An Investigation of Medical Expenditures in Hospitals and Clinics Using Propensity Scores

Author(s):  
Noriko Ishikawa ◽  
Mototsugu Fukushige
Author(s):  
Anja Hildebrand ◽  
Heinz C. Vollmer ◽  
Julia Domma-Reichart
Keyword(s):  

Zusammenfassung. Hintergrund: In Deutschland liegen nur vereinzelte Studien zur PTBS-Prävalenzquote bei Suchtpatienten und zu deren psychischen Befund vor. Fragestellung: Wie hoch ist die relative Häufigkeit einer PTBS bei Patienten mit substanzbezogenen Störungen und wie unterscheiden sich die Patienten mit und ohne PTBS hinsichtlich klinischer und psychosozialer Charakteristika? Methode: Mittels Chi-Quadrat- und t-Tests wurden 376 mittels Propensity Scores gematchte Patienten aus einer Stichprobe von 4105 konsekutiv aufgenommenen Abhängigen in diagnostischen und psychischen Merkmalen retrospektiv miteinander verglichen. Ergebnisse: Die relative Häufigkeit von PTBS lag bei den Patienten mit einer alkoholbezogenen Störung bei 3,8 %, bei den restlichen Suchtpatienten mit Störungen durch andere psychotrope Substanzen bei 10,5 %. Bei den PTBS Patienten lag häufiger eine Persönlichkeitsstörung vor. Außerdem waren die PTBS Patienten stärker psychisch belastet, in ihrem Interaktionsstil abweisender, introvertierter, und nachgiebiger sowie im Bindungsstil vermeidender. Schlussfolgerungen: Die Unterschiede verdeutlichen die Notwendigkeit von auf den Interaktions- und Bindungsstil individuell angepassten Interventionen im Rahmen der Standardbehandlungen für Suchtpatienten mit PTBS.


2008 ◽  
Vol 24 (3) ◽  
pp. 165-173 ◽  
Author(s):  
Niko Kohls ◽  
Harald Walach

Validation studies of standard scales in the particular sample that one is studying are essential for accurate conclusions. We investigated the differences in answering patterns of the Brief-Symptom-Inventory (BSI), Transpersonal Trust Scale (TPV), Sense of Coherence Questionnaire (SOC), and a Social Support Scale (F-SoZu) for a matched sample of spiritually practicing (SP) and nonpracticing (NSP) individuals at two measurement points (t1, t2). Applying a sample matching procedure based on propensity scores, we selected two sociodemographically balanced subsamples of N = 120 out of a total sample of N = 431. Employing repeated measures ANOVAs, we found an intersample difference in means only for TPV and an intrasample difference for F-SoZu. Additionally, a group × time interaction effect was found for TPV. While Cronbach’s α was acceptable and comparable for both samples, a significantly lower test-rest-reliability for the BSI was found in the SP sample (rSP = .62; rNSP = .78). Thus, when researching the effects of spiritual practice, one should not only look at differences in means but also consider time stability. We recommend propensity score matching as an alternative for randomization in variables that defy experimental manipulation such as spirituality.


Author(s):  
Ryoung Choi ◽  
◽  
Ji Eun Park ◽  
Keyword(s):  

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Maiko Kokubu ◽  
Masaru Matsui ◽  
Takayuki Uemura ◽  
Katsuhiko Morimoto ◽  
Masahiro Eriguchi ◽  
...  

Abstract Peritonitis is a critical complication of peritoneal dialysis (PD). Investigators have reported the risk of peritonitis in patients on continuous ambulatory peritoneal dialysis (CAPD) versus automated peritoneal dialysis (APD), but the available evidence is predominantly based on observational studies which failed to report on the connection type. Our understanding of the relationship between peritonitis risk and PD modality thus remained insufficient. We studied 285 participants who began PD treatment between 1997 and 2014 at three hospitals in Nara Prefecture in Japan. We matched 106 APD patients with 106 CAPD patients based on their propensity scores. The primary outcome was time to first episode of peritonitis within 3 years after PD commencement. In total, PD peritonitis occurred in 64 patients during the study period. Patients initiated on APD had a lower risk of peritonitis than did those initiated on CAPD in both the unadjusted and adjusted models. The hazard ratio (HR) and 95% confidence interval (CI) for the primary endpoint were 0.30 (0.17–0.53) in the fully adjusted model including connection type. In the matched cohort, APD patients had a significantly lower risk of peritonitis than did CAPD patients (log-rank: p < 0.001, HR 0.32, 95% CI 0.16–0.59). The weighting-adjusted analysis of the inverse probability of treatment yielded a similar result (HR 0.35, 95% CI 0.18–0.67). In conclusion, patients initiated on APD at PD commencement had a reduced risk of peritonitis compared with those initiated on CAPD, suggesting APD may be preferable for prevention of peritonitis among PD patients.


