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Who leaves the hospital against medical advice in the orthopaedic setting?

BACKGROUND: Patients who leave the hospital against medical advice are at risk for readmission and for a variety of complications and are li … icare [trauma: OR 1.7, 95% CI 1.6-1.8, p < 0.001; infection: OR 2.5, 95% CI 2.4-2.5, p < 0.001] and Medicaid [trauma: OR 2.6, 95% CI 2.5-2.7, p < 0.001; infection: OR 3.2, 95% CI 3.2-3.3, p < 0.001]), and no insurance coverage (trauma: OR 3.0, 95% CI 2.9-3.1, p < 0.001; infection: OR 3.5, 95% CI 3.4-3.5, p < 0.001), less medical comorbidity (trauma: OR 0.9 …

Seamless Navigation of Bispecific Therapies: Optimizing Management and Outpatient Access With a Focus on Coordination.

Bispecific antibodies (BsAbs) have emerged as crucial therapeutic agents for patients with relapsed/refractory diffuse large B-cell lymphoma, multiple myeloma, and most recently, lung cancer. These therapies have demonstrated remarkable efficacy in clinical trials; however, multidisciplinary collaboration is essential to ensure optimal patient outcomes amid the operational complexities associated with BsAb therapy. As BsAbs are being prepared for broader adoption, clinicians and treatment centers must navigate operational challenges, including financial considerations, patient selection, careg

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… Oncology , 23 ( 8 ), 1055 – 1065 . 10.1016/S1470-2045(22)00335-7 35803286 Centers for Medicare & Medicaid Services . ( 2015 ). Fact sheet: Two-midnight rule . https://www.cms.gov/newsroom/fact-sheets/fact-sheet-two-midnight-rule-0 . Centers for Medicare & Medicaid Services . ( 2024a ). … Centers for Medicare & Medicaid Services . ( 2024b ). New medical services and new technologies . https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/new-medical-services-and-new-technologies . Centers for Medicare & Medicaid Services . (n.d.-a). CMS web pricer . …

Update Breast Cancer 2019 Part 5 - Diagnostic and Therapeutic Challenges of New, Personalised Therapies in Patients with Advanced Breast Cancer.

Significant advancements have been made in recent years in advanced breast cancer and nearly all of them have been in the field of targeted therapy. Pertuzumab and trastuzumab-emtansine (T-DM1) have been able to be introduced in HER2-positive breast cancer. Now other anti-HER2 therapies are being developed (e.g. margetuximab, DS-8201a, pyrotinib) which can overcome other resistance mechanisms in the HER2 signalling pathway. In the field of hormone-receptor-positive breast cancer, an mTOR inhibitor and CDK4/6 inhibitors were introduced in the past. Now the introduction of the first PI3K inhibit

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… The assumption of costs through Medicaid was to be promptly adapted in the individual states, however not all states in the US actually implemented this. As a result, there was an inconsistent picture: states with a Medicaid adaptation and those without an adjustment. … It was noted that in states with expanded Medicaid, in comparison to states without an expansion, 6.1% more African-American citizens had access to adequate care; among Caucasian citizens, the difference was only 2% 47 . …

Социальные детерминанты здоровья, качества ухода за больными и результаты лечения неврологических расстройств: систематический обзор.

СПРАВОЧНАЯ ИНФОРМАЦИЯ: Социальные детерминанты здоровья (SDOH) оказывают значительное влияние на оказание медицинской помощи и ее результаты, однако их конкретное воздействие на качество неврологической медицинской помощи по-прежнему недостаточно синтезировано. ЦЕЛЬ: Цель этого систематического обзора заключалась в обобщении данных о связях между СДОГ и качеством медицинского обслуживания и результатах лечения пациентов в связи с серьезными неврологическими расстройствами. МЕТОДЫ: ПОСЛЕ ПРИСМА 2020 Руководящие принципы, мы систематически искали Пуббмеда, Интернет науки и Эмбазу для исследовани

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… Insurance and Racial Effects on Treatment and Outcomes National Trauma Data Bank analysis (n=187,354 moderate-severe TBI, 2002–2012) revealed that in-hospital mortality rates varied by insurance: commercial 5.0%, Medicaid 7.6%, Medicare 8.5%, uninsured 6.2%. 84 Medicaid patients had twice the length … After adjustment for injury severity and demographics, insurance effects on mortality were attenuated but remained significant for Medicaid (aOR=1.18, 95% CI: 1.08–1.29). …

Racial Disparities in Plasma Cell Leukemia Outcomes Among Hospitalized Patients in the United States.

