2023
Variation in Risk‐Standardized Acute Admission Rates Among Patients With Heart Failure in Accountable Care Organizations: Implications for Quality Measurement
Chuzi S, Lindenauer P, Faridi K, Priya A, Pekow P, D'Aunno T, Mazor K, Stefan M, Spatz E, Gilstrap L, Werner R, Lagu T. Variation in Risk‐Standardized Acute Admission Rates Among Patients With Heart Failure in Accountable Care Organizations: Implications for Quality Measurement. Journal Of The American Heart Association 2023, 12: e029758. PMID: 37345796, PMCID: PMC10356066, DOI: 10.1161/jaha.122.029758.Peer-Reviewed Original ResearchConceptsAcute admission ratesHeart failureMedicare Shared Savings Program Accountable Care OrganizationsAccountable care organizationsAdmission ratesMost ACOsPrimary care providersPerformance categoriesCare organizationsACO characteristicsHealth care qualityAdmission riskBlack beneficiariesCare providersMedicare feeService beneficiariesConclusions AdmissionCare qualityPatientsAdmissionHospital affiliationACO structureFuture studiesLower proportionFailureSex Difference in Outcomes of Acute Myocardial Infarction in Young Patients
Sawano M, Lu Y, Caraballo C, Mahajan S, Dreyer R, Lichtman J, D'Onofrio G, Spatz E, Khera R, Onuma O, Murugiah K, Spertus J, Krumholz H. Sex Difference in Outcomes of Acute Myocardial Infarction in Young Patients. Journal Of The American College Of Cardiology 2023, 81: 1797-1806. PMID: 37137590, DOI: 10.1016/j.jacc.2023.03.383.Peer-Reviewed Original ResearchMeSH KeywordsFemaleHealth StatusHospitalizationHumansMaleMyocardial InfarctionRisk FactorsSex CharacteristicsSex FactorsConceptsAcute myocardial infarctionNoncardiac hospitalizationsSubdistribution HRYounger patientsMyocardial infarctionSex differencesYoung womenCause-specific hospitalizationsCause of hospitalizationWorse health statusSignificant sex disparityNoncardiovascular hospitalizationsVIRGO StudyIndex episodeAdverse outcomesIncidence rateHospitalizationHigh riskSex disparitiesHealth statusPatientsU.S. hospitalsWomenInfarctionOutcomesAdjustment for Social Risk Factors in a Measure of Clinician Quality Assessing Acute Admissions for Patients With Multiple Chronic Conditions
Lipska K, Altaf F, Barthel A, Spatz E, Lin Z, Herrin J, Bernheim S, Drye E. Adjustment for Social Risk Factors in a Measure of Clinician Quality Assessing Acute Admissions for Patients With Multiple Chronic Conditions. JAMA Health Forum 2023, 4: e230081. PMID: 36897581, DOI: 10.1001/jamahealthforum.2023.0081.Peer-Reviewed Original ResearchConceptsMultiple chronic conditionsSocial risk factorsMedicare-Medicaid dual eligibilityRisk factorsChronic conditionsSocioeconomic status indexMeasure scoresAcute admissionsCohort studyDual eligibilityHealthcare ResearchDual-eligible patientsRetrospective cohort studyUnplanned hospital admissionsRisk of hospitalizationArea Health Resource FileService beneficiaries 65 yearsBeneficiaries 65 yearsRisk factor adjustmentStatus indexMedicare administrative claimsHospital admissionOutcome measuresAdministrative claimsMAIN OUTCOME
2022
Durable functional limitation in patients with coronavirus disease-2019 admitted to intensive care and the effect of intermediate-dose vs standard-dose anticoagulation on functional outcomes
