2024
Hospital COVID-19 Burden and Adverse Event Rates
Metersky M, Rodrick D, Ho S, Galusha D, Timashenka A, Grace E, Marshall D, Eckenrode S, Krumholz H. Hospital COVID-19 Burden and Adverse Event Rates. JAMA Network Open 2024, 7: e2442936. PMID: 39495512, DOI: 10.1001/jamanetworkopen.2024.42936.Peer-Reviewed Original ResearchConceptsCOVID-19 burdenHospital admissionPatient safetyRelative riskCohort studyStudy of hospital admissionsAcute care hospitalsRisk-adjustment variablesRisk-adjusted ratesMedicare hospital admissionsCOVID-19 pandemicStaffing shortagesHospital characteristicsMain OutcomesHospital resilienceSurge capacityMedicare patientsCare hospitalHighest burdenPrevent declinesPatient admissionsStudy sampleElixhauser comorbiditiesCOVID-19Low burdenSocial Determinants of Health and Delivery of Rehabilitation to Older Adults During ICU Hospitalization
Jain S, Murphy T, Falvey J, Leo-Summers L, O’Leary J, Zang E, Gill T, Krumholz H, Ferrante L. Social Determinants of Health and Delivery of Rehabilitation to Older Adults During ICU Hospitalization. JAMA Network Open 2024, 7: e2410713. PMID: 38728030, PMCID: PMC11087837, DOI: 10.1001/jamanetworkopen.2024.10713.Peer-Reviewed Original ResearchConceptsSocial determinants of healthDeterminants of healthOccupational therapyPhysical therapyOlder adultsRural residentsIntensive care unit hospitalizationRehabilitation deliveryIntensive care unitSocial determinantsSocioeconomic disadvantageNational Health and Aging Trends StudyDelivery of physical therapyIllness hospitalizationFactors associated with lower oddsDelivery of rehabilitationIn-hospital rehabilitationMitigate functional declineMedicaid eligibilityBurden of disabilityHigh school educationDual MedicareTrends StudyMedicare claimsLength of stay
2023
Relationship Between In-Hospital Adverse Events and Hospital Performance on 30-Day All-cause Mortality and Readmission for Patients With Heart Failure
Wang Y, Eldridge N, Metersky M, Rodrick D, Eckenrode S, Mathew J, Galusha D, Peterson A, Hunt D, Normand S, Krumholz H. Relationship Between In-Hospital Adverse Events and Hospital Performance on 30-Day All-cause Mortality and Readmission for Patients With Heart Failure. Circulation Cardiovascular Quality And Outcomes 2023, 16: e009573. PMID: 37463255, PMCID: PMC10351904, DOI: 10.1161/circoutcomes.122.009573.Peer-Reviewed Original ResearchConceptsMore adverse eventsAdverse eventsHeart failureCause mortalityReadmission ratesHigh riskMedicare Patient Safety Monitoring SystemHospital-acquired adverse eventsIn-Hospital Adverse EventsHospital adverse eventsRate of patientsPatient Safety DatabasePerformance categoriesAdverse event dataCross-sectional studyUnited States CentersHospital performanceHospital characteristicsReadmission dataPatient riskMAIN OUTCOMEPatientsWorst hospitalsHospitalHigh mortalitySex-Related Differences in Patient Characteristics, Risk Factors, and Symptomatology in Older Adults with Pulmonary Embolism: Findings from the SERIOUS-PE Study
Bikdeli B, Muriel A, Wang Y, Piazza G, Khairani C, Rosovsky R, Mehdipoor G, O'Donoghue M, Madridano O, Lopez-Saez J, Mellado M, Brasero A, Grandone E, Spagnolo P, Lu Y, Bertoletti L, López-Jiménez L, Núñez M, Blanco-Molina Á, Gerhard-Herman M, Goldhaber S, Bates S, Jimenez D, Krumholz H, Monreal M. Sex-Related Differences in Patient Characteristics, Risk Factors, and Symptomatology in Older Adults with Pulmonary Embolism: Findings from the SERIOUS-PE Study. Seminars In Thrombosis And Hemostasis 2023, 49: 725-735. PMID: 36868268, DOI: 10.1055/s-0043-1764231.Peer-Reviewed Original ResearchConceptsOlder adultsClinical characteristicsRisk factorsElderly womenPE risk stratificationTransient provoking factorsRelevant clinical characteristicsSex differencesWarrants further investigationSex-related differencesSex-specific factorsClot burdenPE presentationChest painHormonal therapyHormone therapyPatient characteristicsPulmonary embolismYounger patientsAtherosclerotic diseaseRisk stratificationLung diseaseMedicare databaseProvoking factorsCardiovascular disease
