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We determined whether adherence to recommendations for coronary angiography more than 12 h after symptom onset but prior to hospital discharge after acute myocardial infarction (AMI) resulted in better survival. Using propensity scores, we created a matched retrospective sample of 19,568 Medicare patients hospitalized with AMI during 1994-1995 in the United(More)
1 During the past two decades, several public and private organizations have initiated programs to report publicly on the quality of medical care provided by specific hospitals and physicians. These programs have sparked broad debate among economists and policy makers. At issue is the question of whether, and to what extent, these " report card " programs(More)
BACKGROUND The outcome after myocardial infarction may be influenced by the type of physician providing ambulatory care. METHODS We studied 35,520 patients 65 years of age or older who were hospitalized for myocardial infarction in seven states during 1994 and 1995 and who survived for at least three months after discharge. From Medicare claims, we(More)
Seven provider organizations in Massachusetts entered the Blue Cross Blue Shield Alternative Quality Contract in 2009, followed by four more organizations in 2010. This contract, based on a global budget and pay-for-performance for achieving certain quality benchmarks, places providers at risk for excessive spending and rewards them for quality, similar to(More)
BACKGROUND Recently observed trends toward increasingly aggressive end-of-life care may reflect providers' concerns that hospice may hasten death. METHODS Using the Surveillance, Epidemiology, and End Results-Medicare linked database, we identified 7879 patients aged 65 years or older who died of advanced non-small-cell lung cancer from 1991 through 1999(More)
OBJECTIVES To assess the physical and mental health status of older long-term cancer survivors. DESIGN Cohort study using propensity score methods to control for baseline differences between cancer survivors and controls. SETTING General community population in the United States. PARTICIPANTS Nine hundred sixty-four cancer patients who had survived(More)
PURPOSE To characterize the aggressiveness of end-of-life cancer treatment for older adults on Medicare, and its relationship to the availability of healthcare resources. PATIENTS AND METHODS We analyzed Medicare claims of 28,777 patients 65 years and older who died within 1 year of a diagnosis of lung, breast, colorectal, or other gastrointestinal cancer(More)
PURPOSE We examined the health-related quality of life (QOL) of a cohort of older women with breast cancer after their diagnosis. PATIENTS AND METHODS Six hundred ninety-one women aged 65 years and older were interviewed approximately 3 months after breast cancer surgery and two additional times in the following year using standardized QOL measures.(More)
OBJECTIVE To evaluate measures that could use existing administrative data to assess the intensity of end-of-life cancer care. METHODS Benchmarking standards and statistical variation were evaluated using Medicare claims of 48,906 patients who died from cancer from 1991 through 1996 in 11 regions of the United States. We assessed accuracy by comparing(More)