2024
Racial and Ethnic Disparities in Age-Specific All-Cause Mortality During the COVID-19 Pandemic
Faust J, Renton B, Bongiovanni T, Chen A, Sheares K, Du C, Essien U, Fuentes-Afflick E, Haywood T, Khera R, King T, Li S, Lin Z, Lu Y, Marshall A, Ndumele C, Opara I, Loarte-Rodriguez T, Sawano M, Taparra K, Taylor H, Watson K, Yancy C, Krumholz H. Racial and Ethnic Disparities in Age-Specific All-Cause Mortality During the COVID-19 Pandemic. JAMA Network Open 2024, 7: e2438918. PMID: 39392630, PMCID: PMC11581672, DOI: 10.1001/jamanetworkopen.2024.38918.Peer-Reviewed Original ResearchConceptsCOVID-19 public health emergencyNon-HispanicPublic health emergencyOther Pacific IslanderExcess mortalityAlaska NativesUS populationExcess deathsRates of excess mortalityCross-sectional study analyzed dataYears of potential lifeMortality relative riskNon-Hispanic whitesCross-sectional studyPacific IslandersStudy analyzed dataAll-cause mortalityEthnic groupsMortality disparitiesMortality ratioTotal populationDeath certificatesEthnic disparitiesMain OutcomesDecedent ageCause-Specific Mortality Rates Among the US Black Population
Arun A, Caraballo C, Sawano M, Lu Y, Khera R, Yancy C, Krumholz H. Cause-Specific Mortality Rates Among the US Black Population. JAMA Network Open 2024, 7: e2436402. PMID: 39348122, PMCID: PMC11443349, DOI: 10.1001/jamanetworkopen.2024.36402.Commentaries, Editorials and Letters
2023
Quantifying Blood Pressure Visit-to-Visit Variability in the Real-World Setting: A Retrospective Cohort Study
Lu Y, Linderman G, Mahajan S, Liu Y, Huang C, Khera R, Mortazavi B, Spatz E, Krumholz H. Quantifying Blood Pressure Visit-to-Visit Variability in the Real-World Setting: A Retrospective Cohort Study. Circulation Cardiovascular Quality And Outcomes 2023, 16: e009258. PMID: 36883456, DOI: 10.1161/circoutcomes.122.009258.Peer-Reviewed Original ResearchConceptsRetrospective cohort studyBlood pressure valuesPatient characteristicsReal-world settingCohort studyPatient subgroupsYale New Haven Health SystemMean body mass indexSystolic blood pressure valuesBlood pressure visitHistory of hypertensionCoronary artery diseaseManagement of patientsMultivariable linear regression modelsBlood pressure readingsBody mass indexPatient-level measuresBlood pressure variationAbsolute standardized differencesNon-Hispanic whitesAntihypertensive medicationsReal-world practiceVisit variabilityArtery diseaseRegression models
2022
Cost-Related Medication Nonadherence in Adults With Diabetes in the United States: The National Health Interview Survey 2013-2018.
