the United States
Ohl ME, Perencevich E, McInnes DK, Kim N, Rimland D, Akgun K, Fiellin DA, Skanderson M, Wang K, Justice A. Antiretroviral Adherence Among Rural Compared to Urban Veterans with HIV Infection in the United States. AIDS And Behavior 2012, 17: 174-180. PMID: 23080359, DOI: 10.1007/s10461-012-0325-8.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnti-Retroviral AgentsConfidence IntervalsFemaleFollow-Up StudiesHIV InfectionsHumansLogistic ModelsMaleMedication AdherenceMiddle AgedOdds RatioResidence CharacteristicsRetrospective StudiesRural PopulationSocioeconomic FactorsUnited StatesUnited States Department of Veterans AffairsUrban PopulationVeteransConceptsRural-dwelling personsAntiretroviral therapyAntiretroviral adherenceUrban veteransRural-Urban Commuting Area codesVeterans Affairs Healthcare SystemCombination antiretroviral therapyHepatitis C infectionMultivariable logistic regressionSubstance use disordersC infectionHIV infectionRemote residentsHigh adherenceWhite raceVA healthcareUse disordersMedian proportionLogistic regressionAdherenceHealthcare systemRemote settingsTherapyInfectionFace barriersProcedure Intensity and the Cost of Care
Chen SI, Dharmarajan K, Kim N, Strait KM, Li SX, Safavi KC, Lindenauer PK, Krumholz HM, Lagu T. Procedure Intensity and the Cost of Care. Circulation Cardiovascular Quality And Outcomes 2012, 5: 308-313. PMID: 22576844, PMCID: PMC3415230, DOI: 10.1161/circoutcomes.112.966069.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overCosts and Cost AnalysisCross-Sectional StudiesFemaleHeart FailureHospital Bed CapacityHospital CostsHospital MortalityHospitalizationHospitals, RuralHospitals, TeachingHospitals, UrbanHumansLength of StayLinear ModelsMaleMiddle AgedModels, EconomicOutcome and Process Assessment, Health CareResidence CharacteristicsRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeUnited StatesYoung AdultConceptsHF hospitalizationHeart failureInvasive proceduresHospital groupRisk-standardized mortality ratesProportion of patientsLength of stayCost of careWilcoxon rank sum testHigher procedure ratesRank sum testPatient demographicsPerspective databaseMedian lengthSurgical proceduresProcedure ratesHospitalizationOutcome differencesMortality rateHospitalPatientsPractice styleProcedure useSum testOverall use
2011
Antidepressant Use and Cognitive Deficits in Older Men: Addressing Confounding by Indications with Different Methods
Han L, Kim N, Brandt C, Allore HG. Antidepressant Use and Cognitive Deficits in Older Men: Addressing Confounding by Indications with Different Methods. Annals Of Epidemiology 2011, 22: 9-16. PMID: 22037381, PMCID: PMC4054866, DOI: 10.1016/j.annepidem.2011.10.004.Peer-Reviewed Original ResearchConceptsDepression-related diagnosisAntidepressant useDepression symptomsOlder personsPropensity scoreHopkins Verbal Learning TestHypertensive menAntidepressant medicationIndication biasVerbal Learning TestMedical recordsPotential confoundingCumulative exposureOlder menCognitive impairmentMemory deficitsCognitive deficitsMultiple linear regressionLinear regressionLearning TestApparent associationScoresSymptomsDiagnosisIndications
2010
Refill Adherence to Oral Hypoglycemic Agents and Glycemic Control in Veterans
Kim N, Agostini JV, Justice AC. Refill Adherence to Oral Hypoglycemic Agents and Glycemic Control in Veterans. Annals Of Pharmacotherapy 2010, 44: 800-808. PMID: 20388863, PMCID: PMC3117591, DOI: 10.1345/aph.1m570.Peer-Reviewed Original ResearchConceptsOral hypoglycemic agentsGlycemic controlGoal A1CHypoglycemic agentsBaseline dateInadequate diabetes controlPercent of patientsPoor glycemic controlMain outcome measuresBaseline A1CContinuous refillNonpersistent patientsComorbid hypertensionDiabetes medicationsMedian ageBetter persistenceMedication nonadherenceDiabetes controlDays' supplyOutcome measuresClinical careEligible veteransPatientsA1CMedicationsEvaluating Interventions to Improve Antiretroviral Adherence: How Much of an Effect Is Required for Favorable Value?
Braithwaite RS, Fiellin DA, Nucifora K, Bryant K, Roberts M, Kim N, Justice AC. Evaluating Interventions to Improve Antiretroviral Adherence: How Much of an Effect Is Required for Favorable Value? Value In Health 2010, 13: 535-542. PMID: 20345544, PMCID: PMC3032536, DOI: 10.1111/j.1524-4733.2010.00714.x.Peer-Reviewed Original ResearchConceptsAbsolute risk reductionNonadherent patientsAdherence interventionsRelative riskRisk factorsAntiretroviral therapy adherence interventionsEffect sizeNonadherence risk factorsBehavioral risk factorsHIV careAntiretroviral adherencePatientsNonadherenceSocietal perspectiveIncremental costIntervention costsSmall effect sizesLife expectancyInterventionRisk reductionPlausible effect sizes