scholarly journals Prediction of medical expenditures of diagnosed diabetics and the assessment of its related factors using a random forest model, MEPS 2000–2015

2020 ◽  
Vol 32 (2) ◽  
pp. 99-112
Author(s):  
Jing Wang ◽  
Leiyu Shi
Keyword(s):  
Random Forest ◽  
Medical Expenditure Panel Survey ◽  
Age Groups ◽  
Correlation Coefficients ◽  
Absolute Error ◽  
Cross Sectional Study ◽  
Medical Expenditures ◽  
Medical Expenditure ◽  
Related Factors ◽  
Cross Sectional

Abstract Objective To predict the medical expenditures of individual diabetics and assess the related factors of it. Design and setting Cross-sectional study. Setting and participants Data were collected from the US household component of the medical expenditure panel survey, 2000–2015. Main outcome measure Random forest (RF) model was performed with the programs of randomForest in R software. Spearman correlation coefficients (rs), mean absolute error (MAE) and mean-related error (MRE) was computed to assess the prediction of all the models. Results Total medical expenditure was increased from $105 Billion in 2000 to $318 Billion in 2015. rs, MAE and MRE between the predicted and actual values of medical expenditures in RF model were 0.644, $0.363 and 0.043%. Top one factor in prediction was being treated by the insulin, followed by type of insurance, employment status, age and economical level. The latter four variables had no impact in predicting of medical expenditure by being treated by the insulin. Further, after the sub-analysis of gender and age-groups, the evaluating indicators of prediction were almost identical to each other. Top five variables of total medical expenditure among male were same as those among all the diabetics. Expenses for doctor visits, hospital stay and drugs were also predicted with RF model well. Treatment with insulin was the top one factor of total medical expenditure among female, 18-, 25- and 65-age-groups. Additionally, it indicated that RF model was little superior to traditional regression model. Conclusions RF model could be used in prediction of medical expenditure of diabetics and assessment of its related factors well.

Comparison of Health Care Expenditures Among U.S. Older Adults With Pain Who Reported Frequent Exercise Versus Nonfrequent Exercise

2021 ◽  
pp. 1-9
Author(s):  
David R. Axon ◽  
Jonathan Chien ◽  
Hanh Dinh
Keyword(s):  
Health Care ◽  
Medical Expenditure Panel Survey ◽  
Survey Design ◽  
Health Care Expenditure ◽  
Prescription Medication ◽  
Health Care Expenditures ◽  
Cross Sectional Study ◽  
Medical Expenditure ◽  
Cross Sectional ◽  
Nationally Representative

This cross-sectional study included a nationally representative sample of U.S. adults aged ≥50 years with self-reported pain in the past 4 weeks from the 2018 Medical Expenditure Panel Survey. Adjusted linear regression analyses accounted for the complex survey design and assessed differences in several types of annual health care expenditures between individuals who reported frequent exercise (≥30 min of moderate–vigorous intensity physical activity ≥5 times per week) and those who did not. Approximately 23,940,144 of 56,979,267 older U.S. adults with pain reported frequent exercise. In adjusted analyses, individuals who reported frequent exercise had 15% lower annual prescription medication expenditures compared with those who did not report frequent exercise (p = .007). There were no statistical differences between frequent exercise status for other health care expenditure types (p > .05). In conclusion, adjusted annual prescription medication expenditures were 15% lower among older U.S. adults with pain who reported frequent exercise versus those who did not.

scholarly journals Triptans Use for Migraine Headache among Nonelderly Adults with Cardiovascular Risk

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Monira Alwhaibi ◽  
Arijita Deb ◽  
Usha Sambamoorthi
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Migraine Headache ◽  
Medical Expenditure Panel Survey ◽  
Cross Sectional Study ◽  
Medical Expenditure ◽  
Lower Percentage ◽  
Panel Survey ◽  
Cross Sectional ◽  
The Relationship