Taha MB, Valero-Elizondo J, Yahya T, Caraballo C, Khera R, Patel KV, Ali HJR, Sharma G, Mossialos E, Cainzos-Achirica M, Nasir K. Cost-Related Medication Nonadherence in Adults With Diabetes in the United States: The National Health Interview Survey 2013-2018. Diabetes Care 2022, 45: 594-603. PMID: 35015860, DOI: 10.2337/dc21-1757.Peer-Reviewed Original ResearchConceptsCost-related medication nonadherenceNational Health Interview SurveyLack of insuranceMedication nonadherenceNational Health Interview Survey 2013Duration of diabetesHigher comorbidity burdenSelf-reported diabetesHealth Interview SurveyWorse health outcomesHealth-related expendituresComorbidity burdenInsulin useCurrent smokingLess medicationMedication adherenceFemale sexWeighted prevalenceHigher oddsAge subgroupsSkipping dosesDiabetesHealth outcomesElderly adultsNHIS participants
2021
Financial Hardship From Medical Bills Among Adults With Chronic Liver Diseases: National Estimates From the United States
Lago‐Hernandez C, Nguyen NH, Khera R, Loomba R, Asrani SK, Singh S. Financial Hardship From Medical Bills Among Adults With Chronic Liver Diseases: National Estimates From the United States. Hepatology 2021, 74: 1509-1522. PMID: 33772833, DOI: 10.1002/hep.31835.Peer-Reviewed Original ResearchConceptsChronic liver diseaseScope and Social Determinants of Food Insecurity Among Adults With Atherosclerotic Cardiovascular Disease in the United States
Mahajan S, Grandhi GR, Valero‐Elizondo J, Mszar R, Khera R, Acquah I, Yahya T, Virani SS, Blankstein R, Blaha MJ, Cainzos‐Achirica M, Nasir K. Scope and Social Determinants of Food Insecurity Among Adults With Atherosclerotic Cardiovascular Disease in the United States. Journal Of The American Heart Association 2021, 10: e020028. PMID: 34387089, PMCID: PMC8475063, DOI: 10.1161/jaha.120.020028.Peer-Reviewed Original ResearchConceptsHigh-risk characteristicsUS adultsNational Health Interview Survey dataHealth Interview Survey dataAtherosclerotic cardiovascular diseaseCoronary heart diseaseSelf-reported diagnosisNon-Hispanic blacksInterview Survey dataFood Security Survey ModuleCardiovascular disease resultsLow family incomeAdult Food Security Survey ModuleFood insecurityHeart diseaseASCVDCardiovascular diseasePocket healthcare expenditureHigher oddsSociodemographic determinantsDisease resultsStudy participantsSocial determinantsHealthcare expendituresSociodemographic subgroupsCost-Related Nonadherence to Medications Among US Adults With Chronic Liver Diseases
Lago-Hernandez C, Nguyen NH, Khera R, Loomba R, Asrani SK, Singh S. Cost-Related Nonadherence to Medications Among US Adults With Chronic Liver Diseases. Mayo Clinic Proceedings 2021, 96: 2639-2650. PMID: 34120754, PMCID: PMC8492496, DOI: 10.1016/j.mayocp.2021.02.026.Peer-Reviewed Original ResearchAssociation of Angiotensin‐Converting Enzyme Inhibitors and Angiotensin Receptor Blockers with the Risk of Hospitalization and Death in Hypertensive Patients with Coronavirus Disease‐19
Khera R, Clark C, Lu Y, Guo Y, Ren S, Truax B, Spatz ES, Murugiah K, Lin Z, Omer SB, Vojta D, Krumholz HM. Association of Angiotensin‐Converting Enzyme Inhibitors and Angiotensin Receptor Blockers with the Risk of Hospitalization and Death in Hypertensive Patients with Coronavirus Disease‐19. Journal Of The American Heart Association 2021, 10: e018086. PMID: 33624516, PMCID: PMC8403305, DOI: 10.1161/jaha.120.018086.Peer-Reviewed Original ResearchConceptsAngiotensin receptor blockersLower hospitalization riskACE inhibitorsCOVID-19 hospitalizationHospitalization riskHospital mortalityReceptor blockersValidation cohortAcute respiratory syndrome coronavirus 2 infectionSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infectionEnzyme inhibitorsSyndrome coronavirus 2 infectionAngiotensin converting enzyme (ACE) inhibitorsCoronavirus 2 infectionRisk of hospitalizationCoronavirus disease-19SARS-CoV-2COVID-19 preventionHypertensive patientsInpatient cohortOutpatient cohortContemporary cohortStudy cohortOutpatient studyMedicare group
2020
