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522 results on '"Rathore, Saif S."'

80. Volume-based referral for cardiovascular procedures in the United States: a cross-sectional regression analysis

Author

Krumholz Harlan M, Rathore Saif S, Epstein Andrew J, and Volpp Kevin GM

Subjects
Public aspects of medicine, RA1-1270
Abstract

Abstract Background We sought to estimate the numbers of patients affected and deaths avoided by adopting the Leapfrog Group's recommended hospital procedure volume minimums for coronary artery bypass graft (CABG) surgery and percutaneous coronary intervention (PCI). In addition to hospital risk-adjusted mortality standards, the Leapfrog Group recommends annual hospital procedure minimums of 450 for CABG and 400 for PCI to reduce procedure-associated mortality. Methods We conducted a retrospective analysis of a national hospital discharge database to evaluate in-hospital mortality among patients who underwent PCI (n = 2,500,796) or CABG (n = 1,496,937) between 1998 and 2001. We calculated the number of patients treated at low volume hospitals and simulated the number of deaths potentially averted by moving all patients to high volume hospitals under best-case conditions (i.e., assuming the full volume-associated reduction in mortality and the capacity to move all patients to high volume hospitals with no related harms). Results Multivariate adjusted odds of in-hospital mortality were higher for patients treated in low volume hospitals compared with high volume hospitals for CABG (OR 1.16, 95% CI 1.10–1.24) and PCI (OR 1.12, 95% CI 1.05–1.20). A policy of hospital volume minimums would have required moving 143,687 patients for CABG and 87,661 patients for PCI from low volume to high volume hospitals annually and prevented an estimated 619 CABG deaths and 109 PCI deaths. Thus, preventing a single death would have required moving 232 CABG patients or 805 PCI patients from low volume to high volume hospitals. Conclusion Recommended hospital CABG and PCI volume minimums would prevent 728 deaths annually in the United States, fewer than previously estimated. It is unclear whether a policy requiring the movement of large numbers of patients to avoid relatively few deaths is feasible or effective.

Published
2005
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82. Trends in Prescribing Psychotropic Medications

Author

Staudenmeier, James J., Jacoby, Itzhak, Rathore, Saif S., Boyko, William L., Jr., Gonzales, Junius J., Bowers, Malcolm B., Jr., MacLean, Rebecca W., Weiss, Erica, Mazure, Carolyn M., Pincus, Harold Alan, Tanielian, Terri L., Zarin, Deborah A., and Marcus, Steven C.

Subjects
Psychotropic drugs -- Health aspects, Antidepressants -- Health aspects, Mental illness -- Drug therapy
Published
1998

84. Lying for Patients

Author

Freeman, Victor G., Rathore, Saif S., Weinfurt, Kevin P., Schulman, Kevin A., and Sulmasy, Daniel P.

Subjects
Deception -- Surveys, Physicians -- Practice, Health
Abstract

Background: Some physicians may resort to deception to secure third-party payer approval for patient procedures. Related physician attitudes, including willingness to use deception, are not well understood. Objective: To determine physician willingness to deceive a third-party payer and physician attitudes toward deception of third-party payers. Methods: A cross-sectional mailed survey was used to evaluate physician willingness to use deception in 6 vignettes of varying clinical severity: coronary bypass surgery, arterial revascularization, intravenous pain medication and nutrition, screening mammography, emergent psychiatric referral, and cosmetic rhinoplasty. We evaluated 169 board-certified internists randomly selected from 4 high- and 4 low-managed care penetration metropolitan markets nationwide for willingness to use deception in each vignette. Results: Physicians were willing to use deception in the coronary bypass surgery (57.7%), arterial revascularization (56.2%), intravenous pain medication and nutrition (47.5%), screening mammography (34.8%), and emergent psychiatric referral (32.1%) vignettes. There was little willingness to use deception for cosmetic rhinoplasty (2.5%). Rates were highest for physicians practicing in predominantly managed care markets, for clinically severe vignettes, and for physicians spending less time in clinical practice. Physician ratings of the justifiability of deception varied by perspective and vignette. Conclusions: Many physicians sanction the use of deception to secure third-party payers' approval of medically indicated care. Such deception may reflect a tension between the traditional ethic of patient advocacy and the new ethic of cost control that restricts patient and physician choice in the use of limited resources. Arch Intern Med. 1999; 159:2263-22 70

Published
1999

85. Racial differences in the use of cardiac catheterization

Author

Barr, Donald A., Jacobs, Elizabeth A., Chen, Jersey, Rathore, Saif S., Krumholz, Harlan M., Epstein, Arnold M., and Ayanian, John Z.

Subjects
Cardiac catheterization -- Demographic aspects, Health and race -- Analysis
Published
2001

91. Abstract 4: Acute, Hospital-Acquired Anemia is Associated With Increased Mortality and Worse Health Status in Patients With Acute Myocardial Infarction

Author

Salisbury, Adam C, primary, Alexander, Karen P, additional, Reid, Kimberly J, additional, Spertus, John A, additional, Masoudi, Frederick A, additional, Rathore, Saif S, additional, Wang, Tracy Y, additional, Bach, Richard G, additional, Marso, Steven P, additional, Charlap, Esti, additional, and Kosiborod, Mikhail, additional

Published
2011
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92. Abstract P141: Health Care Insurance, Financial Concerns in Accessing Care, and Nonelective Readmissions Following Acute Myocardial Infarction

Author

Smolderen, Kim G, primary, Spertus, John A, additional, Nallamothu, Brahmajee K, additional, Krumholz, Harlan M, additional, Tang, Fengming, additional, Xiang, Ying, additional, Wang, Tracy, additional, Ross, Joseph S, additional, Ting, Henry H, additional, Rathore, Saif S, additional, and Chan, Paul S, additional

Published
2011
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93. Abstract P161: Relationship Between Clinical Availability of Hemoglobin A1c and Glucose Therapy Intensification in Patients With Diabetes Hospitalized for Acute Myocardial Infarction

Author

Stolker, Joshua M, primary, Spertus, John A, additional, McGuire, Darren K, additional, Inzucchi, Silvio E, additional, Rathore, Saif S, additional, Maddox, Thomas M, additional, Masoudi, Frederick A, additional, Tang, Fengming, additional, Jones, Philip G, additional, and Kosiborod, Mikhail, additional

Published
2011
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98. IN-HOSPITAL HEMOGLOBIN A1C TESTING AND ITS RELATION TO INITIATION OF GLUCOSE LOWERING THERAPY IN HYPERGLYCEMIC PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

Author

Stolker, Joshua, primary, Spertus, John A., additional, McGuire, Darren K., additional, Inzucchi, Silvio E., additional, Rathore, Saif S., additional, Maddox, Thomas M., additional, Masoudi, Frederick A., additional, Tang, Fengming, additional, Jones, Philip G., additional, and Kosiborod, Mikhail, additional

Published
2010
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