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
  • A more generalizable method to evaluate changes in health care costs with changes in health risks among employers of all sizes.

    abstract::The objective of this study was to estimate the association between changes in health care expenditures relative to changes in health risk status for employers of all sizes. Repeat health risk assessments (HRAs) were obtained from 50,005 employees and spouses with 2 years of health plan enrollment, and from 37,559 emp...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2013.0103

    authors: Musich S,White J,Hartley SK,Bhattarai GR,Hawkins K,Ozminkowski RJ

    更新日期:2014-10-01 00:00:00

  • High rates of inappropriate drug use in the chronic pain population.

    abstract::Chronic opioid treatment is a highly effective method to treat chronic pain; however, the prevalence of abuse of opioids can make treating patients with these agents difficult for clinicians. The objective of this study was to describe rates of inappropriate utilization, abuse, and diversion in a population of patient...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2009.0015

    authors: Couto JE,Romney MC,Leider HL,Sharma S,Goldfarb NI

    更新日期:2009-08-01 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

  • 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

  • Patterns of multimorbidity in primary care patients at high risk of future hospitalization.

    abstract::Care management is seen as a promising approach to address the complex care needs of patients with multimorbidity. Predictive modeling based on insurance claims data is an emerging concept to identify patients likely to benefit from care management interventions. We aimed to identify and explore patterns of multimorbi...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2011.0026

    authors: Freund T,Kunz CU,Ose D,Szecsenyi J,Peters-Klimm F

    更新日期:2012-04-01 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

  • Effectiveness of interventions in reducing antibiotic use for upper respiratory infections in ambulatory care practices.

    abstract::The objective was to evaluate the effect of separate interventions on antimicrobial prescribing for uncomplicated upper respiratory tract infections. The authors conducted a quasi-experimental pre-post study with concurrent control groups for each intervention. Academic detailing led to a significant reduction in unne...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2012.0025

    authors: Vinnard C,Linkin DR,Localio AR,Leonard CE,Teal VL,Fishman NO,Hennessy S

    更新日期:2013-02-01 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

  • 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

  • Understanding Medicaid Managed Care Investments in Members' Social Determinants of Health.

    abstract::Despite widespread interest in addressing social determinants of health (SDH) as a means to improve health and to reduce health care spending, little information is available about how to develop, sustain, and scale nonmedical interventions in diverse payer environments, including Medicaid Managed Care. This study aim...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2016.0092

    authors: Gottlieb L,Ackerman S,Wing H,Manchanda R

    更新日期:2017-08-01 00:00:00

  • 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

  • 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

  • Community Health Needs Assessment: Potential for Population Health Improvement.

    abstract::Derived from various health care policies and initiatives, the concept of population health has been newly adopted by health care and medicine. In particular, it has been suggested that the Patient Protection and Affordable Care Act provision that requires nonprofit hospitals to conduct a community health needs assess...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2015.0075

    authors: Pennel CL,McLeroy KR,Burdine JN,Matarrita-Cascante D,Wang J

    更新日期:2016-06-01 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

  • Trends and Racial/Ethnic Disparities in Pneumococcal Polysaccharide Vaccination.

    abstract::Even though pneumococcal vaccination recommendations have been in existence since 1983, vaccination rates are low in the United States. This study analyzed 5-year trends in pneumococcal polysaccharide vaccination uptake across racial/ethnic groups of individuals aged ≥65 years and high-risk individuals aged 19-64 year...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2017.0176

    authors: Austin S,Ramamonjiarivelo Z,Comer-HaGans D,Pisu M

    更新日期:2018-12-01 00:00:00

  • Cost-Related Medication Nonadherence and Cost-Reduction Strategies Among Elderly Cancer Survivors with Self-Reported Symptoms of Depression.

    abstract::How depression affects the medication cost burden for elderly cancer survivors has not been well studied. This study aims to investigate whether depression is associated with higher rates of cost-related medication nonadherence, and cost-reduction strategies among the elderly cancer survivors. Self-reports from survey...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2019.0035

    authors: Gu D,Shen C

    更新日期:2020-04-01 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

  • A Population Health Measurement Framework: Evidence-Based Metrics for Assessing Community-Level Population Health in the Global Budget Context.

