Impact of Area Deprivation Index on Coronary Stent Utilization in a Medicare Nationwide Cohort.

Abstract:

:Area Deprivation Index (ADI) is a marker of neighborhood deprivation. This study investigates utilization of coronary bare-metal stent (BMS) and drug-eluting stent (DES) in Medicare patients across hospitals with varying ADI. Data were abstracted using Diagnosis-Related Group (DRG) codes 249 (BMS without major complications or comorbidities [MCC]), 246, and 247 (DES with and without MCC, respectively) from the 2011-2012 Medicare Provider Utilization and Payment Data Inpatient File, which was linked to American Hospital Association data (to determine bed size, location, ownership, teaching status), and ADI for each hospital zip code was obtained. Hospitals were divided into quintiles using ADI values: Quintile 1 (privileged) to Quintile 5 (deprived). Logistic regression was conducted to determine odds ratios (ORs) for DES utilization across ADI quintiles. There were 313,739 discharges with DRG codes 246 (52,839), 247 (203,928), and 249 (56,972). DES utilization was lower in the deprived quintile, irrespective of teaching status. It was lower in larger hospitals and hospitals with more annual stent discharges, urban locations and nongovernment not-for-profit institutes. Lower odds of DES utilization were found in Quintile 2 (OR-0.9, 95% confidence interval [CI] 0.87-0.93, P < 0.001), Quintile 3 (OR-0.89, 95% CI 0.86-0.92, P < 0.001), and Quintile 4 (OR-0.95, 95% CI 0.92-0.98, P = 0.001) versus Quintile 1 and there was no difference in utilization of DES in Quintile 5 (OR-1.01, 95% CI 0.98-1.04, P = 0.6) versus Quintile 1. Significant differences exist in DES utilization in a large, uniformly insured cohort based on neighborhood deprivation.

journal_name

Popul Health Manag

authors

Tuliani TA,Shenoy M,Parikh M,Jutzy K,Hilliard A

doi

10.1089/pop.2016.0086

subject

Has Abstract

pub_date

2017-08-01 00:00:00

pages

329-334

issue

4

eissn

1942-7891

issn

1942-7905

journal_volume

20

pub_type

杂志文章
  • Recent trends in Veterans Affairs chronic condition spending.

    abstract::The change in prevalence and total Veterans Affairs (VA) spending were estimated for 16 chronic condition categories between 2000 and 2008. The drivers of changes in spending also were examined. Chronic conditions were identified through diagnoses in encounter records, and treatment costs per patient were estimated us...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2010.0079

    authors: Yoon J,Scott JY,Phibbs CS,Wagner TH

    更新日期:2011-12-01 00:00:00

  • County-Level Concentration of Selected Chronic Conditions Among Medicare Fee-for-Service Beneficiaries and Its Association with Medicare Spending in the United States, 2017.

    abstract::Multiple chronic conditions (MCC) reduce quality of life and are associated with high per capita health care spending. One potential way to reduce Medicare spending for MCC is to identify counties whose populations have high levels of spending compared to level of disease burden. Using a nationally representative samp...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2019.0231

    authors: Matthews KA,Gaglioti AH,Holt JB,McGuire LC,Greenlund KJ

    更新日期:2020-04-01 00:00:00

  • Improved health behaviors persist over two years for employees in a worksite wellness program.

    abstract::This study evaluates whether improvements in health behaviors related to a worksite wellness program persist through 2 years. The program was designed to build behavioral capability and self-efficacy by yielding immediately applicable skills and tools and segmenting the behavior change process into weekly, manageable ...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2011.0083

    authors: LeCheminant JD,Merrill RM

    更新日期:2012-10-01 00:00:00

  • What Happens to High-Cost Patients? An Analysis of the Trajectories of Billed Charges Over Time.

    abstract::A growing literature documents the substantial burden that a small proportion of high-cost, medically complex patients impose on health care systems. However, it is not clear whether high-cost patients remain costly over time. This study looks at the monthly distribution of billed charges for a cohort of high-cost, me...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2016.0149

    authors: Horn BP,Crandall CS,Binder DS,Sklar DP

    更新日期:2017-10-01 00:00:00

  • Value drivers: an approach for estimating health and disease management program savings.

