An assessment of completeness and medical coding of Medicare Advantage hospitalizations in two national data sets.

Objective: To compare the Encounter Data System (EDS) and Medicare Provider Analysis and Review (MedPAR) completeness and medical coding of Medicare Advantage hospitalizations.

Data Sources: FY 2016-FY 2019 data limited to hospitals paid under Medicare's Inpatient Prospective Payment System.

Study Design: Secondary data analysis.

Asymptotics of the meta-atom: plane wave scattering by a single Helmholtz resonator.

Using a combination of multipole methods and the method of matched asymptotic expansions, we present a solution procedure for acoustic plane wave scattering by a single Helmholtz resonator in two dimensions. Closed-form representations for the multipole scattering coefficients of the resonator are derived, valid at low frequencies, with three fundamental configurations examined in detail: the thin-walled, moderately thick-walled and extremely thick-walled limits. Additionally, we examine the impact of dissipation for extremely thick-walled resonators, and also numerically evaluate the scattering, absorption and extinction cross-sections (efficiencies) for representative resonators in all three wall thickness regimes.

Deeply subwavelength giant monopole elastodynamic metacluster resonators.

The giant monopole resonance is a well-known phenomenon, employed to tune the dynamic response of composite materials comprising voids in an elastic matrix which has a bulk modulus much greater than its shear modulus, e.g. elastomers.

Thermo-viscous damping of acoustic waves in narrow channels: A comparison of effects in air and water.

Recent work in the acoustic metamaterial literature has focused on the design of metasurfaces that are capable of absorbing sound almost perfectly in narrow frequency ranges by coupling resonant effects to visco-thermal damping within their microstructure. Understanding acoustic attenuation mechanisms in narrow, viscous-fluid-filled channels is of fundamental importance in such applications. Motivated by recent work on acoustic propagation in narrow, air-filled channels, a theoretical framework is presented that demonstrates the controlling mechanisms of acoustic propagation in arbitrary Newtonian fluids, focusing on attenuation in air and water.

Variation in chest pain emergency department admission rates and acute myocardial infarction and death within 30 days in the Medicare population.

Objectives: The objective was to assess the relationship between emergency department (ED) admission rates for Medicare beneficiaries with chest pain and outcomes, specifically 30-day rates of acute myocardial infarction (AMI) and mortality.

Methods: Using a 20% random sample of Medicare beneficiaries in 2009, 158,295 beneficiaries with a primary diagnosis of chest pain at the conclusion of their ED visits were selected to assess outcomes based on the decision to hospitalize or discharge home. The proportions of these patients admitted to inpatient or observation status at 2,219 U.

Comparative effectiveness of endovascular versus open repair of ruptured abdominal aortic aneurysm in the Medicare population.

Objective: Endovascular aortic repair (EVAR) for abdominal aortic aneurysm (AAA) is increasingly used for emergent treatment of ruptured AAA (rAAA). We sought to compare the perioperative and long-term mortality, procedure-related complications, and rates of reintervention of EVAR vs open aortic repair of rAAA in Medicare beneficiaries.

Methods: We examined perioperative and long-term mortality and complications after EVAR or open aortic repair performed for rAAA in all traditional Medicare beneficiaries discharged from a United States hospital from 2001 to 2008.

Risk of late-onset adhesions and incisional hernia repairs after surgery.

Background: Long-term adhesion-related complications and incisional hernias after abdominal surgery are common and costly. There are few data on the risk of these complications after different abdominal operations.

Study Design: We identified Medicare beneficiaries who underwent endovascular repair of an abdominal aortic aneurysm from 2001-2008 who presumably are not at risk for laparotomy-related complications.

Changes in abdominal aortic aneurysm rupture and short-term mortality, 1995-2008: a retrospective observational study.

Objective: To examine the modern epidemiology of abdominal aortic aneurysm (AAA) rupture and short-term AAA-related mortality after the introduction of endovascular aneurysm repair (EVAR).

Background: Previous epidemiologic studies have demonstrated stable rates of AAA repair, repair mortality, and AAA rupture. Recently, EVAR has been introduced as a less invasive treatment method, and its use has expanded to more than 75% of elective AAA repairs.

Improving observational study estimates of treatment effects using joint modeling of selection effects and outcomes: the case of AAA repair.

Background: When 2 treatment approaches are available, there are likely to be unmeasured confounders that influence choice of procedure, which complicates estimation of the causal effect of treatment on outcomes using observational data.

Objective: To estimate the effect of endovascular (endo) versus open surgical (open) repair, including possible modification by institutional volume, on survival after treatment for abdominal aortic aneurysm, accounting for observed and unobserved confounding variables.

Research Design: Observational study of data from the Medicare program using a joint model of treatment selection and survival given treatment to estimate the effects of type of surgery and institutional volume on survival.

Resident and fellow experiences after the introduction of endovascular aneurysm repair for abdominal aortic aneurysm.

Objectives: This study assessed trends in open and endovascular repair (EVAR) of intact and ruptured abdominal aortic aneurysm (AAA) in the Medicare population and evaluated recent trends in AAA repair at vascular fellowship training programs.

Methods: We identified all Medicare beneficiaries with a diagnosis of AAA who underwent repair or had a primary diagnosis of rupture (1995-2008). Cohorts were compared by type of repair (open vs EVAR) and presentation (intact vs ruptured AAA).

Defining perioperative mortality after open and endovascular aortic aneurysm repair in the US Medicare population.

Background: Perioperative mortality is reported after abdominal aortic aneurysm (AAA) repair, but there is no agreed upon standard definition. Often, 30-day mortality is reported because in-hospital mortality may be biased in favor of endovascular repair given the shorter length of stay. However, the duration of increased risk of death after aneurysm repair is unknown.

