2023
Association of Neighborhood-Level Marginalization With Health Care Use and Clinical Outcomes Following Hospital Discharge in Patients Who Underwent Coronary Catheterization for Acute Myocardial Infarction in a Single-Payer Health Care System
Akioyamen L, Abdel-Qadir H, Han L, Sud M, Mistry N, Alter D, Atzema C, Austin P, Bhatia R, Booth G, Dhalla I, Ha A, Jackevicius C, Kapral M, Krumholz H, Lee D, McNaughton C, Roifman I, Schull M, Sivaswamy A, Tu K, Udell J, Wijeysundera H, Ko D. Association of Neighborhood-Level Marginalization With Health Care Use and Clinical Outcomes Following Hospital Discharge in Patients Who Underwent Coronary Catheterization for Acute Myocardial Infarction in a Single-Payer Health Care System. Circulation Cardiovascular Quality And Outcomes 2023, 16: e010063. PMID: 38050754, DOI: 10.1161/circoutcomes.123.010063.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial infarctionHealth care systemHospital dischargeClinical outcomesSocioeconomic statusFirst acute myocardial infarctionProportional hazards regression modelsCare systemSecondary prevention medicationsWorse clinical outcomesHealth service usePopulation-based studyPrimary care physiciansHealth care useHazards regression modelsGreater long-term riskPrescription medication useSingle-payer health care systemUniversal health care systemLong-term riskLow socioeconomic statusCause mortalityDays postdischargePrevention medications
2022
Association of Neighborhood-Level Material Deprivation With Atrial Fibrillation Care in a Single-Payer Health Care System: A Population-Based Cohort Study
Abdel-Qadir H, Akioyamen LE, Fang J, Pang A, Ha ACT, Jackevicius CA, Alter DA, Austin PC, Atzema CL, Bhatia RS, Booth GL, Johnston S, Dhalla I, Kapral MK, Krumholz HM, McNaughton CD, Roifman I, Tu K, Udell JA, Wijeysundera HC, Ko DT, Schull MJ, Lee DS. Association of Neighborhood-Level Material Deprivation With Atrial Fibrillation Care in a Single-Payer Health Care System: A Population-Based Cohort Study. Circulation 2022, 146: 159-171. PMID: 35678171, PMCID: PMC9287095, DOI: 10.1161/circulationaha.122.058949.Peer-Reviewed Original ResearchConceptsYears of ageCohort studyUniversal health careAF-related adverse eventsNeighbourhood-level material deprivationPopulation-based cohort studyPrimary care physician visitsCause-specific hazards regressionRhythm control interventionsHigh cardiovascular disease burdenCardiovascular disease burdenHealth careAtrial fibrillation careNeighborhood material deprivationSingle-payer health care systemMaterial deprivation quintileAtrial fibrillation diagnosisHealth care systemNoncardiovascular comorbiditiesAdverse eventsHeart failurePhysician visitsHazards regressionAdverse outcomesDeprivation quintile
2021
Variations in Quality of Care by Sex and Social Determinants of Health Among Younger Adults With Acute Myocardial Infarction in the US and Canada
Raparelli V, Pilote L, Dang B, Behlouli H, Dziura JD, Bueno H, D’Onofrio G, Krumholz HM, Dreyer RP. Variations in Quality of Care by Sex and Social Determinants of Health Among Younger Adults With Acute Myocardial Infarction in the US and Canada. JAMA Network Open 2021, 4: e2128182. PMID: 34668947, PMCID: PMC8529414, DOI: 10.1001/jamanetworkopen.2021.28182.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionQuality of careHealth care systemYoung adultsFemale sexMyocardial infarctionCare systemHospital careSocial determinantsRetrospective cohort analysisLow qualityAdverse SDOHLowest tertileReadmission ratesMore patientsPostacute careAMI careOutpatient careCare scoresHigh prevalenceCohort analysisLarge cohortMAIN OUTCOMESDOHHospital
2020
Trends and Predictors of Use of Digital Health Technology in the United States
Mahajan S, Lu Y, Spatz ES, Nasir K, Krumholz HM. Trends and Predictors of Use of Digital Health Technology in the United States. The American Journal Of Medicine 2020, 134: 129-134. PMID: 32717188, DOI: 10.1016/j.amjmed.2020.06.033.Peer-Reviewed Original ResearchQuality of primary health care in China: challenges and recommendations
