scholarly journals AB0521 COST OF ILLNESS OF ANCA-ASSOCIATED VASCULITIS IN ITALY: DATA LINKAGE ANALYSIS OF MULTIPLE CLINICAL AND ADMINISTRATIVE DATABASES IN THE PROVINCE OF UDINE, ITALY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1558.1-1558
Author(s):  
L. Quartuccio ◽  
E. Treppo ◽  
S. De Vita ◽  
F. Valent
Keyword(s):  
Health Care ◽  
Cost Of Illness ◽  
Systemic Vasculitis ◽  
Health Information System ◽  
Clinical Manifestations ◽  
Administrative Databases ◽  
Rank Test ◽  
Hospital Discharges ◽  
Severe Infections ◽  
Regional Population

Background:ANCA-associated vasculitides (AAV) are a group of systemic vasculitis carrying a high risk of hospitalization because the multiorgan involvement, the acute nature of some clinical manifestations, the chronic but very disabling course of some other manifestations and finally the risk of severe infections due to chronic glucocorticoid and immunosuppressor administration. However, data on cost of illness due to AAV are lacking.Objectives:to estimate the cost of illness in patients suffering from AAV in the province of Udine (about 500,000 inhabitants), Friuli Venezia Giulia (FVG), Italy, from year 2010 to 2018.Methods:integration of the information coming from many administrative databases were used to this end. The Regional Health Information System of FVG was used as the source of information for this retrospective cohort study. The system covers the entire regional population and includes various electronic health administrative databases that can be linked with one another on an individual basis through a unique encrypted identifier. In particular, the following databases were matched: the database of the health care beneficiaries (including demographic information and the residential history of all of the subjects living in FVG), the hospital discharge database, the database of exemptions from medical charges, the database of the laboratories. The population under study was selected based on the following inclusion criteria: patients were residents in the province of Udine and they had to carry the exemption code for AAV, including GPA, or EGPA, or MPA. This population was observed from 2010 to 2018.Results:57 patients (201 patient-years) with AAV were identified. They were ANCA-positive in 44/57 (77%). GPA, EGPA and MPA was diagnosed in 18 (31,6%), 15 (26,3%), 11 (19,3%) patients, respectively. The mean age at diagnosis was 54,5 (17,5) years. The disease itself was the main cause of hospitalization in almost half of the hospital discharges (60/126, 47,6%). Four patients died during the observation period due to vasculitis itself (1), pneumonia (2), or haematological malignancy (1). Time to the first event (death or hospitalization) was significantly higher in ANCA-negative AAV patients than in ANCA-positive AAV patients (p=0,03, Log-Rank test), ANCA-positive AAV patients having a three-times higher risk (HR 3,38 95%CI 1,13-10,08, p=0,03). Total estimated cost was € 1,215,078, corresponding to € 6,168 patient-year. Costs for ANCA-positive AAV patients were much higher than those for ANCA-negative AAV patients (€ 1,115,253 vs € 99,825, and € 7058 per person-year vs € 2,559 per person-year, respectively). GPA and MPA showed the highest costs if compared to EGPA [GPA: € 239,168 (€ 5199 per person-year) vs MPA: € 281,502 (€ 4771 per person-year) vs EGPA: € 214,287 (2329 per person-year), respectively]. Costs for hospitalization were the highest [€ 734,957 (€ 3731 per person-year) vs other costs € 480,121 (€ 2437 per person-year)].Conclusion:costs for AAV are very high, confirming the high health care burden of this illness. Management of ANCA-positive patients rather than ANCA-negative patients was burdened by the highest costs. GPA and MPA showed the highest direct costs for hospitalization, which very frequently occurred due to the vasculitis itself.Disclosure of Interests:Luca Quartuccio Consultant of: Abbvie, Bristol, Speakers bureau: Abbvie, Pfizer, Elena Treppo: None declared, Salvatore De Vita Consultant of: Roche, GSK, Speakers bureau: Roche, GSK, Novartis, Francesca Valent: None declared

scholarly journals AB0520 FIVE-YEAR RATE OF HOSPITALIZATIONS IN ANCA-ASSOCIATED VASCULITIDES IN THE ITALIAN REGION OF FRIULI VENEZIA GIULIA (2013-2017)