2020 ◽  
pp. 1-10
Author(s):  
Jeremy S. Ruthberg ◽  
Chandruganesh Rasendran ◽  
Armine Kocharyan ◽  
Sarah E. Mowry ◽  
Todd D. Otteson

BACKGROUND: Vertigo and dizziness are extremely common conditions in the adult population and therefore place a significant social and economic burden on both patients and the healthcare system. However, limited information is available for the economic burden of vertigo and dizziness across various health care settings. OBJECTIVE: Estimate the economic burden of vertigo and dizziness, controlling for demographic, socioeconomic, and clinical comorbidities. METHODS: A retrospective analysis of data from the Medical Expenditures Panel Survey (2007–2015) was performed to analyze individuals with vertigo or dizziness from a nationally representative sample of the United States. Participants were included via self-reported data and International Classification of Diseases, 9th Revision Clinical Modification codes. A cross-validated 2-component generalized linear model was utilized to assess vertigo and dizziness expenditures across demographic, socioeconomic and clinical characteristics while controlling for covariates. Costs and utilization across various health care service sectors, including inpatient, outpatient, emergency department, home health, and prescription medications were evaluated. RESULTS: Of 221,273 patients over 18 years, 5,275 (66% female, 34% male) reported either vertigo or dizziness during 2007–2015. More patients with vertigo or dizziness were female, older, non-Hispanic Caucasian, publicly insured, and had significant clinical comorbidities compared to patients without either condition. Furthermore, each of these demographic, socioeconomic, and clinical characteristics lead to significantly elevated costs due to having these conditions for patients. Significantly higher medical expenditures and utilization across various healthcare sectors were associated with vertigo or dizziness (p <  0.001). The mean incremental annual healthcare expenditure directly associated with vertigo or dizziness was $2,658.73 (95% CI: 1868.79, 3385.66) after controlling for socioeconomic and demographic characteristics. Total annual medical expenditures for patients with dizziness or vertigo was $48.1 billion. CONCLUSION: Vertigo and dizziness lead to substantial expenses for patients across various healthcare settings. Determining how to limit costs and improve the delivery of care for these patients is of the utmost importance given the severe morbidity, disruption to daily living, and major socioeconomic burden associated with these conditions.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 408-408
Author(s):  
Si Young Song ◽  
Hey Jung Jun ◽  
Sun Ah Lee

Abstract The purpose of this study is to explore the effect of employment on depression and life satisfaction among old-aged. Using 12th (2017) wave and 13th (2018) wave of Korean Welfare Panel Study (KoWePS), three stages of analyses were conducted. First, through propensity score matching (PSM) method, sample with similar propensity scores was matched between the group that did not work in 12th wave but worked in 13th wave (experimental group, N=180), and the group that did not work in 12th and 13th wave (comparative group, N=180). Second, the matched sample was used to conduct multiple regression analysis with the group dummy variable (experimental group, comparative group) as an independent variable, and depression and life satisfaction as the dependent variables. Third, combined model of propensity score matching (PSM) and double difference (DD) method was conducted to more appropriately derive the net effect of employment. The results of multiple regression after propensity matching showed that employment had a positive effect on reducing depression (B= -1.70, p&lt; .01) and increasing life satisfaction (B= .12, p&lt; .01) in old-aged. Furthermore, in combined model of PSM and DD, life satisfaction was improved when employed compared to non-employed (B= .15, p&lt; .05). The results of this study are meaningful in that the meaning of employment in old-aged is more clearly derived by solving selection bias and endogenous problems. Also, this study may provide reference for establishing welfare policies related to employment among old-aged.


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