Plasma cell leukemia (PCL) is a rare, aggressive subtype of multiple myeloma (MM) with a poor prognosis. Prior studies have shown that racial disparities affect MM patients in various ways, which may affect patients' outcomes. In this study, we aimed to investigate racial differences in hospitalization outcomes for PCL using Nationwide Inpatient Sample data. Overall, hospitalization rates for PCL tended to decrease over the past decade. Among hospitalized patients with a primary diagnosis of PCL, there was no statistically significant association between race/ethnicity and hospitalization rate

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… Socio-demographics provided in the data set included age, sex (male, female), race/ethnicity (Hispanic, Non-Hispanic (NH) Black, NH-White, NH-Other, or missing), primary hospital payer (Medicare, Medicaid, private insurance, self-pay, other), median zip code income quartile, disposition (routine, transfer … | 4.4662788 | Third quartile | 71316441 | 23.42% | 3589 | 25.09% | 5.0325001 | Highest quartile | 59779208 | 19.63% | 3467 | 24.24% | 5.7996754 | Missing | 6328919 | 2.08% | 288 | 2.01% | 4.5505401 | Primary Payer | | | | | <0.01 Medicare | 142155872 | 46.69% | 6372 | 44.55% | 4.4824037 | Medicaid …

Costs and benefits of early access to new cancer drugs through the US Food and Drug Administration's accelerated approval pathway: retrospective observational study and economic evaluation.

OBJECTIVE: To evaluate the survival gains and additional Medicare spending associated with early access to new cancer drugs granted accelerated approval by the US Food and Drug Administration (FDA), compared with access to cancer drugs following completion of confirmatory trials. DESIGN: Retrospective observational study and economic evaluation. SETTING: US Medicare programme, which provides health insurance for adults aged 65 years and older. PARTICIPANTS: Medicare beneficiaries who received new cancer drug indications from the time of FDA accelerated approval to conversion to regular appr

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… CMS=Centres for Medicare & Medicaid Services The study period began in 2012, the first year for which Medicare spending data were available. … Medicaid and Accelerated Approval: Spending on Drugs with and without Proven Clinical Benefits. J Health Polit Policy Law. 2022;47:673–90. doi: 10.1215/03616878-10041107. 82. Sachs RE, Gavulic KA, Donohue JM, et al. …

Patterns of multimorbidity in older adults with multiple myeloma: An analysis of SEER-Medicare.

OBJECTIVE: Multimorbidity influences the management of symptoms, treatment, and health outcomes for older adults with multiple myeloma. Our study characterized patient profiles defined by discrete chronic condition patterns and examined the distribution of their sociodemographic factors in older adults at time of diagnosis with multiple myeloma. METHODS: Using the Surveillance, Epidemiology and End Results (SEER) Program database linked with Medicare insurance claims (2007-2017), we examined 11,926 individuals diagnosed with multiple myeloma at age ≥ 65 years. Hierarchical cluster analysis wa

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… Supporting information Modifications made to the chronic conditions in the Centers for Medicare and Medicaid Services Chronic Conditions Data Warehouse. … Available from: https://healthcaredelivery.cancer.gov/seermedicare/overview/linked.html 27 Centers for Medicare and Medicaid Services. CMS Chronic Conditions Data Warehouse (CCW) Condition Algorithms and Change History. …

Controlled Substance Prescribing Patterns--Prescription Behavior Surveillance System, Eight States, 2013.