Objective. To examine the association between the cardiovascular (CV) risk factors and triptans use among adults with migraine. Methods. A retrospective cross-sectional study design was used. Data were derived from 2009–2013 Medical Expenditure Panel Survey (MEPS). The study sample consisted of adults (age > 21 years) with migraine headache (N = 1,652). Multivariable logistic regression was used to examine the relationship between CV risk factors and triptans use. Results. Overall, 21% adults with migraine headache used triptans. Nearly two-thirds (61%) of adults with migraine had at least one CV risk factor. A significantly lower percentage of adults with CV risk (18.1%) used triptans compared to those without CV risk factors (25.5%). After controlling for demographic, socioeconomic status, access to care, and health status, adults with no CV risk factors were more likely to use triptans as compared to those with one CV risk factor (AOR = 1.83, 95% CI = 1.17–2.87). There were no statistically significant differences in triptans use between those with two or more CV risk factors and those with one CV risk factor. Conclusion. An overwhelming majority of adults with migraine had a contraindication to triptans based on their CV risk factors. The use of triptans among adults with migraine and multiple CV risk factors warrants further investigation.

scholarly journals Association of Self-Reported Functional Limitations among a National Community-Based Sample of Older United States Adults with Pain: A Cross-Sectional Study

2021 ◽  
Vol 10 (9) ◽  
pp. 1836
Author(s):  
David R. Axon ◽  
Darlena Le
Keyword(s):  
United States ◽  
Medical Expenditure Panel Survey ◽  
Functional Limitations ◽  
Functional Limitation ◽  
Cross Sectional Study ◽  
Medical Expenditure ◽  
Outcome Variable ◽  
Sectional Study ◽  
Cross Sectional ◽  
Logistic Regression Models

The characteristics of self-reported functional limitations among older United States (US) adults with pain are currently unknown. This cross-sectional study aimed to determine the characteristics associated with functional limitations among non-institutionalized older (≥50 years) US adults with pain using 2017 Medical Expenditure Panel Survey (MEPS) data. Eligible subjects were alive for the calendar year, aged ≥50 years, and experienced pain within the past four weeks. Hierarchical logistic regression models were utilized to determine significant characteristics associated with functional limitations (outcome variable; yes, no). Functional limitations included difficulty with bending, stooping, climbing stairs, grasping objects, lifting, reaching overhead, standing for long periods of time, or walking. Extrapolation of national data values was possible by adjusting for the complex MEPS design. We found approximately 22 million of the 57 million older US adults (≥50 years) who reported pain had a functional limitation in 2017. Characteristics associated with functional limitations included: gender, race, ethnicity, employment status, marital status, pain intensity, physical health, number of chronic conditions, and frequent exercise status. Knowledge of characteristics associated with functional limitations may provide an opportunity to identify and resolve gaps in patient care among this population.

scholarly journals Burden of Depression among Working-Age Adults with Rheumatoid Arthritis

Arthritis ◽  
2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Arijita Deb ◽  
Nilanjana Dwibedi ◽  
Traci LeMasters ◽  
Jo Ann Hornsby ◽  
Wenhui Wei ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Medical Expenditure Panel Survey ◽  
Functional Limitations ◽  
Cross Sectional Study ◽  
Medical Expenditure ◽  
Cross Sectional ◽  
Working Age ◽  
Nationally Representative ◽  
Using Data

Objective. This study estimated the excess clinical, humanistic, and economic burden associated with depression among working-age adults with Rheumatoid Arthritis (RA). Methods. A retrospective cross-sectional study was conducted among working-age (18 to 64 years) RA patients with depression (N=647) and without depression (N=2,015) using data from the nationally representative Medical Expenditure Panel Survey for the years 2009, 2011, 2013, and 2015. Results. Overall, 25.8% had depression. In adjusted analyses, adults with RA and depression compared to those without depression were significantly more likely to have pain interference with normal work (severe pain: AOR = 2.22; 95% CI = 1.55, 3.18), functional limitations (AOR = 2.17; 95% CI = 1.61, 2.94), and lower mental health HRQoL scores. Adults with RA and depression had significantly higher annual healthcare expenditures ($14,752 versus 10,541, p<.001) and out-of-pocket spending burden. Adults with RA and depression were more likely to be unemployed and among employed adults, those with depression had a significantly higher number of missed work days annually and higher lost annual wages due to missed work days. Conclusions. This study highlights the importance of effectively managing depression in routine clinical practice of RA patients to reduce pain and functional limitations, improve quality of life, and lower direct and indirect healthcare costs.

