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Healthcare risk adjustment

Rajkumar Bharatia, Manoj Chitale, Ganesh Narain Saxena, Raman Ganesh Kumar, Chikkalingaiah, Abhijit Trailokya, Kalpesh Dalvi, Suhas Talele
INTRODUCTION: Hypertension (HTN), being a major risk factor for cardiovascular diseases (CVDs), is an important issue of medical and public health. High blood pressure (BP) is ranked as the third most important risk factor for attributable burden of disease in south Asia (2010). Hypertension (HTN) exerts a substantial public health burden on cardiovascular health status and healthcare systems in India. Uncontrolled hypertension among adults with hypertension is associated with increased mortality...
July 2016: Journal of the Association of Physicians of India
Chun-Che Huang, Yu-Tung Huang, Ming-Ping Wu
OBJECTIVE: Limited information is available on health issues during pregnancy and after childbirth among nurses, especially on a nationwide level. This study thus aimed to compare antenatal and perinatal complications between nurses and nonmedical working women in Taiwan. MATERIALS AND METHODS: This nationwide population-based study was conducted using data from the Taiwan National Health Insurance Research Database. A total of 44,166 nurses and 442,107 nonmedical working women with full-time employment, aged 20-50 years, who gave birth to singletons were identified between 2007 and 2011...
October 2016: Taiwanese Journal of Obstetrics & Gynecology
Heloise Buys, Rudzani Muloiwa, Colleen Bamford, Brian Eley
BACKGROUND: Klebsiella pneumoniae (KP) is a significant paediatric bloodstream pathogen in children. There is little data from Africa. In this study we describe the epidemiology of multi-drug resistant Klebsiella pneumoniae bloodstream infection (KPBSI) at Red Cross War Memorial Children's Hospital, Cape Town, South Africa. METHODS: We conducted a retrospective cross-sectional study of KPBSI from 1 January 2006 to 31 December 2011 using conventional descriptive and inferential statistical methods...
October 17, 2016: BMC Infectious Diseases
Julia L Marcus, Roger Baxter, Wendy A Leyden, Dharushana Muthulingam, Arnold Yee, Michael A Horberg, Daniel B Klein, William J Towner, Chun R Chao, Charles P Quesenberry, Michael J Silverberg
It is unclear whether HIV-infected individuals remain at higher risk of invasive pneumococcal disease (IPD) compared with HIV-uninfected individuals. We conducted a cohort study of HIV-infected and demographically matched HIV-uninfected adults within Kaiser Permanente Northern California during the period 1996-2011. We used Poisson models to obtain rate ratios (RRs) for incident IPD associated with HIV infection and other risk factors. Among 13,079 HIV-infected and 137,643 HIV-uninfected adults, the IPD rate per 100,000 person-years was 160 (n = 109 events) for HIV-infected and 8 (n = 75 events) for HIV-uninfected subjects, with an adjusted RR of 13...
October 2016: AIDS Patient Care and STDs
Kourtney J Davis, David Hinds, Stephen P Motsko, Earl Goehring, Judith K Jones
PURPOSE: Our objective was to highlight the importance of database selection in observational research and to determine the incidence of corticosteroid-related events in patients exposed to fluticasone propionate intranasal spray (FPNS) compared with other intranasal steroids (INS). METHODS: After a feasibility study using an electronic medical record database in the UK (1990-2002), a retrospective cohort study was conducted using a large administrative claims database in the USA from 1994 to 2002 comparing the incidence and rate ratios of steroid-related events among intermittent, sub-chronic, and chronic FPNS use and other INS use episodes...
March 2016: Drugs—Real World Outcomes
Suliman Alghnam, Glen H Tinkoff, Renan Castillo
BACKGROUND: Repeated injuries, as known as injury recidivism, pose a significant burden on population health and healthcare settings. Therefore, identifying those at risk of recidivism can highlight targeted populations for primary prevention in order to improve health and reduce healthcare expenditures. There has been limited research on factors associated with recidivism in the U.S. Using a population-based sample, we aim to: 1) identify the prevalence and risk factors for injury recidivism among non-institutionalized adults; 2) investigate the trend in nationwide recidivism rates over time...
December 2016: Injury Epidemiology
Mary Adams
BACKGROUND: Limited study has been done on proxy responses for non-respondents with subjective cognitive decline (SCD) on the Behavioral Risk Factor Surveillance System (BRFSS). OBJECTIVE: To directly compare results for survey respondents with SCD with those for proxies provided for non-respondents with SCD. METHODS: Publicly available 2011 BRFSS data from 120,485 households in 21 states were analyzed using Stata. Respondents ages 40 and older with SCD (n = 10,831) were compared with proxy responses for non-respondents ages 40 and older with SCD (n = 4296) living in households where the respondent did not have SCD...