Li X, Krumholz HM, Yip W, Cheng KK, De Maeseneer J, Meng Q, Mossialos E, Li C, Lu J, Su M, Zhang Q, Xu DR, Li L, Normand ST, Peto R, Li J, Wang Z, Yan H, Gao R, Chunharas S, Gao X, Guerra R, Ji H, Ke Y, Pan Z, Wu X, Xiao S, Xie X, Zhang Y, Zhu J, Zhu S, Hu S. Quality of primary health care in China: challenges and recommendations. The Lancet 2020, 395: 1802-1812. PMID: 32505251, PMCID: PMC7272159, DOI: 10.1016/s0140-6736(20)30122-7.Peer-Reviewed Original ResearchConceptsPrimary health care systemHealth care systemPrimary health carePublic health servicesClinical careHealth servicesPrimary health care physiciansPrimary health care practitionersPrimary health care institutionsBasic public health servicesHealth care physiciansHealth careCoronavirus disease 2019Entire health care systemHealth care practitionersHigh-value careLearning health systemChronic diseasesDisease 2019Health care institutionsInfectious diseasesHealth systemCare systemCareSuboptimal educationAgile Health Care Analytics: Enabling Real-Time Disease Surveillance With a Computational Health Platform
Schulz WL, Durant T, Torre CJ, Hsiao AL, Krumholz HM. Agile Health Care Analytics: Enabling Real-Time Disease Surveillance With a Computational Health Platform. Journal Of Medical Internet Research 2020, 22: e18707. PMID: 32442130, PMCID: PMC7257473, DOI: 10.2196/18707.Peer-Reviewed Original ResearchConceptsReal-time dataHealth information technologyReal-world dataHealth platformInformation technologyCombination of technologiesReal timeSevere acute respiratory syndrome coronavirus 2Acute respiratory syndrome coronavirus 2Timely informationRespiratory syndrome coronavirus 2PlatformRespiratory tract infectionsSyndrome coronavirus 2Health care systemTract infectionsCoronavirus disease (COVID-19) outbreakIncident casesCoronavirus 2Novel applicationTechnologyAnalyticsHealth systemCare systemSpecific pathogens
2019
Population Impact of Generic Valsartan Recall
Jackevicius CA, Krumholz HM, Chong A, Koh M, Ozaki AF, Austin PC, Udell JA, Ko DT. Population Impact of Generic Valsartan Recall. Circulation 2019, 141: 411-413. PMID: 31707798, DOI: 10.1161/circulationaha.119.044494.Peer-Reviewed Original ResearchConceptsNational Ambulatory Care Reporting System databaseEmergency department visitsRegistered Persons DatabaseOntario Registered Persons DatabaseReporting System databaseHealth care systemDrug recallsSegmented regression analysisBaseline comorbiditiesOral medicationsDepartment visitsHospital admissionMedication useClinical outcomesDischarge diagnosisVital statusChronic conditionsHealthcare databasesHealth CanadaCare systemCanadian InstituteHealth informationPopulation impactPatientsRegression analysis
2018
Association of the Overall Well-being of a Population With Health Care Spending for People 65 Years of Age or Older
Riley C, Roy B, Herrin J, Spatz ES, Arora A, Kell KP, Rula EY, Krumholz HM. Association of the Overall Well-being of a Population With Health Care Spending for People 65 Years of Age or Older. JAMA Network Open 2018, 1: e182136. PMID: 30646154, PMCID: PMC6324481, DOI: 10.1001/jamanetworkopen.2018.2136.Peer-Reviewed Original ResearchConceptsMedicare FFS beneficiariesPeople 65 yearsHealth care spendingFFS beneficiariesCare spendingPopulation-based cross-sectional studyLower health care spendingHealth care system capacityCross-sectional studyHealth care systemPopulation levelPayment modelsCare payment modelsHighest quintileInverse associationStudy interventionMAIN OUTCOMEMedicare feeMedicare beneficiariesUS national studyOverall healthMedian household incomeBeing IndexCare systemDemographic characteristics
2017
The primary health-care system in China