    abstract::Population health is one of the pillars of the Triple Aim to improve US health care. The authors developed a framework for population health measurement and a proposed set of measures for further exploration to guide the population health efforts in Maryland. The authors searched peer-reviewed, expert-authored literat...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2017.0112

    authors: Hatef E,Lasser EC,Kharrazi HHK,Perman C,Montgomery R,Weiner JP

    更新日期:2018-08-01 00:00:00

  • Is pharmacologic care of chronic obstructive pulmonary disease consistent with the guidelines?

    abstract::Chronic obstructive pulmonary disease (COPD) is a common chronic illness that affects an estimated 210 million people worldwide, including 12 million people in the United States. National and international guidelines for treatment of COPD recommend use of certain medications, especially bronchodilators and corticoster...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2008.0048

    authors: Diette GB,Orr P,McCormack MC,Gandy W,Hamar B

    更新日期:2010-02-01 00:00:00

  • Effectiveness of health and wellness initiatives for seniors.

    abstract::Given the increasing prevalence of obesity and lifestyle-related chronic diseases in the United States and abroad, senior wellness initiatives have emerged as a means to stem the troubling trends that threaten the well-being and the economy of many nations. Seniors are an important demographic for such programs becaus...

    journal_title:Population health management

    pub_type: 杂志文章,评审

    doi:10.1089/pop.2010.0072

    authors: Coberley C,Rula EY,Pope JE

    更新日期:2011-02-01 00:00:00

  • Measuring health-related productivity loss.

    abstract::The objective of this study was to determine the relationship between health status and productivity loss and to provide estimates of the business implications of lost work performance. Health risk appraisal responses from over 1 million participants were analyzed to determine productivity loss associated with several...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2010.0014

    authors: Mitchell RJ,Bates P

    更新日期:2011-04-01 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

  • 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

  • Using accreditation standards as a framework to evaluate and improve a community-based diabetes self-management education program.

    abstract::Diabetes self-management education is an essential component of diabetes clinical management, and community-based programs are an effective intervention for improving glycemic control among adults living with diabetes. The National Standards for Diabetes Self-Management Education and Support are designed to define qua...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2013.0044

    authors: White N,Manning ML,Brawer R,Plumb J

    更新日期:2014-02-01 00:00:00

  • Implementing Value-Based Primary Care Delivery in Federally Qualified Health Centers.

    abstract::Federally Qualified Health Centers (FQHCs), like many health systems, are in transition toward alternative/advanced payment and reimbursement models. Gradually, fee-for-service reimbursements will be replaced by value-based payments with shared accountability for patients' health care outcomes. This article provides a...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2019.0221

    authors: Okeke N,Schmidt C,Alborn S,Kumian E

    更新日期:2020-02-24 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

  • Physician Awareness and Adherence to Clinical Practice Guidelines in the Diagnosis of Vaginitis Patients: A Retrospective Chart Review.

    abstract::Vaginitis is one of the main causes of primary care and gynecological visits in the United States. The most common infectious causes are bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), and trichomoniasis. A physician survey was conducted to measure awareness of vaginitis clinical guidelines and availability ...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2020.0258

    authors: Nyirjesy P,Banker WM,Bonus TM

    更新日期:2020-10-01 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

  • Employee Use of a Wireless Physical Activity Tracker Within Two Incentive Designs at One Company.

    abstract::Physical activity provides numerous health benefits, including reducing risk factors that contribute to the leading causes of morbidity and mortality. Many employers offer incentives to employees to motivate engagement in wellness program activities. Two incentive designs to reward employees for achieving step goals w...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2015.0030

    authors: Norman GJ,Heltemes KJ,Heck D,Osmick MJ

    更新日期:2016-04-01 00:00:00

  • Family physicians' ability to perform population management is associated with adoption of other aspects of the patient-centered medical home.

    abstract::The patient-centered medical home (PCMH) model is considered a promising approach to improving population health, but how elements of these advanced practice models relate to population health capability is unknown. To measure associations between family physicians' performance of population management with PCMH compo...

    journal_title:Population health management

    pub_type: 杂志文章

    doi:10.1089/pop.2014.0023

    authors: Ottmar J,Blackburn B,Phillips RL Jr,Peterson LE,Jaén CR

    更新日期:2015-04-01 00:00:00