2023
Association of Neighborhood-Level Marginalization With Health Care Use and Clinical Outcomes Following Hospital Discharge in Patients Who Underwent Coronary Catheterization for Acute Myocardial Infarction in a Single-Payer Health Care System
Akioyamen L, Abdel-Qadir H, Han L, Sud M, Mistry N, Alter D, Atzema C, Austin P, Bhatia R, Booth G, Dhalla I, Ha A, Jackevicius C, Kapral M, Krumholz H, Lee D, McNaughton C, Roifman I, Schull M, Sivaswamy A, Tu K, Udell J, Wijeysundera H, Ko D. Association of Neighborhood-Level Marginalization With Health Care Use and Clinical Outcomes Following Hospital Discharge in Patients Who Underwent Coronary Catheterization for Acute Myocardial Infarction in a Single-Payer Health Care System. Circulation Cardiovascular Quality And Outcomes 2023, 16: e010063. PMID: 38050754, DOI: 10.1161/circoutcomes.123.010063.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial infarctionHealth care systemHospital dischargeClinical outcomesSocioeconomic statusFirst acute myocardial infarctionProportional hazards regression modelsCare systemSecondary prevention medicationsWorse clinical outcomesHealth service usePopulation-based studyPrimary care physiciansHealth care useHazards regression modelsGreater long-term riskPrescription medication useSingle-payer health care systemUniversal health care systemLong-term riskLow socioeconomic statusCause mortalityDays postdischargePrevention medications
2020
THE IMPACT OF THE AFFORDABLE CARE ACT ON DISPARITIES IN UTILIZATION OF CARDIOVASCULAR PREVENTIVE SERVICES BY SOCIOECONOMIC STATUS
Verma H, Hong J, Mahajan S, Desai N, Virani S, Krumholz H, Krumholz H, Nasir K, Elizondo J. THE IMPACT OF THE AFFORDABLE CARE ACT ON DISPARITIES IN UTILIZATION OF CARDIOVASCULAR PREVENTIVE SERVICES BY SOCIOECONOMIC STATUS. Journal Of The American College Of Cardiology 2020, 75: 2044. DOI: 10.1016/s0735-1097(20)32671-1.Peer-Reviewed Original Research
2019
Characteristics of High Cardiovascular Risk in 1.7 Million Chinese Adults.
Lu J, Lu Y, Yang H, Bilige W, Li Y, Schulz W, Masoudi FA, Krumholz HM. Characteristics of High Cardiovascular Risk in 1.7 Million Chinese Adults. Annals Of Internal Medicine 2019, 170: 298-308. PMID: 30776800, DOI: 10.7326/m18-1932.Peer-Reviewed Original ResearchConceptsHigh CVD riskCVD riskHigh riskHigh cardiovascular disease riskCardiovascular risk increasesHigh cardiovascular riskOverall study populationCardiovascular disease riskBody mass indexMultivariable mixed modelsNational Health CommissionAntihypertensive medicationsAspirin useCardiovascular riskCVD screeningMass indexStudy populationChinese adultsHan ethnicityDisease riskStatinsMixed modelsHealth CommissionSocioeconomic statusPopulation subgroups
2018
Association of Racial and Socioeconomic Disparities With Outcomes Among Patients Hospitalized With Acute Myocardial Infarction, Heart Failure, and Pneumonia
Downing NS, Wang C, Gupta A, Wang Y, Nuti SV, Ross JS, Bernheim SM, Lin Z, Normand ST, Krumholz HM. Association of Racial and Socioeconomic Disparities With Outcomes Among Patients Hospitalized With Acute Myocardial Infarction, Heart Failure, and Pneumonia. JAMA Network Open 2018, 1: e182044. PMID: 30646146, PMCID: PMC6324513, DOI: 10.1001/jamanetworkopen.2018.2044.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBlack PeopleCohort StudiesFee-for-Service PlansFemaleHealth Status DisparitiesHeart FailureHospitalizationHospitalsHumansMaleMedicareMiddle AgedMyocardial InfarctionOutcome Assessment, Health CarePneumoniaRacial GroupsRetrospective StudiesSocial ClassUnited StatesWhite PeopleConceptsAcute myocardial infarctionRisk-standardized mortality ratesRisk-standardized readmission ratesReadmission ratesHeart failureMyocardial infarctionMortality rateIntraclass correlation coefficientAnalysis cohortBlack patientsHospital proportionSocioeconomic disparitiesHospital analysisRisk-standardized outcomesRisk-standardized ratesRetrospective cohort studySocioeconomic statusNeighborhood income levelHospital performanceHospital outcomesCohort studyNumber of hospitalsBroader systemic effectsPatient raceMAIN OUTCOME
2016