Li X, Lu J, Hu S, Cheng K, De Maeseneer J, Meng Q, Mossialos E, Xu DR, Yip W, Zhang H, Krumholz HM, Jiang L, Hu S. The primary health-care system in China. The Lancet 2017, 390: 2584-2594. PMID: 29231837, DOI: 10.1016/s0140-6736(17)33109-4.Peer-Reviewed Original ResearchConceptsPrimary health care systemHealth care systemChronic non-communicable diseasesEvidence-based performance indicatorsNon-communicable diseasesEveryday clinical practiceQuality of careHealth information technology systemsRisk factorsClinical practiceCare deliveryVillage doctorsHealth care reformInadequate educationCost savingsWorld populationPopulationPrevalenceDiseaseReductions in Readmission Rates Are Associated With Modest Improvements in Patient-reported Health Gains Following Hip and Knee Replacement in England
Friebel R, Dharmarajan K, Krumholz HM, Steventon A. Reductions in Readmission Rates Are Associated With Modest Improvements in Patient-reported Health Gains Following Hip and Knee Replacement in England. Medical Care 2017, 55: 834-840. PMID: 28742545, PMCID: PMC5555974, DOI: 10.1097/mlr.0000000000000779.Peer-Reviewed Original ResearchConceptsRisk-adjusted readmission ratesReadmission ratesEQ-VASHealth gainsEQ-5DKnee replacementHip replacementOxford Hip ScoreOxford Knee ScorePatient-reported healthPatient-reported outcomesVisual analog scaleKnee replacement surgeryReadmission reduction initiativesHealth care systemAdditional health gainsHip scoreKnee scoreAnalog scalePresurgical assessmentReplacement surgeryPatients' senseHospital groupModest ImprovementPatient health
2015
Insurance and Prehospital Delay in Patients ≤55 Years With Acute Myocardial Infarction
Chen SI, Wang Y, Dreyer R, Strait KM, Spatz ES, Xu X, Smolderen KG, Desai NR, Lorenze NP, Lichtman JH, Spertus JA, D'Onofrio G, Bueno H, Masoudi FA, Krumholz HM. Insurance and Prehospital Delay in Patients ≤55 Years With Acute Myocardial Infarction. The American Journal Of Cardiology 2015, 116: 1827-1832. PMID: 26541907, PMCID: PMC5323057, DOI: 10.1016/j.amjcard.2015.09.018.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPrehospital delayInsurance statusMyocardial infarctionSpanish patientsGender differencesHealth care systemUS patientsProspective studyUS cohortUS womenPatientsUniversal insuranceCare systemWomenSignificant gender differencesInfarctionMenInsurance groupsHoursStatusAssociationLarge proportionDifferencesCohortAchieving best outcomes for patients with cardiovascular disease in China by enhancing the quality of medical care and establishing a learning health-care system
Jiang L, Krumholz HM, Li X, Li J, Hu S. Achieving best outcomes for patients with cardiovascular disease in China by enhancing the quality of medical care and establishing a learning health-care system. The Lancet 2015, 386: 1493-1505. PMID: 26466053, PMCID: PMC5323019, DOI: 10.1016/s0140-6736(15)00343-8.Peer-Reviewed Original Research
2014
Big Data And New Knowledge In Medicine: The Thinking, Training, And Tools Needed For A Learning Health System
Krumholz HM. Big Data And New Knowledge In Medicine: The Thinking, Training, And Tools Needed For A Learning Health System. Health Affairs 2014, 33: 1163-1170. PMID: 25006142, PMCID: PMC5459394, DOI: 10.1377/hlthaff.2014.0053.Peer-Reviewed Original ResearchConceptsBig dataNext-generation analyticsHealth care dataNew data sourcesAdvanced analyticsData meaningLearning health systemInformation needsUnmet information needsMassive quantitiesData sourcesHealth policy makersComplexity of patientsAnalyticsLearning health care systemComparative effectiveness researchHealth care systemPopulation health researchKnowledge generationCare dataHealth systemPatientsCare systemEffectiveness researchHealth research
2013
Ethical Oversight: Serving the Best Interests of Patients
Selby JV, Krumholz HM. Ethical Oversight: Serving the Best Interests of Patients. The Hastings Center Report 2013, 43: s34-s36. PMID: 23315893, DOI: 10.1002/hast.138.Peer-Reviewed Original Research
2008
Use of Recommended Ambulatory Care Services: Is the Veterans Affairs Quality Gap Narrowing?
