Veterans with diabetes but no recently coded heart disease, older individuals, and African Americans could benefit from programs targeted to introduce LLMs. Up to one third of individuals given LLMs remained above the target level of 130 mg/dL for low-density lipoprotein cholesterol.

The physicians in this sample recognized and implicitly acknowledged suicide risk in their older patients, but all seemed unable to go beyond mere assessment. The absence of clearly articulated treatment plans may reflect a lack of a coherent framework for managing suicide risk, insufficient clinical skills, and availability of mental health specialty support required to address suicide risk effectively. To respond to suicide's numerous challenges to the primary care delivery system, QI strategies will require changes to physician education and may require enhancing practice support.

No abstract

Background/Aims: Payments to hospital providers are not solely driven by the resource requirements of individual patients, but also reflect payment policies specific to the health care payer and hospital provider. For example, Medicare adjusts payments to hospitals according to facility and local geographic characteristics that may not be relevant to studies estimating the associations of individual patient characteristics with true costs of care. We developed a method to estimate hospital costs using the diagnosis related group (DRG) payment weights on which Medicare bases hospital payments that reflect patient medical and surgical acuity. Our purpose was to compare cost estimates for hospital stays calculated using DRG payments weights to actual Medicare hospital payments. Methods: We used Medicare Provider Analysis and Review (MedPAR) files and DRG weight tables linked to participant data from the Study of Osteoporotic Fractures (SOF) from 1992 through 2010. Participants were women age 65 and older recruited in three metropolitan and one rural area of the United States. Standardized hospital costs were estimated using DRG payment weights for 1,397 hospital stays (assigned 182 separate DRG codes) for 795 SOF participants for one year following a hip fracture. Cost estimates based on Medicare payments included Medicare and secondary insurer payments, copay and deductible amounts. Results: The mean (SD) of inpatient DRG-based cost estimates per