Accounting For Patients’ Socioeconomic Status Does Not Change Hospital Readmission Rates
Bernheim SM, Parzynski CS, Horwitz L, Lin Z, Araas MJ, Ross JS, Drye EE, Suter LG, Normand SL, Krumholz HM. Accounting For Patients’ Socioeconomic Status Does Not Change Hospital Readmission Rates. Health Affairs 2016, 35: 1461-1470. PMID: 27503972, PMCID: PMC7664840, DOI: 10.1377/hlthaff.2015.0394.Peer-Reviewed Original ResearchConceptsHospital Readmissions Reduction ProgramPatients' socioeconomic statusMedicare's Hospital Readmissions Reduction ProgramLow socioeconomic statusReadmission ratesSocioeconomic statusRisk-standardized readmission ratesHospital readmission ratesReadmissions Reduction ProgramMedicaid Services methodologyReadmission measuresHospital resultsPatientsHospitalSuch hospitalsPayment penaltiesReduction programsStatusCurrent CentersLower proportionLarge proportionPercentAdjustmentProportionRisk-standardized Acute Admission Rates Among Patients With Diabetes and Heart Failure as a Measure of Quality of Accountable Care Organizations
Spatz ES, Lipska KJ, Dai Y, Bao H, Lin Z, Parzynski CS, Altaf FK, Joyce EK, Montague JA, Ross JS, Bernheim SM, Krumholz HM, Drye EE. Risk-standardized Acute Admission Rates Among Patients With Diabetes and Heart Failure as a Measure of Quality of Accountable Care Organizations. Medical Care 2016, 54: 528-537. PMID: 26918404, PMCID: PMC5356461, DOI: 10.1097/mlr.0000000000000518.Peer-Reviewed Original ResearchConceptsHeart failure measuresAccountable care organizationsAcute admission ratesHeart failureAdmission ratesNational ratesUnplanned hospital admissionsHeart failure cohortRisk-adjustment variablesPopulation-based measuresCare organizationsOutcome measure developmentIntraclass correlation coefficientHospital admissionDiabetes measuresFailure cohortChronic conditionsMedicare feeDiabetesService beneficiariesPatientsMeet criteriaMeasures of qualitySocioeconomic statusPerformance categories
2014
Place of Residence and Outcomes of Patients With Heart Failure
Bikdeli B, Wayda B, Bao H, Ross JS, Xu X, Chaudhry SI, Spertus JA, Bernheim SM, Lindenauer PK, Krumholz HM. Place of Residence and Outcomes of Patients With Heart Failure. Circulation Cardiovascular Quality And Outcomes 2014, 7: 749-756. PMID: 25074375, PMCID: PMC5323058, DOI: 10.1161/circoutcomes.113.000911.Peer-Reviewed Original ResearchConceptsNeighborhood socioeconomic statusIndividual socioeconomic statusOutcomes of patientsHeart failureHigher SES neighborhoodsSocioeconomic statusClinical factorsHeart Failure Outcomes trialPrimary end pointPatient-level factorsUS internal medicineCause mortalityCause readmissionMultivariable adjustmentOutcome trialsMedical chartsPatient interviewsLow-SES neighborhoodsCardiology practiceMortality ratePatientsPlace of residenceInternal medicineReadmissionEnd point
2010
Racial Disparities in Health Literacy and Access to Care Among Patients With Heart Failure
Chaudhry SI, Herrin J, Phillips C, Butler J, Mukerjhee S, Murillo J, Onwuanyi A, Seto TB, Spertus J, Krumholz HM. Racial Disparities in Health Literacy and Access to Care Among Patients With Heart Failure. Journal Of Cardiac Failure 2010, 17: 122-127. PMID: 21300301, PMCID: PMC3053061, DOI: 10.1016/j.cardfail.2010.09.016.Peer-Reviewed Original ResearchConceptsHeart failure patientsHealth literacyFailure patientsHeart failureInsurance statusWorse health literacyOutpatient medical careRacial differencesImportant racial differencesNoncardiac comorbiditiesUnadjusted analysesBlack raceCare existMedical homePatientsMedical careRacial disparitiesSocioeconomic statusStrong associationPotential mediatorsHealth carePoor accessCareSocial supportStatus
2008
Influence of Patients’ Socioeconomic Status on Clinical Management Decisions: A Qualitative Study
Bernheim SM, Ross JS, Krumholz HM, Bradley EH. Influence of Patients’ Socioeconomic Status on Clinical Management Decisions: A Qualitative Study. The Annals Of Family Medicine 2008, 6: 53-59. PMID: 18195315, PMCID: PMC2203396, DOI: 10.1370/afm.749.Peer-Reviewed Original ResearchConceptsClinical management decisionsPatients' socioeconomic statusClinical managementSocioeconomic statusPatient sPatient outcomesPrimary care physiciansStandard of careInfluence of patientLow socioeconomic statusVaried practice settingsHealth care qualitySES influencesCare physiciansHispanic ethnicityPhysician perspectivesPractice settingsCare qualityPatientsPhysiciansPatient interestMinority racial backgroundsInterview guideFinancial strainOutcomes
