2020
Association Between Medicare Expenditures and Adverse Events for Patients With Acute Myocardial Infarction, Heart Failure, or Pneumonia in the United States
Wang Y, Eldridge N, Metersky ML, Sonnenfeld N, Rodrick D, Fine JM, Eckenrode S, Galusha DH, Tasimi A, Hunt DR, Bernheim SM, Normand ST, Krumholz HM. Association Between Medicare Expenditures and Adverse Events for Patients With Acute Myocardial Infarction, Heart Failure, or Pneumonia in the United States. JAMA Network Open 2020, 3: e202142. PMID: 32259263, PMCID: PMC7139276, DOI: 10.1001/jamanetworkopen.2020.2142.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMedicare Patient Safety Monitoring SystemAdverse event ratesAdverse eventsHeart failureMedicare expendituresService patientsMyocardial infarctionMedicare feeEvent ratesHigher adverse event ratesCare expendituresRisk-standardized ratesPatients 65 yearsAdverse event dataAcute care hospitalsCross-sectional studyFinal study sampleInpatient care expendituresRate of occurrenceDates of analysisPatient characteristicsCare hospitalMean ageInpatient careReadmission and Mortality After Hospitalization for Myocardial Infarction and Heart Failure
Ko DT, Khera R, Lau G, Qiu F, Wang Y, Austin PC, Koh M, Lin Z, Lee DS, Wijeysundera HC, Krumholz HM. Readmission and Mortality After Hospitalization for Myocardial Infarction and Heart Failure. Journal Of The American College Of Cardiology 2020, 75: 736-746. PMID: 32081282, DOI: 10.1016/j.jacc.2019.12.026.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPost-discharge mortalityHospital mortalityReadmission ratesHospitalization ratesMyocardial infarctionMortality rateRisk-adjusted mortality ratesHospital Readmissions Reduction ProgramHF hospitalization ratesHeart failure hospitalizationPatients 65 yearsReadmissions Reduction ProgramFailure hospitalizationHF patientsSecondary outcomesHospital readmissionPrimary outcomeReadmissionMortalityAMI hospitalization ratesStudy periodPattern of outcomesHospitalizationOutcomes
2019
Comparative Effectiveness of New Approaches to Improve Mortality Risk Models From Medicare Claims Data
Krumholz HM, Coppi AC, Warner F, Triche EW, Li SX, Mahajan S, Li Y, Bernheim SM, Grady J, Dorsey K, Lin Z, Normand ST. Comparative Effectiveness of New Approaches to Improve Mortality Risk Models From Medicare Claims Data. JAMA Network Open 2019, 2: e197314. PMID: 31314120, PMCID: PMC6647547, DOI: 10.1001/jamanetworkopen.2019.7314.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionICD-9-CM codesMortality risk modelHeart failureHospital admissionC-statisticMAIN OUTCOMEMortality rateRisk-standardized mortality ratesHospital risk-standardized mortality ratesIndex admission diagnosisPatients 65 yearsDays of hospitalizationComparative effectiveness studiesClaims-based dataHospital-level performance measuresMedicare claims dataPatient-level modelsCMS modelRisk-adjustment modelsRisk modelHospital performance measuresAdmission diagnosisNinth RevisionMyocardial infarction
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 measuresCare
2013
Quality of Discharge Practices and Patient Understanding at an Academic Medical Center
Horwitz LI, Moriarty JP, Chen C, Fogerty RL, Brewster UC, Kanade S, Ziaeian B, Jenq GY, Krumholz HM. Quality of Discharge Practices and Patient Understanding at an Academic Medical Center. JAMA Internal Medicine 2013, 173: 1715-1722. PMID: 23958851, PMCID: PMC3836871, DOI: 10.1001/jamainternmed.2013.9318.Peer-Reviewed Original ResearchConceptsPatient understandingAcademic medical centerDischarge instructionsPatients' perceptionsDischarge practicesDischarge careTransitional carePostdischarge interviewsMedical CenterProspective observational cohort studyDischarge care qualityPatients 65 yearsAcute coronary syndromeObservational cohort studyPatient-centered perspectiveCardiology appointmentsCoronary syndromeCohort studyPostdischarge careHeart failureDischarge planningMean agePrimary careDiet advicePatient's perspectiveNational Trends in Heart Failure Hospital Stay Rates, 2001 to 2009
