2024
Racial/Ethnic Disparities in Aortic Valve Replacement Among Medicare Beneficiaries in the United States, 2012-2019
Gupta A, Mori M, Wang Y, Pawar S, Vahl T, Nazif T, Onuma O, Yong C, Sharma R, Kirtane A, Forrest J, George I, Kodali S, Chikwe J, Geirsson A, Makkar R, Leon M, Krumholz H. Racial/Ethnic Disparities in Aortic Valve Replacement Among Medicare Beneficiaries in the United States, 2012-2019. The American Journal Of Medicine 2024, 137: 321-330.e7. PMID: 38190959, PMCID: PMC11019903, DOI: 10.1016/j.amjmed.2023.12.026.Peer-Reviewed Original ResearchAortic valve replacementRace/ethnicityValve replacementAortic stenosisWhite patientsMedicare beneficiariesSurgical aortic valve replacement (SAVR) proceduresCross-sectional cohort studyAortic valve replacement proceduresAortic stenosis treatmentRacial/Ethnic DisparitiesValve replacement proceduresSelf-reported race/ethnicityRace-related differencesIndex admissionIndex hospitalizationCohort studyAsian patientsPrincipal diagnosisProcedural outcomesStenosis treatmentCare spectrumPatientsEthnic disparitiesStenosis
2022
A multicenter evaluation of computable phenotyping approaches for SARS-CoV-2 infection and COVID-19 hospitalizations
Khera R, Mortazavi BJ, Sangha V, Warner F, Patrick Young H, Ross JS, Shah ND, Theel ES, Jenkinson WG, Knepper C, Wang K, Peaper D, Martinello RA, Brandt CA, Lin Z, Ko AI, Krumholz HM, Pollock BD, Schulz WL. A multicenter evaluation of computable phenotyping approaches for SARS-CoV-2 infection and COVID-19 hospitalizations. Npj Digital Medicine 2022, 5: 27. PMID: 35260762, PMCID: PMC8904579, DOI: 10.1038/s41746-022-00570-4.Peer-Reviewed Original ResearchCOVID-19 hospitalizationMayo ClinicDiagnosis codesCOVID-19 diagnosisPositive SARS-CoV-2 PCRYale New Haven Health SystemPositive SARS-CoV-2 testSARS-CoV-2 infectionSARS-CoV-2 PCRSARS-CoV-2 testCOVID-19Higher inhospital mortalitySARS-CoV2 infectionElectronic health record dataICD-10 diagnosisPositive laboratory testsHealth record dataInhospital mortalityAdditional patientsAntigen testSecondary diagnosisPrincipal diagnosisMulticenter evaluationPositive testComputable phenotype definitions
2019
Association of Hospital Payment Profiles With Variation in 30-Day Medicare Cost for Inpatients With Heart Failure or Pneumonia
Krumholz HM, Wang Y, Wang K, Lin Z, Bernheim SM, Xu X, Desai NR, Normand ST. Association of Hospital Payment Profiles With Variation in 30-Day Medicare Cost for Inpatients With Heart Failure or Pneumonia. JAMA Network Open 2019, 2: e1915604. PMID: 31730185, PMCID: PMC6902811, DOI: 10.1001/jamanetworkopen.2019.15604.Peer-Reviewed Original ResearchConceptsHeart failureSame patientSame diagnosisMortality rateRisk-standardized mortality ratesHighest quartile hospitalsObservational cohort studyMedian hospitalQuartile hospitalsIndex hospitalizationCohort studyCritical access hospitalsPatient characteristicsHospital variationAcute careEpisode paymentsPrincipal diagnosisMAIN OUTCOMEMedicare feePneumoniaMedicare beneficiariesPatientsCase mixService Part ADifferent hospitals
2015
Sex Differences in the Rate, Timing, and Principal Diagnoses of 30-Day Readmissions in Younger Patients with Acute Myocardial Infarction