INVESTIGATORS I, Sadeghipour P, Talasaz A, Barco S, Bakhshandeh H, Rashidi F, Rafiee F, Rezaeifar P, Jamalkhani S, Matin S, Baghizadeh E, Tahamtan O, Sharif-Kashani B, Beigmohammadi M, Farrokhpour M, Sezavar S, Payandemehr P, Dabbagh A, Moghadam K, Jimenez D, Monreal M, Maleki M, Siegerink B, Spatz E, Piazza G, Parikh S, Kirtane A, Van Tassell B, Lip G, Goldhaber S, Klok F, Krumholz H, Bikdeli B. Durable functional limitation in patients with coronavirus disease-2019 admitted to intensive care and the effect of intermediate-dose vs standard-dose anticoagulation on functional outcomes. European Journal Of Internal Medicine 2022, 103: 76-83. PMID: 35879217, PMCID: PMC9212871, DOI: 10.1016/j.ejim.2022.06.014.Peer-Reviewed Original ResearchMeSH KeywordsAnticoagulantsCOVID-19Critical CareFemaleHospitalizationHumansMaleMiddle AgedSARS-CoV-2ConceptsStandard-dose prophylactic anticoagulationPatient Health Questionnaire-2Proportion of patientsProphylactic anticoagulationIntermediate doseFunctional limitationsDepressive symptomsFunctional outcomeCOVID-19Intensive care unit hospitalizationCritically Ill PatientsMultiple organ failureSevere functional limitationsFunctional Status ScaleCoronavirus disease 2019Open labelExercise limitationAirway diseaseICU patientsOrgan failureIntensive careStatus ScaleClinical trialsGrade 3Anticoagulation
2019
Associations between community well-being and hospitalisation rates: results from a cross-sectional study within six US states
Roy B, Riley C, Herrin J, Spatz E, Hamar B, Kell KP, Rula EY, Krumholz H. Associations between community well-being and hospitalisation rates: results from a cross-sectional study within six US states. BMJ Open 2019, 9: e030017. PMID: 31780588, PMCID: PMC6886944, DOI: 10.1136/bmjopen-2019-030017.Peer-Reviewed Original ResearchConceptsHospitalisation ratesZip codesPrimary care physician densityCross-sectional study SETTINGCancer-related admissionsRespiratory-related admissionsCross-sectional studyQuality of lifeRace/ethnicityCause hospitalisationSecondary outcomesPrimary outcomeHighest quintileUnnecessary hospitalisationAdmission ratesSD increaseHospitalisationLife benefitsPhysician densityStudy settingMain independent variableBeing IndexHospital bedsAdmissionGallup-Sharecare WellSevere cardiovascular morbidity in women with hypertensive diseases during delivery hospitalization
Ackerman CM, Platner MH, Spatz ES, Illuzzi JL, Xu X, Campbell KH, Smith GN, Paidas MJ, Lipkind HS. Severe cardiovascular morbidity in women with hypertensive diseases during delivery hospitalization. American Journal Of Obstetrics And Gynecology 2019, 220: 582.e1-582.e11. PMID: 30742823, DOI: 10.1016/j.ajog.2019.02.010.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultCardiomyopathiesCardiovascular DiseasesCerebrovascular DisordersCohort StudiesEclampsiaEducational StatusElectric CountershockEthnicityFemaleHeart ArrestHeart FailureHospitalizationHumansHypertension, Pregnancy-InducedInformation Storage and RetrievalInsurance, HealthLogistic ModelsMiddle AgedMultivariate AnalysisMyocardial InfarctionNew York CityObesity, MaternalPovertyPre-EclampsiaPregnancyRetrospective StudiesSeverity of Illness IndexVentricular FibrillationYoung AdultConceptsSevere cardiovascular morbidityCardiovascular morbidityDelivery hospitalizationsHypertensive disordersSevere featuresNormotensive womenGestational hypertensionCardiovascular diseaseRetrospective cohort studyClinical risk factorsPregnancy-related deathsMultivariable logistic regressionChronic hypertensionDiligent screeningSingleton gestationsCohort studyHypertensive diseaseDiabetes mellitusMaternal deathsRisk factorsInclusion criteriaDiseases-10HospitalizationMorbidityPreeclampsia
2018
Admission diagnoses among patients with heart failure: Variation by ACO performance on a measure of risk-standardized acute admission rates