Chen J, Dharmarajan K, Wang Y, Krumholz HM. National Trends in Heart Failure Hospital Stay Rates, 2001 to 2009. Journal Of The American College Of Cardiology 2013, 61: 1078-1088. PMID: 23473413, PMCID: PMC3939721, DOI: 10.1016/j.jacc.2012.11.057.Peer-Reviewed Original ResearchConceptsHospital stay ratesLength of stayHF hospital stayHospital mortalityYears of ageHospital stayPatients 18Stay ratesNational Inpatient Sample dataU.S. hospital dischargesPatients 65 yearsPrimary discharge diagnosisSignificant declineOlder Medicare beneficiariesNational Inpatient SampleBlack menLarge national datasetHospital dischargeOlder patientsPatients 55Younger patientsDischarge diagnosisInpatient SampleMedicare beneficiariesAge 65
2005
Anemia and Outcomes in Patients With Heart Failure: A Study From the National Heart Care Project
Kosiborod M, Curtis JP, Wang Y, Smith GL, Masoudi FA, Foody JM, Havranek EP, Krumholz HM. Anemia and Outcomes in Patients With Heart Failure: A Study From the National Heart Care Project. JAMA Internal Medicine 2005, 165: 2237-2244. PMID: 16246989, DOI: 10.1001/archinte.165.19.2237.Peer-Reviewed Original ResearchConceptsHeart failureLower hematocrit levelsIndependent predictorsHematocrit levelsComorbid illnessesHigh riskCare ProjectMultivariable logistic regression analysisPatients 65 yearsPrincipal discharge diagnosisAcute care hospitalsLogistic regression analysisLow hematocrit valuesCause mortalityHF patientsMultiple comorbiditiesMultivariable adjustmentOlder patientsCare hospitalClinical factorsHospital readmissionComorbid conditionsDischarge diagnosisSevere anemiaAdverse outcomesThe Complexity and Cost of Drug Regimens of Older Patients Hospitalized With Heart Failure in the United States, 1998-2001
Masoudi FA, Baillie CA, Wang Y, Bradford WD, Steiner JF, Havranek EP, Foody JM, Krumholz HM. The Complexity and Cost of Drug Regimens of Older Patients Hospitalized With Heart Failure in the United States, 1998-2001. JAMA Internal Medicine 2005, 165: 2069-2076. PMID: 16216996, DOI: 10.1001/archinte.165.18.2069.Peer-Reviewed Original ResearchConceptsHeart failureOlder patientsNumber of drugsDrug regimensComplex drug regimensPatients 65 yearsChronic lung diseaseNumber of dosesPrior revascularizationConcurrent prescriptionsMultiple comorbiditiesChronic medicationsElderly patientsHospital dischargeMultiple medicationsMedical therapyLung diseaseMultivariable modelDrug treatmentWhite raceMore drugsPatientsYounger ageDrugsUtilization measures77 ADMISSION BODY TEMPERATURE AND MORTALITY IN PATIENTS HOSPITALIZED FOR HEART FAILURE
Nallamothu B, Payvar S, Wang Y, Kosiborod M, Foody J, Masoudi F, Havranek E, Casscells S, Krumholz H. 77 ADMISSION BODY TEMPERATURE AND MORTALITY IN PATIENTS HOSPITALIZED FOR HEART FAILURE. Journal Of Investigative Medicine 2005, 53: s400. DOI: 10.2310/6650.2005.00205.76.Peer-Reviewed Original ResearchOne-year mortalityAdmission body temperatureHeart failureWorse survivalBody temperatureLow body temperatureLogistic regressionPatients 65 yearsAdvanced heart failurePATIENTS HOSPITALIZEDHospital deathMultivariate adjustmentPatient subgroupsIndependent associationClinical dataStudy populationPatientsPolynomial logistic regressionCare ProjectMortalityHospitalSurvivalFailureSignificant relationshipHospitalized
2003
Validity of a Simple ST-Elevation Acute Myocardial Infarction Risk Index
Rathore SS, Weinfurt KP, Gross CP, Krumholz HM. Validity of a Simple ST-Elevation Acute Myocardial Infarction Risk Index. Circulation 2003, 107: 811-816. PMID: 12591749, DOI: 10.1161/01.cir.0000049743.45748.02.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCalibrationCohort StudiesElectrocardiographyFemaleHumansInpatientsMaleMyocardial InfarctionMyocardial ReperfusionPredictive Value of TestsPrognosisRandomized Controlled Trials as TopicReproducibility of ResultsRetrospective StudiesRiskRisk AssessmentSurvival AnalysisConceptsSimple risk indexCommunity-based cohortRCT populationMyocardial infarctionST-segment elevation myocardial infarctionST-elevation myocardial infarctionMyocardial Infarction (TIMI) risk indexRandomized clinical trial dataAcute reperfusion therapyPatients 65 yearsRisk stratification scoresElevation myocardial infarctionCommunity-based populationDistribution of patientsHigh-risk groupLow-risk groupRisk stratification indexClinical trial dataYears of ageRisk indexReperfusion therapyRisk score distributionPrognostic scoreMortality estimatesGeneral population