September 13, 2016: Disability and Health Journal
Marios K Georgakis, Maria A Karalexi, Eleni I Kalogirou, Anton Ryzhov, Anna Zborovskaya, Nadya Dimitrova, Sultan Eser, Luis Antunes, Mario Sekerija, Tina Zagar, Joana Bastos, Domenic Agius, Margareta Florea, Daniela Coza, Evdoxia Bouka, Charis Bourgioti, Helen Dana, Emmanuel Hatzipantelis, Maria Moschovi, Savvas Papadopoulos, Georgios Sfakianos, Evgenia Papakonstantinou, Sophia Polychronopoulou, Spyros Sgouros, Kalliopi Stefanaki, Eftichia Stiakaki, Katerina Strantzia, Basilios Zountsas, Apostolos Pourtsidis, Eustratios Patsouris, Eleni Th Petridou
Pilocytic astrocytomas (PA) comprise the most common childhood central nervous system (CNS) tumor. Exploiting registry-based data from Southern and Eastern Europe (SEE) and SEER, US, we opted to examine incidence, time trends, survival and tentative outcome disparities of childhood PA by sociodemographic and clinical features. Childhood PA were retrieved from 12 SEE registries (N = 552; 1983-2014) and SEER (N = 2723; 1973-2012). Age-standardized incidence rates (ASR) were estimated and survival was examined via Kaplan-Meier and Cox regression analysis...
October 14, 2016: Journal of Neuro-oncology
M Yoshimura, K Moriwaki, S Noto, T Takiguchi
: Although an osteoporosis screening program has been implemented as a health promotion project in Japan, its cost-effectiveness has yet to be elucidated fully. We performed a cost-effectiveness analysis and found that osteoporosis screening and treatment would be cost-effective for Japanese women over 60 years. INTRODUCTION: The purpose of this study was to estimate the cost-effectiveness of osteoporosis screening and drug therapy in the Japanese healthcare system for postmenopausal women with no history of fracture...
October 14, 2016: Osteoporosis International
Steven A Sumner, Matthew J Maenner, Christina M Socias, James A Mercy, Paul Silverman, Sandra P Medinilla, Steven S Martin, Likang Xu, Susan D Hillis
INTRODUCTION: Accurately identifying youth at highest risk of firearm violence involvement could permit delivery of focused, comprehensive prevention services. This study explored whether readily available city and state administrative data covering life events before youth firearm violence could elucidate patterns preceding such violence. METHODS: Four hundred twenty-one individuals arrested for homicide, attempted homicide, aggravated assault, or robbery with a firearm committed in Wilmington, Delaware, from January 1, 2009 to May 21, 2014, were matched 1:3 to 1,259 Wilmington resident controls on birth year and sex...
September 8, 2016: American Journal of Preventive Medicine
Cheng Liu, Chien-Cheng Huang, Chien-Chin Hsu, Hung-Jung Lin, How-Ran Guo, Shih-Bin Su, Jhi-Joung Wang, Shih-Feng Weng
There is no study about cervical herniated intervertebral disc (cervical HIVD) in physicians in the literature; therefore, we conceived a retrospective nationwide, population-based cohort study to elucidate the topic. We identified 26,038 physicians, 33,057 non-physician healthcare providers (HCPs), and identical numbers of non-HCP references (i.e., general population). All cohorts matched a 1:1 ratio with age and gender, and each were chosen from the Taiwan National Health Insurance Research Database (NHIRD)...
October 2016: Medicine (Baltimore)
Lars T Fadnes, Kathy Ainul Møen, Esperanza Diaz
OBJECTIVES: Health status, disease spectrum and use of healthcare have been reported to vary across groups of migrants and according to the different phases of migration. However, most studies are conducted among adults. This study assesses usage of primary healthcare (PHC) by children with immigrant background compared with non-immigrant children in Norway and describes their relative morbidity burden. DESIGN: Population-based retrospective cohort study. SETTING: This study used 3 linked population-based registers in Norway for children under 18 years of age in 2008...
October 13, 2016: BMJ Open
Jeng-Dau Tsai, I-Chung Wang, Hsuan-Ju Chen, Ji-Nan Sheu, Tsai-Chung Li, Henry J Tsai, Chang-Ching Wei
Attention-deficit/hyperactivity disorder (ADHD) and nocturnal enuresis are common disorders with extensive psychosocial suffering in affected children, and healthcare burden on parents. Whether the childhood psychological disorders and nocturnal enuresis are factors contributing to ADHD have not been clearly established. This study conducted a population-based case-control study using data sets from the National Health Research Insurance database, and identified 14 900 children diagnosed with ADHD. Risk factors that have been associated with or possibly related to ADHD development were included in this study...
