Cardiovascular Death and Access to Health Care Among Individuals Incarcerated in US State Prisons From 2001 to 2019.

Background: Incarcerated individuals have a disproportionate burden of cardiovascular risk factors. However, there is a paucity of data focusing on cardiovascular death and access to adequate health care among incarcerated individuals.

Methods: We used the Mortality in Correctional Institutions database from the US Bureau of Justice Statistics to examine cardiovascular deaths in all state prisons from 2001 to 2019, health care provision, as well as differences in these measures between racial and ethnic groups.

Text Message Reminders About Free Transportation for Outpatient Substance Use Disorder Treatment: A Pilot Randomized Encouragement Study.

Introduction: Substance use disorders (SUDs) are a major epidemic in the USA. Patients who lack transportation may have limited access to outpatient SUD treatment programs and are less likely to remain in care. Encouraging the use of free, reliable transportation during enrollment is an untested mechanism for greater retention.

Racial, Socioeconomic, and Geographic Disparities in Preamputation Vascular Care for Patients With Chronic Limb-Threatening Ischemia.

Background: Black patients, those with low socioeconomic status (SES), and those living in rural areas have elevated rates of major lower extremity amputation, which may be related to a lack of subspecialty chronic limb-threatening ischemia care. We evaluated the association between race, rurality, SES, and preamputation vascular care.

Methods: Among patients aged 66 to 86 years with fee-for-service Medicare who underwent major lower extremity amputation for chronic limb-threatening ischemia from July 2010 to December 2019, we compared the proportion who received vascular care in the 12 months before amputation by race (Black versus White), rurality, and SES (dual eligibility for Medicaid versus no dual eligibility) using multivariable logistic regression adjusting for clinical and demographic covariates.

Contribution margins and utilization of transcatheter aortic valve replacement versus surgical aortic valve replacement in the Medicare population.

Background: Hospitals and health systems must balance the demand for transcatheter aortic valve replacement (TAVR) against financial sustainability. Patients may be eligible for both TAVR and surgical aortic valve replacement (SAVR), but financial realities for hospitals may affect differential access to those therapies. We sought to understand the landscape of costs and reimbursement for TAVR and SAVR in the US and to understand the association of procedural reimbursement with receipt of either.

Emergency department visits by older adults receiving postacute care in skilled nursing facilities.

Skilled nursing facilities (SNF) represent a common postdischarge destination for hospitalized older adults. The goals of SNF care include the completion of extended skilled nursing care and physical rehabilitation to enable patients to safely return home. However, nearly one in four older adults discharged to SNF are rehospitalized and one in five seek care in the emergency department (ED) but are discharged back to SNF.

Varying Degree of Overlap Following the Critical Steps of Lumbar Fusion and Short-term Outcomes.

Study Design: Retrospective cohort.

Objective: The present study analyzes the impact of end-overlap on short-term outcomes after single-level, posterior lumbar fusions.

Summary Of Background Data: Few studies have evaluated how "end-overlap" (i.

Development and Description of a National Cohort of Patients With Chronic Limb-Threatening Ischemia.

Background: Chronic limb-threatening ischemia (CLTI) is a common condition with high rates of morbidity and mortality. Despite extensive literature documenting poor outcomes in patients with CLTI, as well as racial, ethnic, socioeconomic, and geographic disparities in these outcomes, process measures for high-quality CLTI care have not been developed. We developed the Chronic Limb threatening Ischemia Process PERformace (CLIPPER) cohort to develop and test the validity of CLTI care quality measures.

Practice Trends and Characteristics of US Hospitalists From 2012 to 2018.

This cohort study uses Medicare data to assess trends and characteristics among hospitalists who shift practice to settings outside of the hospital.

Benzodiazepine and antipsychotic use among hospitalized older adults before versus after restricting visitation: March to May 2020.

Background: Hospital visitation restrictions during the COVID-19 pandemic prompted concerns about unintended consequences for older patients, including an increased incidence of delirium and agitation. While first-line interventions for these conditions are non-pharmacologic, a lack of family support could result in increased use of benzodiazepines and antipsychotics, which are associated with poor outcomes in older adults. Little is known about the association of visitation policies with use of these medications among older adults.

Socioeconomic Status Predicts Short-Term Emergency Department Utilization Following Supratentorial Meningioma Resection.

Introduction By identifying drivers of healthcare disparities, providers can better support high-risk patients and develop risk-mitigation strategies. Household income is a social determinant of health known to contribute to healthcare disparities. The present study evaluates the impact of household income on short-term morbidity and mortality following supratentorial meningioma resection.

Primary Care Appointment Completion Rates and Telemedicine Utilization Among Black and Non-Black Patients from 2019 to 2020.

To understand how differences in primary care appointment completion rates between Black and non-Black patients changed in 2020 within the context of the COVID-19 pandemic and when telemedicine utilization peaked. We conducted a retrospective cohort study using the electronic health record from January 1 to December 31, 2020, among all adults scheduled for a primary care appointment within a large academic medical center. We used mixed-effects logistic regression to estimate adjusted appointment completion rates for Black patients compared with those for non-Black patients in 2020 as compared with those in 2019 within four time periods: (1) prepandemic (January 1, 2020, to March 12, 2020), (2) shutdown (March 13, 2020, to June 3, 2020), (3) reopening (June 4, 2020, to September 30, 2020), and (4) second wave (October 1, 2020, to December 31, 2020).

