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Validating biologic age in selecting elderly patients with pancreatic cancer for surgical resection.

Background and objectivesSelecting frail elderly patients with pancreatic cancer (PC) for pancreas resection using biologic age has not been elucidated. This study determined the feasibility of the deficit accumulation frailty index (DAFI) in identifying such patients and its association with surgical outcomes.MethodsThe DAFI, which assesses frailty based on biologic age, was used to identify frail patients using clinical and health-related quality-of-life data. The characteristics of frail and nonfrail patients were compared.ResultsOf 242 patients (median age, 75.5 years), 61.2% were frail an

Transitions of care for advanced cancer in post-acute and long-term care.

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The Effect of Advancing Age on Total Joint Replacement Outcomes.

ObjectiveTo describe age-related differences in outcomes among older adults undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA).DesignRetrospective study.ParticipantsA total of 1792 patients who underwent primary THA or TKA at the University of Iowa Hospitals and Clinics between 2010 and 2013 were identified in the University HealthSystem Consortium Database and University of Iowa Orthopedics Joint Replacement Registry.Main outcome measuresHospital length of stay (LOS), 30-day readmission rate, in-hospital mortality, number of days admitted to intensive care unit (ICU dis

Расовые различия в выживании нескольких миелом: ассоциации с трансплантацией стволовых клеток, страхованием и расширением сети медицинских учреждений.

На уровне населения чернокожие пациенты с множественной миеломой (ММ) могут выжить хуже, чем белые. Авторы изучили вопрос о том, как автологическая трансплантация стволовых клеток (ASCT), страхование и расширение сети " Медикэйд " связаны с расовыми различиями в общем уровне выживания (rwOS) в реальном мире. МЕТОДЫ: Данные, полученные 4932 больные MM (MM)24% Блэк) в Флатиронской базе данных исследований в области здравоохранения анализировался с использованием моделей " Кокс регрессиал " (rwOS), " Файн энд срей " (ASCT) и " политомная регрессия " (страхо

Post-infusion Costs Associated with Idecabtagene Vicleucel Treatment for Patients with Relapsed/Refractory Multiple Myeloma in the KarMMa Trial.

IntroductionPatients with triple-class exposed relapsed/refractory multiple myeloma (RRMM) have poor outcomes with substantial healthcare costs. Idecabtagene vicleucel (ide-cel), a B-cell maturation antigen (BCMA)-directed chimeric antigen receptor (CAR) T cell therapy, showed deep, durable responses in patients with RRMM in the pivotal phase 2 KarMMa trial (NCT03361748). Healthcare resource utilization (HCRU) and costs were estimated for ide-cel-treated patients in the KarMMa trial.MethodsPost-infusion costs were estimated based on HCRU data, including facility care, diagnostics, medications,

An Integrated Health-System Specialty Pharmacy Model for Coordinating Transitions of Care: Specialty Medication Challenges and Specialty Pharmacist Opportunities.

Adherence and persistence to specialty medications are necessary to achieve successful outcomes of costly therapies. The increasing use of specialty medications has exposed several unique barriers to certain specialty treatments' continuation. Integrated specialty pharmacy teams facilitate transitions in sites of care, between different provider types, among prescribed specialty medications, and during financial coverage changes. We review obstacles encountered within these types of transitions and the role of the specialty pharmacist in overcoming these obstacles. Case examples for each type

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… Patients who reach retirement age and transition from commercial insurance to Medicare part D may incur out-of-pocket costs that are potentially thousands of dollars [ 44 ]. … Uninsured patients include patients who may be in a grace period awaiting insurance coverage from a new employer and underinsured includes patients with Medicare Part D and patients with limited specialty pharmacy coverage. …

Viewing the US presidential electoral map through the lens of public health.