Benchetrit L, Zimmerman C, Bao H, Dharmarajan K, Altaf F, Herrin J, Lin Z, Krumholz HM, Drye EE, Lipska KJ, Spatz ES. Admission diagnoses among patients with heart failure: Variation by ACO performance on a measure of risk-standardized acute admission rates. American Heart Journal 2018, 207: 19-26. PMID: 30404047, DOI: 10.1016/j.ahj.2018.09.006.Peer-Reviewed Original ResearchMeSH KeywordsAccountable Care OrganizationsAgedAlgorithmsAnalysis of VarianceCardiovascular DiseasesComorbidityFemaleHeart FailureHospitalizationHumansInternational Classification of DiseasesMaleMedicare Part AMedicare Part BPatient AdmissionPatient DischargePatient-Centered CareSex DistributionTime FactorsUnited StatesConceptsHeart failureAccountable care organizationsMean admission rateAdmission ratesAdmission typeAcute admission ratesNoncardiovascular conditionsAdmission diagnosisCause admission ratesMedicare Shared Savings Program Accountable Care OrganizationsRate of hospitalizationPrincipal discharge diagnosisProportion of admissionsType of admissionNoncardiovascular causesHF admissionsHF patientsPerson yearsDischarge diagnosisPatient populationPatientsAdmissionKey quality metricDiagnosisSubstantial proportionHeart Failure After Ischemic Stroke or Transient Ischemic Attack in Insulin-Resistant Patients Without Diabetes Mellitus Treated With Pioglitazone
Young LH, Viscoli CM, Schwartz GG, Inzucchi SE, Curtis JP, Gorman MJ, Furie KL, Conwit R, Spatz E, Lovejoy A, Abbott JD, Jacoby DL, Kolansky DM, Ling FS, Pfau SE, Kernan WN. Heart Failure After Ischemic Stroke or Transient Ischemic Attack in Insulin-Resistant Patients Without Diabetes Mellitus Treated With Pioglitazone. Circulation 2018, 138: 1210-1220. PMID: 29934374, PMCID: PMC6202153, DOI: 10.1161/circulationaha.118.034763.Peer-Reviewed Original ResearchConceptsRisk of HFTransient ischemic attackEffect of pioglitazoneHF riskHeart failureInsulin-resistant patientsMyocardial infarctionIschemic attackCardiovascular benefitsIschemic strokeDiabetes mellitusInsulin resistanceHigher C-reactive proteinComposite of strokeHF risk scoreHigher HF riskDrug dose reductionHospitalized heart failureIncident myocardial infarctionLower mean doseC-reactive proteinBaseline patient featuresHF hospitalizationCardiovascular eventsPlacebo groupAssociation of the Overall Well-being of a Population With Health Care Spending for People 65 Years of Age or Older
Riley C, Roy B, Herrin J, Spatz ES, Arora A, Kell KP, Rula EY, Krumholz HM. Association of the Overall Well-being of a Population With Health Care Spending for People 65 Years of Age or Older. JAMA Network Open 2018, 1: e182136. PMID: 30646154, PMCID: PMC6324481, DOI: 10.1001/jamanetworkopen.2018.2136.Peer-Reviewed Original ResearchConceptsMedicare FFS beneficiariesPeople 65 yearsHealth care spendingFFS beneficiariesCare spendingPopulation-based cross-sectional studyLower health care spendingHealth care system capacityCross-sectional studyHealth care systemPopulation levelPayment modelsCare payment modelsHighest quintileInverse associationStudy interventionMAIN OUTCOMEMedicare feeMedicare beneficiariesUS national studyOverall healthMedian household incomeBeing IndexCare systemDemographic characteristics
2017
Identification of Emergency Department Visits in Medicare Administrative Claims: Approaches and Implications
Venkatesh AK, Mei H, Kocher KE, Granovsky M, Obermeyer Z, Spatz E, Rothenberg C, Krumholz H, Lin Z. Identification of Emergency Department Visits in Medicare Administrative Claims: Approaches and Implications. Academic Emergency Medicine 2017, 24: 422-431. PMID: 27864915, PMCID: PMC5905698, DOI: 10.1111/acem.13140.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overClinical CodingEmergency Service, HospitalFemaleHospitalizationHumansMaleMedicareUnited StatesConceptsED visitsEmergency department visitsClaims-based definitionED visitationAdministrative claimsDepartment visitsClaims dataAdministrative claims data setsHealthcare resource utilizationMore ED visitsAcute care practiceAdministrative claims dataQuality improvement interventionsEmergency care researchMedicare administrative claimsClaims data setsED useCritical careED servicesMedicare feeMedicare dataCare practicesService beneficiariesImprovement interventionsProvider definitions