    abstract::Health and disease management (HDM) programs have faced challenges in documenting savings related to their implementation. The objective of this eliminate study was to describe OptumHealth's (Optum) methods for estimating anticipated savings from HDM programs using Value Drivers. Optum's general methodology was review...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2012.0106

    authors: Phillips VL,Becker ER,Howard DH

    更新日期:2013-12-01 00:00:00

  • Comparison of Health Risks and Changes in Risks over Time Among a Sample of Lesbian, Gay, Bisexual, and Heterosexual Employees at a Large Firm.

    abstract::The objective of this study was to estimate the prevalence of health risk factors by sexual orientation over a 4-year period within a sample of employees from a large firm. Propensity score-weighted generalized linear regression models were used to estimate the proportion of employees at high risk for health problems ...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2016.0023

    authors: Mitchell RJ,Ozminkowski RJ

    更新日期:2017-04-01 00:00:00

  • Effect of an employer-sponsored health and wellness program on medical cost and utilization.

    abstract::The objective of this study was to examine the impact of PepsiCo's health and wellness program on medical cost and utilization. The authors analyzed health plan and program data of employees and dependents 19-64 years of age, who had 2 years of baseline data (2002 and 2003) and at least 1 year of data from the interve...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2013.1691

    authors: Liu H,Harris KM,Weinberger S,Serxner S,Mattke S,Exum E

    更新日期:2013-02-01 00:00:00

  • Surveillance of Intrauterine Opioid Exposures Using Electronic Health Records.

    abstract::The objective was to use population-based electronic health records for surveillance of intrauterine exposures to substances of abuse, including opioids, and to monitor changes in exposure rates over time. This retrospective, descriptive analysis utilized geocoded neonatal physician billing records representing intrau...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2017.0184

    authors: Hall ES,Wexelblatt SL,Greenberg JM

    更新日期:2018-12-01 00:00:00

  • Characteristics of prescription and nonprescription sleep medication users in the United States.

    abstract::Sleep deprivation and disturbances can result in lowered productivity and increased errors/accidents. Little is known about population characteristics associated with the use of sleep medications. The objective of this study was to investigate the association of sociodemographic factors with the use of sleep medicatio...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2013.0124

    authors: Vaidya V,Gabriel MH,Gangan N,Borse M

    更新日期:2014-12-01 00:00:00

  • Health Inequalities Among Elderly Type 2 Diabetes Mellitus Patients in Japan.

    abstract::The influence of socioeconomic status (SES) on health inequalities has received much attention worldwide. This study examined the effect of SES on the following older type 2 diabetes mellitus patient health outcomes: oral hypoglycemic agent (OHA) medication adherence (proportion of days covered, PDC), risk of hospital...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2019.0141

    authors: Jiang P,Babazono A,Fujita T

    更新日期:2020-06-01 00:00:00

  • Medical Care Expenditures for Individuals with Prediabetes: The Potential Cost Savings in Reducing the Risk of Developing Diabetes.

    abstract::The United States has 86 million adults with prediabetes. Individuals with prediabetes can prevent or delay the development of type 2 diabetes through lifestyle modifications such as participation in the National Diabetes Prevention Program (DPP), thereby mitigating the medical and economic burdens associated with dia...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2016.0134

    authors: Khan T,Tsipas S,Wozniak G

    更新日期:2017-10-01 00:00:00

  • Measuring Population Health in a Large Integrated Health System to Guide Goal Setting and Resource Allocation: A Proof of Concept.

    abstract::In integrated health care systems, techniques that identify successes and opportunities for targeted improvement are needed. The authors propose a new method for estimating population health that provides a more accurate and dynamic assessment of performance and priority setting. Member data from a large integrated he...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2018.0143

    authors: Stevens ER,Zhou Q,Nucifora KA,Taksler GB,Gourevitch MN,Stiefel MC,Kipnis P,Braithwaite RS

    更新日期:2019-10-01 00:00:00

  • Current and future directions in frailty research.

    abstract::The concept of frailty has been evolving dramatically for the past 30 years. Through its evolution, a variety of single and multidimensional models have been used to describe frailty. This article reviews the current literature related to the defining dimensions of frailty and identifies the gaps in the literature req...

    journal_title:Population health management

    pub_type: 杂志文章,评审

    doi:10.1089/pop.2010.0066

    authors: Mohandas A,Reifsnyder J,Jacobs M,Fox T

    更新日期:2011-12-01 00:00:00

  • Mobile Integrated Healthcare Intervention and Impact Analysis with a Medicare Advantage Population.

