Search

Objective: To determine whether Medicare's Nonpayment Program was associated with decline in venous thromboembolism (VTE) following hip and knee replacements; and whether the decline was greater among hospitals at risk of larger financial losses from the Program.Data Sources: State Inpatient Database for New York (NY) from 2005 to 2013.Study Design: The primary outcome was an occurrence of VTE. Medicare Utilization Ratio (MUR), which is the proportion of inpatient days in a hospital that is financed by Medicare, represented a hospital's financial sensitivity. We used hierarchical logistic regressions with difference-in-differences estimation to study the Program effects.Principal Findings: A total of 98,729 hip replacement and 111,361 knee replacement stays were identified. For hip replacement, the Program was associated with significant reduction (Range: 44% to 53%) in VTE incidence among hospitals in MUR quartiles 2 to 4. For knee replacement, the Program was associated with significant reduction (47%) in VTE incidence only among quartile 2 hospitals.Conclusion: Implementation of the Program was associated with a reduction in VTE, especially for hip replacements, in higher MUR hospitals. Payment reforms such as Medicare's Nonpayment Program that withhold payments for complications are effective and should be continued. [ABSTRACT FROM AUTHOR]

Persons living in communities with limited resources are at heightened risk of posttraumatic stress (PTS) after disasters, especially if they were highly exposed. The support deterrence desistence model and the conservation of resources theory suggest that this risk might increase in the longer-term aftermath of disasters. In the present study, we aimed to test this hypothesis. Two population-based samples of New York City residents in communities affected by Hurricane Sandy were surveyed at either 13-16 months (Time 1; n = 421) or 25-28 months (Time 2; n = 420) postdisaster. Participants reported on their exposure to disaster-related stressors and PTS. The percentage of residents who were unemployed in participants' census tracts was collected from the 2008-2012 American Community Survey. Multilevel models found that disaster-related stressors were more strongly associated with PTS for participants living in communities with high unemployment, but only at Time 2 (Est. = .58, SE = .21, p = .006). Mapping of community unemployment and disaster-related stressors suggested that communities in southern Brooklyn and Queens, and northeastern Staten Island were at particularly high risk for PTS at Time 2. The results suggest the need for ongoing support to economically disadvantaged communities in which residents have endured disaster-related stressors. [ABSTRACT FROM AUTHOR]

The article offers information on the report by Appleseed on the impact of the Brookhaven National Laboratory on the economy of Long Island, New York and on the state itself. It says that the report covers fiscal data from October 1, 2008 to September 30, 2009, in which Brookhaven generated 704 million dollars for the state and created 5,400 jobs. Furthermore, it is estimated that the laboratory will generate an income of 947 million dollars in an average annual basis from 2010 to 2014.