A5041577663- Palliative Care and End-of-Life Issues
- Geriatric Care and Nursing Homes
- Healthcare Policy and Management
- Health Systems, Economic Evaluations, Quality of Life
- Mechanical Circulatory Support Devices
- Primary Care and Health Outcomes
- Cardiac Valve Diseases and Treatments
- Cardiac Structural Anomalies and Repair
- Dementia and Cognitive Impairment Research
- Emergency and Acute Care Studies
- Global Health Care Issues
- Healthcare cost, quality, practices
- Frailty in Older Adults
- Hip and Femur Fractures
- Glioma Diagnosis and Treatment
- Atrial Fibrillation Management and Outcomes
- Venous Thromboembolism Diagnosis and Management
- Health disparities and outcomes
- Congenital Heart Disease Studies
- COVID-19 and healthcare impacts
- Cardiac Arrest and Resuscitation
- Acute Ischemic Stroke Management
- Management of metastatic bone disease
- Glycogen Storage Diseases and Myoclonus
- CNS Lymphoma Diagnosis and Treatment
Cedars-Sinai Medical Center
2020-2025
Mount Sinai Beth Israel
2015-2024
Montefiore Medical Center
2024
Cedars-Sinai Smidt Heart Institute
2022
Geriatric Research Education and Clinical Center
2018-2019
VA Greater Los Angeles Healthcare System
2018-2019
University of California, Los Angeles
2018
The University of Tokyo
2010-2013
Kurume University
1988-1989
The COVID-19 pandemic may have negatively affected medical care for and self-management of chronic hypertension. We sought to examine the impact on blood pressure (BP) among individuals with hypertension.Using an interrupted time series analysis, we compared level trend (slope) BP outcomes before public health emergency declaration (prepandemic period: August 2018 through January 2020) versus after stay-at-home orders (pandemic April 2020 November adults hypertension followed at 3 large...
To examine the association between expansion of Medicaid program under Affordable Care Act and changes in healthcare spending among low income adults during first four years policy implementation (2014-17).Quasi-experimental difference-in-difference analysis to out-of-pocket financial burden after expansions.United States.A nationally representative sample individuals aged 19-64 years, with family incomes below 138% federal poverty level, from 2010-17 Medical Expenditure Panel Survey.Four...
Research suggests that preventive measures are critical to reducing the spread of coronavirus disease 2019 (COVID-19), but evidence regarding association between trust in government and practice is limited. To examine whether against COVID-19 differs by one's level government. A cross-sectional analysis using Japan Society Internet Survey (JACSIS) conducted August September 2020. nationally representative sample Japanese individuals aged 15 through 79 years. The primary outcome was composite...
Abstract Background On October 29th, 2012, Hurricane Sandy caused a storm surge interrupting electricity with disruption to Manhattan’s (New York, USA) health care infrastructure. Beth Israel Medical Center (BIMC) was the only fully functioning major hospital in lower Manhattan during and after Sandy. The impact on emergency department (ED) use by geriatric patients studied. Methods trends of ED visits hospitalizations immediate post-Sandy phase (IPS) actual blackout (October 29 through...
Evidence is limited regarding the comparative effectiveness and safety of mechanical thrombectomy (MT) vs catheter-directed thrombolysis (CDT) for high-risk pulmonary embolism (PE). This observational study aimed to compare outcomes older adults with PE treated MT CDT using a target trial emulation framework. We included Medicare fee-for-service beneficiaries aged 65 99 years admitted (defined by cardiac arrest, shock, vasopressor use) who underwent MT/CDT from 2017 2020. evaluated 1-year...
Importance Evidence suggests that physician gender and patient-physician concordance have the potential to improve patient outcomes, especially for female patients. However, whether long-term outcomes differ by surgeon patient-surgeon has not been studied in US. Objective To compare postoperative concordance. Design, Setting, Participants A population-based cross-sectional study was conducted based on 100% Medicare fee-for-service claims data from 2016 through 2019. Data analysis performed...
