Durability of class I American College of Cardiology/American Heart Association clinical practice guideline recommendations

Neuman MD, Goldstein JN, Cirullo MA, Schwartz JS JAMA 2014 May;311(20):2092-100 PMID: 24867012 Abstract IMPORTANCE: Little is known regarding the durability of clinical practice guideline recommendations over time. OBJECTIVE: To characterize variations in the durability of class I (“procedure/treatment should be performed/administered”) American College of Cardiology/American Heart Association (ACC/AHA) guideline recommendations. DESIGN, SETTING, AND PARTICIPANTS:

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US veterans use vitamins and supplements as substitutes for prescription medication

Goldstein JN, Long JA, Arevalo D, Ibrahim SA, Mao JJ Med Care 2014 Dec;52(12 Suppl 5):S65-9 PMID: 25397826 Abstract BACKGROUND: Vitamins and supplements are the most commonly used form of complementary and alternative medicine in the United States. Growing research suggests that patients substitute vitamins and supplements for their prescription medications. The reasons might include

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Even Faster Door-to-Alteplase Times and Associated Outcomes in Acute Ischemic Stroke

Jung S, Rosini JM, Nomura JT, Caplan RJ, Raser-Schramm J J Stroke Cerebrovasc Dis 2019 Dec;28(12):104329 PMID: 31607439 Abstract BACKGROUND AND PURPOSE: The timely administration of thrombolytic therapy for acute ischemic stroke has been associated with good functional outcomes. Current guidelines recommend alteplase administration within 60 minutes in 75% of eligible patients and within 45

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Impact of care coordination based on insurance and zip code

Goldstein JN, Shinwari M, Kolm P, Elliott DJ, Weintraub WS, Hicks LS Am J Manag Care 2019 06;25(6):e173-e178 PMID: 31211549 Abstract OBJECTIVES: To examine whether a care transitions program, Bridges, differentially reduced rehospitalizations among patients who underwent percutaneous coronary intervention (PCI) based on insurance status and zip code poverty level. STUDY DESIGN: Retrospective observational cohort.

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“Implications of cost-sharing for observation care among Medicare beneficiaries: a pilot survey”

Goldstein JN, Schwartz JS, McGraw P, Hicks LS BMC Health Serv Res 2019 Mar;19(1):149 PMID: 30845953 Abstract BACKGROUND: Medicare beneficiaries hospitalized under observation status have significant cost-sharing responsibilities under Medicare Part B. Prior work has demonstrated an association between increased cost-sharing and health care rationing among low-income Medicare beneficiaries. The objective of this study was

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The Unmet Need for Postacute Rehabilitation Among Medicare Observation Patients: A Single-Center Study

Goldstein JN, Schwartz JS, McGraw P, Banks TL, Hicks LS J Hosp Med 2017 03;12(3):168-172 PMID: 28272593 Abstract BACKGROUND: Medicare beneficiaries admitted under observation status must pay for postacute inpatient rehabilitation (PAIR) services, out of pocket, at potentially prohibitive costs. OBJECTIVE: To determine if there is an unmet need for PAIR among Medicare observation patients

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Observation Status, Poverty, and High Financial Liability Among Medicare Beneficiaries

Goldstein JN, Zhang Z, Schwartz JS, Hicks LS Am. J. Med. 2018 Jan;131(1):101.e9-101.e15 PMID: 28774801 Abstract BACKGROUND: Medicare beneficiaries hospitalized under observation status are subject to cost-sharing with no spending limit under Medicare Part B. Because low-income status is associated with increased hospital use, there is concern that such beneficiaries may be at increased risk

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