Dreyer RP, Ranasinghe I, Wang Y, Dharmarajan K, Murugiah K, Nuti SV, Hsieh AF, Spertus JA, Krumholz HM. Sex Differences in the Rate, Timing, and Principal Diagnoses of 30-Day Readmissions in Younger Patients with Acute Myocardial Infarction. Circulation 2015, 132: 158-166. PMID: 26085455, PMCID: PMC5322973, DOI: 10.1161/circulationaha.114.014776.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial infarctionPrincipal diagnosisYounger patientsHigh riskUtilization Project State Inpatient DatabasesYoung womenCause readmission rateGreater mortality riskSex differencesNoncardiac diagnosesReadmission diagnosesReadmission timingReadmission ratesInpatient DatabaseReadmission riskFemale sexCondition categoriesReadmissionMortality riskHealthcare costsDay 2InfarctionPatientsDiagnosisHospital Variability in Use of Anticoagulant Strategies During Acute Myocardial Infarction Treated With an Early Invasive Strategy
Arnold SV, Li SX, Alexander KP, Spertus JA, Nallamothu BK, Curtis JP, Kosiborod M, Gupta A, Wang TY, Lin H, Dharmarajan K, Strait KM, Lowe TJ, Krumholz HM. Hospital Variability in Use of Anticoagulant Strategies During Acute Myocardial Infarction Treated With an Early Invasive Strategy. Journal Of The American Heart Association 2015, 4: e002009. PMID: 26077589, PMCID: PMC4599539, DOI: 10.1161/jaha.115.002009.Peer-Reviewed Original ResearchConceptsEarly invasive strategyAnticoagulant strategiesMyocardial infarctionBleeding rateInvasive strategyAcute myocardial infarction patientsOptimal anticoagulant strategyHalf of patientsPercutaneous coronary interventionAcute myocardial infarctionMyocardial infarction patientsHospital use patternsComparative effectiveness studiesRisk-standardized mortalityChoice of anticoagulantsMedian odds ratioCoronary interventionPatient factorsSystemic anticoagulationHospital variabilityInfarction patientsPrincipal diagnosisOdds ratioMultivariate regression modelPatterns of use
2014
Trends in Hospitalizations Among Medicare Survivors of Aortic Valve Replacement in the United States From 1999 to 2010
Murugiah K, Wang Y, Dodson JA, Nuti SV, Dharmarajan K, Ranasinghe I, Cooper Z, Krumholz HM. Trends in Hospitalizations Among Medicare Survivors of Aortic Valve Replacement in the United States From 1999 to 2010. The Annals Of Thoracic Surgery 2014, 99: 509-517. PMID: 25527425, PMCID: PMC4454375, DOI: 10.1016/j.athoracsur.2014.08.045.Peer-Reviewed Original ResearchConceptsAortic valve replacementValve replacementHospitalization ratesAnnual Medicare paymentsPrincipal diagnosisOne-year hospitalization rateCommon principal diagnosisRisk of hospitalizationMean lengthGeneral Medicare populationMedicare paymentsPostoperative complicationsHeart failureBlack patientsMedicare patientsHospitalizationMedicare populationMedicare beneficiariesMortality ratePatientsStayCumulative daysCumulative lengthCertain subgroupsSurvivorsDevelopment and use of an administrative claims measure for profiling hospital-wide performance on 30-day unplanned readmission.
Horwitz LI, Partovian C, Lin Z, Grady JN, Herrin J, Conover M, Montague J, Dillaway C, Bartczak K, Suter LG, Ross JS, Bernheim SM, Krumholz HM, Drye EE. Development and use of an administrative claims measure for profiling hospital-wide performance on 30-day unplanned readmission. Annals Of Internal Medicine 2014, 161: s66-75. PMID: 25402406, PMCID: PMC4235629, DOI: 10.7326/m13-3000.Peer-Reviewed Original ResearchConceptsUnplanned readmissionReadmission measuresReadmission ratesReadmission riskMedicare feeHospital-wide readmission measureRisk-standardized readmission ratesPayer dataAdministrative Claims MeasureRisk-standardized ratesAverage-risk patientsUnplanned readmission rateDays of dischargeHospital risk-standardized readmission ratesAdult hospitalizationsComorbid conditionsPrincipal diagnosisClaims dataService claimsService beneficiariesReadmissionMeasure development studiesMedicaid ServicesRisk adjustmentHospital
2012
Discontinuation of Antihyperglycemic Therapy After Acute Myocardial Infarction: Medical Necessity or Medical Error?