2001
Quality of Medical Care and Excess Mortality in Older Patients With Mental Disorders
Druss BG, Bradford WD, Rosenheck RA, Radford MJ, Krumholz HM. Quality of Medical Care and Excess Mortality in Older Patients With Mental Disorders. JAMA Psychiatry 2001, 58: 565-572. PMID: 11386985, DOI: 10.1001/archpsyc.58.6.565.Peer-Reviewed Original ResearchMeSH KeywordsAdrenergic beta-AntagonistsAge FactorsAgedAngiotensin-Converting Enzyme InhibitorsAspirinCluster AnalysisCohort StudiesComorbidityFemaleFollow-Up StudiesHospitalizationHumansMaleMedicareMental DisordersMyocardial InfarctionMyocardial ReperfusionProportional Hazards ModelsQuality of Health CareRisk FactorsSmoking CessationVentricular Function, LeftConceptsExcess mortalityMajor affective disordersMyocardial infarctionMedical careMental disordersAffective disordersMedicare patients 65 yearsCardiac risk factorsPatients 65 yearsAcute myocardial infarctionProportional hazards modelPatient's medical carePotential confounding factorsCessation counselingOlder patientsVentricular functionAdmission characteristicsNational cohortHospital characteristicsRisk factorsHazards modelEnzyme inhibitorsConfounding factorsMortalityInfarctionAspirin and the Treatment of Heart Failure in the Elderly
Krumholz HM, Chen YT, Radford MJ. Aspirin and the Treatment of Heart Failure in the Elderly. JAMA Internal Medicine 2001, 161: 577-582. PMID: 11252118, DOI: 10.1001/archinte.161.4.577.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseHeart failureArtery diseaseBenefits of aspirinPatients 65 yearsRetrospective cohort studyUse of aspirinGroup of patientsAspirin prescriptionAspirin therapyCohort studyDischarge medicationsOlder patientsPatient characteristicsRandomized trialsVascular diseaseTreatment characteristicsConnecticut hospitalsBaseline differencesAspirinPatientsLower mortalityStrong associationDiseaseStudy sample
2000
Mental Disorders and Use of Cardiovascular Procedures After Myocardial Infarction
Druss BG, Bradford DW, Rosenheck RA, Radford MJ, Krumholz HM. Mental Disorders and Use of Cardiovascular Procedures After Myocardial Infarction. JAMA 2000, 283: 506-511. PMID: 10659877, DOI: 10.1001/jama.283.4.506.Peer-Reviewed Original ResearchMeSH KeywordsAgedAngioplasty, Balloon, CoronaryCardiac CatheterizationCohort StudiesComorbidityCoronary Artery BypassFemaleHumansLogistic ModelsMaleMental DisordersMultivariate AnalysisMyocardial InfarctionOutcome Assessment, Health CareRetrospective StudiesSocioeconomic FactorsSurvival AnalysisUnited StatesConceptsPercutaneous transluminal coronary angioplastyComorbid mental disordersAcute myocardial infarctionCardiac catheterizationMyocardial infarctionMental disordersProvider factorsCardiovascular proceduresRates of PTCACoronary artery bypass graft surgeryArtery bypass graft surgeryBypass graft surgeryPatients 65 yearsRetrospective cohort studyTransluminal coronary angioplastyLong-term outcomesCooperative Cardiovascular ProjectCoronary revascularization proceduresSex-based differencesGraft surgeryIndex hospitalizationCohort studyCoronary angioplastyMedical chartsRevascularization proceduresPredictors of readmission among elderly survivors of admission with heart failure
Krumholz H, Chen Y, Wang Y, Vaccarino V, Radford M, Horwitz R. Predictors of readmission among elderly survivors of admission with heart failure. American Heart Journal 2000, 139: 72-77. PMID: 10618565, DOI: 10.1016/s0002-8703(00)90311-9.Peer-Reviewed Original ResearchConceptsHigh-risk patientsHeart failureRisk predictorsCause readmissionClinical factorsValidation cohortHeart failure-related readmissionsPrior heart failurePatients 65 yearsPredictors of readmissionRisk of readmissionMedical record reviewGroup of patientsPrincipal discharge diagnosisResource-intensive interventionsMedicare administrative databasesCreatinine levelsElderly patientsPrior admissionReadmission ratesDerivation cohortRecord reviewDischarge diagnosisAdministrative databasesConnecticut hospitals
1999
Early beta-blocker therapy for acute myocardial infarction in elderly patients.
