Letter
Medicine, General & Internal
Eli Raver, Jeah Jung, Wendy Y. Xu
Summary: This study investigates whether Medicare Advantage (MA) enrollees with a larger number of chronic conditions were more likely to disenroll during the rapid growth in MA enrollment from 2009 to 2019.
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2023)
Article
Medicine, General & Internal
Julia G. Burgdorf, Chanee D. Fabius, Catherine Riffin, Jennifer L. Wolff
Summary: This study analyzed data from 2017 Medicare beneficiary and their family and unpaid caregivers surveys to describe characteristics and assess the prevalence of adequate transitional care training among family caregivers for older adults. Among caregivers who assisted with posthospitalization care transitions, Black caregivers and those experiencing financial difficulty were less likely to receive adequate training. Strategies such as standardized caregiver assessments may be needed to ensure equitable support of family caregivers during the discharge process.
Article
Oncology
Yaw A. Nyame, Sarah K. Holt, Ruth D. Etzioni, John L. Gore
Summary: Black men in the US have a higher mortality rate from prostate cancer due to lower quality care. The study found that black patients were more likely to receive care from surgeons and facilities with lower surgical volumes, which could impact surgical quality and outcomes. Access to high-quality prostate cancer care can help reduce racial disparities in disease outcomes.
Editorial Material
Medicine, General & Internal
Douglas Jacobs, Purva Rawal, Liz Fowler, Meena Seshamani
Summary: By better aligning its initiatives and policies related to accountable care organizations, CMS aims to create pathways for payers and providers to advance high-quality, accountable care.
NEW ENGLAND JOURNAL OF MEDICINE
(2022)
Article
Clinical Neurology
Aakash Bipin Gandhi, Eberechukwu Onukwugha, Husam Albarmawi, Abree Johnson, Daniela E. Myers, David Gray, Jose Alvir, Lauren Hynicka, Lisa M. Shulman
Summary: This study compared health care resource utilization between Medicare beneficiaries with and without Parkinson's disease over a 10-year period, finding that beneficiaries with PD had higher rates of inpatient admissions, emergency department visits, skilled nursing facility admissions, healthcare provider encounters, neurologist visits, rehabilitation service visits, and non-PD medication fills compared to those without PD. The results provide evidence for the allocation of healthcare resources for PD management.
Article
Geriatrics & Gerontology
Berna Demiralp, Jessica S. Speelman, Christine M. Cook, Danielle Pierotti, Marie Steele-Adjognon, Norbert Hudak, Michael P. Neuman, Ian Juliano, Sharon Harder, Lane Koenig
Summary: This study investigated the prevalence of incomplete home health referrals after acute care hospitalization and found that complete referrals were associated with lower mortality and readmission rates as well as higher spending. As policymakers implement alternative policies and payment models, they should consider the tradeoff between quality and cost in increasing home health care utilization.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2021)
Article
Geriatrics & Gerontology
Samir K. Shah, Adoma Manful, Amanda J. Reich, Robert S. Semco, Jennifer Tjia, Keren Ladin, Joel S. Weissman
Summary: The study found low utilization of ACP billing codes among Medicare patients with ADRD undergoing surgery, with a reactive pattern of ACP occurring most commonly after surgery and in association with postoperative mortality and complications. Further research is needed to understand barriers to the use of ACP.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2021)
Article
Health Care Sciences & Services
Steven C. Martino, Megan Mathews, Cheryl L. Damberg, Joshua S. Mallett, Nate Orr, Judy H. Ng, Denis Agniel, Loida Tamayo, Marc N. Elliott
Summary: This study investigated the differences in rates of voluntary disenrollment from Medicare Advantage plans by race/ethnicity, finding that Hispanic, Black, and API beneficiaries had significantly higher rates of disenrollment compared to Whites when controlling for variables such as age, sex, dual eligibility, disability, and state of residence. Racial/ethnic minority groups tended to be more concentrated in higher disenrollment plans within states.
