2022
Trends in 10-Year Outcomes Among Medicare Beneficiaries Who Survived an Acute Myocardial Infarction
Wang Y, Leifheit EC, Krumholz HM. Trends in 10-Year Outcomes Among Medicare Beneficiaries Who Survived an Acute Myocardial Infarction. JAMA Cardiology 2022, 7: 613-622. PMID: 35507330, PMCID: PMC9069341, DOI: 10.1001/jamacardio.2022.0662.Peer-Reviewed Original ResearchConceptsRecurrent acute myocardial infarctionAcute myocardial infarctionHealth priority areasLong-term outcomesCause mortalityHazard ratioWhite patientsMyocardial infarctionMedicare feeMedicare-MedicaidService beneficiariesInitial acute myocardial infarctionTen-year mortalityShort-term outcomesDemographic subgroupsEligible patientsPatient characteristicsAMI survivorsAcute periodMean ageRecurrence rateSubgroup analysisMAIN OUTCOMEMortality riskAMI admissionsSex Differences in PrEsentation, Risk Factors, Drug and Interventional Therapies, and OUtcomes of Elderly PatientS with Pulmonary Embolism: Rationale and design of the SERIOUS-PE study
Bikdeli B, Piazza G, Jimenez D, Muriel A, Wang Y, Khairani CD, Rosovsky RP, Mehdipoor G, O'Donoghue ML, Spagnolo P, Dreyer RP, Bertoletti L, López-Jiménez L, Núñez MJ, Blanco-Molina Á, Bates SM, Gerhard-Herman M, Goldhaber SZ, Monreal M, Krumholz HM. Sex Differences in PrEsentation, Risk Factors, Drug and Interventional Therapies, and OUtcomes of Elderly PatientS with Pulmonary Embolism: Rationale and design of the SERIOUS-PE study. Thrombosis Research 2022, 214: 122-131. PMID: 35537232, DOI: 10.1016/j.thromres.2022.04.019.Peer-Reviewed Original ResearchConceptsRisk factorsElderly patientsUS Medicare feeInterventional therapyMedicare feeInternational registryService beneficiariesSex differencesNational US databasePrognostic prediction rulePulmonary embolism studyLarge international registryPrincipal discharge diagnosisSex-based disparitiesAssessment of outcomesPotential sex differencesSex-specific findingsPE presentationPulmonary embolismVenous thromboembolismTreatment patternsDischarge diagnosisAvailable therapiesDisease presentationTreatment-based differences
2021
National Trends and Disparities in Hospitalization for Acute Hypertension Among Medicare Beneficiaries (1999–2019)
Lu Y, Wang Y, Spatz ES, Onuma O, Nasir K, Rodriguez F, Watson KE, Krumholz HM. National Trends and Disparities in Hospitalization for Acute Hypertension Among Medicare Beneficiaries (1999–2019). Circulation 2021, 144: 1683-1693. PMID: 34743531, DOI: 10.1161/circulationaha.121.057056.Peer-Reviewed Original ResearchConceptsHigher hospitalization ratesAcute hypertensionHospitalization ratesMedicare feeService beneficiariesBlack adultsSerial cross-sectional analysisCause readmission rateNational hospitalization ratesPrimary discharge diagnosisAnnual hospitalization rateCause mortality ratesPoisson link functionDual-eligible statusMedicare/MedicaidCross-sectional analysisHypertension controlReadmission ratesDischarge diagnosisDiseases codesMedicare denominatorInpatient filesHypertensionInternational ClassificationMedicare beneficiaries
2020
Variation in Risk-standardized Rates and Causes of Unplanned Hospital Visits Within 7 Days of Hospital Outpatient Surgery
Desai MM, Zogg CK, Ranasinghe I, Parzynski CS, Lin Z, Gorbaty M, Merrill A, Krumholz HM, Drye EE. Variation in Risk-standardized Rates and Causes of Unplanned Hospital Visits Within 7 Days of Hospital Outpatient Surgery. Annals Of Surgery 2020, 276: e714-e720. PMID: 33214469, DOI: 10.1097/sla.0000000000004627.Peer-Reviewed Original ResearchConceptsUnplanned hospital visitsHospital outpatient surgeryHospital outpatient departmentsHospital visitsOutpatient surgeryShort-term safety outcomesFacility-level variationHierarchical logistic regression modelingPost-surgical visitSame-day surgeryHalf of proceduresLogistic regression modelingUrinary retentionStudy cohortUnplanned visitsClinical comorbiditiesOutpatient departmentOutpatient settingPreventable conditionPreventable reasonsBACKGROUND DATASafety outcomesMedicare feeSurgeryService beneficiariesTimely estimation of National Admission, readmission, and observation-stay rates in medicare patients with acute myocardial infarction, heart failure, or pneumonia using near real-time claims data
Li SX, Wang Y, Lama SD, Schwartz J, Herrin J, Mei H, Lin Z, Bernheim SM, Spivack S, Krumholz HM, Suter LG. Timely estimation of National Admission, readmission, and observation-stay rates in medicare patients with acute myocardial infarction, heart failure, or pneumonia using near real-time claims data. BMC Health Services Research 2020, 20: 733. PMID: 32778098, PMCID: PMC7416804, DOI: 10.1186/s12913-020-05611-w.Peer-Reviewed Original Research