Krumholz H, Radford M, Wang Y, Chen J, Marciniak T. Early beta-blocker therapy for acute myocardial infarction in elderly patients. Annals Of Internal Medicine 1999, 131: 648-54. PMID: 10577326, DOI: 10.7326/0003-4819-131-9-199911020-00003.Peer-Reviewed Original ResearchConceptsEarly beta-blocker therapyBeta-blocker therapyAcute myocardial infarctionMyocardial infarctionElderly patientsEarly useHospital mortality ratePatients 65 yearsMedical chart reviewAcute care hospitalsYears of ageHospital mortalityHospital deathChart reviewPatient demographicsCare hospitalClinical factorsTreatment characteristicsEarly treatmentBaseline differencesObservational studyHigh riskMedicare beneficiariesMortality ratePatientsComparing AMI Mortality Among Hospitals in Patients 65 Years of Age and Older
Krumholz H, Chen J, Wang Y, Radford M, Chen Y, Marciniak T. Comparing AMI Mortality Among Hospitals in Patients 65 Years of Age and Older. Circulation 1999, 99: 2986-2992. PMID: 10368115, DOI: 10.1161/01.cir.99.23.2986.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial infarctionWhite blood cell countPatients 65 yearsSystolic blood pressureCongestive heart failureMedical chart reviewReceiver-operating characteristic curveBlood cell countRisk-adjusted outcomesYears of ageAdministrative billing codesRisk-adjustment modelsHospital outcomesSerum creatinineChart reviewDerivation cohortHeart failurePatient characteristicsBlood pressureCardiac arrestValidation cohortCandidate predictor variablesAMI mortalityBilling codes
1998
Clinical correlates of in-hospital costs for acute myocardial infarction in patients 65 years of age and older
Krumholz H, Chen J, Murillo J, Cohen D, Radford M. Clinical correlates of in-hospital costs for acute myocardial infarction in patients 65 years of age and older. American Heart Journal 1998, 135: 523-531. PMID: 9506340, DOI: 10.1016/s0002-8703(98)70331-x.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPatients 65 yearsHospital costsMyocardial infarctionAcute myocardial infarction hospitalizationsActual clinical practiceMyocardial infarction hospitalizationsClinical characteristicsAdverse outcomesClinical correlatesMedical recordsClinical practiceHospital proceduresRoom costsInfarctionStudy sampleTotal meanRelative paucityAgeLarge proportionCorrelatesHospitalizationPatientsHospitalYears
1996
Aspirin for secondary prevention after acute myocardial infarction in the elderly: prescribed use and outcomes.
Krumholz HM, Radford MJ, Ellerbeck EF, Hennen J, Meehan TP, Petrillo M, Wang Y, Jencks SF. Aspirin for secondary prevention after acute myocardial infarction in the elderly: prescribed use and outcomes. Annals Of Internal Medicine 1996, 124: 292-8. PMID: 8554223, DOI: 10.7326/0003-4819-124-3-199602010-00002.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPrescription of aspirinMyocardial infarctionPatient characteristicsPrescribed useMortality rate 6 monthsBetter overall health statusRate 6 monthsBeta-blocker therapyPatients 65 yearsUse of aspirinPatient demographic characteristicsAcute care hospitalsOverall health statusPrescribed aspirinDischarge medicationsElderly patientsHospital dischargeSecondary preventionCare hospitalClinical factorsMedical chartsMultivariable analysisCardiac proceduresTreatment characteristics