Financial Hardship After Traumatic Injury: Risk Factors and Drivers of Out-of-Pocket Health Expenses
O'Neill KM, Jean RA, Gross CP, Becher RD, Khera R, Elizondo JV, Nasir K. Financial Hardship After Traumatic Injury: Risk Factors and Drivers of Out-of-Pocket Health Expenses. Journal Of Surgical Research 2020, 256: 1-12. PMID: 32663705, DOI: 10.1016/j.jss.2020.05.095.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedChildChild, PreschoolCost of IllnessCross-Sectional StudiesFamilyFemaleFinancial StressHealth ExpendituresHospitalizationHumansInfantInfant, NewbornInsurance, HealthMaleMiddle AgedPrescription DrugsRetrospective StudiesRisk FactorsSocioeconomic FactorsUnited StatesWounds and InjuriesYoung AdultConceptsTraumatic injuryOOP expensesPocket health expensesExcess financial burdenHealth expensesInpatient costsCatastrophic medical expensesFinancial burdenMultivariable logistic regression analysisMedical expensesHealth care factorsCostly medical conditionsCross-sectional studyMedical Expenditure Panel SurveyLogistic regression analysisPrescription drug costsFinancial hardshipHealth care systemFamily membersTrauma-related disordersPrimary outcomeCare factorsEmergency roomRisk factorsDrug costsCumulative Burden of Financial Hardship From Medical Bills Across the Spectrum of Diabetes Mellitus and Atherosclerotic Cardiovascular Disease Among Non‐Elderly Adults in the United States
Mszar R, Grandhi GR, Valero‐Elizondo J, Caraballo C, Khera R, Desai N, Virani SS, Blankstein R, Blaha MJ, Nasir K. Cumulative Burden of Financial Hardship From Medical Bills Across the Spectrum of Diabetes Mellitus and Atherosclerotic Cardiovascular Disease Among Non‐Elderly Adults in the United States. Journal Of The American Heart Association 2020, 9: e015523. PMID: 32394783, PMCID: PMC7660844, DOI: 10.1161/jaha.119.015523.Peer-Reviewed Original ResearchConceptsAtherosclerotic cardiovascular diseaseDiabetes mellitusNon-elderly adultsMedical billsCardiovascular diseaseBackground Atherosclerotic cardiovascular diseaseNational Health Interview SurveyEffective public health policiesThird of deathsTreatment-related expensesHealth Interview SurveyHigher relative oddsLogistic regression analysisFinancial hardshipPublic health policyASCVD statusPatient populationStudy populationHigh riskRelative oddsWeighted populationCumulative burdenHealth policyInterview SurveyStrong associationBurden and Consequences of Financial Hardship From Medical Bills Among Nonelderly Adults With Diabetes Mellitus in the United States
Caraballo C, Valero-Elizondo J, Khera R, Mahajan S, Grandhi GR, Virani SS, Mszar R, Krumholz HM, Nasir K. Burden and Consequences of Financial Hardship From Medical Bills Among Nonelderly Adults With Diabetes Mellitus in the United States. Circulation Cardiovascular Quality And Outcomes 2020, 13: e006139. PMID: 32069093, DOI: 10.1161/circoutcomes.119.006139.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge FactorsBlack or African AmericanComorbidityCost of IllnessCross-Sectional StudiesDiabetes MellitusFemaleFinancing, PersonalFood SupplyHealth Care CostsHealth Care SurveysHealth ExpendituresHealth Services AccessibilityHumansIncomeMaleMedically UninsuredMiddle AgedPatient ComplianceRisk AssessmentRisk FactorsUnited StatesYoung AdultConceptsDiabetes mellitusMedical billsHigher oddsMedical careNational Health Interview Survey dataHealth Interview Survey dataCost-related medication nonadherenceHigher comorbidity burdenCost-related nonadherenceSelf-reported diagnosisNon-Hispanic blacksInterview Survey dataFinancial hardshipMedication nonadherenceMean ageNonmedical needsHigh prevalenceMellitusMultivariate analysisPocket expenditureFood insecurityNonadherenceHigh financial distressPatientsAdults
2019
Cost-Related Medication Nonadherence in Adults With Atherosclerotic Cardiovascular Disease in the United States, 2013 to 2017