Health, disease, and mortality vary greatly at the county level, and there are strong geographical trends of disease in the United States. Healthcare is and has been a top priority for voters in the U.S., and an important political issue. Consequently, it is important to determine what relationship voting patterns have with health, disease, and mortality, as doing so may help guide appropriate policy. We performed a comprehensive analysis of the relationship between voting patterns and over 150 different public health and wellbeing variables at the county level, comparing all states, including

Multiple myeloma care, treatment patterns, and treatment durations in academic and community care settings.

AIM: Evaluate multiple myeloma (MM) treatment patterns, healthcare utilization (HCRU), and costs from academic and community settings. METHODS: This observational study linked US MM insurance claims (1 April 2017-30 June 2022) with provider affiliations to evaluate patient characteristics and treatment durations across patient cohorts defined by care setting of treatment (academic only, community only, mixed [both]), as well as treatment patterns, HCRU, and costs of care (e.g. treatment, office visits, hospitalization) in each setting. RESULTS: 3778 patients were included. By cohort (n = 530

The Economic Value of Hybrid Single-photon Emission Computed Tomography With Computed Tomography Imaging in Pulmonary Embolism Diagnosis.

ObjectiveThe objective was to quantify the potential economic value of single-photon emission computed tomography (SPECT) with computed tomography (CT; SPECT/CT) versus CT pulmonary angiography (CTPA), ventilation-perfusion (V/Q) planar scintigraphy, and V/Q SPECT imaging modalities for diagnosing suspected pulmonary embolism (PE) patients in an emergency setting.MethodsAn Excel-based simulation model was developed to compare SPECT/CT versus the alternate scanning technologies from a payer's perspective. Clinical endpoints (diagnosis, treatment, complications, and mortality) and their correspo

Screening for comprehensive social needs in patients with cancer: a narrative review.

BackgroundPatients with cancer who report social needs have worse quality of life, lower health-care access, and suboptimal health outcomes. However, screening for social needs does not happen systematically, and successful screening tools, strategies, and workflows have seldom been described. The downstream effects of screening including resource navigation have also not been well characterized. The objective of this narrative review was to fill these gaps.MethodsTwo investigators searched PubMed and Embase for studies that implemented a patient-facing social screening tool among patients wit

Новые оценки издержек, связанных с неблагоприятными явлениями у больных раком.

Стоимость неблагоприятных явлений (ОЭ) является одним из важнейших компонентов экономических моделей здравоохранения для лечения раковых заболеваний; однако в настоящее время имеется мало всеобъемлющих оценок этих расходов. В предыдущих исследованиях основное внимание уделялось затратам, связанным с конкретными ПВ, типами рака или режимами лечения. В настоящем исследовании дается оценка дополнительных издержек, связанных с ЭВ, в различных областях 13 (Международная статистическая классификация болезней и связанных с ними проблем в области здравоохранения]ICD-10]) пациентам с диагнозом: 2016 и

Identifying Frail Patients by Using Electronic Health Records in Primary Care: Current Status and Future Directions.

With the rapidly aging population, frailty, characterized by an increased risk of adverse outcomes, has become a major public health problem globally. Several frailty guidelines or consensuses recommend screening for frailty, especially in primary care settings. However, most of the frailty assessment tools are based on questionnaires or physical examinations, adding to the clinical workload, which is the major obstacle to converting frailty research into clinical practice. Medical data naturally generated by routine clinical work containing frailty indicators are stored in electronic health r

Экономические последствия эгранатамаба для лечения пациентов с повторной или рефрактной миеломой.

Оценить бюджетные последствия добавления эгранатамаба в американскую формулу для лечения взрослых с помощью RRMM, которые получили ≥4 :: предыдущая терапия, включая протеаозный ингибитор, иммуномодулятивный препарат и anti-CD38 Была разработана экономическая модель для оценки последствий для бюджета эгранатамаба для бюджета. one-million- Запомните американский торговый и медицинский план. Эпидемиологические данные были получены из базы данных СЭЭУ и в рамках крупного исследования реального мира в США. К числу основных клинических вводимых ресурсов относятся продолжительность лечения, ПФС, обще

Catchment area and cancer population health research through a novel population-based statewide database: a scoping review.

