2021
SARS-CoV-2 Infection Hospitalization Rate and Infection Fatality Rate Among the Non-Congregate Population in Connecticut
Mahajan S, Caraballo C, Li SX, Dong Y, Chen L, Huston SK, Srinivasan R, Redlich CA, Ko AI, Faust JS, Forman HP, Krumholz HM. SARS-CoV-2 Infection Hospitalization Rate and Infection Fatality Rate Among the Non-Congregate Population in Connecticut. The American Journal Of Medicine 2021, 134: 812-816.e2. PMID: 33617808, PMCID: PMC7895685, DOI: 10.1016/j.amjmed.2021.01.020.Peer-Reviewed Original ResearchConceptsInfection hospitalization rateInfection fatality rateHospitalization ratesFatality rateSeroprevalence estimatesSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodiesSARS-CoV-2 antibodiesConnecticut Hospital AssociationNon-Hispanic black peopleProportion of deathsCoronavirus disease 2019Total infected individualsTotal hospitalizationsAdverse outcomesNon-congregate settingsHigh burdenDisease 2019Prevalence studyMost subgroupsInfected individualsHospitalizationOlder peopleHospital AssociationConnecticut DepartmentDeath
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 infarctionAssociation Between Insurance Status and Access to Hospital Care in Emergency Department Disposition
Venkatesh AK, Chou SC, Li SX, Choi J, Ross JS, D’Onofrio G, Krumholz HM, Dharmarajan K. Association Between Insurance Status and Access to Hospital Care in Emergency Department Disposition. JAMA Internal Medicine 2019, 179: 686-693. PMID: 30933243, PMCID: PMC6503571, DOI: 10.1001/jamainternmed.2019.0037.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAsthmaCritical CareCross-Sectional StudiesDatabases, FactualEmergency Service, HospitalFemaleHealth Services AccessibilityHospitalizationHumansInsurance CoverageInsurance, HealthLung DiseasesMaleMedicaidMedically UninsuredMiddle AgedPatient DischargePatient TransferPneumoniaPulmonary Disease, Chronic ObstructiveUnited StatesConceptsNational Emergency Department SampleEmergency Department SampleCommon medical conditionsUninsured patientsCritical care capabilitiesED dischargeED visitsED transfersPulmonary diseaseCare capabilitiesInsurance statusHigher oddsMedicaid beneficiariesMedical conditionsChronic obstructive pulmonary diseaseAcute pulmonary diseaseEmergency department transfersAdult ED visitsHospital admission ratesObstructive pulmonary diseaseEmergency department dispositionPatient insurance statusPatient case mixHospital ownership statusIntensive care capabilitiesAssociation of in-hospital resource utilization with post-acute spending in Medicare beneficiaries hospitalized for acute myocardial infarction: a cross-sectional study
Nuti SV, Li SX, Xu X, Ott LS, Lagu T, Desai NR, Murugiah K, Duan M, Martin J, Kim N, Krumholz HM. Association of in-hospital resource utilization with post-acute spending in Medicare beneficiaries hospitalized for acute myocardial infarction: a cross-sectional study. BMC Health Services Research 2019, 19: 190. PMID: 30909904, PMCID: PMC6432744, DOI: 10.1186/s12913-019-4018-0.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial infarctionPost-acute care costsPost-acute care utilizationOverall episode costsPremier Healthcare DatabaseHospital resource utilizationStudy of patientsCross-sectional studyGreater resource utilizationPost-acute periodHigh cost tertilesHigh-cost hospitalsHospital meanResultsAmong patientsReadmission ratesCare utilizationHospitalization costsEpisode costsMedicare feeTertileMedicare beneficiariesMortality rateHealthcare databasesService beneficiaries
2017
Discovery of temporal and disease association patterns in condition-specific hospital utilization rates
Haimovich JS, Venkatesh AK, Shojaee A, Coppi A, Warner F, Li SX, Krumholz HM. Discovery of temporal and disease association patterns in condition-specific hospital utilization rates. PLOS ONE 2017, 12: e0172049. PMID: 28355219, PMCID: PMC5371293, DOI: 10.1371/journal.pone.0172049.Peer-Reviewed Original Research
2016
Hospital Phenotypes in the Management of Patients Admitted for Acute Myocardial Infarction
Xu X, Li SX, Lin H, Normand SL, Lagu T, Desai N, Duan M, Kroch EA, Krumholz HM. Hospital Phenotypes in the Management of Patients Admitted for Acute Myocardial Infarction. Medical Care 2016, 54: 929-936. PMID: 27261637, PMCID: PMC5305177, DOI: 10.1097/mlr.0000000000000571.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPercutaneous coronary interventionICU admission rateICU admissionMyocardial infarctionAdmission ratesProcedure ratesIntensive care unit admissionHigher ICU admissionLower ICU admissionCare unit admissionCoronary artery bypassPatients' clinical characteristicsManagement of patientsOpen heart surgeryRisk-standardized mortalityArtery bypassUnit admissionClinical characteristicsCoronary interventionReadmission ratesGroup of hospitalsHospital costsPractice patternsCABGIdentification of Hospital Cardiac Services for Acute Myocardial Infarction Using Individual Patient Discharge Data