scholarly journals Healthcare Expenditures Associated with Comorbid Anxiety and Depression among Adults with Migraine

2019 ◽  
Author(s):  
Monira Alwhaibi ◽  
Abdulkarim M. Meraya ◽  
Yazed AlRuthia
Keyword(s):  
Medical Expenditure Panel Survey ◽  
Cross Sectional Study ◽  
Medical Expenditure ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Comorbid Depression ◽  
Healthcare Expenditures ◽  
Cross Sectional ◽  
Comorbid Anxiety ◽  
Anxiety Screening

Abstract Objective. To examine direct healthcare expenditures among adults with migraine alone or with comorbid anxiety and/or depression. Methods. This was a retrospective cross-sectional study using the 2012, 2014, and 2016 Medical Expenditure Panel Survey data. Adult patients aged ≥22 years with migraine headache were included in the study. The direct healthcare expenditures of four migraine groups (migraine alone, migraine and anxiety, migraine and depression, migraine and both conditions) were compared. Results. There were 1,556 patients met the inclusion criteria and were eventually enrolled in the study. Approximately, 50% of the study sample had migraine with comorbid depression and/or anxiety (16.1% have depression, 12.3% have anxiety disorder, and 13.9% have both). The mean total healthcare expenditures of adults with migraine alone ($6,461) were significantly lower than those with comorbid depression and anxiety ($11,102), comorbid anxiety ($10,817), and comorbid depression ($14,577). Migraine with comorbid anxiety and depression was significantly associated with incremental costs of $1,027 in outpatient’s and $662 emergency room healthcare expenditures, compared to the migraine alone group after controlling for a multitude of covariates. Besides, migraine with comorbid anxiety and/or depression was significantly associated with incremental costs of prescription drug, compared to the migraine alone group. Conclusions. The healthcare expenditures associated with migraine with comorbid depression and/or anxiety are significantly higher than those without mental health comorbidities. Therefore, regular depression and anxiety screening for patients with migraine may help in reducing the healthcare expenditures associated with depression and/or anxiety comorbidities as well as in improving the quality of care.

scholarly journals Incremental Healthcare Expenditures Associated with Thyroid Disorders among Individuals with Diabetes

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Amit D. Raval ◽  
Usha Sambamoorthi
Keyword(s):  
Health Status ◽  
Medical Expenditure Panel Survey ◽  
Cross Sectional Study ◽  
Least Square ◽  
Medical Expenditure ◽  
Thyroid Disorders ◽  
Healthcare Expenditures ◽  
Cross Sectional ◽  
Outpatient Prescription ◽  
Lifestyle Risk Factors

Objective. To estimate incremental healthcare expenditures associated with thyroid disorders among individuals with diabetes.Research Design and Methods. Cross-sectional study design with data on adults over 20 years of age with diabetes (N=4,490) from two years (2007 and 2009) of the Medical Expenditure Panel Survey (MEPS) was used. Ordinary least square regressions on log-transformed total expenditures and type of healthcare expenditures (inpatient, emergency room, outpatient, prescription drug, and other) were performed to estimate the incremental expenditures associated with thyroid disorders after controlling for demographic, socioeconomic, health status, lifestyle risk factors, macrovascular comorbid conditions (MCCs), and chronic conditions (CCs).Results. Among individuals with diabetes, those with thyroid disorders had significantly greater average annual total healthcare expenditures ($15,182) than those without thyroid disorders ($11,093). Individuals with thyroid disorders had 34.3% greater total healthcare expenditures compared to those without thyroid disorders, after controlling for demographic, socio-economic, and perceived health status. Furthermore, controlling for CCs and MCCs, this increase in expenditures was reduced to 21.4%.Conclusions. Among individuals with diabetes, thyroid disorders were associated with greater healthcare expenditures; such excess expenditures may be due to CCs and MCCs. Comanagement of CCs and reducing MCCs may be a pathway to reduce high healthcare expenditures.