October 12, 2016: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
Edward Roddy, Kelvin P Jordan, Raymond Oppong, Ying Chen, Sue Jowett, Peter Dawes, Samantha L Hider, Jon Packham, Kay Stevenson, Irena Zwierska, Elaine M Hay
OBJECTIVES: To determine (1) reconsultation frequency, (2) change in self-reported health status, (3) baseline factors associated with reconsultation and change in health status and (4) associated healthcare costs and quality-adjusted life-years (QALYs), following assessment at a musculoskeletal Clinical and Assessment Treatment Service (CATS). DESIGN: Prospective cohort study. SETTING: Single musculoskeletal CATS at the primary-secondary care interface...
October 12, 2016: BMJ Open
Marilyn L Moy, Michael K Gould, In-Lu Amy Liu, Janet S Lee, Huong Q Nguyen
The independent relationship between physical inactivity and risk of death after an index chronic obstructive pulmonary disease (COPD) hospitalisation is unknown. We conducted a retrospective cohort study in a large integrated healthcare system. Patients were included if they were hospitalised for COPD between January 1, 2011 and December 31, 2011. All-cause mortality in the 12 months after discharge was the primary outcome. Physical activity, expressed as self-reported minutes of moderate to vigorous physical activity (MVPA), was routinely assessed at outpatient visits prior to hospitalisation...
January 2016: ERJ Open Research
Irina Odnoletkova, Dirk Ramaekers, Frank Nobels, Geert Goderis, Bert Aertgeerts, Lieven Annemans
BACKGROUND: People with diabetes have a high risk of developing micro- and macrovascular complications associated with diminished life expectancy and elevated treatment costs. Patient education programs can improve diabetes control in the short term, but their cost-effectiveness is uncertain. Our study aimed to analyze the lifelong cost-effectiveness of a nurse-led telecoaching program compared to usual care in people with type 2 diabetes from the perspective of the Belgian healthcare system...
2016: PloS One
Louisa G Gordon, Robbie James, Haitham W Tuffaha, Anthony Lowe, John Yaxley
PURPOSE: To evaluate the cost-effectiveness of multiparametric magnetic resonance imaging (mpMRI) to diagnose prostate cancer and direct all low-risk patients into active surveillance (AS). MATERIALS AND METHODS: A Markov cohort model was developed to assess three scenarios: 1) no mpMRI and current AS; 2) mpMRI and current AS; and 3) mpMRI and increased AS. Men were tracked from diagnosis to end-of-life. Estimates to populate the model were derived from systematic reviews, meta-analyses, epidemiological publications, and national cost reports...
October 11, 2016: Journal of Magnetic Resonance Imaging: JMRI
C Klop, T P van Staa, C Cooper, N C Harvey, F de Vries
: One-year mortality following a fracture was greater for men compared to women, varied markedly between regions in England with the lowest rates in the London region, and was higher among black women compared to white women. The excess in mortality did not change during the study period. INTRODUCTION: Fractures are associated with increased mortality. With the shift towards an increasingly elderly demography, and so increasing numbers of fractures, the impact of such events on mortality is of key public health importance...
October 8, 2016: Osteoporosis International
Éva Belicza, Péter Mihalicza, Judit Lám, Cecília Surján
The European Health Care Outcomes, Performance and Efficiency research was financed by the European Union between 2010 and 2013. In this program a new methodology was developed which made the analysis of regularly collected data and international benchmarking of the healthcare results of 5 socially and economically critical diagnosis group between the 7 participant countries possible. This paper presents the most important areas of the development, such as (1) the principles of the methodology, (2) the definition of available databases, code systems, (3) the events to be analysed, (4) the general rules of analyses and indicator development, (5) the exact methodology of data collection, processing, and analysis, (6) the methods of risk adjustment, (7) and the development of the standardised database...
October 2016: Orvosi Hetilap
Sanjay Basu, Vishnu Shankar, John S Yudkin
BACKGROUND: Optimal prescription of blood pressure, lipid, and glycaemic control treatments for adults with type 2 diabetes remains unclear. We aimed to compare the effectiveness and cost-effectiveness of two treatment approaches for diabetes management in five low-income and middle-income countries. METHODS: We developed a microsimulation model to compare a treat-to-target (TTT) strategy, aiming to achieve target levels of biomarkers (blood pressure <130/80 mm Hg, LDL <2·59 mmol/L, and HbA1c <7% [ie, 53·0 mmol/mol]), with a benefit-based tailored treatment (BTT) strategy, aiming to lower estimated risk for complications (to a 10 year cardiovascular risk <10% and lifetime microvascular risk <5%) on the basis of age, sex, and biomarker values...
October 4, 2016: Lancet Diabetes & Endocrinology
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