2022
Temporal trends in postoperative and ventilator-associated pneumonia in the United States
Metersky M, Wang Y, Klompas M, Eckenrode S, Mathew J, Krumholz H. Temporal trends in postoperative and ventilator-associated pneumonia in the United States. Infection Control And Hospital Epidemiology 2022, 44: 1247-1254. PMID: 36326283, DOI: 10.1017/ice.2022.264.Peer-Reviewed Original ResearchConceptsVentilator-associated pneumoniaMajor surgical proceduresPostoperative pneumoniaAcute myocardial infarctionSurgical proceduresHeart failureMyocardial infarctionMedicare Patient Safety Monitoring SystemAnnual riskRetrospective cohort studyPrior yearRisk-adjusted ratesAdverse event measuresCohort studyRetrospective reviewPneumoniaPatientsInfarctionUnited StatesRiskSignificant changesYearsTemporal trendsFailureTrends in Adverse Event Rates in Hospitalized Patients, 2010-2019
Eldridge N, Wang Y, Metersky M, Eckenrode S, Mathew J, Sonnenfeld N, Perdue-Puli J, Hunt D, Brady PJ, McGann P, Grace E, Rodrick D, Drye E, Krumholz HM. Trends in Adverse Event Rates in Hospitalized Patients, 2010-2019. JAMA 2022, 328: 173-183. PMID: 35819424, PMCID: PMC9277501, DOI: 10.1001/jama.2022.9600.Peer-Reviewed Original ResearchMeSH KeywordsAccidental FallsAdultAgedAged, 80 and overCross InfectionCross-Sectional StudiesDrug-Related Side Effects and Adverse ReactionsFemaleHeart FailureHospitalizationHumansMaleMedicareMiddle AgedMyocardial InfarctionPatient SafetyPneumoniaPostoperative ComplicationsPressure UlcerRisk AssessmentSurgical Procedures, OperativeUnited StatesConceptsMajor surgical proceduresAcute myocardial infarctionAdverse event ratesGeneral adverse eventsAdverse eventsHeart failureAdverse drug eventsAcute care hospitalsMyocardial infarctionHospital-acquired infectionsSurgical proceduresEvent ratesHospital dischargeCare hospitalDrug eventsMedicare Patient Safety Monitoring SystemSerial cross-sectional studyPatient safetyUS acute care hospitalsHospital adverse eventsSignificant decreaseSurgical procedure groupsCross-sectional studyRisk-adjusted ratesAdult patientsTrends in 10-Year Outcomes Among Medicare Beneficiaries Who Survived an Acute Myocardial Infarction
Wang Y, Leifheit EC, Krumholz HM. Trends in 10-Year Outcomes Among Medicare Beneficiaries Who Survived an Acute Myocardial Infarction. JAMA Cardiology 2022, 7: 613-622. PMID: 35507330, PMCID: PMC9069341, DOI: 10.1001/jamacardio.2022.0662.Peer-Reviewed Original ResearchConceptsRecurrent acute myocardial infarctionAcute myocardial infarctionHealth priority areasLong-term outcomesCause mortalityHazard ratioWhite patientsMyocardial infarctionMedicare feeMedicare-MedicaidService beneficiariesInitial acute myocardial infarctionTen-year mortalityShort-term outcomesDemographic subgroupsEligible patientsPatient characteristicsAMI survivorsAcute periodMean ageRecurrence rateSubgroup analysisMAIN OUTCOMEMortality riskAMI admissionsSex Differences in PrEsentation, Risk Factors, Drug and Interventional Therapies, and OUtcomes of Elderly PatientS with Pulmonary Embolism: Rationale and design of the SERIOUS-PE study