Chang TE, Krumholz HM, Li S, Martin J, Ranasinghe I. Identification of Hospital Cardiac Services for Acute Myocardial Infarction Using Individual Patient Discharge Data. Journal Of The American Heart Association 2016, 5: e003680. PMID: 27628573, PMCID: PMC5079029, DOI: 10.1161/jaha.116.003680.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPatient discharge dataCardiac servicesMyocardial infarctionAmerican Heart Association/American CollegePremier Healthcare DatabaseCurrent Procedural Terminology codesProcedural Terminology codesAmerican Hospital Association Annual SurveyDischarge dataPremier hospitalsCardiology guidelinesNinth RevisionAMI careInpatient careClinical ModificationAmerican CollegeTerminology codesInternational ClassificationHealthcare databasesCare variesCare processesHospitalHospital servicesPremier databaseTreatment for Multiple Acute Cardiopulmonary Conditions in Older Adults Hospitalized with Pneumonia, Chronic Obstructive Pulmonary Disease, or Heart Failure
Dharmarajan K, Strait KM, Tinetti ME, Lagu T, Lindenauer PK, Lynn J, Krukas MR, Ernst FR, Li SX, Krumholz HM. Treatment for Multiple Acute Cardiopulmonary Conditions in Older Adults Hospitalized with Pneumonia, Chronic Obstructive Pulmonary Disease, or Heart Failure. Journal Of The American Geriatrics Society 2016, 64: 1574-1582. PMID: 27448329, PMCID: PMC4988873, DOI: 10.1111/jgs.14303.Peer-Reviewed Original ResearchMeSH KeywordsAdrenal Cortex HormonesAgedAged, 80 and overAnti-Bacterial AgentsCardiotonic AgentsCohort StudiesComorbidityCross-Sectional StudiesDiureticsDrug Therapy, CombinationFemaleHeart FailureHospitalizationHumansMalePneumoniaPulmonary Disease, Chronic ObstructiveRetrospective StudiesUnited StatesVasodilator AgentsConceptsChronic obstructive pulmonary diseaseAcute cardiopulmonary conditionsObstructive pulmonary diseaseHeart failureCardiopulmonary conditionsOlder adultsPulmonary diseasePremier Research DatabaseEpisodes of pneumoniaRetrospective cohort studyReal-world treatmentHF hospitalizationCohort studyHospital daysPneumonia hospitalizationsCOPD hospitalizationsClinical syndromeAcute conditionsPneumoniaDiagnostic uncertaintyResearch DatabaseHospitalizationDiagnostic categoriesU.S. hospitalsAdultsChina Patient-centered Evaluative Assessment of Cardiac Events Prospective Study of Acute Myocardial Infarction: Study Design
Li J, Dreyer RP, Li X, Du X, Downing NS, Li L, Zhang HB, Feng F, Guan WC, Xu X, Li SX, Lin ZQ, Masoudi FA, Spertus JA, Krumholz HM, Jiang LX, Group T. China Patient-centered Evaluative Assessment of Cardiac Events Prospective Study of Acute Myocardial Infarction: Study Design. Chinese Medical Journal 2016, 129: 72-80. PMID: 26712436, PMCID: PMC4797546, DOI: 10.4103/0366-6999.172596.Peer-Reviewed Original ResearchConceptsPatient-reported outcomesAcute myocardial infarctionChina PatientMedical historyMyocardial infarctionPatient experienceLong-term adverse eventsRisk factor controlConsecutive AMI patientsAMI studyPatient's medical historyQuality of lifeNational Coordinating CentreQuality improvement activitiesHospital outcomesCardiac eventsPatient demographicsAdverse eventsMedical chartsHealthcare utilizationAMI patientsMedication adherenceProspective studyHospitalization eventsRisk factors
2015
Intravenous 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
“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 ResearchMeSH KeywordsCosts and Cost AnalysisEconomics, HospitalHeart FailureHospital MortalityHospitalizationHospitalsHumansQuality of Health CareConceptsLower 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 ValueNational Patterns of Risk-Standardized Mortality and Readmission After Hospitalization for Acute Myocardial Infarction, Heart Failure, and Pneumonia: Update on Publicly Reported Outcomes Measures Based on the 2013 Release