PROBLEM/CONDITION: Drug overdose is the leading cause of injury death in the United States. The death rate from drug overdose in the United … rolled substance prescriptions paid for in cash varied almost threefold, and the percentage paid by Medicaid varied sixfold. In West Virginia, for 1 of every 5 days of treatment with an opioid, the patient also was taking a benzodiazepine. Multiple-provider episode rates were highest in Ohio and lowest in Louisiana. INTERPRETATION: This report presents ra …

Weekend admission and outcomes in cancer-associated pulmonary embolism: a cross-sectional national inpatient sample study, 2016-2022.

The "weekend effect" has been variably associated with outcomes in acute pulmonary embolism (PE), but its relevance in cancer-associated PE remains uncertain. Among U.S. hospitalizations for cancer-associated PE, is weekend admission independently associated with in-hospital mortality, and do PE-related interventions differ by day of admission? Retrospective cross-sectional study using the HCUP National Inpatient Sample (2016-2022). Adults (≥ 18 years) hospitalized with a principal diagnosis of PE and concomitant malignancy were included. Weekend admission was Saturday-Sunday. Survey-weighted

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… Relative to Medicare, self-pay hospitalizations had higher mortality risk (OR 2.02, 95% CI 1.46–2.74; P < 0.001), as did other payer (OR 1.56, 95% CI 1.18–2.03; P = 0.001), while Medicaid was not significantly different (OR 1.20, 95% CI 0.98–1.45; P = 0.071). … By primary payer, the weekend effect was most pronounced among privately insured hospitalizations (OR 1.41, 95% CI 1.15–1.71; P < 0.001), with no significant differences in Medicare, Medicaid, or self-pay strata. Hospital-level analyses suggested heterogeneity by care setting. …

Реальное удовлетворение и опыт использования инжекторного и автоинжекторного устройства для атумумаба указывают на наличие множественных склерозов.

Оценка общего уровня удовлетворенности, удобства использования устройств и инъекционного опыта пациентов MS, самоуправляющихся atumumab, с использованием автоинжекторного устройства Sensorede в Соединенных Штатах (США). МЕТОДЫ: В рамках данного исследования, проведенного в США в целях перекрестного обследования, были охвачены пациенты, имеющие MS (см.≥ 18 ) с использованием устройства &quot; Sensoredy &quot; в рамках предыдущего 12 месяцев обследования. Пациенты, имеющие право на получение медицинской помощи 30-item Вопросник de novo, в котором основное внимание уделяется общему сатисфакции ус

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… 51.4% 40.0% 58.5%  African American 26.7% 22.5% 29.2%  Latino or Hispanic 13.3% 17.5% 10.8%  Others 1 13.4% 27.5% 4.5% US geographical region  Northeast 72.4% 72.5% 72.3%  South 20.0% 20.0% 20.0%  Midwest 3.8% 0.0% 6.2%  West 3.8% 7.5% 1.5% Insurance type  Commercial 66.7% 72.5% 63.1%  Medicare or Medicaid … 19.0% 30.0% 12.3%  Others 5 20.0% 20.0% 20.0% Abbreviations: DMT disease-modifying therapy, SD standard deviation,  US  United States Notes: 1 Includes Asians, Native Americans, and those who preferred not to disclose or unknown. 2 Includes Medicare Advantage or Medicare Supplemental plans, Medicaid …

An overview of cancer health disparities: new approaches and insights and why they matter.

Cancer health disparities remain stubbornly entrenched in the US health care system. The Affordable Care Act was legislation to target these disparities in health outcomes. Expanded access to health care, reduction in tobacco use, uptake of other preventive measures and cancer screening, and improved cancer therapies greatly reduced cancer mortality among women and men and underserved communities in this country. Yet, disparities in cancer outcomes remain. Underserved populations continue to experience an excessive cancer burden. This burden is largely explained by health care disparities, lif

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… Still, race/ethnic disparities remain ( 62 ), and Medicaid expansion may not have lowered the disparity in breast cancer mortality between African American and European American women ( 63 ). … Kim, U. et al. (2020) The effect of Medicaid expansion among adults from low-income communities on stage at diagnosis in those with screening-amenable cancers. Cancer, 126, 4209–4219. 62. …

Real-World Treatment Outcomes in Black, Hispanic, Asian, and White People with Multiple Sclerosis Treated with Fumarates in the USA.

