2023
Quality, outcome, and cost of care provided to very low birth weight infants in California
Lapcharoensap W, Bennett M, Xu X, Lee H, Profit J, Dukhovny D. Quality, outcome, and cost of care provided to very low birth weight infants in California. Journal Of Perinatology 2023, 44: 224-230. PMID: 37805592, DOI: 10.1038/s41372-023-01792-4.Peer-Reviewed Original ResearchMeSH KeywordsBirth WeightCaliforniaHumansInfantInfant, NewbornInfant, Very Low Birth WeightIntensive Care Units, NeonatalRetrospective StudiesRisk FactorsConceptsVery low birth weightCare of VLBW infantsLow birth weightRisk-adjusted costVLBW infantsQuality of careMethodsRetrospective studyBirth weightClinical outcomesHospital discharge recordsClinical factorsCost of careClinical dataHierarchical generalized linear modelsResultsIn totalBirth certificatesPatient outcomesInfantsPearson correlation coefficientAssociation of costDischarge recordsHospitalMeasures of costOutcomesCareTimeliness of diagnostic evaluation for postmenopausal bleeding: A retrospective cohort study using claims data
Xu X, Chen L, Nunez-Smith M, Clark M, Wright J. Timeliness of diagnostic evaluation for postmenopausal bleeding: A retrospective cohort study using claims data. PLOS ONE 2023, 18: e0289692. PMID: 37682914, PMCID: PMC10490884, DOI: 10.1371/journal.pone.0289692.Peer-Reviewed Original ResearchMeSH KeywordsDatabases, FactualFemaleGenital Neoplasms, FemaleHumansInsurancePostmenopauseRetrospective StudiesUnited StatesUterine HemorrhageConceptsPostmenopausal bleedingFirst diagnostic procedureDiagnostic evaluationDiagnostic proceduresGynecologic conditionsMedicaid patientsCox proportional hazards modelPrompt diagnostic evaluationRetrospective cohort studyMarketScan Research DatabasesAdditional risk factorsNon-clinical factorsCommon gynecologic conditionProportional hazards modelLower ratesCohort studyMost patientsPatient characteristicsBenign etiologyGynecologic cancerCancer patientsPreventive careUterine cancerInsurance typeRisk factors
2022
Surgical Complications and Hospital Costs in Robot-Assisted Versus Conventional Laparoscopic Hysterectomy With Concurrent Sacrocolpopexy: Analysis of the Nationwide Readmissions Database
Andiman SE, Bui A, Ascher-Walsh C, Wright J, Xu X. Surgical Complications and Hospital Costs in Robot-Assisted Versus Conventional Laparoscopic Hysterectomy With Concurrent Sacrocolpopexy: Analysis of the Nationwide Readmissions Database. Urogynecology 2022, 28: e142-e148. PMID: 35113048, DOI: 10.1097/spv.0000000000001133.Peer-Reviewed Original ResearchConceptsConventional laparoscopic procedureConventional laparoscopic hysterectomyNationwide Readmissions DatabasePerioperative complicationsLaparoscopic hysterectomyLaparoscopic proceduresHospital costsMajor perioperative complicationsConventional laparoscopic approachMultivariable regression analysisRobot-assisted approachLarge national databaseProcedure codesSurgical complicationsInvasive hysterectomyLaparoscopic approachHysterectomyLower riskComplicationsReadmissionSacrocolpopexyPatient linkageNational databaseWeighted samplePatients
2021
Endometrial Sampling for Preoperative Diagnosis of Uterine Leiomyosarcoma
Kho RM, Desai VB, Schwartz PE, Wright JD, Gross CP, Hutchison LM, Boscoe FP, Lin H, Xu X. Endometrial Sampling for Preoperative Diagnosis of Uterine Leiomyosarcoma. Journal Of Minimally Invasive Gynecology 2021, 29: 119-127. PMID: 34265441, PMCID: PMC8752465, DOI: 10.1016/j.jmig.2021.07.004.Peer-Reviewed Original ResearchMeSH KeywordsEndometrial NeoplasmsEndometriumFemaleHumansHysterectomyLeiomyosarcomaRetrospective StudiesUterine NeoplasmsConceptsEndometrial samplingUterine leiomyosarcomaPreoperative diagnosisPreoperative detectionNew York State Cancer RegistryNew York Statewide PlanningPreoperative endometrial samplingSuboptimal surgical managementUse of hysteroscopyOutcomes of patientsRetrospective cohort studyState Cancer RegistryMultivariable regression analysisResearch Cooperative SystemAmbulatory surgery centersSample eligibility criteriaRace/ethnicityIndex surgeryCohort studyLocalized stageSupracervical hysterectomyCancer RegistryOutpatient encountersSurgical managementTumor size
2020
Hospital variation in responses to safety warnings about power morcellation in hysterectomy