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1557.2-1558
Author(s):  
L. Quartuccio ◽  
E. Treppo ◽  
S. De Vita ◽  
F. Valent
Keyword(s):  
Health Care ◽  
Granulomatosis With Polyangiitis ◽  
Burden Of Illness ◽  
Clinical Manifestations ◽  
Administrative Databases ◽  
Eosinophilic Granulomatosis With Polyangiitis ◽  
Italian Region ◽  
Potential Health ◽  
Number Of Patients ◽  
Friuli Venezia Giulia

Background:ANCA-associated vasculitides (AAV) are a group of systemic vasculitis carrying a high risk of hospitalization because the multiorgan involvement, the acute nature of some clinical manifestations, the chronic but very disabling course of some other manifestations and finally the risk of severe infections due to chronic glucocorticoid and immunosuppressor administration. However, data on hospitalization due to ANCA-associated vasculitis are still scarce.Objectives:to estimate the rate of the first hospitalization or the death in patients suffering from AAV in the Italian region of Friuli Venezia Giulia (about 1,200,000 inhabitants) from year 2013 to 2017.Methods:integration of the information coming from many administrative databases were used to this end. The Regional Health Information System of Friuli Venezia Giulia was used as the source of information for this retrospective cohort study. The system covers the entire regional population and includes various electronic health administrative databases that can be linked with one another on an individual basis through a unique encrypted identifier. In particular, the following databases were matched: the database of the regional potential health care beneficiaries (including demographic information and the residential history of all of the subjects living in the region), the hospital discharge database, the database of exemptions from medical charges were used for this study, the database of the different regional laboratories. The population under study was selected based on the following inclusion criteria: patients were residents in Friuli Venezia Giulia and they had to carry the exemption code for AAV, including Granulomatosis with Polyangiitis (GPA), or Eosinophilic Granulomatosis with Polyangiitis (EGPA), or Microscopic Polyangiitis (MPA). This population was observed from 2013 to 2017. The coded event was the occurrence of the first hospitalization or the death. Also, all the hospitalization and their main discharge diagnoses were registered.Results:103 patient with AAV were identified. The number of patients with at least one hospitalization/death was 74/103 (71,8%). Seven patients died during the observation period (6,6%). The whole number of hospitalizations was 285 in 74 patients. 55/74 (74,3%) patients experienced more than one hospitalization. In the majority of the hospitalizations (119/285, 41,7%), the cause of hospitalization was directly attributable to the disease itself, while the second cause of hospitalization was the infections (26/285, 9,1%). In 10/103 patients (9,7%), an end stage renal disease was recorded as event. The presence of at least one positivity for ANCA antibodies was documented in 76/103 patients (73,8%), mainly in patients carrying GPA. Globally, the presence of ANCA antibody seems to be associated with greater likelihood of an event (p=0,07, log-rank test). The first event occurred in 50% of ANCA-positive patients within 180 days from diagnosis, while in 50% of ANCA negative patients in 859 days. 6 out of the 7 deaths occurred in ANCA positive patients.Conclusion:the rate of hospitalization in AAV is very high confirming the high health care burden of illness. The disease itself is often the cause of the hospitalization, as well as the infectious complication, highlighting the need for more effective treatments, and glucocorticoid sparing therapies. ANCA antibody may represent a biomarker of a more serious disease.Disclosure of Interests:Luca Quartuccio Consultant of: Abbvie, Bristol, Speakers bureau: Abbvie, Pfizer, Elena Treppo: None declared, Salvatore De Vita Consultant of: Roche, GSK, Speakers bureau: Roche, GSK, Novartis, Francesca Valent: None declared

Manitoba's Population-Based Databases and Long-Term Planning: Beyond the Hospital Databases

1995 ◽  
Vol 8 (3) ◽  
pp. 5-13 ◽  
Author(s):  
Marsha M. Cohen ◽  
Noralou P. Roos ◽  
Carolyn DeCoster ◽  
Charlyn Black ◽  
Kathleen M. Decker
Keyword(s):  
Health Care ◽  
Information System ◽  
Health Policy ◽  
Health Services Research ◽  
Health Information System ◽  
Population Based ◽  
Administrative Databases ◽  
Services Research ◽  
Policy Analysts

The Manitoba Centre for Health Policy and Evaluation (MCHPE) conducts health services research focusing on Manitoba's administrative databases. Administrative databases contain information which is routinely and systematically collected for administrative purposes such as hospital and physician claims and funding requirements. This article describes the MCHPE's five major databases, their strengths and limitations, and the development of the Population Health Information System (PHIS). Four modules from PHIS illustrate how the data are used to provide useful information for health care planners, administrators and policy analysts. Finally, future projects and directions for using administrative databases are explored.