Thirty-day mortality and late survival with reinterventions and readmissions after open and endovascular aortic aneurysm repair in Medicare beneficiaries.

Objectives: Late survival is similar after open and endovascular abdominal aortic aneurysm (AAA) repair (EVAR), despite a perioperative benefit with EVAR. AAA-related reinterventions are more common after EVAR, whereas laparotomy-related reinterventions are more common after open repair. The effect of reinterventions on survival, however, is unknown.

Volume-outcome relationships and abdominal aortic aneurysm repair.

Background: There is a well-established literature relating procedure volume to outcomes, but incorporating such information into clinical decision making is problematic when there is >1 treatment option for a condition.

Methods And Results: We used data from the Medicare program to investigate the relationship between institutional volume for open and endovascular abdominal aortic aneurysm (AAA) repair and outcomes, examine trends in volume, and explore the implications for physicians making referrals for AAA repair. Trends in institutional volume were measured for the time period 2001-2006, whereas outcomes were assessed with the use of a previously assembled propensity score-matched cohort covering the time period 2001-2004.

Core competencies for hair restoration surgeons recommended by the International Society of Hair Restoration Surgery.

Background: Because hair restoration surgery has changed so significantly, the International Society of Hair Restoration Surgery (ISHRS) recently developed and published a Core Curriculum for Hair Restoration Surgery (CCHRS). The ISHRS organized a task force to develop training programs that would not only present the CCHRS but also provide the practical experience necessary to allow a physician to practice safe, aesthetically sound hair restoration surgery. The task force recognized early on that identification of core competencies for hair restoration surgeons was essential to guiding the development of these training experiences.

Risk prediction for perioperative mortality of endovascular vs open repair of abdominal aortic aneurysms using the Medicare population.

Objectives: The impact of risk factors upon perioperative mortality might differ for patients undergoing open vs endovascular repair (EVAR) of abdominal aortic aneurysms (AAA). In order to investigate this, we developed a differential predictive model of perioperative mortality after AAA repair.

Methods: A total of 45,660 propensity score matched Medicare beneficiaries undergoing elective open or endovascular AAA repair from 2001 to 2004 were studied.

Spatiotemporal analysis of epiphytotics of downy mildew of oilseed poppy in tasmania, australia.

Downy mildew, caused by Peronospora arborescens, has become the major disease affecting oilseed poppy (Papaver somniferum) since its first record in Tasmania in 1996. Two field trials conducted in 2000 and 2001 studied the progression and spatial distribution of downy mildew epiphytotics. The logistic and exponential models best described the progression of disease incidence and severity, respectively.

Medicare psychiatric admissions, 1987-2004: does the past offer insights for the future?

In 2005, Medicare implemented a new prospective payment system (PPS) for inpatient psychiatric facilities (IPFs). Analysis of Medicare psychiatric inpatient claims for 1987-2004 provides insights into future experience after implementation. Growth in the under-age-sixty-five disabled population was the dominant factor driving growth in psychiatric admissions.

Endovascular vs. open repair of abdominal aortic aneurysms in the Medicare population.

Background: Randomized trials have shown reductions in perioperative mortality and morbidity with endovascular repair of abdominal aortic aneurysm, as compared with open surgical repair. Longer-term survival rates, however, were similar for the two procedures. There are currently no long-term, population-based data from the comparison of these strategies.

Prospective payment for Medicare inpatient psychiatric care: assessing the alternatives.

This article reports the findings of an empirical analysis of per case and per diem models of prospective payment for Medicare inpatient psychiatric care. Quantitative measures are presented that show the improvement of a per diem model over a per case model. The research supports the viability of per diem prospective payment and identifies directions for future research that would refine current per diem models.

Overview: Medicare post-acute care since the Balanced Budget Act of 1997.

The Balanced Budget Act (BBA) of 1997 contained the most sweeping changes in payment policy for Medicare post-acute care (PAC) services ever enacted in a single piece of legislation. Research on the early impacts of these changes is now beginning to appear, and this issue of the includes six articles covering a range of timely PAC issues. There are two articles on skilled nursing facility (SNF) care—the first by Chapin White, Steven D.

The effects of finasteride on scalp skin and serum androgen levels in men with androgenetic alopecia.

Background: Data suggest that androgenetic alopecia is a process dependent on dihydrotestosterone (DHT) and type 2 5alpha-reductase. Finasteride is a type 2 5alpha-reductase inhibitor that has been shown to slow further hair loss and improve hair growth in men with androgenetic alopecia.

Objective: We attempted to determine the effect of finasteride on scalp skin and serum androgens.

Standardizing the classification and description of follicular unit transplantation and mini-micrografting techniques. The American Society for Dermatologic Surgery, Inc.

Previous attempts at classifying small graft transplants have focused mainly upon graft size and have not taken into consideration other technical factors involved in graft production that may influence the outcome of the surgery. The proposed classification attempts to consider these factors by including various technical aspects of harvesting, dissection, and placement, all of which impact the quality and quantity of the small grafts used in the procedure. By standardizing the nomenclature, as well as the description of the other factors involved in the surgery, communication between physicians and patients may be facilitated.

Medicare prospective payment without separate urban and rural rates.

The elimination of urban-rural differences in the Medicare prospective payment system (PPS) standard rates implies a need to re-examine all the PPS payment adjustments. Refinements for case mix, outliers, and the wage index can make a significant contribution to avoiding payment disparities in a single-rate system. However, changes in the adjustments for teaching and disproportionate-share (DSH) hospitals are also needed.

Hair transplantation in females.

Hair transplantation in females, to thicken discrete areas of thinning, reconstitute a hairline, or cover scars from previous facial surgery, is a viable treatment option. Techniques dealing with hair transplantation in females are discussed.