Disease Burden News, Research & Data Analysis

BioFire’s Pneumonia Panel Early Detection of Pathogens May Lead to Reduced Length of Stay and Associated Costs

In Pneumonia

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By: Avinash Kumar  Jul. 11, 2019

Pneumonia is one of the leading causes of infection-related deaths in the United States, which also leads to other severe complications such as respiratory failure and sepsis. According to BioFire, “Pneumonia is one of the most common reasons patients go to the hospital, yet the underlying cause of the infection is frequently not identified. This leads to over-treatment of the patient and overuse of antibiotics, contributing to the longer hospital stays and higher costs, as well as to the development of antimicrobial resistance".

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T2Biosystems’s Bacterial Panel Solution Could Help in Bacterial Sepsis Related Mortality

In Sepsis

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By: Avinash Kumar  Jul. 01, 2019

Treating bloodstream infections earlier may prevent progression to sepsis, one of the leading causes of death in the U.S. According to T2Biosystems, for patients at risk of sepsis, rapid targeted treatment based on the identification of causative pathogens is critical because it is estimated that every hour of speeding up the time to targeted therapy decreases patient mortality by nearly 8%

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Post Pacemaker & ICD Infection Readmissions at Top Hospitals continue to pose challenges

In Cardiovascular

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By: Avinash Kumar  May. 30, 2019

Infections developed from cardiovascular implantable electronic devices (CIED) implant procedures are serious complications and lead to follow on readmissions. Dexur Analysed Medicare Inpatient data for the year Jan 2017 to Dec 2017, to determine post - CIED infections related readmission.  Below is the table of five large top 5 Hospitals performing CIED procedures and post CIED infection readmission rates at 30 days and 1 year.

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Patients with Atrial Fibrillation are a big contributor to Hospital Readmissions for Skilled Nursing Facilities (SNFs)

In Atrial fibrillation (AFib)

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By: Avinash Kumar  May. 10, 2019

CMS recently instituted a program to evaluate and incentivize skilled nursing facilities (SNF) based on Hospital 30 day readmissions. For example, if a patient is discharged from a hospital to a SNF on Jan 15th 2019 and is readmitted back to a hospital on Jan 27 2019, then this would be counted as part of the measure for SNF Hospital 30 Day readmissions. Dexur analyzed Medicare claims (Oct 2015 to Mar 2018) for three separate skilled nursing facilities to understand the role of Atrial Fibrillation (AFib) on the overall readmissions for these SNFs.

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RNS System is associated with lower 30 Day readmission rates in DRG 026

In Epilepsy

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By: Raj Kumar  May. 08, 2019

RNS system (Neurostimulator system)’s ICD 10 Procedure code 00H00MZ used by Hospitals to get additional payment under NTAP program from CMS. NTAP(New Technology Add-on payment) payment is an additional payment over and above the DRG allowed payment amount.

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What are major Oncology combination therapies based on claims data?

In Oncology

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By: Avinash Kumar  May. 01, 2019

Dexur analyzed Medicare claims data based on a 5% sample for the time period of Jan 2016 to June 2018, to understand the prevalence of oncology combination therapies. This methodology checked for relevant J codes of HCPCS code set in the claim files across the patient’s history. If a patient used a base drug, it was then checked to see what other drugs were used on the same patient.

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“How are you going to treat your family, how are you going to treat your friends? That's how you should treat your patients”: an interview with Dr. Chris Evanich

In Orthopedics

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By: James Pitt  Jan. 28, 2019

Dr. Christopher J. Evanich is a top-ranked orthopedic surgeon who practices at the Orthopedic Institute of Wisconsin. James Pitt interviewed Dr. Evanich about his practice, his method of patient education, what's good and bad in EHRs, and how his time as an engineer helped him in medicine. This interview has been edited for length and clarity.

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Five Cardiac Surgeons Affiliated with Methodist Hospital San Antonio Among Top in Texas, Nation

In Heart Failure

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By: James Pitt  Jan. 17, 2019

Dr. William C.L. Wu performed more stent procedures on Medicare inpatients than any other doctor in Texas over a five year period from 2013 to 2017. This also placed him among the top 30 stent procedure surgeons in the entire United States over this period.

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In-Hospital Quality Outcomes for Hepatocellular Carcinoma with Gastrointestinal Hemorrhage

In Hepatocellular Carcinoma (HCC)

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By: James Pitt  Dec. 19, 2018

Gastrointestinal hemorrhage contributed to 3% of hospitalizations and 2.35% of in-hospital deaths among patients with hepatocellular carcinoma as a primary or secondary diagnosis, according to a Dexur analysis of 2013-2017 Medicare claims data.

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Doppler Ultrasound Devices Like Deltex CardioQ Could Help Address Excess Length of Stay in Bowel Surgery Patients With Major Complications

In Fluid Imbalance

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By: James Pitt  Oct. 22, 2018

In goal-directed fluid therapy (GDT or GDFT), physicians use hemodynamic variables such as stroke volume (the amount of fluid the heart moves with each beat) to estimate the amount of fluid in circulation. Physicians provide fluid as needed to keep these hemodynamics variables near target values.

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How to Evaluate the Impact of Venous Thromboembolism (VTE): Part 2: Incidence

In Venous Thromboembolism (VTE)

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By: James Pitt  Aug. 13, 2018

Hospitalized patients are at greater risk of venous thromboembolism than the general population, in part because immobility increases VTE risk. According to the CDC report on healthcare-associated VTE, up to 70% of HA-VTE cases are preventable.