    abstract::Mobile Integrated Healthcare (MIH) is a patient-centered, innovative delivery model offering on-demand, needs-based care and preventive services, delivered in the patient's home or mobile environment. An interprofessional MIH clinical team delivered a care coordination program for a Medicare Advantage Preferred Provid...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2017.0130

    authors: Roeper B,Mocko J,O'Connor LM,Zhou J,Castillo D,Beck EH

    更新日期:2018-10-01 00:00:00

  • Evaluation of a university-based community outreach weight management program.

    abstract::This study tested the effectiveness of a 6-month university-based community outreach weight management program for overweight/obese adults that utilized standard guidelines from the National Heart, Lung, and Blood Institute (NHLBI). This article also provides practical observations for clinicians desirous to employ a ...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2010.0034

    authors: LeCheminant JD,Covington NK,Smith J,Lox CL,Kirk EP,Heden TD

    更新日期:2011-08-01 00:00:00

  • Clinical metric and medication persistency effects: evidence from a Medicaid care management program.

    abstract::The objective was to estimate clinical metric and medication persistency impacts of a care management program. The data sources were Medicaid administrative claims for a sample population of 32,334 noninstitutionalized Medicaid-only aged, blind, or disabled patients with diagnosed conditions of asthma, coronary artery...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2014.0003

    authors: Berg GD,Leary F,Medina W,Donnelly S,Warnick K

    更新日期:2015-02-01 00:00:00

  • A Promising New Strategy to Improve Treatment Outcomes for Patients with Depression.

    abstract::Each year, ineffective medical management of patients with mental illness compromises the health and well-being of individuals, and also impacts communities and our society. A variety of interrelated factors have impeded the health system's ability to treat patients with behavior health conditions adequately. A key co...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2018.0101

    authors: Carpenter G,Harbin HT,Smith RL,Hornberger J,Nash DB

    更新日期:2019-06-01 00:00:00

  • Burden of illness for an employed population with chronic obstructive pulmonary disease.

    abstract::Chronic obstructive pulmonary disease (COPD) affects approximately 7% of Americans. COPD impacts productivity and forces 1 in 5 employees ages 45-65 years old to retire prematurely. Our objective was to quantify the direct and indirect costs of COPD in an employed population in the United States. A retrospective analy...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2011.0049

    authors: Nair K,Ghushchyan V,Van Den Bos J,Halford ML,Tan G,Frech-Tamas FH,Doyle J

    更新日期:2012-10-01 00:00:00

  • Social Listening as a Rapid Approach to Collecting and Analyzing COVID-19 Symptoms and Disease Natural Histories Reported by Large Numbers of Individuals.

    abstract::Given the severe and rapid impact of COVID-19, the pace of information sharing has been accelerated. However, traditional methods of disseminating and digesting medical information can be time-consuming and cumbersome. In a pilot study, the authors used social listening to quickly extract information from social media...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2020.0189

    authors: Picone M,Inoue S,DeFelice C,Naujokas MF,Sinrod J,Cruz VA,Stapleton J,Sinrod E,Diebel SE,Wassman ER , Jr

    更新日期:2020-10-01 00:00:00

  • Face-to-Face Meetings with Neurosurgical Patients Before Hospital Discharge: Impact on Telephone Outreach, Emergency Department Visits, and Hospital Readmissions.

    abstract::The Johns Hopkins Community Health Partnerships (JCHiP) was developed in 2010 within the Johns Hopkins Health Systems. As part of JCHiP, the Patient Access Line call center was created. The average telephone reach rate at The Johns Hopkins Hospital in 2014 was only 53%. In a population of adult neurosurgical patients,...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2019.0038

    authors: Vergara FH,Davis JE,Budhathoki C,Sullivan NJ,Sheridan DJ

    更新日期:2020-04-01 00:00:00

  • The role of comprehensive eye exams in the early detection of diabetes and other chronic diseases in an employed population.

    abstract::The main objective of this study is to assess the cost benefit associated with comprehensive eye exams as a tool for the early detection of diabetes, hypertension, and high cholesterol. A retrospective, claims-based analysis was performed using U.S.-based employees and spouses from a large, national database. Individu...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2009.0050

    authors: Schaneman J,Kagey A,Soltesz S,Stone J

    更新日期:2010-08-01 00:00:00

  • Hospital Partnerships in Population Health Initiatives.