Background: Evidence is limited as to whether outcomes differ between patients with tricuspid regurgitation (TR) treated transcatheter edge-to-edge repair (T-TEER) versus surgical valve repair. We aimed compare these two approaches. Methods: analyzed the data on Medicare fee-for-service beneficiaries aged 65 99 TR who underwent T-TEER or isolated July 2016 and December 2020. The primary outcome was two-year all-cause mortality. Other included in-hospital mortality permanent pacemaker...
Abstract Background Previous studies have demonstrated positive impacts of advance care planning (ACP) on end‐of‐life (EOL) care. We sought to examine trends in ACP and EOL intensity among persons living with dementia who required surrogate decision‐making their final days life. Methods analyzed the participants Health Retirement Study (HRS), a nationally representative longitudinal panel study U.S. residents, 70 years older life died between 2000 2014. Based reports after death participant,...
Background: Percutaneous microaxial ventricular assist devices (pVAD) have the potential to reduce mortality of patients with cardiogenic shock (CS). However, association between distribution pVAD-performing centers and outcomes CS has not been explored. Methods: This observational study included Medicare fee-for-service beneficiaries aged 65–99 years treated pVAD for from 2016 2020 examined associations patient two exposure variables: hospitals’ procedure volumes patient-hospital distances...
Research suggests that the Affordable Care Act (ACA) Medicaid expansions improved financial protection for poor. However, evidence is limited on whether subsidies offered through ACA Marketplaces, law's other major coverage expansion, were associated with reduced burden. Using national survey data from period 2008-17, we examined changes in household health care spending among low-income adults eligible both Marketplace premium and cost-sharing reductions (139-250 percent of federal poverty...
Abstract Background Despite possible major adverse cognitive, physical, social, and behavioral consequences, little is known about how persons living with dementia perceive satisfaction life, a key component of well‐being. We sought to examine (i) whether lower level compared their peers without (ii) the associations between individual characteristics life are different dementia. Methods Using nationally representative sample community‐dwelling older adults aged ≥70 years in U.S. from Health...
To evaluate outcomes associated with an integrated inpatient and outpatient program aimed at optimizing the care of geriatric fracture patients in a mixed community academic health system setting.
Abstract Background The Centers for Medicare & Medicaid Services (CMS) began to reimburse clinicians advance care planning (ACP) discussions, effective January 1, 2016. We sought characterize the timing and setting of first‐billed ACP discussions among decedents inform future research on billing codes. Methods Using a random 20% sample fee‐for‐service beneficiaries aged 66 years older who died in 2017–2019, we described (relative death) (inpatient, nursing home, office, or outpatient...
End-of-life (EOL) care patterns may differ by physician age given differences in how physicians are trained or changes associated with aging. We sought to compare of EOL delivered older Americans according age.
Abstract Background Hospital transfers from VA Community Living Centers (CLCs) are common. The objective of this study was to evaluate the effect introducing Intervention Reduce Acute Care Transfers (INTERACT) program into CLCs. Methods Cluster randomized trial involving 16 pair‐matched Interventions CLC nursing staff were trained in use INTERACT tools designed identify early signs a clinical change condition and improve communication documentation. One tool embedded Electronic Medical...
Acute exogenous lipoid pneumonia is an uncommon condition caused by aspiration of oil-based substances, occurring mainly in children. Here, we report the case 83-year-old patient with Alzheimer's disease who presented coughing and hypoxia. The diagnosis acute accidental kerosene ingestion was made on basis patient's clinical history, typical radiological cytological findings. cognitive impairment unsafe environment, which 91-year-old husband stored old shochu bottle, were responsible for...
Abstract Background Geriatric training is designed to prepare physicians meet the complex needs of older adults, including persons with dementia at end‐of‐life (EOL) stage. We sought compare patterns EOL care delivered between versus without geriatric training. Methods conducted a cross‐sectional study 20% random sample fee‐for‐service Medicare beneficiaries who died in 2016–2018 ( n = 99,631). attributed physician had largest number primary visits during last 6 months life and determined...