INTRODUCTION: Multiple sclerosis (MS) is a heterogeneous disease affecting a diverse population. Compared with white people with MS (PwMS), Black PwMS have more severe disease and higher incidence of MS, whereas Hispanic PwMS experience earlier onset disease; however, MS is not adequately studied in these groups. We compared the effectiveness of fumarates across Black, Hispanic, Asian, and white PwMS. METHODS: This retrospective analysis using the Komodo Health database included PwMS. Patients with a claim for diroximel fumarate or dimethyl fumarate were followed from disease-modifying therap

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… In this study, Black PwMS were less likely to use commercial insurance plans and were more likely to rely on Medicare/Medicaid compared with Hispanic, Asian, or white PwMS. … Additionally, Expanded Disability Status Scale data were not available to assess higher disability in the Black PwMS group, who were more likely to use Medicare/Medicaid insurance than other racial/ethnic groups. …

Сопоставление эффективности и рентабельности лечения ритуксимаба и пероральных агентов у пациентов с расстройствами спектрального спектра нейромиелита: когортное исследование на основе популяции.

Rituximab (RTX) является хорошо известным эффективным лечением расстройства спектра нейромиелита (NMOSD). AIMS: Изучение эффективности лечения RTX у пациентов с NMOSD и сопоставление медицинских расходов между RTX и другими оральными агентами. МЕТОДЫ: Используя данные из базы данных Национальной системы медицинского страхования (2010 - 2021 годы), мы сравнили время с первым рецидивом и медицинскими расходами после каждого лекарства между группами с РТХ и оральными агентами. Кроме того, мы проанализировали связь между уровнем инвалидности и видом наркотиков. Результаты: В общей сложности было о

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… There was a significant difference in the household income of patients, especially those who belonged to Medicaid, or the highest group was higher in the group with RTX ( p  = 0.043; Table 1 ). Table 1. Baseline characteristics. … disorder 1 (0.1) 1 (0.1) 0 (0) Level of disability at diagnosis <0.001  Normal 663 (73.7) 573 (77.0) 90 (58.1)  Moderate 116 (12.9) 92 (12.4) 24 (15.5)  Severe 120 (13.3) 79 (10.6) 41 (26.5) Type of residence <01  Rural 260 (28.9) 238 (32.0) 22 (14.2)  Urban 639 (71.1) 506 (68.0) 133 (85.8) Income 0.043  Medicaid …

Treatment Satisfaction and Burden of Illness in Patients with Newly Diagnosed Multiple Myeloma.

ObjectivesThis observational study identified attributes of patient-reported satisfaction with therapy for multiple myeloma (MM), described the treatment-related time burden and indirect costs, and investigated the effect of administration route (oral vs. injectable) on these outcomes among patients with newly diagnosed MM (NDMM) and among caregivers.MethodsPatients residing in the USA with a self-reported diagnosis of NDMM were recruited from PatientsLikeMe, MyelomaCrowd, and Facebook (16 December 2016 and 6 July 2017) to complete an electronic survey including questions on treatment experien

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… /dual refers to enrolees of both Medicare and Medicaid, or Medicare and Commercial insurance Characteristic | Total ( N = 188) Age, years Mean | 61.3 ± 8.92 Median (IQR) | 63.0 (54.0–67.0) < 65 | 111 (59.0) 65–74 | 68 (36.2) ≥ 75 | 9 (4.8) Sex Female | 114 (60.6) Male | 73 (38.8) Missing | 1 (0.5) Race … /dual a | 50 (26.6) Missing | 9 (4.8) Pharmacy insurance Commercial | 114 (60.6) Medicare | 35 (18.6) Medicaid/dual | 32 (17.0) Missing | 7 (3.7) Region Midwest | 40 (21.3) Northeast | 44 (23.4) South | 72 (38.3) West | 31 (16.5) Missing | 1 (0.5) Prior stem-cell transplant No | 97 (51.6) Yes | 91 (48.4 …

Erythropoiesis-Stimulating Agents in the Management of Anemia in Chronic Kidney Disease or Cancer: A Historical Perspective.