Lovig KO, Horwitz L, Lipska K, Kosiborod M, Krumholz HM, Inzucchi SE. Discontinuation of Antihyperglycemic Therapy After Acute Myocardial Infarction: Medical Necessity or Medical Error? The Joint Commission Journal On Quality And Patient Safety 2012, 38: 403-407. PMID: 23002492, PMCID: PMC3534988, DOI: 10.1016/s1553-7250(12)38051-3.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionLeft ventricular ejection fractionAntihyperglycemic therapyDiabetic patientsMyocardial infarctionMedical necessityOne-year mortalityDetailed chart reviewVentricular ejection fractionIschemic heart diseaseNational Medicare databaseMedical errorsAcademic medical centerQuality improvement opportunitiesChart reviewClinical characteristicsOlder patientsRecurrent hypoglycemiaEjection fractionMedicare databaseBlood glucoseHeart diseasePrincipal diagnosisCommunity hospitalMedical CenterSkilled Nursing Facility Referral and Hospital Readmission Rates after Heart Failure or Myocardial Infarction
Chen J, Ross JS, Carlson MD, Lin Z, Normand SL, Bernheim SM, Drye EE, Ling SM, Han LF, Rapp MT, Krumholz HM. Skilled Nursing Facility Referral and Hospital Readmission Rates after Heart Failure or Myocardial Infarction. The American Journal Of Medicine 2012, 125: 100.e1-100.e9. PMID: 22195535, PMCID: PMC3246370, DOI: 10.1016/j.amjmed.2011.06.011.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionRisk-standardized readmission ratesSkilled nursing facilitiesHeart failureHospital-level variationReadmission ratesMyocardial infarctionRate of dischargeHospital-level readmission ratesSubstantial hospital-level variationService Medicare patientsCause readmission rateRisk of readmissionHospital readmission ratesHF admissionsRegression modelsAMI patientsFacility referralPrincipal diagnosisMedicare patientsMedicare claimsClaims dataAMI admissionsAMI hospitalizationNursing facilities
2011
30-Day Readmission for Patients Undergoing Percutaneous Coronary Interventions in New York State
Hannan EL, Zhong Y, Krumholz H, Walford G, Holmes DR, Stamato NJ, Jacobs AK, Venditti FJ, Sharma S, King SB. 30-Day Readmission for Patients Undergoing Percutaneous Coronary Interventions in New York State. JACC Cardiovascular Interventions 2011, 4: 1335-1342. PMID: 22192374, DOI: 10.1016/j.jcin.2011.08.013.Peer-Reviewed Original ResearchConceptsPercutaneous coronary interventionReadmission ratesUnique risk factorsRisk factorsCoronary interventionAdministrative databasesComplications of PCIPre-procedural risk factorsRepeat percutaneous coronary interventionChronic ischemic heart diseaseOverall readmission rateHigher readmission ratesIschemic heart diseaseLength of stayNew York State patientsRecognition of patientsDiagnostic risk factorsCost-effectiveness standpointPCI patientsPCI registryChest painHeart failureHospital readmissionHeart diseasePrincipal diagnosis
2010
The performance of US hospitals as reflected in risk‐standardized 30‐day mortality and readmission rates for medicare beneficiaries with pneumonia
Lindenauer PK, Bernheim SM, Grady JN, Lin Z, Wang Y, Wang Y, Merrill AR, Han LF, Rapp MT, Drye EE, Normand S, Krumholz HM. The performance of US hospitals as reflected in risk‐standardized 30‐day mortality and readmission rates for medicare beneficiaries with pneumonia. Journal Of Hospital Medicine 2010, 5: e12-e18. PMID: 20665626, DOI: 10.1002/jhm.822.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesReadmission ratesHospital referral regionsReferral regionsMedicare beneficiariesMortality rateRisk-standardized readmission ratesNonfederal acute care hospitalsNational quality improvement effortsPattern of hospitalAcute care hospitalsCross-sectional studyService Medicare beneficiariesQuality improvement effortsMedian hospitalHospital dischargeElderly patientsHospital admissionCare hospitalReadmission analysisOutpatient MedicareLeading causePrincipal diagnosisPneumoniaPatients