    abstract::Hospitals are expected to fulfill a role in the communities they serve by improving the health of the population in the community as mandated in the Affordable Care Act. One way hospitals achieve this is to create partnerships with diverse organizations, such as local public health departments, state/federal agencies,...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2019.0074

    authors: Park S,Hamadi H,Apatu E,Spaulding AC

    更新日期:2020-06-01 00:00:00

  • Development and validation of a multilateral index to determine economic status in developing countries: the Patient Financial Eligibility Tool (PFET).

    abstract::The objective was to develop and validate a multilateral index to determine patient ability to pay for medication in low- and middle-income countries. Primary data were collected in 2009 from 117 cancer patients in China, India, Thailand, and Malaysia. The initial tool included income, expenditures, and assets-based i...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2012.0049

    authors: Saba J,Audureau E,Bizé M,Koloshuk B,Ladner J

    更新日期:2013-04-01 00:00:00

  • A Worksite Occupational Health Clinic-Based Diabetes Mellitus Management Program.

    abstract::This study is an analysis of a workplace diabetes management program offered to employees of a Fortune 100 financial services corporation located in the United States. The 12-month worksite-based educational program was for employees who were at risk for diabetes, had prediabetes, or were diagnosed with diabetes. This...

    journal_title:Population health management

    pub_type: 杂志文章,多中心研究

    doi:10.1089/pop.2014.0141

    authors: Burton WN,Chen CY,Li X,Erickson D,McCluskey M,Schultz A

    更新日期:2015-12-01 00:00:00

  • A Historical Retrospective Analysis of the Impact of Diabetes Quality Measure Attainment on Outcomes in Medicare Advantage Members.

    abstract::The objective of this study was to assess achievement of 4 diabetes mellitus (DM)-related quality measures (QMs) and examine the relationship between QM attainment, concurrent health care costs, and DM complications over 1 year by conducting a retrospective analysis of claims data for Medicare Advantage Prescription D...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2015.0159

    authors: Saundankar V,Ellis J,Moretz C,Meah Y,DeLuzio T,Allen E,Suehs BT,Bouchard J

    更新日期:2017-04-01 00:00:00

  • Organizational scope of practice: assessing the primary care and public health activities of health centers and health departments in Iowa.

    abstract::The objective was to understand how Federally Qualified Health Centers (FQHCs) and local health departments (LHDs) address their shared mission of improving population health by determining the scope of primary care and public health activities each provides in their community. A brief mail survey was designed and fie...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2014.0066

    authors: Wright B,Ugwi P,Nice AJ

    更新日期:2015-04-01 00:00:00

  • Food Insecurity in Patients with High Hospital Utilization.

    abstract::Having access to adequate and appropriate food is a major population health issue. This study investigated food insecurity in patients with high rates of inpatient hospitalization ("super-utilizers"). Forty adults with ≥3 hospital inpatient admissions within a 12-month period were interviewed in an urban hospital in P...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2015.0127

    authors: Phipps EJ,Singletary SB,Cooblall CA,Hares HD,Braitman LE

    更新日期:2016-12-01 00:00:00

  • Impact of systems of care and blood pressure management on stroke outcomes.

    abstract::Stroke is the third leading cause of death in the United States and the leading cause of disability. Stroke patients' outcomes are strongly determined by how long they remain untreated ("time is brain"). The Joint Commission's adoption of stroke performance improvement measures combined with the Centers for Medicare a...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2010.0068

    authors: Shulkin DJ,Jewell KE,Alexandrov AW,Bernard DB,Brophy GM,Hess DC,Kohlbrenner J,Martin-Schild S,Mayer SA,Peacock WF,Qureshi AI,Sung GY,Lyles A

    更新日期:2011-12-01 00:00:00

  • Prescribing Housing: A Scoping Review of Health System Efforts to Address Housing as a Social Determinant of Health.

    abstract::US health systems have begun to address housing instability within a larger effort to address social determinants of health. To explore existing themes within efforts by health systems to reduce housing instability and improve health, the authors conducted a scoping review supplemented with key informant interviews. T...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2020.0154

    authors: Koeman J,Mehdipanah R

    更新日期:2020-08-17 00:00:00

  • Medical cost associated with prediabetes.

    abstract::In this article, we estimate national health care resource use and medical costs in 2007 associated with prediabetes (PD), defined as either fasting plasma glucose between 100 and 125 or oral glucose tolerance test between 140 and 200. We use Poisson regression with medical claims for an adult population continuously ...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2009.12302

    authors: Zhang Y,Dall TM,Chen Y,Baldwin A,Yang W,Mann S,Moore V,Le Nestour E,Quick WW

    更新日期:2009-06-01 00:00:00