2019
Pulmonary Embolism Hospitalization, Readmission, and Mortality Rates in US Older Adults, 1999-2015
Bikdeli B, Wang Y, Jimenez D, Parikh SA, Monreal M, Goldhaber SZ, Krumholz HM. Pulmonary Embolism Hospitalization, Readmission, and Mortality Rates in US Older Adults, 1999-2015. JAMA 2019, 322: 574-576. PMID: 31408124, PMCID: PMC6692667, DOI: 10.1001/jama.2019.8594.Peer-Reviewed Original ResearchDigoxin Use and Associated Adverse Events Among Older Adults
Angraal S, Nuti SV, Masoudi FA, Freeman JV, Murugiah K, Shah ND, Desai NR, Ranasinghe I, Wang Y, Krumholz HM. Digoxin Use and Associated Adverse Events Among Older Adults. The American Journal Of Medicine 2019, 132: 1191-1198. PMID: 31077654, DOI: 10.1016/j.amjmed.2019.04.022.Peer-Reviewed Original ResearchConceptsRate of hospitalizationDigoxin useDigoxin toxicityNational Prescription AuditMedicare feeService beneficiariesDigoxin prescriptionAssociated adverse eventsAdverse eventsCohort studyAdverse outcomesSecondary diagnosisNational cohortPrescription auditPrescription trendsClinical guidelinesHospitalizationMortality rateClinical practiceOlder adultsSubsequent outcomesOutcomesToxicityPrescriptionNational-level trendsAssociation 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 beneficiariesAssociation of Inferior Vena Cava Filter Use With Mortality Rates in Older Adults With Acute Pulmonary Embolism
Bikdeli B, Wang Y, Jimenez D, Ross JS, Monreal M, Goldhaber SZ, Krumholz HM. Association of Inferior Vena Cava Filter Use With Mortality Rates in Older Adults With Acute Pulmonary Embolism. JAMA Internal Medicine 2019, 179: 263-265. PMID: 30535318, PMCID: PMC6439651, DOI: 10.1001/jamainternmed.2018.5287.Peer-Reviewed Original Research
2018
Ventricular septal rupture complicating acute myocardial infarction: Incidence, treatment, and outcomes among medicare beneficiaries 1999–2014
Goldsweig AM, Wang Y, Forrest JK, Cleman MW, Minges KE, Mangi AA, Aronow HD, Krumholz HM, Curtis JP. Ventricular septal rupture complicating acute myocardial infarction: Incidence, treatment, and outcomes among medicare beneficiaries 1999–2014. Catheterization And Cardiovascular Interventions 2018, 92: 1104-1115. PMID: 29513365, DOI: 10.1002/ccd.27576.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionVentricular septal ruptureTimely primary PCIMortality ratePrimary PCIPercutaneous repairSeptal ruptureMyocardial infarctionRetrospective cohort studyUnadjusted mortality ratesUnrepaired patientsVSR repairFatal complicationCohort studyAnnual incidenceMedicare feeService beneficiariesPatientsIncidenceStudy periodMortalityHospitalizationInfarctionRepairPCIDefining Multiple Chronic Conditions for Quality Measurement
Drye EE, Altaf FK, Lipska KJ, Spatz ES, Montague JA, Bao H, Parzynski CS, Ross JS, Bernheim SM, Krumholz HM, Lin Z. Defining Multiple Chronic Conditions for Quality Measurement. Medical Care 2018, 56: 193-201. PMID: 29271820, DOI: 10.1097/mlr.0000000000000853.Peer-Reviewed Original ResearchConceptsMultiple chronic conditionsChronic conditionsMedicare feeService beneficiariesMedicare Chronic Conditions WarehouseMCC cohortBroad cohortChronic Conditions WarehouseRisk-standardized ratesNational quality measuresUnplanned admissionsFinal cohortTotal admissionsAdmission riskAccountable care organizationsAdmission ratesOutcome measuresAdmissionCohortCohort conditionCare organizationsPatientsStakeholder inputNarrow cohortBeneficiaries
2017
Quality of Care in the United States Territories, 1999–2012
Nuti SV, Wang Y, Masoudi FA, Nunez-Smith M, Normand ST, Murugiah K, Rodríguez-Vilá O, Ross JS, Krumholz HM. Quality of Care in the United States Territories, 1999–2012. Medical Care 2017, 55: 886-892. PMID: 28906314, PMCID: PMC6482857, DOI: 10.1097/mlr.0000000000000797.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionHeart failureHospitalization ratesMedicare beneficiariesMortality rateService Medicare beneficiariesQuality of careRecent study periodPneumonia hospitalizationsMyocardial infarctionPatient outcomesMillions of AmericansMedicare feeHealth outcomesPneumoniaService beneficiariesHospital reimbursementUnique beneficiariesHealth equityStudy periodPatient paymentsInpatient paymentsHealth careMortalityCareAssociation of Changing Hospital Readmission Rates With Mortality Rates After Hospital Discharge