US local public health department spending between 2008 and 2016 did not increase for communities in need.

Background: Greater US local public health department (LPHD) spending has been associated with decreases in population-wide mortality. We examined the association between changes in LPHD spending between 2008 and 2016 and county-level sociodemographic indicators of public health need.

Methods: Multivariable linear regression was used to estimate the association between changes in county-level per-capita LPHD spending and 2008 sociodemographic indicators of interest: percent of population that was over 65 years old, Black, Hispanic, in poverty, unemployed, and uninsured.

Assessment of Gender Disparities in Short-Term and Long-Term Outcomes Following Posterior Fossa Tumor Resection.

Introduction The analysis of social determinants of health (SDOH) across different surgical populations is critical for the identification of health disparities and the development risk mitigation strategies among vulnerable patients. Research into the impact of gender on neurosurgical outcomes remains limited. The aim of the present study was to assess the effect of gender on outcomes, in a matched sample, following posterior fossa tumor resection, a high-risk neurosurgical procedure.

The Influence of Household Income on Survival following Posterior Fossa Tumor Resection at a Large Academic Medical Center.

 The present study examines the effect of median household income on mid- and long-term outcomes in a posterior fossa brain tumor resection population.  This is a retrospective regression analysis.  The study conducted at a single, multihospital, urban academic medical center.

Overlap Before the Critical Step of Lumbar Fusion Does Not Lead to Increased Short-Term Morbidity.

Background: Few studies have assessed the impact of overlapping surgery during different timepoints of neurosurgical procedures.

Objective: To evaluate the impact of overlap before the critical portion of surgery on short-term patient outcomes following lumbar fusion.

Methods: In total, 3799 consecutive patients who underwent single-level, posterior-only lumbar fusion over 6 yr (2013-2019) at an academic hospital system were retrospectively studied.

Postoperative outcomes and the association with overlap before or after the critical step of lumbar fusion.

Objective: This study assesses how degree of overlap, either before or after the critical operative portion, affects lumbar fusion outcomes.

Methods: The authors retrospectively studied 3799 consecutive patients undergoing single-level, posterior-only lumbar fusion over 6 years (2013-2019) at a university health system. Outcomes recorded within 30-90 and 0-90 postoperative days included emergency department (ED) visit, readmission, reoperation, overall morbidity, and mortality.

Older adults' access to primary care: Gender, racial, and ethnic disparities in telemedicine.

Background: In 2020, primary care practices adopted telemedicine as an alternative to in-person visits. Little is known about whether access to telemedicine was equitable, especially among older patients. Our objectives were to (1) examine older adults' use of telemedicine versus in-person primary care visits and (2) compare hospitalization for ambulatory care sensitive conditions (ACSCs) between the groups.

The impact of gender on long-term outcomes following supratentorial brain tumor resection.

Purpose: Gender is a known social determinant of health which has been linked disparities in medical care. This study intends to assess the impact of gender on 90-day and long-term morbidity and mortality outcomes following supratentorial brain tumor resection in a coarsened-exact matched population.

Materials And Methods: A total of 1970 consecutive patients at a single, university-wide health system undergoing supratentorial brain tumor resection over a six-year period (09 June 2013 to 26 April 2019) were analyzed retrospectively.

The influence of race on outcomes following pituitary tumor resection.

Objective: To assess the influence of race on short-term patient outcomes in a pituitary tumor surgery population.

Patients And Methods: Coarsened exact matching was used to retrospectively analyze consecutive patients (n = 567) undergoing pituitary tumor resection over a six-year period (June 07, 2013 to April 29, 2019) at a single, multi-hospital academic medical center. Black/African American and white patients were exact matched based on twenty-nine (29) patient, procedure, and hospital characteristics.

Effect of Household Income on Short-Term Outcomes Following Cerebellopontine Angle Tumor Resection.

 The objective of this study is to elucidate the impact of income on short-term outcomes in a cerebellopontine angle (CPA) tumor resection population.  This is a retrospective regression analysis.  This study was done at a single, multihospital, urban academic medical center.

Association of Police Transport With Survival Among Patients With Penetrating Trauma in Philadelphia, Pennsylvania.

Importance: Police in Philadelphia, Pennsylvania, routinely transport patients with penetrating trauma to nearby trauma centers. During the past decade, this practice has gained increased acceptance, but outcomes resulting from police transport of these patients have not been recently evaluated.

Objective: To assess mortality among patients with penetrating trauma who are transported to trauma centers by police vs by emergency medical services (EMS).

The role of socioeconomic status on outcomes following cerebellopontine angle tumor resection.

Purpose: It is well documented that the interaction between many social factors can affect clinical outcomes. However, the independent effects of economics on outcomes following surgery are not well understood. The goal of this study is to investigate the role socioeconomic status has on postoperative outcomes in a cerebellopontine angle (CPA) tumor resection population.

Absence of Gender Disparity in Thirty-Day Morbidity and Mortality After Supratentorial Brain Tumor Resection.

Background: Gender is a complex social determinant of health affected by both social and biological factors. There is a need to investigate the effect of gender on outcomes, in the absence of confounding characteristics, to mitigate disparities in care.

Methods: A total of 1970 consecutive patients at a university health system undergoing nonmeningioma supratentorial brain tumor resection over a 6-year period (June 9, 2013-April 26, 2019) were analyzed retrospectively.