Ross JS, Keyhani S, Keenan PS, Bernheim SM, Penrod JD, Boockvar KS, Federman AD, Krumholz HM, Siu AL. Use of Recommended Ambulatory Care Services: Is the Veterans Affairs Quality Gap Narrowing? JAMA Internal Medicine 2008, 168: 950-958. PMID: 18474759, DOI: 10.1001/archinte.168.9.950.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAmbulatory CareBehavioral Risk Factor Surveillance SystemBreast NeoplasmsCholesterolColorectal NeoplasmsCounselingDiabetes MellitusDiabetic RetinopathyDisease ManagementDyslipidemiasFemaleHospitals, VeteransHumansInfluenza VaccinesMaleMiddle AgedPneumococcal VaccinesPreventive Health ServicesQuality of Health CareSmoking CessationUnited StatesVeteransConceptsVeterans Affairs Medical CenterAmbulatory care servicesInsured adultsCancer screeningCare servicesBehavior Risk Factor Surveillance SystemRisk Factor Surveillance SystemCardiovascular risk reductionColorectal cancer screeningChronic disease careBreast cancer screeningQuality improvement initiativesQuality of careUS health care systemInfectious disease preventionHealth care systemHealth Care Quality Improvement InitiativeEye examinationSelf-reported useDisease careCancer preventionMellitus managementMedical CenterAmbulatory careService useDual Use of Veterans Affairs Services and Use of Recommended Ambulatory Care
Ross JS, Keyhani S, Keenan PS, Bernheim SM, Penrod JD, Boockvar KS, Krumholz HM, Siu AL. Dual Use of Veterans Affairs Services and Use of Recommended Ambulatory Care. Medical Care 2008, 46: 309-316. PMID: 18388846, DOI: 10.1097/mlr.0b013e31815b9db3.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAmbulatory CareBehavioral Risk Factor Surveillance SystemCross-Sectional StudiesFemaleHealth Services AccessibilityHumansMaleMiddle AgedPrimary Health CareQuality Indicators, Health CareQuality of Health CareSocioeconomic FactorsUnited StatesUnited States Department of Veterans AffairsConceptsVA usersPatient characteristicsCancer screeningDual usersVeterans Affairs Medical SystemBehavior Risk Factor Surveillance SystemRisk Factor Surveillance SystemCardiovascular risk reductionMultivariable logistic regressionProstate cancer screeningAmbulatory care servicesVeterans Affairs servicesCommunity-dwelling adultsBreast cancer screeningLow useCross-sectional analysisInfectious disease preventionHealth care systemInfluenza vaccinationCare patientsSelf-reported useUnadjusted analysesCancer preventionOutcome measuresAmbulatory care
2006
Regionalization of ST-Segment Elevation Acute Coronary Syndromes Care Putting a National Policy in Proper Perspective
Rathore SS, Epstein AJ, Nallamothu BK, Krumholz HM. Regionalization of ST-Segment Elevation Acute Coronary Syndromes Care Putting a National Policy in Proper Perspective. Journal Of The American College Of Cardiology 2006, 47: 1346-1349. PMID: 16580519, PMCID: PMC2789345, DOI: 10.1016/j.jacc.2005.11.053.Peer-Reviewed Original ResearchConceptsPrimary percutaneous coronary interventionPrimary PCISTEMI patientsFibrinolytic therapyPCI hospitalsST-segment elevation myocardial infarction (STEMI) careAcute coronary syndrome careHigh-volume PCI hospitalsHigh-risk STEMI patientsElevation Myocardial Infarction CareHigh-volume hospitalsLow-volume hospitalsPercutaneous coronary interventionMyocardial infarction careCardiac care facilitiesHealth care resourcesHealth care systemInitial hospitalPCI patientsCoronary interventionU.S. health care systemAverage patientSingle deathCare facilitiesPatients
1999
Cost-Effectiveness Analysis and the Treatment of Acute Coronary Syndromes
Krumholz H. Cost-Effectiveness Analysis and the Treatment of Acute Coronary Syndromes. Contemporary Cardiology 1999, 601-610. DOI: 10.1007/978-1-59259-731-4_25.Peer-Reviewed Original ResearchAcute coronary syndromeCoronary heart diseaseHealth care resourcesCost-effectiveness analysisHealth care systemHealth care expendituresCoronary syndromeCardiac eventsPharmacologic interventionsHeart diseaseEfficacious therapyCardiovascular diseaseCare resourcesNew interventionsCare expendituresCare systemHealth benefitsInterventionCare organizationsDiseaseTreatmentStandard practicePatientsHospitalSyndrome