Khera R, Valero-Elizondo J, Das SR, Virani SS, Kash BA, de Lemos JA, Krumholz HM, Nasir K. Cost-Related Medication Nonadherence in Adults With Atherosclerotic Cardiovascular Disease in the United States, 2013 to 2017. Circulation 2019, 140: 2067-2075. PMID: 31760784, DOI: 10.1161/circulationaha.119.041974.Peer-Reviewed Original ResearchConceptsAtherosclerotic cardiovascular diseaseCost-related nonadherenceMedication nonadherenceCardiovascular diseaseHigher oddsHistory of ASCVDNational Health Interview SurveyCost-related medication nonadherenceHigher comorbidity burdenLong-term therapyLow-cost medicationsVulnerable patient groupHealth Interview SurveyLow family incomeASCVD morbidityComorbidity burdenEssential therapySecondary preventionLess medicationPatient groupFemale sexMedication fillsWorse outcomesPrescribed dosesDrug costsNational Trends in Healthcare-Associated Infections for Five Common Cardiovascular Conditions
Miller PE, Guha A, Khera R, Chouairi F, Ahmad T, Nasir K, Addison D, Desai NR. National Trends in Healthcare-Associated Infections for Five Common Cardiovascular Conditions. The American Journal Of Cardiology 2019, 124: 1140-1148. PMID: 31371062, PMCID: PMC7883647, DOI: 10.1016/j.amjcard.2019.06.029.Peer-Reviewed Original ResearchConceptsLength of stayCommon cardiovascular conditionCentral line-associated bloodstream infectionsCatheter-associated urinary tract infectionsLine-associated bloodstream infectionsUrinary tract infectionVentilator-associated pneumoniaClostridium difficile infectionCardiovascular conditionsTract infectionsBloodstream infectionsDifficile infectionOutcome of HAICoronary artery bypassTotal hospital chargesAcute myocardial infarctionSkilled care facilityHealthcare-Associated InfectionsValue-based careHospital mortalityArtery bypassCardiogenic shockHeart failurePropensity matchingAtrial fibrillationAssociation Between Hospital Recognition for Resuscitation Guideline Adherence and Rates of Survival for In-Hospital Cardiac Arrest
Khera R, Tang Y, Link MS, Krumholz HM, Girotra S, Chan PS. Association Between Hospital Recognition for Resuscitation Guideline Adherence and Rates of Survival for In-Hospital Cardiac Arrest. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005429. PMID: 30871337, PMCID: PMC6592630, DOI: 10.1161/circoutcomes.118.005429.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAwards and PrizesFemaleGuideline AdherenceHeart ArrestHospital MortalityHospitalsHumansInpatientsMaleMiddle AgedOutcome and Process Assessment, Health CarePatient DischargePractice Guidelines as TopicPractice Patterns, Physicians'Quality Indicators, Health CareRegistriesResuscitationTime FactorsTime-to-TreatmentTreatment OutcomeUnited StatesYoung AdultConceptsHospital cardiac arrestCardiac arrestRate of survivalSpontaneous circulationIn-Hospital Cardiac ArrestGuidelines-Resuscitation registryCardiac arrest survivalEndotracheal tube placementHigh rateHospital performanceBest tertileGuidelines-ResuscitationNational GetGuideline adherenceOverall survivalBackground HospitalTube placementNational registryChest compressionsResuscitation qualityHospitalHospital recognitionAward statusSurvivalWeak associationAssociation of Income Disparities with Patient-Reported Healthcare Experience
Okunrintemi V, Khera R, Spatz ES, Salami JA, Valero-Elizondo J, Warraich HJ, Virani SS, Blankstein R, Blaha MJ, Pawlik TM, Dharmarajan K, Krumholz HM, Nasir K. Association of Income Disparities with Patient-Reported Healthcare Experience. Journal Of General Internal Medicine 2019, 34: 884-892. PMID: 30783877, PMCID: PMC6544715, DOI: 10.1007/s11606-019-04848-4.Peer-Reviewed Original ResearchConceptsPatient healthcare experienceHealthcare experiencesHigher oddsMedical Expenditure Panel Survey cohortHealthcare providersRepresentative US adult populationUS adult populationTimes higher oddsQuality of careTimes greater oddsLow incomePoor healthcare experiencesRetrospective studyPatient incomePatient levelPatient reportsUS adultsProvider satisfactionGreater oddsPatientsHealth outcomesSurvey cohortAdult populationStudy participantsAspects of access
2018
Readmissions of adults within three age groups following hospitalization for pneumonia: Analysis from the Nationwide Readmissions Database