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Chicago’s Wide Variance in Fracture Readmission Rates Indicates Opportunities for Osteoporosis Treatment

In Osteoporosis

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By: James Pitt  Jul. 30, 2018

Osteoporosis is a common disease of aging, associated with weakened bones. Bone fractures are associated with higher subsequent mortality. According to University of Washington Medicine, “The one-year mortality following a hip fracture is 12 to 24%. It is estimated that 14% of deaths following a hip or pelvic fracture in previously ambulatory women were caused or hastened by the fracture.”

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Pressure Ulcer Readmission Rates in Los Angeles Area Hospitals Range From 0.94% to 3.83%

In Pressure Ulcer

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By: James Pitt  Jul. 20, 2018

Pressure ulcers are wounds that develop due to reduced blood flow, typically in patients who lie in the same position for long periods. Elderly and critically ill patients are at particular risk. A study based on 2006-2007 Medicare data found that patients with pressure ulcers are more likely to die in-hospital (odds ratio 2.81); have more than double the average length of stay; and are more likely to be readmitted within 30 days of discharge (odds ratio 1.33).

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In Arizona, Asthma Highest in Tucson and Phoenix, COPD Highest Near State Borders

In Chronic Obstructive Pulmonary Disease (COPD)

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By: James Pitt  Jul. 19, 2018

Asthma and chronic obstructive pulmonary disease (COPD) are two of the most common lung disorders in the United States. Differential diagnosis can be a challenge. According to the American Academy of Family Physicians guidelines on distinguishing asthma from COPD, asthma generally has earlier onset, more variable symptoms, and normal chest X-ray. Many options for diagnosis and treatment are available, including recently developed digital health tools.

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Bon Secours Hospital Treats the Most Surgical Patients with Iron Deficiency Anemia in Maryland

In Iron Deficiency Anemia (IDA)

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By: James Pitt  Jul. 04, 2018

Iron deficiency anemia (IDA) is a condition in which the body has too little iron to properly supply red blood cells, leading to fatigue and weakness. According to the Merck Manual, blood loss is the most common cause of IDA. About 70% of the body's iron is already in red blood cells, rather than stored in reserve, so patients may require iron supplementation after major blood loss.

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Mortality Rates Nearly Double with Hyperkalemia in California DRG 871 Sepsis Patients

In Hyperkalemia

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By: James Pitt  Jul. 03, 2018

Hyperkalemia, i.e. high potassium, is a common electrolyte imbalance. Like other forms of fluid imbalance, it may affect sepsis outcomes. Dexur has extensively reported on fluid imbalance in sepsis.

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In Southern Arizona Hospitals, DRG 640 Hyponatremia Rate Exceeds National Rate at All But One

In Hyponatremia

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By: James Pitt  Jun. 27, 2018

Hyponatremia, i.e. low blood sodium, is a common electrolyte imbalance. According to the Mayo Clinic, risk factors for hyponatremia include age, certain medications, kidney disease and heart failure (due to their effects on water excretion), and intensive physical activities like marathons.

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Jackson Health Hospitals Have Lower ABSSSI Incidence Than Miami-Dade County Average

In Acute Bacterial Skin and Skin Structure Infections (ABSSSI)

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By: James Pitt  Jun. 26, 2018

A June 4 Miami Herald investigation found that according to CMS data, Jackson Health System performed under the national benchmark on incidence of MRSA bloodstream infections, but at or above the national benchmark on five other types of infection. Dr. Lilian Abbo of Jackson Health attributed this to the case mix at Jackson Health and the high prevalence of MRSA in Miami-Dade County.

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Asthma is a Significant Contributor to 30 Day Readmissions in Mississippi

In Asthma

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By: James Pitt  Jun. 19, 2018

Asthma is a chronic lung disease which narrows the airways. It affects over 25 million people in the US, including 7 million children. Risk factors for developing asthma include air pollution, poverty, and tobacco smoke. Though asthma is often regarded as a childhood disease, 8.8% of adults had asthma as of 2011-2014.

Dexur analysts examined hospital-level data at the twenty hospitals in Mississippi with the most Medicare-eligible inpatient discharges for asthma in 2013-2016. The average readmission rate across these hospitals was close to Mississippi's state average, so they are a fair representation of the state.

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Florida Orlando Hospital Has Particularly Low Mortality, Length of Stay, & Readmission Rates for Interstitial Lung Disease With Major Complications

In Interstitial Lung Disease (ILD)

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By: James Pitt  May. 30, 2018

Interstitial lung diseases (ILD) are more than 300 different conditions with similar symptoms. According to the European Respiratory Society, “Only about one in three cases of interstitial lung disease has a known cause.” Different ILDs present very different risks: “Survival rates at 5 years range from 20% for idiopathic pulmonary fibrosis [IPF] to almost 100% for cryptogenic organizing pneumonia.”

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High Variation in Readmissions May Suggest Need For Better Lung Cancer Diagnostics in New York

In Lung Cancer

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By: James Pitt  May. 29, 2018

Lung cancer rates are falling, but it remains the leading cause of cancer deaths in the US. Detecting cancer early can improve survival. But in recent years, overdiagnosis became a concern. The only lung cancer screen the CDC recommends is low dose CT (LDCT). But even LDCT picks up many findings that may not be dangerous. A 2016 randomized clinical trial in The Lancet Oncology found that only 4% of new solid nodules detected on LDCT were lung cancer.

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Cigarette Use Data May Help Pinpoint Patients At Particular Risk of Malignant Hypertension in Kentucky; Louisville at Low Risk

In Hypertension

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By: James Pitt  May. 28, 2018

People in industrialized countries have an over 90% lifetime risk of developing hypertension, according to a 2007 review in The Lancet. Many diseases cause hypertension. Primary or “essential” hypertension is defined as hypertension with no such cause. This definition is misleading because diet, exercise, and several known genes affect the risk of primary hypertension.

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