2024
Factors Underlying Reduced Hospitalizations for Myocardial Infarction During the COVID-19 Pandemic
Wilcock A, Zubizarreta J, Wadhera R, Yeh R, Zachrison K, Schwamm L, Mehrotra A. Factors Underlying Reduced Hospitalizations for Myocardial Infarction During the COVID-19 Pandemic. JAMA Cardiology 2024, 9 PMID: 39083317, PMCID: PMC11292572, DOI: 10.1001/jamacardio.2024.2031.Peer-Reviewed Original ResearchHospital encountersAcute myocardial infarctionCare avoidanceShort-term acute careAcute myocardial infarction incidenceAcute myocardial infarction ratesTemporal trendsCOVID-19 pandemicPatient characteristicsTraditional Medicare claimsCross-sectional studyPandemic-related changesAMI incidenceCOVID-19 death ratesAcute careMyocardial infarctionMedicare claimsMain OutcomesExcess deathsExcess mortalityStudy samplePrepandemic levelsTraditional MedicareUnited StatesCOVID-19
2020
Safety and Outcomes of Intravenous tPA in Acute Ischemic Stroke Patients With Prior Stroke Within 3 Months
Shah S, Liang L, Kosinski A, Hernandez A, Schwamm L, Smith E, Fonarow G, Bhatt D, Feng W, Peterson E, Xian Y. Safety and Outcomes of Intravenous tPA in Acute Ischemic Stroke Patients With Prior Stroke Within 3 Months. Circulation Cardiovascular Quality And Outcomes 2020, 13: e006031. PMID: 31903770, DOI: 10.1161/circoutcomes.119.006031.Peer-Reviewed Original ResearchMeSH KeywordsAdministrative Claims, HealthcareAgedAged, 80 and overBrain IschemiaDatabases, FactualFemaleFibrinolytic AgentsHospital MortalityHumansInfusions, IntravenousIntracranial HemorrhagesMaleMedicareRecurrenceRegistriesRetrospective StudiesRisk AssessmentRisk FactorsStrokeThrombolytic TherapyTime FactorsTissue Plasminogen ActivatorTreatment OutcomeUnited StatesConceptsAcute ischemic stroke patientsPrior ischemic strokeSymptomatic intracranial hemorrhageIschemic stroke patientsPrior strokeHospital mortalityIntravenous tPAIschemic strokeIntracranial hemorrhageStroke patientsGuidelines-Stroke hospitalsHigher stroke severityGood functional outcomeHistory of strokeRetrospective observational studyYears of ageCardiovascular comorbiditiesStroke providersStroke severityUnadjusted riskFunctional outcomeHigh prevalenceObservational studyMedicare claimsElevated risk
2019
Hospital Factors Associated With Interhospital Transfer Destination for Stroke in the Northeast United States
Zachrison K, Onnela J, Reeves M, Hernandez A, Camargo C, Zhao X, Matsouaka R, Goldstein J, Metlay J, Schwamm L. Hospital Factors Associated With Interhospital Transfer Destination for Stroke in the Northeast United States. Journal Of The American Heart Association 2019, 9: e011575. PMID: 31888430, PMCID: PMC6988147, DOI: 10.1161/jaha.118.011575.Peer-Reviewed Original ResearchMeSH KeywordsCatchment Area, HealthDatabases, FactualDelivery of Health Care, IntegratedFibrinolytic AgentsHospitalsHospitals, High-VolumeHospitals, Low-VolumeHumansMedicarePatient TransferPractice Patterns, Physicians'Quality Indicators, Health CareRetrospective StudiesStrokeThrombolytic TherapyTissue Plasminogen ActivatorUnited StatesConceptsAcute ischemic strokeAlteplase administrationIschemic strokeUS hospitalsHospital qualityHospital stroke volumeTransfer destinationsHospital referral regionsHospital factorsNumber of hospitalsStroke patientsHospital characteristicsStroke volumeMedicare claimsReferral regionsHospitalLogistic regressionStrokePatientsHospital performancePotential strategyAdministrationHome timeResult dataConnected dyadsThe Medicare Shared Savings Program and Outcomes for Ischemic Stroke Patients: a Retrospective Cohort Study
Kaufman B, O’Brien E, Stearns S, Matsouaka R, Holmes G, Weinberger M, Song P, Schwamm L, Smith E, Fonarow G, Xian Y. The Medicare Shared Savings Program and Outcomes for Ischemic Stroke Patients: a Retrospective Cohort Study. Journal Of General Internal Medicine 2019, 34: 2740-2748. PMID: 31452032, PMCID: PMC6854149, DOI: 10.1007/s11606-019-05283-1.Peer-Reviewed Original ResearchConceptsAccountable care organizationsIschemic strokeRecurrent strokeMSSP accountable care organizationsIndex hospital stayIncident ischemic strokeRetrospective cohort studyAcute care utilizationIschemic stroke patientsMedicare Shared Savings Program Accountable Care OrganizationsModerate ischemic strokeConclusionsAmong patientsMain MeasuresOutcomesCause readmissionHospital stayCohort studyHome dischargeCare utilizationStroke patientsTransitional careProbability of dischargeCare coordinationPatient outcomesMedicare claimsService beneficiariesMedicare claims can identify post-stroke epilepsy
Moura L, Smith J, Blacker D, Vogeli C, Schwamm L, Hsu J. Medicare claims can identify post-stroke epilepsy. Epilepsy Research 2019, 151: 40-47. PMID: 30780120, PMCID: PMC6640134, DOI: 10.1016/j.eplepsyres.2019.02.002.Peer-Reviewed Original ResearchConceptsElectronic health recordsAccountable care organizationsMedicare claimsCommunity-dwelling elderly individualsPost-stroke epilepsyElderly Medicare beneficiariesClaims-based algorithmPositive predictive valuePioneer Accountable Care OrganizationsDiscrete etiologyNeurologist visitOverall prevalenceMedicare patientsClaims diagnosesPSE diagnosisElderly individualsMedicare beneficiariesPatientsPredictive valueEpilepsyFuture epidemiological surveillanceEpidemiological surveillanceInverse probabilityHealth recordsDiagnosis
2016
Hospital Variation in Home-Time After Acute Ischemic Stroke
O'Brien E, Xian Y, Xu H, Wu J, Saver J, Smith E, Schwamm L, Peterson E, Reeves M, Bhatt D, Maisch L, Hannah D, Lindholm B, Olson D, Prvu Bettger J, Pencina M, Hernandez A, Fonarow G. Hospital Variation in Home-Time After Acute Ischemic Stroke. Stroke 2016, 47: 2627-2633. PMID: 27625383, DOI: 10.1161/strokeaha.116.013563.Peer-Reviewed Original ResearchConceptsIschemic strokeStroke survivorsStroke volumeAdmission volumePost dischargeAcute ischemic strokeIschemic stroke survivorsHighest priority outcomesMore comorbiditiesRegistry patientsSevere strokeHospital factorsAdjusted analysisHospital variationHospital characteristicsPost strokeMedicare claimsRural locationsHospitalStrokePatientsRisk adjustmentLinear mixed modelsFirst yearSurvivors