Jain S, Khera R, Mortensen EM, Weissler JC. Readmissions of adults within three age groups following hospitalization for pneumonia: Analysis from the Nationwide Readmissions Database. PLOS ONE 2018, 13: e0203375. PMID: 30212485, PMCID: PMC6136736, DOI: 10.1371/journal.pone.0203375.Peer-Reviewed Original ResearchConceptsMiddle-aged adultsNationwide Readmissions DatabaseAge groupsPneumonia readmissionsIndex pneumonia hospitalizationPatterns of readmissionRate of readmissionRisk-adjusted analysisMultivariable regression modelsYears of ageRisk-adjustment modelsPneumonia hospitalizationsReadmission ratesPrimary diagnosisHigh burdenReadmissionReadmission eventsHospitalizationMean costInsurance payerPneumoniaPotential interventionsYoung adultsAdultsSubstantial rateIncreasing Sepsis Rates in the United States: Results From National Inpatient Sample, 2005 to 2014
Rubens M, Saxena A, Ramamoorthy V, Das S, Khera R, Hong J, Armaignac D, Veledar E, Nasir K, Gidel L. Increasing Sepsis Rates in the United States: Results From National Inpatient Sample, 2005 to 2014. Journal Of Intensive Care Medicine 2018, 35: 858-868. PMID: 30175649, DOI: 10.1177/0885066618794136.Peer-Reviewed Original ResearchAnnual Burden and Costs of Hospitalization for High-Need, High-Cost Patients With Chronic Gastrointestinal and Liver Diseases
Nguyen NH, Khera R, Ohno-Machado L, Sandborn WJ, Singh S. Annual Burden and Costs of Hospitalization for High-Need, High-Cost Patients With Chronic Gastrointestinal and Liver Diseases. Clinical Gastroenterology And Hepatology 2018, 16: 1284-1292.e30. PMID: 29474966, PMCID: PMC6056327, DOI: 10.1016/j.cgh.2018.02.015.Peer-Reviewed Original ResearchConceptsFunctional gastrointestinal disordersChronic liver diseaseInflammatory bowel diseaseHigh-cost patientsCost of hospitalizationGastrointestinal hemorrhageLiver diseasePancreatic diseaseChronic gastrointestinalHospitalization costsAnnual burdenNationwide Readmissions Database 2013Medicare/Medicaid insuranceHigher comorbidity burdenInfection-related hospitalizationNationwide database analysisMultivariate logistic regressionDays/monthLarge rural hospitalPopulation health managementLow-income statusCardiopulmonary causesComorbidity burdenIndex hospitalizationHigh-value care
2017
Burden of Catastrophic Health Expenditures for Acute Myocardial Infarction and Stroke Among Uninsured in the United States
Khera R, Hong JC, Saxena A, Arrieta A, Virani SS, Blankstein R, de Lemos JA, Krumholz HM, Nasir K. Burden of Catastrophic Health Expenditures for Acute Myocardial Infarction and Stroke Among Uninsured in the United States. Circulation 2017, 137: 408-410. PMID: 29133601, PMCID: PMC5780190, DOI: 10.1161/circulationaha.117.030128.Commentaries, Editorials and LettersMeSH KeywordsAdolescentAdultFemaleHealth Care CostsHealth ExpendituresHealth Services AccessibilityHospital ChargesHospital CostsHumansIncomeMaleMedically UninsuredMiddle AgedMyocardial InfarctionPatient Protection and Affordable Care ActProcess Assessment, Health CareStrokeTime FactorsUnited StatesYoung AdultComparison of Readmission Rates After Acute Myocardial Infarction in 3 Patient Age Groups (18 to 44, 45 to 64, and ≥65 Years) in the United States
Khera R, Jain S, Pandey A, Agusala V, Kumbhani DJ, Das SR, Berry JD, de Lemos JA, Girotra S. Comparison of Readmission Rates After Acute Myocardial Infarction in 3 Patient Age Groups (18 to 44, 45 to 64, and ≥65 Years) in the United States. The American Journal Of Cardiology 2017, 120: 1761-1767. PMID: 28865892, PMCID: PMC5825232, DOI: 10.1016/j.amjcard.2017.07.081.Peer-Reviewed Original ResearchConceptsYounger age groupsLow-income patientsReadmission ratesAge groupsHigh hospitalization burdenIndex AMI hospitalizationNationwide Readmissions DatabaseRisk of readmissionPatient age groupsAcute myocardial infarctionVulnerable patient groupSignificant resource utilizationMultivariable hierarchical modelsYears of ageHealth care resourcesHealth care systemReadmission periodHospitalization burdenPayer databaseAMI survivorsPost-AMIPatient groupInpatient hospitalizationMyocardial infarctionReadmission