COVID-19 Vaccines: Moderna And Pfizer-BioNTech Use Varied By Urban, Rural Counties.

We investigated county-level variation in mRNA COVID-19 vaccine use among Medicare beneficiaries throughout the United States. There was greater use of Pfizer-BioNTech vaccines than Moderna vaccines in urban areas for first and booster doses.

Development and implementation of pharmaceutical care planning software for nursing homes based on the Fleetwood Model.

PURPOSE: The effectiveness of pharmaceutical care planning software for nursing homes and the extent to which the software assisted in the implementation of the Fleetwood Model are described. METHODS: During the study, one long-term-care pharmacy identified 13 nursing homes to participate in the intervention group of a study evaluating the effectiveness of the Fleetwood Model. To successfully implement the Fleetwood Model, which demands prospective drug regimen review and collaborative practices between dispensing and consultant pharmacists, a software system that exchanged information between these pharmacists was deemed necessary. Pharmacists' self-reported assessments of the use of the software and the technical difficulties reported with its use were collected. The number of interventions performed by pharmacist type, the proportion of residents receiving interventions by multiple pharmacists, and the extent to which the interventions were prospective and performed before the mandated 30-day review were estimated from data documented in the software. The consistency of software use by the pharmacists was also estimated. RESULTS: Seventy-one percent of dispensing pharmacists and 40% of consultant pharmacists reported using the software most or all of the time. Fourteen percent of dispensing pharmacists and 40% of consultant pharmacists reported technical difficulties with the software. Over half of newly admitted or readmitted residents received a Fleetwood intervention within 3 days of admittance into the nursing home-71.2% occurred in less than 30 days of admission. CONCLUSION: The use of information technology to increase communication among health care professionals and assist in providing prospective drug regimen review in long-term-care facilities is feasible. Collaboration and extensive field testing with end users, realistic expectations, appropriate training, and technical support are necessary when implementing new technology.

The residential history file: studying nursing home residents' long-term care histories(*).

OBJECTIVE: To construct a data tool, the Residential History File (RHF), that summarizes information from Medicare claims and nursing home (NH) Minimum Data Set (MDS) assessments to track people through health care locations, including non-Medicare-paid NH stays. DATA SOURCES: Online Survey of Certification and Reporting (OSCAR) data for 202 free-standing NHs, Medicare Denominator, claims (parts A and B), and MDS assessments for 60,984 people who were present in one of these NHs in 2006. METHODS: The algorithm creating the RHF is outlined and the RHF for the study data are used to describe place of death. The identification of residents in NHs is compared with the reports in OSCAR and part B claims. PRINCIPAL FINDINGS: The RHF correctly identified 84.8 percent of part B claims with place-of-service in NH, and it identified 18.3 less residents on average than reported in the OSCAR on the day of the survey. The RHF indicated that 17.5 percent non-Medicare NH decedents were transferred to the hospital to die versus 45.6 percent skilled nursing facility decedents. CONCLUSIONS: The population-based design of the RHF makes it possible to conduct policy-relevant research to examine the variation in the rate and type of health care transitions across the United States.