Dharmarajan K, Wang Y, Lin Z, Normand ST, Ross JS, Horwitz LI, Desai NR, Suter LG, Drye EE, Bernheim SM, Krumholz HM. Association of Changing Hospital Readmission Rates With Mortality Rates After Hospital Discharge. JAMA 2017, 318: 270-278. PMID: 28719692, PMCID: PMC5817448, DOI: 10.1001/jama.2017.8444.Peer-Reviewed Original ResearchConceptsRisk-adjusted readmission ratesRisk-adjusted mortality ratesAcute myocardial infarctionHeart failureReadmission ratesMortality rateMyocardial infarctionMedicare feeService beneficiariesHospital readmission ratesMean hospitalHospital mortalityPostdischarge mortalityHospital dischargeHospital readmissionRetrospective studyAffordable Care ActReadmission reductionMAIN OUTCOMEPneumoniaHospitalSecondary analysisWeighted Pearson correlation coefficientMortalityCare ActSex Differences in Trajectories of Risk After Rehospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia
Dreyer RP, Dharmarajan K, Hsieh AF, Welsh J, Qin L, Krumholz HM. Sex Differences in Trajectories of Risk After Rehospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia. Circulation Cardiovascular Quality And Outcomes 2017, 10: e003271. PMID: 28506980, PMCID: PMC5650228, DOI: 10.1161/circoutcomes.116.003271.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial infarctionHeart failureReadmission riskDaily riskImmediate postdischarge periodRisk of rehospitalizationSex differencesDeath 1 yearPrincipal discharge diagnosisHospitalization of patientsAssociation of sexRehospitalization riskPostdischarge periodDischarge diagnosisMedicare patientsHigh riskMortality riskMedicare feeTrajectories of riskRehospitalizationInfarctionService beneficiariesHospitalizationPneumoniaIdentification 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 ResearchConceptsED 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
Association Between Hospital Penalty Status Under the Hospital Readmission Reduction Program and Readmission Rates for Target and Nontarget Conditions
Desai NR, Ross JS, Kwon JY, Herrin J, Dharmarajan K, Bernheim SM, Krumholz HM, Horwitz LI. Association Between Hospital Penalty Status Under the Hospital Readmission Reduction Program and Readmission Rates for Target and Nontarget Conditions. JAMA 2016, 316: 2647-2656. PMID: 28027367, PMCID: PMC5599851, DOI: 10.1001/jama.2016.18533.Peer-Reviewed Original ResearchConceptsHospital Readmissions Reduction ProgramAcute myocardial infarctionReadmission ratesReadmissions Reduction ProgramHeart failurePenalty statusNontarget conditionsMedicare feeMean readmission rateThirty-day riskRetrospective cohort studyUnplanned readmission rateReduction programsHRRP announcementHRRP implementationPenalized hospitalsCohort studyService patientsMyocardial infarctionMAIN OUTCOMEExcess readmissionsMedicare beneficiariesService beneficiariesHospitalPatientsTrajectories of Risk for Specific Readmission Diagnoses after Hospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia
Krumholz HM, Hsieh A, Dreyer RP, Welsh J, Desai NR, Dharmarajan K. Trajectories of Risk for Specific Readmission Diagnoses after Hospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia. PLOS ONE 2016, 11: e0160492. PMID: 27716841, PMCID: PMC5055318, DOI: 10.1371/journal.pone.0160492.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionRisk of readmissionHeart failureReadmission diagnosesHospital dischargeReadmission riskTiming of riskMyocardial infarctionImmediate post-discharge periodDiagnostic categoriesPhysiologic systemsRisk of rehospitalizationGeneral elderly populationRisk of deathPost-discharge periodPost-discharge interventionsTrauma/injuryHospitalization riskHospitalizationTrajectories of riskElderly populationMedicare feePneumoniaRehospitalizationService beneficiariesRisk-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
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 dataTakotsuboTTCReadmissionCardiomyopathyYearsMortality, Hospitalizations, and Expenditures for the Medicare Population Aged 65 Years or Older, 1999-2013
Krumholz HM, Nuti SV, Downing NS, Normand SL, Wang Y. Mortality, Hospitalizations, and Expenditures for the Medicare Population Aged 65 Years or Older, 1999-2013. JAMA 2015, 314: 355-365. PMID: 26219053, PMCID: PMC5459402, DOI: 10.1001/jama.2015.8035.Peer-Reviewed Original ResearchConceptsMonths of lifeMedicare beneficiariesService beneficiariesMedicare feeInpatient expendituresCause mortalitySerial cross-sectional analysisCause mortality ratesNumber of hospitalizationsIntensity of careUnique Medicare beneficiariesCross-sectional analysisPercentage of beneficiariesCause hospitalizationTotal hospitalizationsMore hospitalizationsHospitalization ratesMedicare denominatorInpatient filesHospitalizationMAIN OUTCOMEMortality rateMortalityHealth careKey demographic groups