Bikdeli B, Piazza G, Jimenez D, Muriel A, Wang Y, Khairani CD, Rosovsky RP, Mehdipoor G, O'Donoghue ML, Spagnolo P, Dreyer RP, Bertoletti L, López-Jiménez L, Núñez MJ, Blanco-Molina Á, Bates SM, Gerhard-Herman M, Goldhaber SZ, Monreal M, Krumholz HM. Sex Differences in PrEsentation, Risk Factors, Drug and Interventional Therapies, and OUtcomes of Elderly PatientS with Pulmonary Embolism: Rationale and design of the SERIOUS-PE study. Thrombosis Research 2022, 214: 122-131. PMID: 35537232, DOI: 10.1016/j.thromres.2022.04.019.Peer-Reviewed Original ResearchConceptsRisk factorsElderly patientsUS Medicare feeInterventional therapyMedicare feeInternational registryService beneficiariesSex differencesNational US databasePrognostic prediction rulePulmonary embolism studyLarge international registryPrincipal discharge diagnosisSex-based disparitiesAssessment of outcomesPotential sex differencesSex-specific findingsPE presentationPulmonary embolismVenous thromboembolismTreatment patternsDischarge diagnosisAvailable therapiesDisease presentationTreatment-based differencesAnalysis of Hospital-Level Readmission Rates and Variation in Adverse Events Among Patients With Pneumonia in the United States
Wang Y, Eldridge N, Metersky ML, Rodrick D, Faniel C, Eckenrode S, Mathew J, Galusha DH, Tasimi A, Ho SY, Jaser L, Peterson A, Normand ST, Krumholz HM. Analysis of Hospital-Level Readmission Rates and Variation in Adverse Events Among Patients With Pneumonia in the United States. JAMA Network Open 2022, 5: e2214586. PMID: 35639379, PMCID: PMC9157270, DOI: 10.1001/jamanetworkopen.2022.14586.Peer-Reviewed Original ResearchConceptsRisk-standardized readmission ratesMedicare Patient Safety Monitoring SystemCause readmission rateAdverse eventsReadmission ratesHigh riskHospital-level readmission ratesHigher patient riskHospital adverse eventsAdverse event dataCross-sectional studyHospital performanceIndex hospitalizationMedian ageHospital characteristicsMedical recordsReadmission dataPatient riskHospital careMAIN OUTCOMEPneumoniaHospital levelPatientsReadmissionGreater risk
2021
Clinician Trends in Prescribing Direct Oral Anticoagulants for US Medicare Beneficiaries
Wheelock KM, Ross JS, Murugiah K, Lin Z, Krumholz HM, Khera R. Clinician Trends in Prescribing Direct Oral Anticoagulants for US Medicare Beneficiaries. JAMA Network Open 2021, 4: e2137288. PMID: 34870678, PMCID: PMC8649845, DOI: 10.1001/jamanetworkopen.2021.37288.Peer-Reviewed Original ResearchConceptsDOAC useAnticoagulant prescriptionOral anticoagulantsUS cliniciansMedicare beneficiariesNational clinical practice guidelinesElevated bleeding riskOral anticoagulant prescriptionsRetrospective cohort studyDirect oral anticoagulantsClinical practice guidelinesUS Medicare beneficiariesInternal medicine physiciansNumber of cliniciansAnticoagulant prescribingDOAC prescriptionsUnique cliniciansBleeding riskCohort studyAnticoagulant strategiesPrescription claimsPractice guidelinesMAIN OUTCOMEMost indicationsMedicare populationPatterns of Prescribing Sodium-Glucose Cotransporter-2 Inhibitors for Medicare Beneficiaries in the United States
Sangha V, Lipska K, Lin Z, Inzucchi SE, McGuire DK, Krumholz HM, Khera R. Patterns of Prescribing Sodium-Glucose Cotransporter-2 Inhibitors for Medicare Beneficiaries in the United States. Circulation Cardiovascular Quality And Outcomes 2021, 14: e008381. PMID: 34779654, PMCID: PMC9022137, DOI: 10.1161/circoutcomes.121.008381.Peer-Reviewed Original ResearchConceptsType 2 diabetesMedicare beneficiariesSodium-glucose cotransporter 2 inhibitorsLarge randomized clinical trialsMedicare Part D prescriber dataChronic kidney diseaseCotransporter 2 inhibitorsAtherosclerotic cardiovascular diseasePercent of cliniciansRandomized clinical trialsUS Medicare beneficiariesAdvanced practice providersCross-sectional studyKidney outcomesSGLT2i useSulfonylurea prescriptionUnique cliniciansCardiovascular deathMedication classesKidney diseaseLabel indicationsClinical trialsSGLT2iCardiovascular diseasePractice providersNational Trends and Disparities in Hospitalization for Acute Hypertension Among Medicare Beneficiaries (1999–2019)