Anemia is common in patients with cancer or with chronic kidney disease (CKD). Although the introduction of erythropoiesis-stimulating agents (ESAs) has transformed the management of anemia, their use has been complicated by a number of factors including frequent guideline updates, safety concerns and, in the United States, a Risk Evaluation and Mitigation Strategy (REMS) program, which aimed to ensure that the benefits of ESAs outweigh the risks. Many previous concerns around ESA use in cancer and CKD have been addressed by the reassuring results of post-approval studies, and biosimilar ESAs

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… Medicare and Medicaid Services, 2007 ; US Food and Drug Administration, 2007b , 2017 ). … FIGURE 1 South Carolina Medicaid claim data (2002–2012). Reductions in the number of claims for ESAs were observed over the period 2006–2012, indicating the “black box” warning resulted in reductions in ESA use. …

Реальные модели лечения и результаты лечения пациентов с множественной миеломой, инициирующих эгранатамаб: результаты ALTITUDE-1 и ALTITUDE-2 Ретроспективные когортные исследования.

AIM: Elranatamab в настоящее время является антителом с биенной спецификой, утвержденным в Соединенных Штатах (США) для лечения повторной/охлажденной множественной миеломы (ММ). С учетом его недавнего одобрения реальные данные являются ограниченными. МЕТОДЫ: РЕЗУЛЬТАТЫ РАБОТЫ two исследования реального мира (РВ) с использованием административных требований (см.ALTITUDE-1) и данные о плате за услуги (ALTITUDE-2) сообща сообщаются здесь. Американские пациенты с MM, которые запустили Elranatamab после августа 2023 в сентябре/октябре 2025. Сообщалось о характеристиках пациентов, клинической истори

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… Note: Per Centers for Medicare & Medicaid Services (CMS) suppression policies – which govern the Medicare FFS data with cell counts >0 but <11 must be masked and is reported as “<11”. … Note: Per Centers for Medicare & Medicaid Services (CMS) suppression policies – which govern the Medicare FFS data with cell counts >0 but <11 must be masked and is reported as “<11”. …

Совместное управление триазолами с хемапаевыми и/или иммунозопрессивными агентами, известными умеренным взаимодействием между наркотиками и наркотиками у пациентов с гематологическими заболеваниями, госпитализировано в связи с инвазивным аспергиллозом.

ОБРАЩЕНИЕ: Триазолы широко используются для лечения и профилактики инвазивного аспергиллоза (ИА), но могут вызывать серьезное взаимодействие с наркотиками (ДПИ) с химиотерапией (ХТ) и иммунодепрессантами (ИС) посредством ингибирования CYP3A4. Частота получения трехазол-ХТ или одновременного лечения в случае гематологовых заболеваний (ГМ) вновь принятых в ПА пациентов в целом неизвестна. Мы изучили американские претензии IQVIA, в том числе в отношении взрослых ≥ 1 требование о пребывании в стационаре с диагностическим кодом для АИ с октября 1, 2015- ноябрь 30, 2022 и доказательства существовани

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… use for ≥ 3 days during the hospitalization for invasive aspergillosis # Commercial includes private and employer-sponsored health insurance plans; Medicare includes federal health insurance programs for adults ≥ 65 years and eligible younger individuals with disabilities or end-stage renal disease; Medicaid … N = 317 n (%) Age 18–44 years | 44 (13.9) 45–64 years | 138 (43.5) ≥ 65 years | 135 (42.6) Male sex | 201 (63.4) Geographic Census region West | 227 (71.6) South | 36 (11.4) Midwest | 31 (9.8) Northeast | 23 (7.3) Payer type # Commercial | 122 (38.5) Medicare | 111 (35.0) Unknown/other | 58 (18.3) Medicaid …

Время отключения в слоях при мукозите и его ассоциация с системными осложнениями у пациентов с пересадкой гематопоэтических стволовых клеток: выводы из национального исследования в стационаре.