BackgroundPopulation-based linked datasets are vital to generate catchment area and population health research. The novel Cancer Information and Population Health Resource (CIPHR) links statewide cancer registry data, public and private insurance claims, and provider- and area-level data, representing more than 80% of North Carolina's large, diverse population of individuals diagnosed with cancer. This scoping review of articles that used CIPHR data characterizes the breadth of research generated and identifies further opportunities for population-based health research.MethodsArticles publishe

Disparities in the enrollment to systemic therapy and survival for patients with multiple myeloma.

BackgroundDisparities driven by socioeconomic factors have been shown to impact outcomes for cancer patients. We sought to explore this relationship among patients with multiple myeloma (MM) who were not considered for hematopoietic stem cell transplant in the first-line setting and how it varied over time.MethodsWe queried the National Cancer Database for patients diagnosed with MM between 2004 and 2016 and included only those who received systemic therapy as the first-line treatment. Enrollment rates for therapy were calculated as receipt of systemic therapy as the incident event of interest

Disparities in care of older adults of color with cancer: A narrative review.

This review describes the barriers and challenges faced by older adults of color with cancer and highlights methods to improve their overall care. In the next decade, cancer incidence rates are expected to increase in the United States for people aged ≥65 years. A large proportion will be older adults of color who often have worse outcomes than older White patients. Many issues contribute to racial disparities in older adults, including biological factors and social determinants of health (SDOH) related to healthcare access, socioeconomic concerns, systemic racism, mistrust, and the neighborho

Time's up: the urgency to investigate time toxicity in patients with genitourinary malignancies.

Patients with genitourinary (GU) malignancies have seen the development of multiple life-prolonging treatments in the past decade. As patients and clinicians consider their treatment options along the cancer journey, time spent with healthcare contact, or "time toxicity," has emerged as a new outcome measure that comprehensively considers time receiving cancer care, including planned visits for evaluation and treatment as well as unplanned urgent care addressing complications. Despite its rising study across cancer populations, there has been a surprising lack of work evaluating time toxicity

Economic burden of disease progression among multiple myeloma patients who have received transplant and at least one line of therapy in the US.

Effects of disease progression on healthcare resource utilization (HRU) and costs among multiple myeloma (MM) patients with ≥1 line of therapy (LOT) who received their first stem cell transplant (SCT) within 1 year of initial MM diagnosis were estimated using a large US claims database. Disease progression was defined as advancement to the next LOT, bone metastasis, hypercalcemia, soft tissue plasmacytoma, skeletal related events, acute kidney disease, or death within 12 months of LOT initiation. Annual HRU and costs in the first three LOTs (L1-L3) were compared for patients with versus withou

Patient-reported measures of well-being in older multiple myeloma patients: use of secondary data source.

BackgroundChanges in well-being of patients with multiple myeloma (MM) before and after diagnosis have not been quantified.AimsExplore the use of secondary data to examine the changes in the well-being of older patients with MM.MethodsWe used the Health and Retirement Study (HRS), linked to Medicare claims to identify older MM patients. We compared patient-reported measures (PRM), including physical impairment, sensory impairment, and patient experience (significant pain, self-rated health, depression) in the interviews before and after MM diagnosis using McNemar's test. We propensity-matched

Exploring the landscape of palliative care provision for black patients with hematologic cancers: A scoping review.

ObjectivesPatients with cancer benefit greatly from receiving palliative care (PC), improving their overall survival and quality of life. Despite its benefits, PC is underutilized among patients with hematologic malignancies (HMs), particularly among Black patients, who face higher symptom burdens and lower survival rates compared to White patients. The purpose of this review was to identify and describe what is known about PC use among Black HM patients in the United States.MethodsThis review was conducted using the Joanna Briggs Institute approach for scoping reviews and included a search of