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Association between insurance type, clinical characteristics, and healthcare use in adults with congenital heart disease.
Int J Cardiol Congenit Heart Dis
December 2024
Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR, USA.
Introduction: Adults with congenital heart disease (CHD) represent a heterogeneous and growing population with high healthcare utilization. We sought to understand the association between insurance type, healthcare use, and outcomes among adults with CHD in Oregon.
Methods: The Oregon All Payers All Claims database from 2010 to 2017 was queried for adults aged 18-65 in 2014 with ICD-9 or 10 codes consistent with CHD; patient demographics, comorbidities, healthcare use, and disease severity were identified.
Background: Emergency department (ED) use is common among patients with Medicaid insurance during pregnancy. However, it is unknown how ED utilization differs among those with different types of Medicaid such as Emergency Medicaid, with which access to outpatient care is more restricted.
Objective: We sought to compare differences in ED use during between pregnant persons with Emergency Medicaid and Traditional Medicaid and pregnancy outcomes by ED utilization.
Individual and prescription level factors associated with overdose in opioid naïve older people.
J Am Geriatr Soc
December 2024
Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Background: Opioid naïve older adults may be at risk of overdose after receiving an initial opioid prescription.
Methods: This population-based cohort study from a linked dataset of patients in Oregon, linking all payer claims data to other administrative datasets, aimed to assess the prescription- and patient-level characteristics associated with increased odds of opioid overdose after an initial opioid prescription. Included patients were ≥65 years old and received an index pain-formulation opioid prescription between 2016 and 2019.
Outliers of Total Shoulder Arthroplasty in the Bundled Payment Era.
J Shoulder Elbow Surg
December 2024
Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, OR, USA. Electronic address:
Background: The Centers for Medicare & Medicaid Services (CMS) implemented the Bundled Payments for Care Improvement Advanced (BPCIA) Model that covers 90-day care episodes after select orthopedic procedures including anatomic or reverse ball-and-socket total shoulder arthroplasty (TSA/rTSA). This study investigated whether patients undergoing TSA/rTSA for non-degenerative processes incur higher costs than patients undergoing arthroplasty for degenerative processes.
Methods: A retrospective review was conducted of all patients at a single academic medical center enrolled in the BPCIA model for TSA/rTSA from October 1, 2018, through December 31, 2022.
Risk of Hospitalization Among Assisted Living Residents Dually Enrolled in Medicare and Medicaid.
J Am Med Dir Assoc
December 2024
Center for Equity in Aging, Johns Hopkins School of Nursing, Johns Hopkins University, Baltimore, MD, USA.
Objectives: To examine how risk of hospitalization among assisted living (AL) residents differs by dual enrollment in Medicare and Medicaid and by the percent of dually enrolled individuals in an AL community.
Design: Retrospective cohort study.
Setting And Participants: We used Medicare data from 2008 to 2018 and a national directory of licensed AL communities to identify Medicare beneficiaries with a change in their ZIP+4 code suggesting a new residence in an AL.
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