Suter LG, Li SX, Grady JN, Lin Z, Wang Y, Bhat KR, Turkmani D, Spivack SB, Lindenauer PK, Merrill AR, Drye EE, Krumholz HM, Bernheim SM. National Patterns of Risk-Standardized Mortality and Readmission After Hospitalization for Acute Myocardial Infarction, Heart Failure, and Pneumonia: Update on Publicly Reported Outcomes Measures Based on the 2013 Release. Journal Of General Internal Medicine 2014, 29: 1333-1340. PMID: 24825244, PMCID: PMC4175654, DOI: 10.1007/s11606-014-2862-5.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesAcute myocardial infarctionHeart failurePneumonia mortalityMyocardial infarctionMedian risk-standardized mortality rateHospital-level mortalityUnplanned readmission ratePrincipal discharge diagnosisHospital performanceRisk-Standardized MortalityHF mortalityReadmission resultsReadmission ratesDischarge diagnosisOutcome measuresAMI mortalityReadmission measuresPneumoniaMortality rateService MedicareHierarchical logistic modelsMortalityMedicaid ServicesReadmissionHospital Variation in the Use of Noninvasive Cardiac Imaging and Its Association With Downstream Testing, Interventions, and Outcomes
Safavi KC, Li SX, Dharmarajan K, Venkatesh AK, Strait KM, Lin H, Lowe TJ, Fazel R, Nallamothu BK, Krumholz HM. Hospital Variation in the Use of Noninvasive Cardiac Imaging and Its Association With Downstream Testing, Interventions, and Outcomes. JAMA Internal Medicine 2014, 174: 546-553. PMID: 24515551, PMCID: PMC5459406, DOI: 10.1001/jamainternmed.2013.14407.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionNoninvasive cardiac imagingDownstream testingReadmission ratesRevascularization proceduresCardiac imagingHospital variationCardiac ischemiaProportion of patientsNoninvasive imagingLower readmission ratesPrincipal discharge diagnosisCross-sectional studyCardiac biomarker testsQ4 hospitalsChest discomfortCoronary angiographyCoronary diseaseDischarge diagnosisCoronary angiogramEmergency departmentMyocardial infarctionSame hospitalCurrent guidelinesInpatient wards
2013
Acute Decompensated Heart Failure Is Routinely Treated as a Cardiopulmonary Syndrome
Dharmarajan K, Strait KM, Lagu T, Lindenauer PK, Tinetti ME, Lynn J, Li SX, Krumholz HM. Acute Decompensated Heart Failure Is Routinely Treated as a Cardiopulmonary Syndrome. PLOS ONE 2013, 8: e78222. PMID: 24250751, PMCID: PMC3824040, DOI: 10.1371/journal.pone.0078222.Peer-Reviewed Original ResearchConceptsDecompensated heart failureHeart failureRespiratory therapyHospital daysCardiopulmonary syndromeAcute decompensated heart failureAcute heart failure treatmentChronic obstructive pulmonary diseaseReceipt of medicationHeart failure hospitalizationHigh-dose corticosteroidsHospital day 2Hospital day 3Half of patientsChronic lung diseaseDays of hospitalizationHeart failure treatmentObstructive pulmonary diseaseShortness of breathIntensive care unitPrincipal discharge diagnosisLate intubationAcute asthmaFailure hospitalizationHospital deathContraindicated Initiation of β-Blocker Therapy in Patients Hospitalized for Heart Failure
Dharmarajan K, Masoudi FA, Spertus JA, Li SX, Krumholz HM. Contraindicated Initiation of β-Blocker Therapy in Patients Hospitalized for Heart Failure. JAMA Internal Medicine 2013, 173: 1547-1549. PMID: 23797379, PMCID: PMC4043342, DOI: 10.1001/jamainternmed.2013.7717.Peer-Reviewed Original ResearchPatterns of Change in Nesiritide Use in Patients With Heart Failure How Hospitals React to New Information
Partovian C, Li SX, Xu X, Lin H, Strait KM, Hwa J, Krumholz HM. Patterns of Change in Nesiritide Use in Patients With Heart Failure How Hospitals React to New Information. JACC Heart Failure 2013, 1: 318-324. PMID: 24621935, PMCID: PMC5322944, DOI: 10.1016/j.jchf.2013.04.005.Peer-Reviewed Original ResearchConceptsHeart failureNesiritide useHospital characteristicsHospital groupDecompensated heart failureProportion of hospitalizationsPatterns of changeMultivariate regression analysisPatient characteristicsEarly reliefHospital patternsHospitalTeaching statusPremier databaseMedical evidenceHospitalizationPatientsRegression analysisSafety concernsLow usersUse ratesGroupFailureFurther researchDyspneaSpending 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 Research
2012
Procedure 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
Long-term Trends in Short-term Outcomes in Acute Myocardial Infarction
Nguyen HL, Saczynski JS, Gore JM, Waring ME, Lessard D, Yarzebski J, Reed G, Spencer FA, Li SX, Goldberg RJ. Long-term Trends in Short-term Outcomes in Acute Myocardial Infarction. The American Journal Of Medicine 2011, 124: 939-946. PMID: 21962314, PMCID: PMC3185241, DOI: 10.1016/j.amjmed.2011.05.023.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionShort-term outcomesOlder patientsAtrial fibrillationMyocardial infarctionAdverse short-term outcomesGreater Worcester medical centersShort-term death ratesShort-term mortality rateMen 75 yearsShort-term mortalityTargeted treatment approachCardiogenic shockHeart failureMajor complicationsAge differencesElderly menMedical CenterStudy populationMortality rateTreatment approachesPatientsDeath rateFemale residentsWomen