2016
Geographic Variation in Trends and Disparities in Acute Myocardial Infarction Hospitalization and Mortality by Income Levels, 1999-2013
Spatz ES, Beckman AL, Wang Y, Desai NR, Krumholz HM. Geographic Variation in Trends and Disparities in Acute Myocardial Infarction Hospitalization and Mortality by Income Levels, 1999-2013. JAMA Cardiology 2016, 1: 255-65. PMID: 27438103, PMCID: PMC5459393, DOI: 10.1001/jamacardio.2016.0382.Peer-Reviewed Original ResearchSex Differences in Clinical Profiles and Quality of Care Among Patients With ST‐Segment Elevation Myocardial Infarction From 2001 to 2011: Insights From the China Patient‐Centered Evaluative Assessment of Cardiac Events (PEACE)‐Retrospective Study
Du X, Spatz ES, Dreyer RP, Hu S, Wu C, Li X, Li J, Wang S, Masoudi FA, Spertus JA, Nasir K, Krumholz HM, Jiang L, Group F. Sex Differences in Clinical Profiles and Quality of Care Among Patients With ST‐Segment Elevation Myocardial Infarction From 2001 to 2011: Insights From the China Patient‐Centered Evaluative Assessment of Cardiac Events (PEACE)‐Retrospective Study. Journal Of The American Heart Association 2016, 5: e002157. PMID: 26903002, PMCID: PMC4802449, DOI: 10.1161/jaha.115.002157.Peer-Reviewed Original ResearchConceptsST-segment elevation myocardial infarctionElevation myocardial infarctionQuality of careEvidence-based therapiesMyocardial infarctionClinical profileHospitalization ratesST-segment elevation myocardial infarction presentationSex differencesMyocardial infarction presentationYounger age groupsProportion of womenMyocardial infarction hospitalizationsEarly aspirinHospital deathCardiac eventsHospital admissionMedian ageSymptom onsetChina PatientRetrospective studyAdmission timeHigh riskSex disparitiesPatients
2015
Trends in Short- and Long-Term Outcomes for Takotsubo Cardiomyopathy Among Medicare Fee-for-Service Beneficiaries, 2007 to 2012
Murugiah K, Wang Y, Desai NR, Spatz ES, Nuti SV, Dreyer RP, Krumholz HM. Trends in Short- and Long-Term Outcomes for Takotsubo Cardiomyopathy Among Medicare Fee-for-Service Beneficiaries, 2007 to 2012. JACC Heart Failure 2015, 4: 197-205. PMID: 26746377, PMCID: PMC5323042, DOI: 10.1016/j.jchf.2015.09.013.Peer-Reviewed Original ResearchConceptsLong-term outcomesReadmission ratesNonwhite patientsHospitalization ratesSecondary diagnosisMedicare feeYears of ageTakotsubo cardiomyopathyWorse outcomesWhite racePatientsService beneficiariesHospitalMortalityTime pointsOutcomesHospitalizationCohortDiagnosisRepresentative dataTakotsuboTTCReadmissionCardiomyopathyYearsComparative Effectiveness of CRT-D Versus Defibrillator Alone in HF Patients With Moderate-to-Severe Chronic Kidney Disease
Friedman DJ, Singh JP, Curtis JP, Tang WHW, Bao H, Spatz ES, Hernandez AF, Patel UD, Al-Khatib SM. Comparative Effectiveness of CRT-D Versus Defibrillator Alone in HF Patients With Moderate-to-Severe Chronic Kidney Disease. Journal Of The American College Of Cardiology 2015, 66: 2618-2629. PMID: 26670062, DOI: 10.1016/j.jacc.2015.09.097.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCardiac Resynchronization TherapyComorbidityComparative Effectiveness ResearchDefibrillators, ImplantableElectric CountershockFemaleGlomerular Filtration RateHeart FailureHospitalizationHumansMaleMedicareProportional Hazards ModelsRenal Insufficiency, ChronicSeverity of Illness IndexSurvival AnalysisTreatment OutcomeUnited StatesConceptsSevere chronic kidney diseaseChronic kidney diseaseCardiac resynchronization therapyCRT-eligible patientsHF hospitalizationKidney diseaseNational Cardiovascular Data Registry ICD RegistryUse of CRTComparative effectivenessInverse probability-weighted analysisReal-world comparative effectivenessEnd-stage renal diseaseCox proportional hazards modelCRT-D useHeart failure hospitalizationAcceptable complication rateDevice-related complicationsProportional hazards modelFine-Gray modelCKD classCKD stageFailure hospitalizationHF patientsPrimary endpointSecondary endpointsStandardized Outcome Measurement for Patients With Coronary Artery Disease: Consensus From the International Consortium for Health Outcomes Measurement (ICHOM)