Article
Health Care Sciences & Services
Cleo A. Samuel-Ryals, Olive M. Mbah, Sharon Peacock Hinton, Sarah H. Cross, Bryce B. Reeve, Stacie B. Dusetzina
Summary: Racial disparities were observed in hospice use and emergency department visits in the 90 days prior to death among Medicare beneficiaries in the USA, with black beneficiaries being less likely to enroll in hospice, particularly among those without cancer. However, patient-provider communication did not account for the racial disparities in hospice or emergency department use.
JOURNAL OF GENERAL INTERNAL MEDICINE
(2021)
Article
Neurosciences
Caroline Pearson, Alex Hartzman, Dianne Munevar, Megan Feeney, Rachel Dolhun, Veronica Todaro, Sheera Rosenfeld, Allison Willis, James C. Beck
Summary: It is important to understand how people with Parkinson's disease (PD) in the US utilize the healthcare system. A study analyzed the healthcare utilization patterns of PD patients enrolled in Medicare in 2019 and found significant disparities in care. Many patients did not see a neurologist or receive recommended therapy services, indicating the need for further research on barriers to accessing PD-related health care.
NPJ PARKINSONS DISEASE
(2023)
Article
Oncology
Christopher T. Aquina, Zachary J. Brown, Joal D. Beane, Aslam Ejaz, Jordan M. Cloyd, Allan Tsung, Mohamed O. Adam, Timothy M. Pawlik, Alex C. Kim
Summary: This study found that only a small proportion of elderly patients received liver-directed therapies (LDT) for colorectal cancer liver metastases (CRCLM). Patient factors associated with lower odds of receiving LDT included older age, female sex, Black race, greater comorbidity burden, higher social vulnerability index, primary rectal cancer, synchronous liver metastasis, and further distance from a high-volume liver surgery center.
ANNALS OF SURGICAL ONCOLOGY
(2023)
Article
Clinical Neurology
Samuel Waller Terman, Wesley T. Kerr, Carole E. Aubert, Chloe E. Hill, Zachary A. Marcum, James F. Burke
Summary: This study compares adherence to antiseizure medications (ASMs) and non-ASMs among individuals with epilepsy, and finds that adherence to ASMs is relatively low. The study also suggests that differences in adherence are mainly due to individual factors rather than medication class. Furthermore, it shows that individuals with epilepsy have slightly higher adherence to non-ASMs compared to those without epilepsy.
Letter
Medicine, General & Internal
Suhas Gondi, Yong Li, Dana Drzayich Antol, Emily Boudreau, William H. Shrank, Brian W. Powers
Summary: This cohort study examines the relationship between value-based payment and acute care in a national population of Medicare Advantage beneficiaries.
Article
Cardiac & Cardiovascular Systems
Sidra N. Bonner, Shukri H. A. Dualeh, Nicholas Kunnath, Justin B. Dimick, Rishindra Reddy, Andrew M. Ibrahim, Kiran Lagisetty
Summary: Recent research has raised concerns about health care segregation, the concentration of racial groups in a subset of hospitals, as a key contributor to persistent disparities in surgical care. However, the extent and effect of hospital-level segregation among patients undergoing lung cancer resection remains unclear.
ANNALS OF THORACIC SURGERY
(2023)
Article
Oncology
Lee A. Hugar, Jonathan G. Yabes, Pauline Filippou, Elizabeth M. Wulff-Burchfield, Samia H. Lopa, John Gore, Benjamin J. Davies, Bruce L. Jacobs
Summary: This study aimed to quantify the proportion of patients with bladder cancer receiving high-intensity end-of-life care, identify associated risk factors, and assess the impact of palliative care. Results showed that 45% of patients received high-intensity care, with a decrease over time; these patients often had comorbidities, advanced bladder cancer, and nonbladder cancer cause of death. Additionally, they more often received palliative care, but further from bladder cancer diagnosis.