scholarly journals The Humanistic and Economic Burden Associated with Anxiety and Depression among Adults with Comorbid Diabetes and Hypertension

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Kimberly Wallace ◽  
Xiaohui Zhao ◽  
Ranjita Misra ◽  
Usha Sambamoorthi
Keyword(s):  
Economic Burden ◽  
Diabetes Management ◽  
Medical Expenditure Panel Survey ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Medical Expenditure ◽  
Depression And Anxiety ◽  
Annual Household Income ◽  
Healthcare Expenditures ◽  
Cross Sectional

We conducted a retrospective cross-sectional study to estimate the humanistic and economic burden associated with depression and anxiety among adults with comorbid diabetes and hypertension. Pooled data from the 2013 and 2015 Medical Expenditure Panel Survey were used to include adults (≥18 years old) who were alive and diagnosed with both diabetes and hypertension during the observation period. We assessed the humanistic burden with health-related quality of life (HRQoL) and economic burden with the total annual healthcare expenditures. Depending on the presence/absence of depression and anxiety, the study sample was divided into four groups (i.e., no depression/anxiety, depression only, anxiety only, and depression and anxiety). Multivariable regression analyses were used to evaluate the associations between the depression/anxiety categories and disease burden measures. The incremental burden associated with depression and/or anxiety was estimated with the counterfactual recycled prediction. Of the 4560 adults with comorbid diabetes and hypertension, 13.2% reported depression only, 8.7% reported anxiety only, and 7.7% reported both. Results from adjusted analyses indicated that the presence/absence of depression and anxiety was associated with significantly poorer HRQoL, especially on the mental component. Having either depression or anxiety corresponded to reduced mental component summary scores by more than four points. The reduction was as high as 10.35 points when both conditions occurred. Comparing to adults without depression or anxiety, the per-capital incremental annual healthcare expenditures were $4607 for the depression group, $2481 for the anxiety group, and $8709 for adults with both conditions. Furthermore, adults with depression and anxiety were 58% more likely to spend at least 10% of annual household income on healthcare as compared to those with neither the conditions. Our results highlight the needs for integrating cost-effective mental health services into diabetes management to improve the HRQoL and reduce healthcare costs for adults with comorbid diabetes and hypertension.

scholarly journals Psychological and Emotional Changes among Students Undergoing Different Teaching Strategies- A Survey

2021 ◽  
pp. 933-941
Author(s):  
Srivaths Mukka ◽  
G. Sridevi ◽  
S. Preetha
Keyword(s):  
Online Education ◽  
Teaching Strategies ◽  
Regular Education ◽  
Age Groups ◽  
Antidepressant Drugs ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Related Factors ◽  
Cross Sectional ◽  
Chennai City

Background: Stress is a common and serious threat that affects different populations in various age groups. Students belonging to professional courses in medical and dental colleges are subjected to higher levels of stress. Objective: The objective of the present study was to assess stress associated with different teaching strategies in students of various professional colleges and its influence on academic, social and health-related factors. Methods: A cross-sectional study was conducted among 100 students of medical, dental and engineering colleges from the urban area of Chennai city using a convenience sampling technique. A self-developed questionnaire consisting of 18 questions was used for the data collection to analyse the level, frequency, reason for stress, stress symptoms, type of education they undergo, stress relief methods followed. This questionnaire was circulated by Google forms and the responses were collected. Analysis was done using frequency analysis and chi-square test. Results: Results revealed that the majority of participants about 57.7 % are undergoing regular education, 23% of students are undergoing express education and 18% of students are undergoing online education. About 70% of respondents stated that they feel stress. Majority of participant in the regular mode of education responded that they took antidepressant drugs (23%), music (16.5%) for the habit of fighting against stress and the association was found to be statistically significant. Conclusion: The study concluded an innovative finding that most of the students underwent regular education and were better at academic performance and stress pertaining to academics was dealt with habit of hearing music and intake of antidepressant drugs.

scholarly journals Evaluation of the depth and width of normal fetal Sylvian fissure by trans-cerebellar section