Cost of illness studies in health care: a comparison of two cases

Health Policy ◽  
1993 ◽  
Vol 26 (1) ◽  
pp. 29-42 ◽  
Author(s):  
André Ament ◽  
Silvia Evers
Keyword(s):  
Health Care ◽  
Cost Of Illness ◽  
Cost Of Illness Studies

Manajemen Diri (Self Management) Perilaku Sehat pada Pasien Hipertensi

2021 ◽  
Vol 6 (1) ◽  
pp. 1
Author(s):  
Vera Kurnia ◽  
Desti Nataria
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Intervention Group ◽  
Sampling Technique ◽  
Healthy Diet ◽  
Rank Test ◽  
Control Group ◽  
Healthy Behavior ◽  
Education Management ◽  
Primary Health

Hypertension is one of the most common causes of morbidity and mortality  all over the world, also known as “the silent killer” because people with hypertension are without symptoms. West Sumatera Province reported that the prevalence of hypertension at the age 18 years has increased from 25,8% in 2013 to 31,7% in 2018. Successful strategies to manage the blood preasure depends on patients self-care management or the ability and willingness of the patient to change and maintain certain behavior.The purpose of this research is to determine the effect of self-education management of hypertension patients in the working area of primary health care in Bukittinggi.Design of this research is a quasi experimental design with pretest-posttest with control group. The sample which used were 62 respondents consist of 31 people in the intervention group and 31 people in the group control. Sampling was done by consecutive sampling technique. Data was analyzed Wilcoxon signed rank test and Mann Whitney test. The result of this research shows that there isn’t any effect of self education management to healthy behavior which includes exercise and healthy diet of the intervention group and the control group at community health center in Bukittinggi (mean rank after the intervention < 10; p> 0,05). Based on the result of this research it can be concluded that the habits of respondents who carry out light and medium activities every day and also education provided by primary health care  have given big impact to respondent’s habits where they always do exercise and healthy diet in their daily life.The result of this research can be used as an input for primary health care to maintain and improve education of healthy behavior for hypertension patients.

scholarly journals THE ROLE OF HEALTH INFORMATION SYSTEM IN MATERNAL AND CHILD HEALTHCARE SERVICES

2017 ◽  
Vol 10 (6) ◽  
pp. 29
Author(s):  
Rakhi Chowdhury ◽  
Leena Kumari ◽  
Subhamay Panda
Keyword(s):  
Health Care ◽  
Information System ◽  
Child Health ◽  
Health Information ◽  
Maternal And Child Health ◽  
Health Information System ◽  
Health Care Sector ◽  
Related Information ◽  
Health Related ◽  
And Child Health

Health information system deals with any system that helps in capturing, storing, transmitting, and managing health-related information of an individual or to demonstrate the activities or organizations working within health-care sector. In the developing countries, maternal and child health is gaining concern due to increasing cases of morbidity and mortality. The disparities among the maternal, infant, and child health are a growing concern in India and are governed by various determinants such as socioeconomic status, literacy, quality of health care, discrimination, and biological and genetic factors. Accurate and reliable health information and data are the basis for decision-making across the health-care sector and are crucial for the development and implementation of health system policy by the policy-makers. Strict monitoring and evaluation of the present program design and its implementation is required at the microlevel to effectively utilize the resources for the improvement of maternal and child health. Our present article focuses on evaluating the coverage gap at the different levels for the provision of health-care facilities to maternal, neonatal, and child health, immunization, and treatment of poor children. Big data plays a major role in providing sound and reliable health-related information and also help in managing and recording structured and unstructured data. More concrete plans are required further to reduce the inequalities in health-care interventions for providing better maternal and child health-care services in our nation.

scholarly journals Is Staphylococcus lugdunensis Significant in Clinical Samples?

