The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) provides feedback to hospitals on risk-adjusted outcomes. It is not known if participation in the program improves outcomes and reduces costs relative nonparticipating hospitals.To evaluate association enrollment ACS NSQIP with Medicare payments compared control that did participate program.Quasi-experimental study using national data (2003-2012) for a total 1,226,479 patients undergoing general...

<h3>Context</h3>It is unclear if advance directives (living wills) are associated with end-of-life expenditures and treatments.<h3>Objective</h3>To examine regional variation in the associations between treatment-limiting directive use, Medicare expenditures, use of palliative intensive treatments.<h3>Design, Setting, Patients</h3>Prospectively collected survey data from Health Retirement Study for 3302 beneficiaries who died 1998 2007 linked to claims National Death Index. Multivariable...

<h3>Importance</h3>Starting in 2006, the Centers for Medicare &amp; Medicaid Services (CMS) has restricted coverage of bariatric surgery to hospitals designated as centers excellence (COE) by 2 major professional organizations.<h3>Objective</h3>To evaluate whether implementation COE component national decision was associated with improved outcomes patients.<h3>Design, Setting, and Patients</h3>Retrospective, longitudinal study using 2004-2009 hospital discharge data from 12 states (n = 321...

The number of older adults with cognitive impairment is increasing, and such often require a surrogate to make decisions about health care. However, little known the aggressiveness end-of-life care for these people, especially those who reside in community. We found that common among approaching end life, whether they live community or nursing home, nearly 30 percent patients severe dementia remained until death. Among patients, having an advance directive form living will was associated...

<h3>Importance</h3> Alzheimer disease and related dementias (ADRD), currently incurable neurodegenerative diseases, can threaten patients' financial status owing to memory deficits changes in risk perception. Deteriorating capabilities are among the earliest signs of cognitive decline, but frequency extent adverse events before after diagnosis have not been characterized. <h3>Objectives</h3> To describe presentation ADRD using administrative credit data. <h3>Design, Setting,...

Objective To assess the value of a novel composite measure for identifying best hospitals major procedures. Data Source We used national Medicare data patients undergoing five high‐risk surgical procedures between 2005 and 2008. Study Design For each procedure, we empirical Bayes techniques to create combining hospital volume, risk‐adjusted mortality with procedure interest, other related procedures, variables. Hospitals were ranked based on 2005–2006 placed in one three groups: 1‐star...

Abstract Older adults are at elevated risk of reducing labor supply due to poor health, partly because high rates symptoms that may be alleviated by medical marijuana. Yet, surprisingly little is known about how this group responds marijuana laws (MMLs). We quantify the effects state on health and age 51 older, focusing 55 percent with one or more conditions respond use longitudinal data from Health Retirement Study estimate event study differences‐in‐differences regression models. Three...

<h3>Objectives</h3> To determine whether high rates of compliance with perioperative processes care used for public reporting and pay-for-performance are associated lower risk-adjusted mortality high-risk surgical complications. <h3>Design</h3> Retrospective analysis Medicare inpatient claims data (from January 1, 2005, through December 31, 2006). Hierarchical logistic regression models assessed the relationship between adverse outcomes hospital reported on Hospital Compare Web site....

We sought to determine whether the changes in incentive design phase 2 of Medicare's flagship pay-for-performance program, Premier Hospital Quality Incentive Demonstration (HQID), reduced surgical mortality or complication rates at participating hospitals.The HQID was initiated 2003 reward high-performing hospitals. The program redesigned its structure 2006 also hospitals that achieved significant improvement. impact change on outcomes populations is unknown.We examined discharge data for...

Abstract Understanding the downstream consequences of initial Medicare plan selection is necessary to ensure access and affordability health care services, especially for older adults with serious illness. We used 2008-2020 data from Health Retirement Study estimate financial burden by (traditional without supplemental coverage, traditional plus or Advantage) self-reported history cancer. Initially choosing benefits greater protections (either coverage relative was associated lower levels...

This case-control study uses Health and Retirement Study data to examine the trajectories of wealth among US older adults at risk dementia.

Informal care is the largest source of long-term for elderly, surpassing home health and nursing care. By definition, informal unpaid. It remains a puzzle why so many adult children give freely their time. Transfers time to older generation may be balanced by financial transfers going younger generation. This leads question whether inter-vivos are causally related. We analyze data from 1999 2003 waves National Longitudinal Survey Mature Women. examine elderly parents more monetary who...

Fraud and abuse contribute to unnecessary spending in the Medicare program, federal agencies have prioritized fund recovery exclusion of health care practitioners who violate policy. However, human costs fraud terms patient are unknown.To assess whether beneficiaries' receipt services from perpetrators (FAPs) is associated with worse outcomes.Retrospective cross-sectional study comparing mortality emergency hospitalization rates 8204 patients treated by an FAP those among a randomly selected...

Abstract We study the effect of recent legalization recreational marijuana use laws (RMLs) in United States on new applications and allowances for Social Security Disability Insurance Supplemental Income over period 2001–2019. combine administrative caseload data from Administration with state policy changes using two‐way fixed‐effects methods. find that RML adoption increases both benefits. However, there is no change post‐RML. provide suggestive evidence observed post‐RML are driven by...

Diabetes health services research often utilizes secondary data sources, including survey self-report and Medicare claims, to identify study the diabetic population, but disagreement exists between these two sources. We assessed agreement Chronic Condition Warehouse diabetes algorithm for claims measures of diabetes. Differences in healthcare utilization outcomes under each definition were also explored. Claims from Beneficiary Annual Summary File linked blood collected 2006 Health...