Association between provider specialty and healthcare costs and glycemic control for patients with diabetes

Gill, Max; Chhabra, Harmeet; Shah, Mona; Zhu, Cyrus; Lando, Howard M.; Caldarella, Felice A.

doi:10.1080/13696998.2018.1467324

Cited by 6 publications

(7 citation statements)

References 6 publications

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“…Although that criticism is valid, it is no less valid for paper-based medical records, in which data-entry errors vary by type of entry, with medication lists being inaccurate in more than 50% of medical records. 3,4 A more substantive shortcoming of any claims-based study, even one as carefully controlled and analyzed as the study by Morse and coauthors, 1 is the difficulty in drawing granular, specific clinical conclusions from a pure analysis of claims and demographic information. Without actual visual acuity, visual field, or other visual function indicators, one cannot know with sufficient certainty whether the clinical visual loss was stable and permanent, transient and improved, or even absent at the time of admission.…”

Section: Discussionmentioning

confidence: 99%

“…The Medicare database contains payment data for all services rendered. The Clinformatics DataMart provides closely approximated payments using standard prices . These data sources have been used previously to study patients with ocular diseases .…”

Section: Methodsmentioning

confidence: 99%

“…The Clinformatics DataMart provides closely approximated payments using standard prices. 4 These data sources have been used previously to study patients with ocular diseases. [5][6][7] The University of Michigan Institutional Review Board approved this research as a nonregulated study.…”

Section: Data Sourcesmentioning

confidence: 99%

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Association of Vision Loss With Hospital Use and Costs Among Older Adults

et al. 2019

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IMPORTANCE Patients with vision loss who are hospitalized for common illnesses are often not identified as requiring special attention. This perception, however, may affect the outcomes, resource use, and costs for these individuals.OBJECTIVE To assess whether the mean hospitalization lengths of stay, readmission rates, and costs of hospitalization differed between individuals with vision loss and those without when they are hospitalized for similar medical conditions. DESIGN, SETTING, AND PARTICIPANTS This analysis of health care claims data used 2 sources: Medicare database and Clinformatics DataMart. Individuals with vision loss were matched 1:1 to those with no vision loss (NVL), on the basis of age, years from initial hospitalization, sex, race/ethnicity, urbanicity of residence, and overall health. Both groups had the same health insurance (Medicare or a commercial health plan), and all had been hospitalized for common illnesses. Vision loss was categorized as either partial vision loss (PVL) or severe vision loss (SVL). Data were analyzed from April 2015 through April 2018. MAIN OUTCOMES AND MEASURESThe outcomes were lengths of stay, readmission rates, and health care costs during hospitalization and 90 days after discharge. Multivariable logistic and linear regression models were built to identify factors associated with these outcomes among the NVL, PVL, and SVL groups. RESULTS Among Medicare beneficiaries, 6165 individuals with NVL (with a mean [SD] age of 82.0 [8.3] years, and 3833 [62.2%] of whom were female) were matched to 6165 with vision loss. Of those with vision loss, 3401 (55.2%) had PVL and 2764 (44.8%) had SVL. In the Clinformatics DataMart database, 5929 individuals with NVL (with a mean [SD] age of 73.7 [15.1] years, and 3587 [60.5%] of whom were female) were matched to 5929 individuals with vision loss. Of the commercially insured enrollees with vision loss, 3515 (59.3%) had PVL and 2414 (40.7%) had SVL. Medicare enrollees with SVL, compared with those with NVL, had longer mean lengths of stay (6.48 vs 5.26 days), higher readmission rates (23.1% vs 18.7%), and higher hospitalization and 90-day postdischarge costs

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Association of Vision Loss With Hospital Use and Costs Among Older Adults

et al. 2019

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“…We conducted a retrospective cohort analysis comparing demographic characteristics and clinical and cost outcomes from the time before the implementation of our GSP to the time following implementation. Cost outcomes, claims data from patients who received a surgical procedure at our institution, regardless of type of insurance coverage, were extracted from Clinformatics DataMart, a deidentified administrative health database 16 . In summary, this database, which is updated annually, has 63 million unique individuals from all 50 states, yielding a geographically representative sample of the population.…”

Section: Methodsmentioning

confidence: 99%

“…Cost outcomes, claims data from patients who received a surgical procedure at our institution, regardless of type of insurance coverage, were extracted from Clinformatics DataMart, a deidentified administrative health database. 16 In summary, this database, which is updated annually, has 63 million unique individuals from all 50 states, yielding a geographically representative sample of the population. It includes complete enrollment information as well as medical records, prescription medication use, and inpatient hospitalization data.…”

Section: Study Design Data Collectionmentioning

confidence: 99%

Implementation of a Multispecialty Geriatric Surgery Pathway Reduces Inpatient Cost for Frail Patients

et al. 2023

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Objective: The objective of this study was to evaluate the effect of geriatric surgical pathway (GSP) implementation on inpatient cost of care. Background: Achieving high-value care for older patients is the goal of the American College of Surgeons Geriatric Verification Program (ACS-GSV). We have previously shown that implementation of our geriatric surgery pathway, which aligns with the ACS-GSV standards, resulted in a reduction in loss of independence and complications. Methods: Patients ≥ 65 years who underwent an inpatient elective surgical procedure included in the American College of Surgeons National Quality Improvement Program (ACS NSQIP) registry from July 2016 through December 2017 were compared with those patients from February 2018 to December 2019 who were cared for on our GSP. An amalgamation of Clinformatics DataMart, the electronic health record, and the ACS NSQIP registry produced the analytical dataset. We compared mean total and direct costs of care for the entire cohort as well as through propensity matching of frail surgical patients to account for differences in clinical characteristics. Results: The total mean cost of health care services during hospitalization was significantly lower in the cohort on our GSP ($23,361 ± $1110) as compared with the precohort ($25,452 ± $1723), P < 0.001. On propensity-matched analysis, cost savings was more evident in our frail geriatric surgery patients. Conclusions: This study shows that high-value care can be achieved with the implementation of a GSP that aligns with the ACS-GSV program.

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Adult Care: Practical Considerations for Patients with Endocrine Conditions Transitioning from Pediatric to Adult Care

Agarwal

2019

Transitioning From Pediatric to Adult Care in Endocrinology

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Association between provider specialty and healthcare costs and glycemic control for patients with diabetes

Abstract: DM management by an endocrinologist was associated with greater HbA1C improvement and significantly lower medical costs. Total costs were higher with an endocrinologist, but for patients with T1D lower costs were seen, ranging from 2-9% regardless of insurance type.

Cited by 6 publications

References 6 publications

Association of Vision Loss With Hospital Use and Costs Among Older Adults

Association of Vision Loss With Hospital Use and Costs Among Older Adults

Implementation of a Multispecialty Geriatric Surgery Pathway Reduces Inpatient Cost for Frail Patients

Adult Care: Practical Considerations for Patients with Endocrine Conditions Transitioning from Pediatric to Adult Care

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