Xu X, Desai VB, Wright JD, Lin H, Schwartz PE, Gross CP. Hospital variation in responses to safety warnings about power morcellation in hysterectomy. American Journal Of Obstetrics And Gynecology 2020, 224: 589.e1-589.e13. PMID: 33359176, PMCID: PMC8180513, DOI: 10.1016/j.ajog.2020.12.1207.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overFemaleGuideline AdherenceHealthcare DisparitiesHospitalsHumansHysterectomyIntraoperative ComplicationsLaparoscopyLogistic ModelsMiddle AgedMorcellationOutcome Assessment, Health CarePatient SafetyPostoperative ComplicationsPractice Guidelines as TopicPractice Patterns, Physicians'Retrospective StudiesRisk AssessmentUnited StatesYoung AdultConceptsLaparoscopic supracervical hysterectomyOpen abdominal hysterectomySupracervical hysterectomyPower morcellationAbdominal hysterectomySurgical complicationsMajor complicationsPatient clinical risk factorsNew York Statewide PlanningClinical risk factorsDistinct trajectory patternsState Ambulatory SurgeryState Inpatient DatabasesSafety warningsTrajectory groupsResearch Cooperative SystemLow useHigher useHysterectomy practiceMinor complicationsBenign hysterectomyBenign indicationsComplication riskHospital variationCorpus uteriPhysician trajectories of abandoning long‐course breast radiotherapy and their cost impact
Xu X, Soulos PR, Herrin J, Wang S, Pollack CE, Evans SB, Yu JB, Gross CP. Physician trajectories of abandoning long‐course breast radiotherapy and their cost impact. Health Services Research 2020, 56: 497-506. PMID: 33070305, PMCID: PMC8143683, DOI: 10.1111/1475-6773.13572.Peer-Reviewed Original ResearchConceptsPhysician peer groupsWhole breast irradiationCF-WBIRisk-adjusted ratesBreast radiotherapyPractice patternsLow useChronic Conditions Data WarehouseDistinct practice patternsPatients' clinical characteristicsSetting of radiotherapyAdjuvant breast radiotherapyYears of ageDistinct trajectoriesImportant cost implicationsHigher useAdjuvant radiotherapyClinical characteristicsEligible womenBreast cancerCost implicationsLatent class growth analysisService beneficiariesMedicare programRadiotherapyTrial of Labor After Two Prior Cesarean Deliveries: Patient and Hospital Characteristics and Birth Outcomes.
Dombrowski M, Illuzzi JL, Reddy UM, Lipkind HS, Lee HC, Lin H, Lundsberg LS, Xu X. Trial of Labor After Two Prior Cesarean Deliveries: Patient and Hospital Characteristics and Birth Outcomes. Obstetrics And Gynecology 2020, 136: 109-117. PMID: 32541284, PMCID: PMC7321852, DOI: 10.1097/aog.0000000000003845.Peer-Reviewed Original ResearchConceptsComposite severe maternal morbidityTrial of laborPrior cesarean deliverySevere maternal morbidityCesarean deliveryMaternal morbidityNewborn complicationsHospital characteristicsPropensity score-matched analysisSevere neonatal morbiditySuccessful vaginal birthSingleton live birthsAssociation of patientCohort of mothersBirth certificate dataSample eligibility criteriaModest increaseNeonatal morbidityNeonatal outcomesHospital dischargeBirth outcomesVaginal birthClear contraindicationsLive birthsMultivariable regression
2019
Laparoscopic Hysterectomy Route, Resource Use, and Outcomes: Change After Power Morcellation Warning.
Desai VB, Wright JD, Lin H, Gross CP, Sallah YH, Schwartz PE, Xu X. Laparoscopic Hysterectomy Route, Resource Use, and Outcomes: Change After Power Morcellation Warning. Obstetrics And Gynecology 2019, 134: 227-238. PMID: 31348209, DOI: 10.1097/aog.0000000000003375.Peer-Reviewed Original ResearchConceptsLaparoscopic supracervical hysterectomyTotal laparoscopic hysterectomyLaparoscopic hysterectomySupracervical hysterectomySurgical outcomesFDA warningOperative timeSurgeons National Surgical Quality Improvement ProgramNational Surgical Quality Improvement ProgramSurgical Quality Improvement ProgramLength of stayInterrupted time series analysisQuality Improvement ProgramHysterectomy routePatient characteristicsBenign indicationsInpatient stayPower morcellationPatient outcomesHysterectomyAmerican CollegeSurgical settingU.S. FoodOutcomesStay
2018
Hospital variation in utilization and success of trial of labor after a prior cesarean
