scholarly journals A retrospective database analysis of burden of IPD and pneumonia in children <15y in Veneto region

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Barbieri ◽  
A Cantarutti ◽  
G Porcu ◽  
T Hu ◽  
T Petigara ◽  
...  
Keyword(s):  
Primary Care ◽  
Average Cost ◽  
Disease Burden ◽  
Disease Incidence ◽  
Population Data ◽  
Interrupted Time Series ◽  
Invasive Disease ◽  
Healthcare Resource Utilization ◽  
Incidence Rates ◽  
Regional Population

Abstract Background IPD and pneumonia are associated with high mortality and healthcare resource utilization (HCRU). This analysis assessed incidence, HCRU and costs of IPD and pneumonia following PCV13 introduction in 2010 in Veneto. Methods IPD, unspecified invasive disease episodes, outpatient pneumococcal and unspecified pneumonia episodes were identified in Pedianet, a pediatric primary care database from 2010-2017. HCRU includes primary care and specialist visits, antibiotic prescriptions, diagnostics, ER visits and hospitalizations. Incidence rates (IRs) were numbers of episodes/1,000 person-years. Standardized regional incidence rates (SRIRs) were calculated by standardizing IRs with regional population data by age and year. Regional expenditures (€/1,000 person-years) were calculated by multiplying SRIRs with average costs per episode. Interrupted time series (ITS) analyses assessed trends in annual IRs in the early and late PCV13 (2010-2013, 2014-2017) periods. Results During 2010-2017, IPD and unspecified invasive disease incidence decreased from 0.40 to 0.31/1,000 person-years. While incidence was numerically lower in 2017 than in 2010, ITS analysis did not detect a significant trend in the early (coef=1.97; p = 0.63) or late PCV13 (coef=0.50; p = 0.90) periods. Average cost per episode was €4206 and average regional expenditure was €171/1,000 person-year. SRIR for outpatient pneumonia decreased from 13.35 to 5.48/1,000 person-year during 2010 to 2017. Pneumonia episodes were associated with 0.29 ER visits and 0.15 short stay and 0.06 long stay hospitalization. Average cost per episode was €345, majority of which was associated with ER visits (€50.8) and hospitalizations (€243.9). Regional expenditures decreased from €12852.31 to €5351.98/1,000 person-year. Conclusions IPD and unspecified invasive disease burden did not change significantly following PCV13 introduction, while disease burden declined for outpatient pneumococcal and unspecified pneumonia. Key messages IPD and unspecified invasive disease burden did not change significantly following PCV13 introduction. Disease burden declined for outpatient pneumococcal and unspecified pneumonia following PCV13.

scholarly journals A retrospective database analysis to estimate the burden of AOM in children <15y in Veneto region

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Barbieri ◽  
A Cantarutti ◽  
G Porcu ◽  
T Hu ◽  
T Petigara ◽  
...  
Keyword(s):  
Primary Care ◽  
Acute Otitis Media ◽  
Population Data ◽  
Healthcare Resource Utilization ◽  
Incidence Rates ◽  
Prescription Costs ◽  
Regional Population ◽  
Retrospective Database Analysis ◽  
Care Database ◽  
Retrospective Database

Abstract Background Acute Otitis Media (AOM) causes substantial healthcare resource utilization (HCRU) in children. This analysis assessed AOM HCRU and costs following PCV13 introduction in 2010 in Veneto. Methods AOM episodes in children &lt;15 years residing in Veneto were identified in Pedianet, a pediatric primary care, database from 2010-2017. Recurrent AOM was defined as at least three episodes in 6 months, or four or more episodes in 12 months. HCRU includes primary care visits, antibiotic prescriptions, diagnostic tests, specialist visits, emergency room (ER) visits and hospitalizations. Incidence rates (IRs) were numbers of episodes/1,000 person-years. Standardized regional incidence rates (SRIRs) were calculated by standardizing IRs with regional population data by age and year. Regional expenditures (€/1,000 person-years) were calculated by multiplying SRIRs with average cost per episode. Results Simple AOM episodes were associated with 1.03 primary care visits and 1.52 antibiotic prescriptions on average. Only 2.4% and 0.18% of simple AOM episodes included an ER visit, and a hospitalization respectively. Recurrent AOM episodes were associated with 1.06 primary care visits and 1.62 antibiotic prescriptions. Annual costs per episode were €50 for simple AOM and €54.2 for recurrent AOM, majority of which were associated with primary care visits and antibiotic prescriptions. Average antibiotic prescription costs were €14.2 for simple AOM and €16 for recurrent AOM. During 2010 and 2017, SRIRs declined from 100 to 72/1000 person-year for simple AOM and from 13 to 11/1,000 person-year for recurrent AOM. Regional expenditures decreased from €4702.7 to €3358.5/1,000 person-year for simple AOM and from €672.4 to €572.6/1000 person-year for recurrent AOM. Conclusions SRIRs and regional expenditures declined for simple and recurrent AOM after PCV13 introduction. Primary care visits and antibiotic prescriptions account for the majority of expenditures. Key messages SRIRs and regional expenditures declined for simple and recurrent AOM after PCV13 introduction. Primary care visits and antibiotic prescriptions account for the majority of expenditures.