Lu Y, Wang Y, Spatz ES, Onuma O, Nasir K, Rodriguez F, Watson KE, Krumholz HM. National Trends and Disparities in Hospitalization for Acute Hypertension Among Medicare Beneficiaries (1999–2019). Circulation 2021, 144: 1683-1693. PMID: 34743531, DOI: 10.1161/circulationaha.121.057056.Peer-Reviewed Original ResearchConceptsHigher hospitalization ratesAcute hypertensionHospitalization ratesMedicare feeService beneficiariesBlack adultsSerial cross-sectional analysisCause readmission rateNational hospitalization ratesPrimary discharge diagnosisAnnual hospitalization rateCause mortality ratesPoisson link functionDual-eligible statusMedicare/MedicaidCross-sectional analysisHypertension controlReadmission ratesDischarge diagnosisDiseases codesMedicare denominatorInpatient filesHypertensionInternational ClassificationMedicare beneficiariesTrends in Transcatheter and Surgical Aortic Valve Replacement Among Older Adults in the United States
Mori M, Gupta A, Wang Y, Vahl T, Nazif T, Kirtane AJ, George I, Yong CM, Onuma O, Kodali S, Geirsson A, Leon MB, Krumholz HM. Trends in Transcatheter and Surgical Aortic Valve Replacement Among Older Adults in the United States. Journal Of The American College Of Cardiology 2021, 78: 2161-2172. PMID: 34823659, DOI: 10.1016/j.jacc.2021.09.855.Peer-Reviewed Original ResearchScope of Practice of US Interventional Cardiologists from an Analysis of Medicare Billing Data
Murugiah K, Chen L, Castro-Dominguez Y, Khera R, Krumholz HM. Scope of Practice of US Interventional Cardiologists from an Analysis of Medicare Billing Data. The American Journal Of Cardiology 2021, 160: 40-45. PMID: 34610872, DOI: 10.1016/j.amjcard.2021.08.041.Peer-Reviewed Original ResearchPrior Authorization, Copayments, and Utilization of Sacubitril/Valsartan in Medicare and Commercial Plans in Patients With Heart Failure With Reduced Ejection Fraction
Ozaki AF, Krumholz HM, Mody FV, Tran TT, Le QT, Yokota M, Jackevicius CA. Prior Authorization, Copayments, and Utilization of Sacubitril/Valsartan in Medicare and Commercial Plans in Patients With Heart Failure With Reduced Ejection Fraction. Circulation Cardiovascular Quality And Outcomes 2021, 14: e007665. PMID: 34465124, DOI: 10.1161/circoutcomes.120.007665.Peer-Reviewed Original ResearchConceptsSacubitril/valsartanSacubitril/valsartan useInsurance plan typeReduced ejection fractionHeart failureEjection fractionValsartan useCommercial plansNew York Heart Association classPA criteriaReduced ejection fraction patientsReduced ejection fraction populationPlan typeEjection fraction patientsMedicare plansEjection fraction populationCross-sectional studyProportion of plansPrescription copaymentsAssociation classCopayment amountPrimary outcomeClinical outcomesPlan populationMore prescriptionsMulticentre methodological study to create a publicly available score of hospital financial standing in the USA
Zinoviev R, Krumholz HM, Ciccarone R, Antle R, Forman HP. Multicentre methodological study to create a publicly available score of hospital financial standing in the USA. BMJ Open 2021, 11: e046500. PMID: 34301654, PMCID: PMC8311305, DOI: 10.1136/bmjopen-2020-046500.Peer-Reviewed Original ResearchConceptsCredit ratingsFinancial dataBond ratingsMoody’s credit ratingsHospital's financial standingHospital financial dataFinancial literatureFinancial stabilityFinancial indicatorsFinancial scoresFinancial trendsFinancial healthFinancial standingFinancial metricsGreater shareMedicare dischargesWeighted variablesShareHospital operationsUnique variablesSingle composite scoreVariablesMoodyHealth systemModelIncorporating Present-on-Admission Indicators in Medicare Claims to Inform Hospital Quality Measure Risk Adjustment Models