2021 ◽  
Author(s):  
pingping xu ◽  
dirong zhang ◽  
yu shi ◽  
fengbei kong ◽  
chunxiao yao ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Reference Range ◽  
Linear Regression Analysis ◽  
Age Groups ◽  
Correlation Coefficients ◽  
Cross Sectional Study ◽  
Sylvian Fissure ◽  
Cross Sectional ◽  
Normal Fetus ◽  
Dependent Variables

Abstract Objective On the basis of retrospectively analysis the trans-cerebellar section showing the Sylvian fissure of normal fetus is better than trans-thalamic section in middle and late trimester, we prospectively established the normal reference range of developmental parameters related to the Sylvian fissure of normal fetus in the trans-cerebellar section in order to provide valuable information for the diagnosis of fetal cerebral cortical dysplasia. Methods A prospective cross-sectional study was conducted on 845 normal fetuses at 21 to 32 weeks of gestation from January 2019 to September 2020. The depth and width of the Sylvian fissure was measured respectively, and regression analysis was performed according to different gestational age groups. Results The depth of Sylvian fissure was positively correlated with gestational weeks, and the width of Sylvian fissure was negatively correlated with gestational weeks, with correlation coefficients 0.751 and 0.825 respectively (all P < 0.001).Taking gestational weeks as the independent variable, and the depth and width of Sylvian fissure of fetus as the dependent variables, linear regression analysis showed that there was a linear relationship between the independent variables and the dependent variables. The obtained equation was simplified to a formula: Fetal Sylvian fissure depth (mm)=7+0.6X(gestational weeks-21), Sylvian fissure width (mm)=8-0.6X(gestational weeks-21). Conclusion The reference range of the depth and width of Sylvian fissure of normal fetus at 21 to 32 weeks of pregnancy through the trans-cerebellar section was established, which could provide valuable information for the evaluation of the normal development of the lateral fissure of fetus and the prenatal diagnosis of fetal cortical hypoplasia. Key words Fetus; Sylvian fissure; depth; width; trans-cerebellar section

scholarly journals Healthcare Expenditures Associated With Comorbid Anxiety and Depression Among Adults With Migraine

2021 ◽  
Vol 12 ◽  
Author(s):  
Monira Alwhaibi ◽  
Abdulkarim M. Meraya ◽  
Yazed AlRuthia
Keyword(s):  
Medical Expenditure Panel Survey ◽  
Financial Burden ◽  
Cross Sectional Study ◽  
Medical Expenditure ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Comorbid Depression ◽  
Healthcare Expenditures ◽  
Cross Sectional ◽  
Comorbid Anxiety

Introduction: Depression and anxiety are common among patients with migraine and usually associated with a humanistic and financial burden. This study aims to examine the direct healthcare expenditures among adults with migraine alone or with comorbid anxiety and/or depression.Methods: This was a retrospective cross-sectional study using 2012, 2014, and 2016 Medical Expenditure Panel Survey data. Adult patients aged ≥22 years with migraine headache were included in the study. The direct healthcare expenditures of four migraine groups (migraine alone, migraine and anxiety, migraine and depression, and migraine and both conditions) were compared.Results: There were 1,556 patients who met the inclusion criteria and eventually enrolled in the study. Approximately 42% of the study sample had migraine with comorbid depression and/or anxiety (16.1% have depression, 12.3% have anxiety disorder, and 13.9% have both). The mean total healthcare expenditures of adults with migraine alone ($6,461) were significantly lower than those with comorbid depression and anxiety ($11,102), comorbid anxiety ($10,817), and comorbid depression ($14,577). Migraine with comorbid anxiety and depression was significantly associated with incremental costs of $1,027 in outpatient and $662 emergency room healthcare expenditures and prescription drug compared to the migraine alone group.Conclusions: The healthcare expenditures associated with migraine with comorbid depression and/or anxiety are significantly higher than those without mental health comorbidities. Therefore, regular depression and anxiety screening for patients with migraine may help reduce the healthcare expenditures associated with depression and/or anxiety comorbidities and improve the quality of care.

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