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Outpatient Palliative Care and End-of-Life Care Intensity: Linking Massachusetts Cancer Registry with All-Payer Claims.
JNCI Cancer Spectr
January 2025
Division of General Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.
Background: Early palliative care is associated with better outcomes for patients with advanced-stage cancers. Using a novel data linkage, we assessed outpatient palliative care use before death and its association with end-of-life care intensity and variation across eight provider networks.
Methods: We linked Massachusetts Cancer Registry and the All-Payer Claims Database for individuals with commercial insurance, Medicaid or Medicare Advantage diagnosed with colorectal, lung, prostate, and breast cancers from 2010 through 2013 who died by December 31, 2014.
National Trends in Stroke Presentation, Treatments, and Outcomes During the First 2 Years of the COVID-19 Pandemic.
Neurol Clin Pract
April 2025
Department of Health Care Policy, Harvard Medical School, Boston, MA.
Background And Objectives: Early presentation and acute treatment for patients presenting with ischemic stroke are associated with improved outcomes. The onset of the COVID-19 pandemic was associated with a large decrease in patients presenting with ischemic stroke, but it is unknown whether these changes persisted.
Methods: This study analyzed emergency department (ED) stroke presentations (n = 158,060) to all nonfederal hospitals in the 50 states and Washington, D.
Palliative Care Initiated in the Emergency Department: A Cluster Randomized Clinical Trial.
JAMA
January 2025
Department of Emergency Medicine, Henry Ford Health, Detroit, Michigan.
Importance: The emergency department (ED) offers an opportunity to initiate palliative care for older adults with serious, life-limiting illness.
Objective: To assess the effect of a multicomponent intervention to initiate palliative care in the ED on hospital admission, subsequent health care use, and survival in older adults with serious, life-limiting illness.
Design, Setting, And Participants: Cluster randomized, stepped-wedge, clinical trial including patients aged 66 years or older who visited 1 of 29 EDs across the US between May 1, 2018, and December 31, 2022, had 12 months of prior Medicare enrollment, and a Gagne comorbidity score greater than 6, representing a risk of short-term mortality greater than 30%.
Cardiovascular Safety of Anti-CGRP Monoclonal Antibodies in Older Adults or Adults With Disability With Migraine.
JAMA Neurol
January 2025
Geriatric Research Education and Clinical Center, North Florida/South Georgia Veterans Health System, Gainesville, Florida.
Importance: Monoclonal antibodies (mAbs) targeting calcitonin gene-related peptide (CGRP) or its receptor (anti-CGRP mAbs) offer effective migraine-specific preventive treatment. However, concerns exist about their potential cardiovascular risks due to CGRP blockade.
Objective: To compare the incidence of cardiovascular disease (CVD) between Medicare beneficiaries with migraine who initiated anti-CGRP-mAbs vs onabotulinumtoxinA in the US.
Quality of Hospices Used by Medicare Advantage and Traditional Fee-for-Service Beneficiaries.
JAMA Netw Open
December 2024
Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Article Synopsis
- The study investigates the differences in hospice care quality and enrollment between Medicare Advantage (MA) beneficiaries and those enrolled in traditional Medicare fee-for-service (FFS).
- Using a population-based data analysis of over 4 million decedents and 2 million hospice enrollees from 2018-2019, the research aims to assess hospice usage and quality indicators.
- Findings indicate that MA plan beneficiaries are more likely to use hospice care in the last six months of life compared to FFS beneficiaries, highlighting potential disparities in hospice access.
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