2007
Socioeconomic disparities in outcomes after acute myocardial infarction
Bernheim SM, Spertus JA, Reid KJ, Bradley EH, Desai RA, Peterson ED, Rathore SS, Normand SL, Jones PG, Rahimi A, Krumholz HM. Socioeconomic disparities in outcomes after acute myocardial infarction. American Heart Journal 2007, 153: 313-319. PMID: 17239695, DOI: 10.1016/j.ahj.2006.10.037.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionBaseline clinical statusClinical factorsQuality of careLow socioeconomic statusSocioeconomic statusClinical statusMyocardial infarctionMultivariable modelingWorse clinical statusEducation levelSelf-reported household incomeCause mortalityCause rehospitalizationHazard ratioCare measuresObservational studyHousehold incomeRehospitalizationHigh riskUS hospitalsHigh mortalityPatientsMortalitySocioeconomic disparities
2006
Socioeconomic status, treatment, and outcomes among elderly patients hospitalized with heart failure: Findings from the National Heart Failure Project
Rathore SS, Masoudi FA, Wang Y, Curtis JP, Foody JM, Havranek EP, Krumholz HM. Socioeconomic status, treatment, and outcomes among elderly patients hospitalized with heart failure: Findings from the National Heart Failure Project. American Heart Journal 2006, 152: 371-378. PMID: 16875925, PMCID: PMC2790269, DOI: 10.1016/j.ahj.2005.12.002.Peer-Reviewed Original ResearchConceptsLeft ventricular systolic function assessmentHigh SES patientsVentricular systolic function assessmentHeart failureSES patientsSystolic function assessmentYear of dischargeQuality of careSocioeconomic statusMultivariable adjustmentFunction assessmentEnzyme inhibitorsNational Heart Failure ProjectHeart Failure ProjectPrescription of angiotensinLow SES patientsPatients' socioeconomic statusAssociation of SESYear of admissionMedical record dataHierarchical logistic regression modelsLow socioeconomic statusLogistic regression modelsPatient sElderly patients
2005
The impact of socioeconomic status and race on trial participation for older women with breast cancer
Gross CP, Filardo G, Mayne ST, Krumholz HM. The impact of socioeconomic status and race on trial participation for older women with breast cancer. Cancer 2005, 103: 483-491. PMID: 15597407, DOI: 10.1002/cncr.20792.Peer-Reviewed Original ResearchMeSH KeywordsAgedAsianBlack or African AmericanBreast NeoplasmsCase-Control StudiesClinical Trials as TopicFemaleHispanic or LatinoHumansLogistic ModelsMedicaidMultivariate AnalysisNational Institutes of Health (U.S.)Odds RatioPatient SelectionPovertySEER ProgramUnemploymentUnited StatesWhite PeopleConceptsBreast cancer trialsTrial participationOlder womenBreast cancerSocioeconomic statusMedicaid insuranceTrial enrollmentCancer patientsCancer trialsMultivariable logistic regression modelBreast cancer patientsMedicaid insurance coverageAssociation of SESHigh-poverty zip codesCase-control studyPopulation-based sampleLow socioeconomic statusLogistic regression modelsImpact of SESWhite patientsBlack patientsSEER areasBlack raceElderly womenTrial participants
1995
Cholesterol and Coronary Heart Disease Risk in Elderly Patients-Reply
Krumholz H, Seeman T, de Leon C, Vaccarino V, Berkman L. Cholesterol and Coronary Heart Disease Risk in Elderly Patients-Reply. JAMA 1995, 273: 1330-1331. DOI: 10.1001/jama.1995.03520410023011.Peer-Reviewed Original ResearchLow cholesterol levelsCholesterol levelsHealth statusCoronary heart disease riskHeart disease riskOverall health statusPoor health statusAssociation of cholesterolEarly mortalityAdverse outcomesFunctional statusElderly populationPsychosocial supportPotential associationDisease riskCognitive functionPatients' repliesSocioeconomic statusCholesterol groupSignificant differencesAfrican AmericansCholesterolOnly unique featureSubstantial numberStatus