scholarly journals Using Capture-Recapture Methods to Estimate Local Influenza Hospitalization Incidence Rates

2020 ◽  
Author(s):  
GK Balasubramani ◽  
Mary Patricia Nowalk ◽  
Lloyd G. Clarke ◽  
Jason A. Lyons ◽  
Klancie Dauer ◽  
...  
Keyword(s):  
Disease Burden ◽  
Disease Incidence ◽  
Incidence Rates ◽  
Multiplier Method ◽  
Administrative Databases ◽  
Administrative Database ◽  
Research Database ◽  
Multiple Sources ◽  
Current Season ◽  
Capture Recapture

AbstractBackgroundAccurate population estimates of disease incidence and burden are needed to set appropriate public health policy. The capture-recapture (C-R) method combines data from multiple sources to better estimate prevalence than is possible using single sources. This study used the C-R method to estimate influenza cases using research and administrative databases to calculate county-wide influenza hospitalization burden.MethodsData were derived from a database of clinical virology test results and research data from an influenza vaccine effectiveness study from seasons 2015-2016 to 2018-2019. Missed influenza cases were estimated using C-R method. These estimates were used to calculate disease burden using the multiplier method to correct for underreporting due to curtailing data collection before the end of influenza circulation.ResultsOver all seasons, 422 influenza cases were reported in the administrative database and 382 influenza cases in the research database. Seventy-five cases (18%) reported in the administrative database were not captured in the research database, and 35 (9%) cases in the research database were not captured in the administrative database. Completeness of the influenza hospitalization was estimated to be 76%. Influenza hospitalizations were higher among unvaccinated (32%) than vaccinated (22%) in the current season and among unvaccinated (28%) than vaccinated (23%) in the previous year. The incidence rates for influenza hospitalizations varied by age and season and averaged 421 cases/100,000 population annually.ConclusionThe capture-recapture method offers a more accurate method for estimating influenza hospitalization than relying on a single data source. Using the multiplier method with adjustments improves the detection of influenza disease burden through a matched database. The incidence rates are consistent with national estimates.

Impact of an enhanced antibiotic stewardship on reducing methicillin-resistant Staphylococcus aureus in primary and secondary healthcare settings

2013 ◽  
Vol 142 (3) ◽  
pp. 494-500 ◽  
Author(s):  
M. A. ALDEYAB ◽  
M. G. SCOTT ◽  
M. P. KEARNEY ◽  
Y. M. ALAHMADI ◽  
F. A. MAGEE ◽  
...  
Keyword(s):  
Primary Care ◽  
Staphylococcus Aureus ◽  
High Risk ◽  
Hospital Setting ◽  
Interrupted Time Series ◽  
Antibiotic Use ◽  
Incidence Rates ◽  
Methicillin Resistant ◽  
Trend Coefficient ◽  
The Impact

SUMMARYThe objective of this study was to evaluate the impact of restricting high-risk antibiotics on methicillin-resistant Staphylococcus aureus (MRSA) incidence rates in a hospital setting. A secondary objective was to assess the impact of reducing fluoroquinolone use in the primary-care setting on MRSA incidence in the community. This was an interventional, retrospective, ecological investigation in both hospital and community (January 2006 to June 2010). Segmented regression analysis of interrupted time-series was employed to evaluate the intervention. The restriction of high-risk antibiotics was associated with a significant change in hospital MRSA incidence trend (coefficient = −0·00561, P = 0·0057). Analysis showed that the intervention relating to reducing fluoroquinolone use in the community was associated with a significant trend change in MRSA incidence in community (coefficient = −0·00004, P = 0·0299). The reduction in high-risk antibiotic use and fluoroquinolone use contributed to both a reduction in incidence rates of MRSA in hospital and community (primary-care) settings.