ОБЪЕКТ ИССЛЕДОВАНИЯ: Оральные узловатые мукозные инфекции (ОУМИ) являются частой и серьезной осложнением трансплантации гемопоэтических клеток (ТГК). Определено ли то, что длительное время выписки из больницы, используемое как прокси для увеличенного срока пребывания (СПП), идентифицирует большую системную морбидность у пациентов, которые развивают ОУМИ, остается неясным. Настоящее ретроспективное когортное исследование направлено на оценку, у пациентов с документированным ОУМИ среди получателей ТГК, длительное время выписки независимо связано с увеличением системных осложнений.МЕТОДЫ: Настоящ

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… Baseline covariates abstracted from discharge records encompassed age, sex, race/ethnicity (White, Black, Hispanic, Asian/other), ZIP code-derived median household income quartile, primary payer (Medicare, Medicaid, private, self-pay/other), residence per the National Center for Health Statistics urban-rural … -25th percentile | 185.0 (18.6) | 70.0 (25.0) | 26th to 50th percentile | 250.0 (25.1) | 50.0 (17.9) | 51st to 75th percentile | 275.0 (27.6) | 60.0 (21.4) | 76th to 100th percentile | 285.0 (28.6) | 100.0 (35.7) | Expected primary payer (%) | | | 0.79 Medicare | 350.0 (34.8) | 80.0 (28.6) | Medicaid …

Hospitalized cancer patients with severe sepsis: analysis of incidence, mortality, and associated costs of care.

IntroductionInfection is an important complication in cancer patients, which frequently leads to or prolongs hospitalization, and can also lead to acute organ dysfunction (severe sepsis) and eventually death. While cancer patients are known to be at higher risk for infection and subsequent complications, there is no national estimate of the magnitude of this problem. Our objective was to identify cancer patients with severe sepsis and to project these numbers to national levels.MethodsData for all 1999 hospitalizations from six states (Florida, Massachusetts, New Jersey, New York, Virginia, an

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… We used institution-specific cost-to-charge ratios from the 1999 Centers for Medicare and Medicaid Services Payment Impact File (Centers for Medicare and Medicaid Services, Baltimore, MD, USA) and obtained information on cancer prevalence from the National Cancer Institute, Surveillance, Epidemiology … Washington, DC: Centers for Medicare and Medicaid Services, US Bureau of Census; 1990. National Cancer Institute: Surveillance, Epidemiology, and End Results initiative (SEER) http://seer.cancer.gov accessed 8 February 2001. Deyo RA, Cherkin DC, Ciol MA. …

Интеллектуальные расстройства и расстройства в развитии диагностируются в Калифорнии и неблагоприятно сказываются на материнском здоровье.

СПРАВОЧНАЯ ИНФОРМАЦИЯ: Женщины, страдающие умственными расстройствами и расстройствами в области развития, относятся к категории населения, результаты деятельности по охране материнского здоровья которого по-прежнему плохо задокументированы. Мы провели оценку связей между диагностикой ИПД у матерей в Калифорнии и неблагоприятными последствиями для матерей, а также проанализировали, способствуют ли эти отношения дородовые клинические характеристики. МЕТОДЫ: Это ретроспективное исследование групп населения охватывало все роды ≥22 Неделя беременности в Калифорнии между 2007 и 2021, с использовани

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… Although recent estimates from a Medicaid birth cohort estimated the birth rate for women with IDD from 2011 to 2022 to be 9–10 births per 1000 [ 1 ], maternal health outcomes among pregnant people with IDD remain poorly documented [ 2 ]. … The population‐based design and inclusion of fetal deaths after 22 weeks reduce the probability of selection bias and may improve generalizability beyond studies relying on Medicaid records alone. …