2006
Delay in the Diagnosis of Acute Myocardial Infarction: Effect on Quality of Care and Its Assessment
Graff LG, Wang Y, Borkowski B, Tuozzo K, Foody JM, Krumholz HM, Radford MJ. Delay in the Diagnosis of Acute Myocardial Infarction: Effect on Quality of Care and Its Assessment. Academic Emergency Medicine 2006, 13: 931-938. PMID: 16894002, DOI: 10.1197/j.aem.2006.04.016.Peer-Reviewed Original ResearchMeSH KeywordsAdrenergic beta-AntagonistsAge DistributionAgedAged, 80 and overAngina, UnstableAspirinCohort StudiesConnecticutEvidence-Based MedicineFemaleFibrinolytic AgentsHumansMaleMyocardial InfarctionPatient AdmissionQuality Assurance, Health CareQuality of Health CareRetrospective StudiesTime FactorsConceptsAcute myocardial infarctionAdmission diagnosisBeta blockersQuality of careMyocardial infarctionDiagnosis of AMICharacteristics of patientsPercutaneous coronary interventionPrincipal discharge diagnosisEvidence-based therapiesRate of administrationCoronary interventionCardiac catheterizationDischarge diagnosisPrincipal diagnosisFrequency of delaysDischarge statusPatient careAdmissionAMI diagnosisPatientsDiagnosisMedicare casesCareInfarction
2002
Risk and Predictors of Stroke After Myocardial Infarction Among the Elderly
Lichtman JH, Krumholz HM, Wang Y, Radford MJ, Brass LM. Risk and Predictors of Stroke After Myocardial Infarction Among the Elderly. Circulation 2002, 105: 1082-1087. PMID: 11877359, DOI: 10.1161/hc0902.104708.Peer-Reviewed Original ResearchConceptsMonths of dischargeRisk of strokeAcute myocardial infarctionMyocardial infarctionIschemic strokeOlder patientsStroke admission ratesPatients 75 yearsPeripheral vascular diseasePredictors of strokeRisk stratification scoresRate of admissionSimple clinical factorsPrior strokeStroke admissionsClinical factorsHospital admissionIndependent predictorsStratification scoresAtrial fibrillationBlack racePrincipal diagnosisVascular diseaseAdmission ratesMedicare patients
2000
Intracranial Hemorrhage Associated With Thrombolytic Therapy for Elderly Patients With Acute Myocardial Infarction
Brass L, Lichtman J, Wang Y, Gurwitz J, Radford M, Krumholz H. Intracranial Hemorrhage Associated With Thrombolytic Therapy for Elderly Patients With Acute Myocardial Infarction. Stroke 2000, 31: 1802-1811. PMID: 10926938, DOI: 10.1161/01.str.31.8.1802.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionThrombolytic therapyIntracranial hemorrhageMyocardial infarctionElderly patientsIntracranial Hemorrhage AssociatedRetrospective cohort studyRisk stratification scaleMain outcome measuresAcute care hospitalsTissue plasminogen activatorExcessive anticoagulationPrior strokeCohort studyOlder patientsBlood pressureHemorrhage AssociatedIndependent predictorsMedical chartsSerious complicationsMedian weightAlternate therapyBlack racePrincipal diagnosisMedicare patients
1999
Use of critical pathways to improve the care of patients with acute myocardial infarction11Dr. Krumholz is a Paul Beeson Faculty Scholar. This article was written by CDR Eric S. Holmboe while a fellow in the Robert Wood Johnson Clinical Scholars Program, Yale University School of Medicine. The views expressed in this article are those of the author and do not reflect the official policy or position of the Department of the Navy, Department of Defense, nor the U.S. Government.