Work-related Musculoskeletal Disorders in Emergency Medical Personnel

2020 ◽  
pp. 42-45
Author(s):  
L.M. Karamova ◽  
V.O. Krasovskiy ◽  
D.M. Vagapova ◽  
N.V. Vlasova ◽  
A.S. Khafizova ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Musculoskeletal Disorders ◽  
Disease Incidence ◽  
Medical Personnel ◽  
Incidence Rates ◽  
Connective Tissue Disorders ◽  
Ambulance Personnel ◽  
Occupational Risk Factors ◽  
Emergency Medical ◽  
Emergency Medical Personnel

Relevance. The importance of studying and analyzing contribution of occupational risk factors in musculoskeletal disorders among emergency medical personnel is related to high disease incidence rates and work specifics. The objective of our research envisaged formalization of information obtained for the analysis and assessment of occupational risks of developing musculoskeletal and connective tissue disorders in ambulance personnel. Results. According to professional medical examination results, musculoskeletal and connective tissue disorders ranked second among all diagnosed diseases. The relative risk of developing those disorders was 70% indicating the link between them and transport vibration (category 1) affecting the backbone during long trips in ambulance cars.

scholarly journals Correction to: Measuring the impact of the Afordable Care Act Medicaid expansion on access to primary care using an interrupted time series approach

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Elizabeth A. Brown ◽  
Brandi M. White ◽  
Walter J. Jones ◽  
Mulugeta Gebregziabher ◽  
Kit N. Simpson
Keyword(s):  
Primary Care ◽  
Time Series ◽  
Interrupted Time Series ◽  
Medicaid Expansion ◽  
Time Series Approach ◽  
Access To Primary Care ◽  
The Impact

An amendment to this paper has been published and can be accessed via the original article.

scholarly journals Epidemiology of West Nile Virus Infections in Humans, Italy, 2012–2020: A Summary of Available Evidences

2021 ◽  
Vol 6 (2) ◽  
pp. 61
Author(s):  
Matteo Riccò ◽  
Simona Peruzzi ◽  
Federica Balzarini
Keyword(s):  
West Nile Virus ◽  
Age Groups ◽  
Invasive Disease ◽  
Incidence Rates ◽  
Annual Incidence ◽  
Virus Infections ◽  
West Nile ◽  
Po River ◽  
Air Temperatures ◽  
Sex Risk

In Italy, human cases of West Nile virus (WNV) infection have been recorded since 2008, and seasonal outbreaks have occurred almost annually. In this study, we summarize available evidences on the epidemiology of WNV and West Nile neuro-invasive disease (WNND) in humans reported between 2012 and 2020. In total, 1145 WNV infection cases were diagnosed; of them 487 (42.5%) had WNND. A significant circulation of the pathogen was suggested by studies on blood donors, with annual incidence rates ranging from 1.353 (95% confidence intervals (95% CI) 0.279–3.953) to 19.069 cases per 100,000 specimens (95% CI 13.494–26.174). The annual incidence rates of WNND increased during the study period from 0.047 cases per 100,000 (95% CI 0.031–0.068) in 2012, to 0.074 cases per 100,000 (95% CI 0.054–0.099) in 2020, peaking to 0.377 cases per 100,000 (95% CI 0.330–0.429) in 2018. There were 60 deaths. Cases of WNND were clustered in Northern Italy, particularly in the Po River Valley, during the months of August (56.7%) and September (27.5%). Higher risk for WNND was reported in subjects of male sex (risk ratio (RR) 1.545, 95% CI 1.392–1.673 compared to females), and in older age groups (RR 24.46, 95% CI 15.61–38.32 for 65–74 y.o.; RR 43.7, 95% CI 28.33–67.41 for subjects older than 75 years), while main effectors were identified in average air temperatures (incidence rate ratio (IRR) 1.3219, 95% CI 1.0053–1.7383), population density (IRR 1.0004, 95% CI 1.0001–1.0008), and occurrence of cases in the nearby provinces (IRR 1.0442, 95% CI 1.0340–1.0545). In summary, an enhanced surveillance is vital for the early detection of human cases and the prompt implementation of response measures.

scholarly journals The Epidemiology of Infantile Spasms

2001 ◽  
Vol 28 (4) ◽  
pp. 309-312 ◽  
Author(s):  
P.M. Brna ◽  
K.E. Gordon ◽  
J.M. Dooley ◽  
E.P. Wood
Keyword(s):  
Prince Edward Island ◽  
Disease Incidence ◽  
Population Based ◽  
Epidemiologic Studies ◽  
Incidence Rates ◽  
Infantile Spasms ◽  
Clinical Impression ◽  
Birth Cohorts ◽  
Marked Variability ◽  
Canadian Provinces