Triche EW, Xin X, Stackland S, Purvis D, Harris A, Yu H, Grady JN, Li SX, Bernheim SM, Krumholz HM, Poyer J, Dorsey K. Incorporating Present-on-Admission Indicators in Medicare Claims to Inform Hospital Quality Measure Risk Adjustment Models. JAMA Network Open 2021, 4: e218512. PMID: 33978722, PMCID: PMC8116982, DOI: 10.1001/jamanetworkopen.2021.8512.Peer-Reviewed Original ResearchConceptsPOA indicatorRisk factorsOutcome measuresQuality outcome measuresRisk-adjustment modelsClaims dataAdmission indicatorsPatient risk factorsAcute myocardial infarctionPatient-level outcomesAdministrative claims dataQuality improvement studyClaims-based measuresComparative effectiveness studiesPatient claims dataInternational Statistical ClassificationMortality outcome measuresRelated Health ProblemsHospital quality measuresRisk model performanceHospital stayIndex admissionCare algorithmHeart failureMortality outcomesAssociation of Cardiac Care Regionalization With Access, Treatment, and Mortality Among Patients With ST-Segment Elevation Myocardial Infarction
Shen YC, Krumholz H, Hsia RY. Association of Cardiac Care Regionalization With Access, Treatment, and Mortality Among Patients With ST-Segment Elevation Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2021, 14: e007195. PMID: 33641339, PMCID: PMC7969448, DOI: 10.1161/circoutcomes.120.007195.Peer-Reviewed Original ResearchConceptsPercutaneous coronary interventionST-segment elevation myocardial infarction (STEMI) systemsSame-day percutaneous coronary interventionST-segment elevation myocardial infarctionSTEMI regionalizationLong-term mortalityOutcomes of patientsElevation myocardial infarctionPCI-capable hospitalsEmergency medical services agenciesMyocardial infarction systemLocal emergency medical services agenciesPoints greater reductionPercentage point decreasePCI capabilityCoronary interventionMyocardial infarctionAdministrative databasesPatientsSTEMIPoint decreaseMortalityTimely accessReadmissionGreater reductionAdministrative Claims Measure for Profiling Hospital Performance Based on 90-Day All-Cause Mortality Following Coronary Artery Bypass Graft Surgery
Mori M, Nasir K, Bao H, Jimenez A, Legore SS, Wang Y, Grady J, Lama SD, Brandi N, Lin Z, Kurlansky P, Geirsson A, Bernheim SM, Krumholz HM, Suter LG. Administrative Claims Measure for Profiling Hospital Performance Based on 90-Day All-Cause Mortality Following Coronary Artery Bypass Graft Surgery. Circulation Cardiovascular Quality And Outcomes 2021, 14: e006644. PMID: 33535776, DOI: 10.1161/circoutcomes.120.006644.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesCoronary artery bypass graft surgeryArtery bypass graft surgeryBypass graft surgeryMortality rateGraft surgeryC-statisticMedicaid ServicesAdministrative Claims MeasureCause mortality ratesMortality measuresUnadjusted mortality ratesProfiling Hospital PerformanceHierarchical logistic regression modelsAlternate payment modelsHospital performanceLogistic regression modelsCABG recoveryPayment modelsCABG surgeryCause mortalityCABG proceduresDays postsurgeryHospital levelSurgery
2020
Associations Between the Severity of Influenza Seasons and Mortality and Readmission Risks After Elective Surgical Aortic Valve Replacement and Coronary Artery Bypass Graft Surgery in Older Adults
Mori M, Wang Y, Mahajan S, Geirsson A, Krumholz HM. Associations Between the Severity of Influenza Seasons and Mortality and Readmission Risks After Elective Surgical Aortic Valve Replacement and Coronary Artery Bypass Graft Surgery in Older Adults. JAMA Network Open 2020, 3: e2031078. PMID: 33355673, PMCID: PMC7758803, DOI: 10.1001/jamanetworkopen.2020.31078.Peer-Reviewed Original ResearchConceptsSurgical aortic valve replacementElective surgical aortic valve replacementAortic valve replacementValve replacementReadmission riskCoronary artery bypass graft surgeryArtery bypass graft surgeryOlder adultsBypass graft surgeryCoronary artery bypassCross-sectional studyArtery bypassGraft surgeryInfluenza seasonMedicaid ServicesMortalitySeverityAdultsRiskAssociationSurgeryBypass