Xu X, Lee HC, Lin H, Lundsberg LS, Campbell KH, Lipkind HS, Pettker CM, Illuzzi JL. Hospital variation in utilization and success of trial of labor after a prior cesarean. American Journal Of Obstetrics And Gynecology 2018, 220: 98.e1-98.e14. PMID: 30278176, DOI: 10.1016/j.ajog.2018.09.034.Peer-Reviewed Original ResearchMeSH KeywordsAdultCaliforniaCesarean SectionCohort StudiesDatabases, FactualFemaleGestational AgeHospitals, High-VolumeHospitals, Low-VolumeHumansInfant, NewbornMaternal AgePatient SafetyPregnancyPregnancy OutcomeRetrospective StudiesRisk AssessmentTrial of LaborUterine RuptureVaginal Birth after CesareanConceptsSuccess of trialCesarean deliveryTrial of laborHospital variationSuccess rateLow success rateNewborn hospital discharge recordsPatient clinical risk factorsSevere unexpected newborn complicationsNewborn respiratory complicationsUnexpected newborn complicationsClinical risk factorsPrior cesarean deliveryHospital discharge recordsPatient case mixBirth certificate dataMidwife-attended birthsAnesthesia availabilityNewborn infectionRespiratory complicationsUterine ruptureNewborn morbidityPrior cesareanNewborn complicationsVaginal birth
2017
Regional Medicare Expenditures and Survival Among Older Women With Localized Breast Cancer
Tannenbaum S, Soulos PR, Herrin J, Mougalian S, Long JB, Wang R, Ma X, Gross CP, Xu X. Regional Medicare Expenditures and Survival Among Older Women With Localized Breast Cancer. Medical Care 2017, 55: 1030-1038. PMID: 29068906, PMCID: PMC5863278, DOI: 10.1097/mlr.0000000000000822.Peer-Reviewed Original ResearchConceptsBreast cancer careHospital referral regionsNonmetastatic breast cancerBreast cancerCancer careMedicare beneficiariesMedicare expendituresCancer expendituresBetter survivalEnd Results-MedicareRetrospective cohort studyPatients 3 yearsClinical characteristicsCohort studyOverall survivalCancer stagePatient outcomesOutcome measuresReferral regionsOlder womenSignificant associationStage IIBivariate analysisCancerQuintile
2016
Inpatient Laparoscopic Hysterectomy in the United States: Trends and Factors Associated With Approach Selection
Desai VB, Guo XM, Fan L, Wright JD, Xu X. Inpatient Laparoscopic Hysterectomy in the United States: Trends and Factors Associated With Approach Selection. Journal Of Minimally Invasive Gynecology 2016, 24: 151-158.e1. PMID: 27614151, DOI: 10.1016/j.jmig.2016.08.830.Peer-Reviewed Original ResearchConceptsLaparoscopic supracervical hysterectomyTotal laparoscopic hysterectomyLaparoscopic approachLaparoscopic hysterectomyNational Inpatient SampleHospital characteristicsPatient race/ethnicityFemale adult patientsClinical Modification codesDifferent laparoscopic approachesAssociation of patientHospital teaching statusHospital inpatient careBenign laparoscopic hysterectomyRace/ethnicityNonobstetric indicationsAdult patientsVaginal hysterectomyClinical factorsSupracervical hysterectomyBenign indicationsComorbid conditionsRetrospective studyNinth RevisionNIS database
2015
The Role of Patient Factors, Cancer Characteristics, and Treatment Patterns in the Cost of Care for Medicare Beneficiaries with Breast Cancer
Xu X, Herrin J, Soulos PR, Saraf A, Roberts KB, Killelea BK, Wang SY, Long JB, Wang R, Ma X, Gross CP. The Role of Patient Factors, Cancer Characteristics, and Treatment Patterns in the Cost of Care for Medicare Beneficiaries with Breast Cancer. Health Services Research 2015, 51: 167-186. PMID: 26119176, PMCID: PMC4722219, DOI: 10.1111/1475-6773.12328.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBreast NeoplasmsComorbidityFemaleHealth ExpendituresHumansMedicareRetrospective StudiesSEER ProgramSocioeconomic FactorsUnited StatesConceptsBreast cancer careHospital referral regionsCancer careMedicare expendituresBreast cancerRadiation therapyTreatment factorsMean Medicare expendituresEnd Results-MedicareSpecific treatment modalitiesContribution of patientCost of careHighest spending quintilePatient factorsTreatment patternsTumor characteristicsCancer characteristicsTreatment modalitiesReferral regionsMedicare beneficiariesQuintilePatientsCancerCareTherapy
2013
Cost-effectiveness of endometrial evaluation prior to morcellation in surgical procedures for prolapse
McPencow AM, Erekson EA, Guess MK, Martin DK, Patel DA, Xu X. Cost-effectiveness of endometrial evaluation prior to morcellation in surgical procedures for prolapse. American Journal Of Obstetrics And Gynecology 2013, 209: 22.e1-22.e9. PMID: 23545164, DOI: 10.1016/j.ajog.2013.03.033.Peer-Reviewed Original ResearchConceptsIncremental cost-effectiveness ratioEndometrial biopsyTransvaginal ultrasoundCost-effectiveness ratioPostmenopausal womenEndometrial cancerEndometrial evaluationScreening optionsInvasive sacral colpopexyRisk of upstagingPelvic organ prolapseCancer upstagingSupracervical hysterectomySacral colpopexyCancer prevalenceOrgan prolapsePatient costsPreoperative detectionSurgical proceduresUniversal screeningBiopsyMorcellationCancerUltrasoundUpstaging