McNamara RL, Spatz ES, Kelley TA, Stowell CJ, Beltrame J, Heidenreich P, Tresserras R, Jernberg T, Chua T, Morgan L, Panigrahi B, Rosas Ruiz A, Rumsfeld JS, Sadwin L, Schoeberl M, Shahian D, Weston C, Yeh R, Lewin J. Standardized Outcome Measurement for Patients With Coronary Artery Disease: Consensus From the International Consortium for Health Outcomes Measurement (ICHOM). Journal Of The American Heart Association 2015, 4: e001767. PMID: 25991011, PMCID: PMC4599409, DOI: 10.1161/jaha.115.001767.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionHealth Outcomes MeasurementOutcome measurementsMyocardial infarctionCoronary artery disease outcomesPatient-reported health statusCoronary artery bypassPercutaneous coronary interventionCoronary artery diseasePatient-centered outcomesStandardized outcome measurementsLongitudinal outcomesCardiovascular hospital admissionsAsymptomatic CADAcute complicationsArtery bypassCoronary interventionRenal failureArtery diseaseHospital admissionInternational Working GroupRisk factorsCardiovascular diseaseDisease outcomeOutcome measuresPatterns of Use of Angiotensin‐Converting Enzyme Inhibitors/Angiotensin Receptor Blockers Among Patients With Acute Myocardial Infarction in China From 2001 to 2011: China PEACE‐Retrospective AMI Study
Liu J, Masoudi FA, Spertus JA, Wang Q, Murugiah K, Spatz ES, Li J, Li X, Ross JS, Krumholz HM, Jiang L, Group C. Patterns of Use of Angiotensin‐Converting Enzyme Inhibitors/Angiotensin Receptor Blockers Among Patients With Acute Myocardial Infarction in China From 2001 to 2011: China PEACE‐Retrospective AMI Study. Journal Of The American Heart Association 2015, 4: e001343. PMID: 25713293, PMCID: PMC4345866, DOI: 10.1161/jaha.114.001343.Peer-Reviewed Original ResearchConceptsACEI/ARB therapyAcute myocardial infarctionClass I indicationsARB therapyMyocardial infarctionMortality riskReceptor blockersAngiotensin-Converting Enzyme Inhibitors/Angiotensin Receptor BlockersEnzyme inhibitors/angiotensin receptor blockersChina PEACE-Retrospective AMI StudyChinese AMI patientsClass IIa recommendationRates of therapyAbsence of contraindicationsAngiotensin receptor blockersHigher mortality riskCost-effective therapyIIa recommendationAMI patientsChina PatientRetrospective studyHigh riskPatterns of useChinese guidelinesPatients
2012
Patterns and Loss of Sexual Activity in the Year Following Hospitalization for Acute Myocardial Infarction (a United States National Multisite Observational Study)
Lindau ST, Abramsohn E, Gosch K, Wroblewski K, Spatz ES, Chan PS, Spertus J, Krumholz HM. Patterns and Loss of Sexual Activity in the Year Following Hospitalization for Acute Myocardial Infarction (a United States National Multisite Observational Study). The American Journal Of Cardiology 2012, 109: 1439-1444. PMID: 22546209, PMCID: PMC3341956, DOI: 10.1016/j.amjcard.2012.01.355.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionActivity 1 yearSexual activityMyocardial infarctionMain outcome measurementsActivity-related outcomesThird of womenMultivariable hierarchical modelsHospital discharge instructionsLack of counselingMultisite observational studyCorrelates of lossTRIUMPH registryPhysician counselingDischarge counselingYear mortalityDischarge instructionsMean ageObservational studyOutcome measurementsHospitalizationFirst monthPatientsMortalityInfarction