UROLOGIC ONCOLOGY-SEMINARS AND ORIGINAL INVESTIGATIONS
(2021)
Article
Gastroenterology & Hepatology
Lauren S. Tufts, Emma D. Jarnagin, Jessica R. Flynn, Mithat Gonen, Jose G. Guillem, Philip B. Paty, Garrett M. Nash, Joshua J. Smith, Iris H. Wei, Emmanouil Pappou, Michael I. D'Angelica, Peter J. Allen, T. Peter Kingham, Vinod P. Balachandran, Jeffrey A. Drebin, Julio Garcia-Aguilar, William R. Jarnagin, Martin R. Weiser
Article
Gastroenterology & Hepatology
Marc A. Attiyeh, Jayasree Chakraborty, Lior Gazit, Liana Langdon-Embry, Mithat Gonen, Vinod P. Balachandran, Michael I. D'Angelica, Ronald P. DeMatteo, William R. Jarnagin, T. Peter Kingham, Peter J. Allen, Richard K. Do, Amber L. Simpson
Article
Oncology
Raja R. Narayan, John M. Creasy, Debra A. Goldman, Mithat Gonen, Cyriac Kandoth, Ritika Kundra, David B. Solit, Gokce Askan, David S. Klimstra, Olca Basturk, Peter J. Allen, Vinod P. Balachandran, Michael D'Angelica, Ronald P. DeMatteo, Jeffrey A. Drebin, T. Peter Kingham, Amber L. Simpson, Ghassan K. Abou-Alfa, James J. Harding, Eileen M. O'Reilly, Jean M. Butte, Ryusei Matsuyama, Itaru Endo, William R. Jarnagin
Article
Oncology
Raja R. Narayan, Debra A. Goldman, Mithat Gonen, Jonathan Reichel, Kety H. Huberman, Sandeep Raj, Agnes Viale, Nancy E. Kemeny, Peter J. Allen, Vinod P. Balachandran, Michael I. D'Angelica, Ronald P. DeMatteo, Jeffrey A. Drebin, William R. Jarnagin, T. Peter Kingham
ANNALS OF SURGICAL ONCOLOGY
(2019)
Article
Oncology
Kenneth L. Kehl, Michael J. Hassett, Deborah Schrag
Editorial Material
Oncology
Christopher R. Manz, Deborah Schrag
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE
(2021)
Article
Oncology
Marla Lipsyc-Sharf, Fang-Shu Ou, Matthew B. Yurgelun, Douglas A. Rubinson, Deborah Schrag, Shaker R. Dakhil, Philip J. Stella, Douglas J. Weckstein, Donald B. Wender, Meredith Faggen, Tyler J. Zemla, Erica N. Heying, Samantha R. Schuetz, Stephanie Noble, Jeffrey A. Meyerhardt, Tanios Bekaii-Saab, Charles S. Fuchs, Kimmie Ng
Summary: The study investigated the efficacy of combining bevacizumab with irinotecan and cetuximab in patients with irinotecan-refractory metastatic colorectal cancer. Although there was no significant difference in progression-free survival between the two treatment groups, there was a statistically significant improvement in overall survival favoring the group that received bevacizumab in addition to irinotecan and cetuximab. Further investigation on this combination therapy is warranted.
Article
Oncology
David J. Papke Papke Jr, Neal I. Lindeman, Deborah Schrag, J. Bryan Lorgulescu
Summary: Utilization of MMR/MSI testing has increased for advanced colorectal cancer patients, but there is still room for improvement. Testing rates lagged for older patients, those from the poorest households, and those managed at community cancer programs.
CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION
(2022)
Article
Oncology
Jessica R. Schumacher, Heather B. Neuman, Menggang Yu, David J. Vanness, Yajuan Si, Elizabeth S. Burnside, Kathryn J. Ruddy, Ann H. Partridge, Deborah Schrag, Stephen B. Edge, Ying Zhang, Elizabeth A. Jacobs, Jeffrey Havlena, Amanda B. Francescatti, David P. Winchester, Daniel P. McKellar, Patricia A. Spears, Benjamin D. Kozower, George J. Chang, Caprice C. Greenberg
Summary: This study evaluated the association between different methods of detecting distant recurrence in breast cancer patients and survival rates, finding that asymptomatic imaging detection was associated with better outcomes for patients with estrogen receptor and progesterone receptor negative, HER2 negative or HER2 positive cancers. However, no association was observed in patients with estrogen receptor or progesterone receptor positive, HER2 negative cancers.
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE
(2022)
Article
Oncology
Kenneth L. Kehl, Hajime Uno, Alexander Gusev, Stefan Groha, Samantha Brown, Jessica A. Lavery, Deborah Schrag, Katherine S. Panageas
CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION
(2023)
Article
Medicine, General & Internal
Deborah Schrag, Qian Shi, Martin R. Weiser, Marc J. Gollub, Leonard B. Saltz, Benjamin L. Musher, Joel Goldberg, Tareq Al Baghdadi, Karyn A. Goodman, Robert R. McWilliams, Jeffrey M. Farma, Thomas J. George, Hagen F. Kennecke, Ardaman Shergill, Michael Montemurro, Garth D. Nelson, Brian Colgrove, Vallerie Gordon, Alan P. Venook, Eileen M. O'Reilly, Jeffrey A. Meyerhardt, Amylou C. Dueck, Ethan Basch, George J. Chang, Harvey J. Mamon
Summary: Preoperative FOLFOX chemotherapy is as effective as preoperative chemoradiotherapy for locally advanced rectal cancer eligible for sphincter-sparing surgery.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Article
Oncology
Joan M. Griffin, Barbara L. Kroner, Sandra L. Wong, Liliana Preiss, Ashley Wilder Smith, Andrea L. Cheville, Sandra A. Mitchell, Nicola Lancki, Michael J. Hassett, Deborah Schrag, Raymond U. Osarogiagbon, Jennifer L. Ridgeway, David Cella, Roxanne E. Jensen, Ann Marie Flores, Jessica D. Austin, Betina Yanez
Summary: This study examined portal access and persistence of portal use and associations with patient and structural factors before the implementation of interventions. The results showed that male sex, membership in a racial and ethnic minority group, rural dwelling, not working, and limited broadband access were associated with lower odds of portal access. Younger age and more clinical encounters were associated with higher odds of portal access. Multiple modalities for portal access, being middle-aged, and having more clinical encounters were associated with persistent portal use. Patient and structural factors affect portal access and use and may exacerbate disparities in cancer symptom surveillance and management.
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE
(2023)
Meeting Abstract
Gastroenterology & Hepatology
D. Schrag, Q. Shi, M. R. Weiser
DISEASES OF THE COLON & RECTUM
(2023)
Article
Health Care Sciences & Services
Nadine J. McCleary, Ellana K. Haakenstad, Jessica L. F. Cleveland, Michael Manni, Michael J. Hassett, Deb Schrag
Summary: This article describes the development process of the electronic New Patient Intake Questionnaire at the Dana-Farber Cancer Institute, involving various stakeholders and multiple updates in response to feedback. The implementation of the electronic questionnaire improved accessibility and provided more data for patients and clinicians, potentially benefiting cancer care outcomes.
Article
Oncology
Ya-Chen Tina Shih, Ying Xu, Hui Zhao, Deborah Schrag, James Yao
Summary: The study estimated the financial burden of discarded weight-based intravenous antineoplastic drugs on private insurers and patients, finding that private payers spent $5090 per patient and patients' mean out-of-pocket expense on discarded drugs was $63. Approximately 39.7% of patients had high-deductible plans, with those in high-deductible plans having significantly higher out-of-pocket expenses for discarded drugs compared to those without.
JNCI CANCER SPECTRUM
(2021)