Functional movement disorders in U.S. veterans: Psychiatric comorbidity and health care utilization

2019 ◽  
Vol 34 (5) ◽  
pp. 755-756 ◽  
Author(s):  
Joel Mack ◽  
Joseph F. Quinn ◽  
Brenna M. Lobb ◽  
Susan O'Connor
2003 ◽  
Vol 43 (1) ◽  
pp. 86-91 ◽  
Author(s):  
M. E. Kunik ◽  
A. L. Snow ◽  
V. A. Molinari ◽  
T. J. Menke ◽  
J. Souchek ◽  
...  

Author(s):  
Charles N Bernstein ◽  
Carol A Hitchon ◽  
Randy Walld ◽  
James M Bolton ◽  
Lisa M Lix ◽  
...  

Abstract Background Inflammatory bowel disease (IBD) is associated with an increase in psychiatric comorbidity (PC) compared with the general population. We aimed to determine the impact of PC on health care utilization in persons with IBD. Methods We applied a validated administrative definition of IBD to identify all Manitobans with IBD from April 1, 2006, to March 31, 2016, and a matched cohort without IBD. A validated definition for PC in IBD population was applied to both cohorts; active PC status meant ≥2 visits for psychiatric diagnoses within a given year. We examined the association of active PC with physician visits, inpatient hospital days, proportion with inpatient hospitalization, and use of prescription IBD medications in the following year. We tested for the presence of a 2-way interaction between cohort and PC status. Results Our study matched 8459 persons with IBD to 40,375 controls. On crude analysis, IBD subjects had ≥3.7 additional physician visits, had >1.5 extra hospital days, and used 2.1 more drug types annually than controls. Subjects with active PC had >10 more physician visits, had 3.1 more hospital days, and used >6.3 more drugs. There was a synergistic effect of IBD (vs no IBD) and PC (vs no PC) across psychiatric disorders of around 4%. This synergistic effect was greatest for anxiety (6% [2%, 9%]). After excluding psychiatry-related visits and psychiatry-related hospital stays, there remained an excess health care utilization in persons with IBD and PC. Conclusion Inflammatory bowel disease with PC increases health care utilization compared with matched controls and compared with persons with IBD without PC. Active PC further increases health care utilization.


2020 ◽  
Vol 158 (6) ◽  
pp. S-9
Author(s):  
Charles N. Bernstein ◽  
Carol Hitchon ◽  
Randy Walld ◽  
Lisa Lix ◽  
Scott Patten ◽  
...  

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A379-A379
Author(s):  
B Al-Shawwa ◽  
E Glynn ◽  
M Hoffman ◽  
Z Ehsan ◽  
D Ingram

Abstract Introduction This study was aimed to identify health care utilization of sleep disorders in pediatrics and adults by using Cerner health facts database. Methods Health facts database has unidentified health records from all the participating facilities that have Cerner as their electronic medical records software. There are 68.7 million patients in the data warehouse with about 506.9 million encounters in about 100 healthcare systems. Sleep disorders are mostly seen in outpatient settings and therefore this study included outpatient records between the years 2010 to 2017. Results There were 20.5 million patients with total of 127.4 million outpatient encounters. In pediatric patients (ages 0-18 years), healthcare utilization of major sleep diagnoses per 100,000 encounters showed sleep related breathing disorders are the most commonly seen followed by parasomnia, insomnia, sleep movement disorders, hypersomnolence then circadian rhythm disorders (820.1, 258.1, 181.6, 68.3, 48.1 and 16.2 per 100,000 encounters). However, for adult patients the ranking was: sleep related breathing disorders, insomnia, sleep related movement disorders, hypersomnolence, parasomnia then circadian rhythm disorders (1352.6, 511.6, 166.3, 79.1, 25.7 and 4.2 per 100,000 encounters). Further analysis for the age groups showed bimodal pattern for sleep related breathing disorders and sleep movement disorders with the highest utilization were between the ages of 2-11 year and 40-60 years. Adolescents (age 12-18 years) showed increase utilization in the areas of circadian rhythm disorders. Conclusion Patients with sleep disorders have relatively low health care utilization despite high prevalence of these sleep disorders in the general population. This may highlight underrecognized sleep problem or decreased access to health care. In addition, this study highlights the effect of age on different sleep disorders which may have an impact on allocating resources. Support None


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