Objective:The aim of this study was to estimate population based incidence rates for infantile spasms (IS) and to study our clinical impression that the incidence of IS has recently decreased in the Canadian Provinces of Nova Scotia and Prince Edward Island.Methods:Birth cohorts from 1978 to 1998, identified through the hospital health records, EEG records and physician computerized databases, were followed for two years for the development of IS. Disease incidence rates were calculated using denominators derived from Statistics Canada's reported annual live birth rates.Results:The inclusion criteria for IS were fulfilled by 75 patients. The overall incidence of IS was 30.7/100,000 live births (95% CI 24.3, 38.8). Etiologic classification was symptomatic for 51 cases (68%), cryptogenic for 18 (24%), and idiopathic in six children (8%). Although there were more males (N=44) than females (N=31), the incidence rates were similar. There was a marked variability in annual and five-year incidence rates.Conclusion:Although the clinical characteristics of our patients were similar to other reported IS populations, the instability in IS incidence rates indicates a need for caution in interpreting smaller IS epidemiologic studies.

scholarly journals Tyrosine Kinase Inhibitor Induced Isolated Pericardial Effusion

2015 ◽  
Vol 8 (1) ◽  
pp. 88-93 ◽  
Author(s):  
Vineet Agrawal ◽  
Eric S. Christenson ◽  
Margaret M. Showel
Keyword(s):  
Primary Care ◽  
Pericardial Effusion ◽  
Tyrosine Kinase ◽  
Kinase Inhibitor ◽  
Early Recognition ◽  
Primary Care Providers ◽  
Incidence Rates ◽  
Term Therapy ◽  
Care Providers

Long-term therapy with tyrosine kinase inhibitors (TKI) has resulted in improved outcomes for patients suffering from Bcr-Abl fusion protein-harboring leukemias. As a result, a growing population of patients on TKI therapy present to their primary care providers. In this case, we report on the case of a 62-year-old male who presented with a symptomatic pericardial effusion. After pericardiocentesis, malignancy and infectious etiologies were excluded. The pericardial effusion was attributed to his TKI, with a transition of this medication to a different TKI. A repeat evaluation 1 month following the withdrawal of the offending agent showed no recurrence of his pericardial effusion on echocardiogram. In this report, we will highlight a rare but important side effect of TKI therapy before discussing its purported mechanisms and differing incidence rates. Early recognition of serosal inflammation related to long-term TKI therapy by primary care providers is important in preventing patient morbidity and mortality.

scholarly journals Effectiveness and cost-effectiveness of implementing HIV testing in primary care in East London: protocol for an interrupted time series analysis

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e018163 ◽  
Author(s):  
Werner Leber ◽  
Lee Beresford ◽  
Claire Nightingale ◽  
Estela Capelas Barbosa ◽  
Stephen Morris ◽  
...  
Keyword(s):  
Primary Care ◽  
Time Series ◽  
General Practice ◽  
Cost Effectiveness ◽  
Hiv Testing ◽  
Cost Effective ◽  
Interrupted Time Series ◽  
Rapid Hiv Testing ◽  
Post Trial ◽  
Implementation Programme

IntroductionHIV remains underdiagnosed. Guidelines recommend routine HIV testing in primary care, but evidence on implementing testing is lacking. In a previous study, the Rapid HIV Assessment 2 (RHIVA2) cluster randomised controlled trial, we showed that providing training and rapid point-of-care HIV testing at general practice registration (RHIVA2 intervention) in Hackney led to cost-effective, increased and earlier diagnosis of HIV. However, interventions effective in a trial context may be less so when implemented in routine practice. We describe the protocol for an MRC phase IV implementation programme, evaluating the impact of rolling out the RHIVA2 intervention in a post-trial setting. We will use a longitudinal study to examine if the post-trial implementation in Hackney practices is effective and cost-effective, and a cross-sectional study to compare Hackney with two adjacent boroughs providing usual primary care (Newham) and an enhanced service promoting HIV testing in primary care (Tower Hamlets).Methods and analysisService evaluation using interrupted time series and cost-effectiveness analyses. We will include all general practices in three contiguous high HIV prevalence East London boroughs. All adults aged 16 and above registered with the practices will be included. The interventions to be examined are: a post-trial RHIVA2 implementation programme (including practice-based education and training, external quality assurance, incentive payments for rapid HIV testing and incorporation of rapid HIV testing in the sexual health Local Enhanced Service) in Hackney; the general practice sexual health Network Improved Service in Tower Hamlets and usual care in Newham. Coprimary outcomes are rates of HIV testing and new HIV diagnoses.Ethics and disseminationThe chair of the Camden and Islington NHS Research Ethics Committee, London, has endorsed this programme as an evaluation of routine care. Study results will be published in peer-reviewed journals and reported to commissioners.

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