Holmboe E, Meehan T, Radford M, Wang Y, Marciniak T, Krumholz H. Use of critical pathways to improve the care of patients with acute myocardial infarction11Dr. Krumholz is a Paul Beeson Faculty Scholar. This article was written by CDR Eric S. Holmboe while a fellow in the Robert Wood Johnson Clinical Scholars Program, Yale University School of Medicine. The views expressed in this article are those of the author and do not reflect the official policy or position of the Department of the Navy, Department of Defense, nor the U.S. Government. The American Journal Of Medicine 1999, 107: 324-331. PMID: 10527033, DOI: 10.1016/s0002-9343(99)00239-9.Peer-Reviewed Original ResearchConceptsLength of stayEvidence-based medical therapyProportion of patientsMyocardial infarctionMedical therapyMedicare patientsMain endpointCritical pathwaysAngiotensin-converting enzyme inhibitorAcute myocardial infarctionCare of patientsLongitudinal cohort studyProcess of careFirst dayQuality of careCross-sectional analysisReperfusion therapyCohort studyPrincipal diagnosisConnecticut hospitalsPatientsEnzyme inhibitorsYale University SchoolStayClinical Scholars Program
1998
Warfarin Use Following Ischemic Stroke Among Medicare Patients With Atrial Fibrillation
Brass LM, Krumholz HM, Scinto JD, Mathur D, Radford M. Warfarin Use Following Ischemic Stroke Among Medicare Patients With Atrial Fibrillation. JAMA Internal Medicine 1998, 158: 2093-2100. PMID: 9801175, DOI: 10.1001/archinte.158.19.2093.Peer-Reviewed Original ResearchConceptsUse of warfarinAtrial fibrillationIschemic strokeRecurrent strokeWarfarin useElderly patientsPrincipal diagnosisMedicare patientsLower riskConnecticut Peer Review OrganizationRegimen of warfarinElderly stroke patientsRisk of strokeAcute myocardial infarctionHigh-risk populationHigh rateChart reviewPeer review organizationsStroke patientsMyocardial infarctionWarfarin sodiumPatientsWarfarinFibrillationAnticoagulationImproving the Quality of Care for Medicare Patients With Acute Myocardial Infarction: Results From the Cooperative Cardiovascular Project
Marciniak TA, Ellerbeck EF, Radford MJ, Kresowik TF, Gold JA, Krumholz HM, Kiefe CI, Allman RM, Vogel RA, Jencks SF. Improving the Quality of Care for Medicare Patients With Acute Myocardial Infarction: Results From the Cooperative Cardiovascular Project. JAMA 1998, 279: 1351-1357. PMID: 9582042, DOI: 10.1001/jama.279.17.1351.Peer-Reviewed Original ResearchMeSH KeywordsAlabamaCardiologyCardiology Service, HospitalConnecticutData CollectionHospital MortalityHospitalsHumansIowaMedicareMyocardial InfarctionPilot ProjectsProfessional Review OrganizationsQuality Assurance, Health CareQuality Indicators, Health CareStatistics, NonparametricSurvival AnalysisUnited StatesWisconsinConceptsAcute myocardial infarctionQuality of careMyocardial infarctionMedicare patientsBeta-blocker useAdministration of aspirinClinical practice guidelinesCooperative Cardiovascular ProjectLength of stayAcute care hospitalsQuality improvement projectQuality Improvement ProgramPilot statesPostinfarction mortalityAspirin useCessation counselingCare hospitalPeer review organizationsMedian lengthInpatient claimsPrincipal diagnosisPractice guidelinesInfarctionPatientsMortality comparisons
1995
Quality of Care for Medicare Patients With Acute Myocardial Infarction: A Four-State Pilot Study From the Cooperative Cardiovascular Project
Ellerbeck E, Jencks S, Radford M, Timothy F, Craig A, Gold J, Krumholz H, Vogel R. Quality of Care for Medicare Patients With Acute Myocardial Infarction: A Four-State Pilot Study From the Cooperative Cardiovascular Project. JAMA 1995, 273: 1509-1514. DOI: 10.1001/jama.1995.03520430045037.Peer-Reviewed Original ResearchAcute myocardial infarctionQuality of careMedicare patientsMyocardial infarctionΒ-blockersRetrospective medical record reviewPercentage of patientsMedical record reviewClinical practice guidelinesCooperative Cardiovascular ProjectAcute care hospitalsHealth care professionalsPrimary hospitalizationInitial hospitalizationCare hospitalRecord reviewStandard treatmentAMI careCare indicatorsPrincipal diagnosisPractice guidelinesAMI therapyHospitalizationCare professionalsPatientsQuality of care for Medicare patients with acute myocardial infarction. A four-state pilot study from the Cooperative Cardiovascular Project.
Ellerbeck EF, Jencks SF, Radford MJ, Kresowik TF, Craig AS, Gold JA, Krumholz HM, Vogel RA. Quality of care for Medicare patients with acute myocardial infarction. A four-state pilot study from the Cooperative Cardiovascular Project. JAMA 1995, 273: 1509-14. PMID: 7739077, DOI: 10.1001/jama.273.19.1509.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionQuality of careMedicare patientsMyocardial infarctionRetrospective medical record reviewPercentage of patientsMedical record reviewClinical practice guidelinesCooperative Cardiovascular ProjectAcute care hospitalsHealth care professionalsPrimary hospitalizationInitial hospitalizationCare hospitalRecord reviewStandard treatmentAMI careCare indicatorsPrincipal diagnosisPractice guidelinesAMI therapyMAIN OUTCOMEHospitalizationCare professionalsPatients