2017 ◽  
Vol 55 (11) ◽  
pp. 3167-3174 ◽  
Author(s):  
Xavier Argemi ◽  
Yves Hansmann ◽  
Philippe Riegel ◽  
Gilles Prévost
Keyword(s):  
Pathogenic Bacteria ◽  
Clinical Manifestations ◽  
Clinical Samples ◽  
Opportunistic Pathogens ◽  
Coagulase Negative Staphylococci ◽  
Staphylococcus Lugdunensis ◽  
Content Type ◽  
Severe Infections ◽  
Microbiological Data

ABSTRACTThe implication of coagulase-negative staphylococci in human diseases is a major issue, particularly in hospital settings wherein these species often act as opportunistic pathogens. In addition, some coagulase-negative staphylococci such asS. lugdunensishave emerged as pathogenic bacteria, implicated in severe infections, particularly, osteoarticular infections, foreign-body-associated infections, bacteremia, and endocarditis.In vitrostudies have shown the presence of several putative virulence factors such as adhesion factors, biofilm production, and proteolytic factors that might explain clinical manifestations. Taken together, the clinical and microbiological data might change the way clinicians and microbiologists look atS. lugdunensisin clinical samples.

scholarly journals Clinical and immunological variants of ANCA-associated systemic vasculitis: a look at the phenomenon of IgG4 overproduction. Literature review and own observations

2020 ◽  
Vol 58 (5) ◽  
pp. 550-559
Author(s):  
T. V. Beketova ◽  
N. V. Kokosadze
Keyword(s):  
Clinical Case ◽  
Plasma Cells ◽  
Systemic Vasculitis ◽  
Clinical Manifestations ◽  
Definite Diagnosis ◽  
Related Disease ◽  
Epitope Specificity ◽  
Igg4 Related Disease ◽  
Choice Of Treatment ◽  
Combined Data

Systemic vasculitis (SV) associated with anti-neutrophilic cytoplasmic antibodies is a multifactorial process characterized by the variability of the epitope specificity of anti-neutrophilic cytoplasmic antibodies and the diversity of clinical phenotypes of the disease. In recent years, there has been an increasing interest in the combination of AAV and the phenomenon of IgG4 hyperproduction, which varies widely within AAV, from anti-neutrophilic cytoplasmic antibodies products of IgG4 subclass of undetermined significance, the presence of IgG4 positive plasma cells in the foci of immunoinflammatory lesions in patients with a definite diagnosis of AAV, to the typical clinical manifestations of an IgG4-related disease (IgG4-RD). We introduce own clinical case and analyze the combined data of the literature, which included 35 cases of a combination of AAV and IgG4-related pathology, indicating existing differences in the clinical manifestations of classical IgG4-RD and when combined with AAV. The currently accumulated data allows us to discuss the allocation of a specific clinical and immunological variant of AAV with IgG4 hyperproduction, characterized by a combination of clinical manifestations of AAV and clinical and / or histological signs of IgG4-related pathology. It is important to emphasize that the allocation of phenotypes of AAV in the future may be important for the personalized choice of treatment tactics for patients.

scholarly journals Functional diseases of the gastrointestinal tract in the context with overlapping functional disorders: current status of the problem

2020 ◽  
Vol 92 (2) ◽  
pp. 111-118
Author(s):  
M. A. Osadchuk ◽  
A. A. Svistunov ◽  
N. V. Kireeva ◽  
M. M. Osadchuk
Keyword(s):  
Health Care ◽  
Gastrointestinal Tract ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Current Status ◽  
Functional Disorders ◽  
Digestive Tube ◽  
Psychosocial Disorders ◽  
Significant Damage ◽  
Course Features

Functional diseases of the gastrointestinal tract cause significant damage to the health care system. Their frequent combination in the same patient with the migration of clinical symptoms throughout the digestive tube is accompanied by continuous exacerbations, refractory to the therapy and severe psychosocial disorders. This review provides data on the main etiopathogenetic factors, clinical manifestations, course features and management tactics for patients with overlapping for the most common functional diseases of the gastrointestinal tract.

Development of the integrated New Jersey Safety and Health Outcomes (NJ-SHO) data warehouse: catalysing advancements in injury prevention research

2021 ◽  
pp. injuryprev-2020-044101
Author(s):  
Allison E Curry ◽  
Melissa R Pfeiffer ◽  
Kristina B Metzger ◽  
Meghan E Carey ◽  
Lawrence J Cook
Keyword(s):  
New Jersey ◽  
Health Outcomes ◽  
Injury Prevention ◽  
Data Warehouse ◽  
Administrative Databases ◽  
Birth Certificates ◽  
Hospital Discharges ◽  
Match Probability ◽  
Match Rate ◽  
Safety And Health

ObjectiveOur objective was to describe the development of the New Jersey Safety and Health Outcomes (NJ-SHO) data warehouse—a unique and comprehensive data source that integrates state-wide administrative databases in NJ to enable the field of injury prevention to address critical, high-priority research questions.MethodsWe undertook an iterative process to link data from six state-wide administrative databases from NJ for the period of 2004 through 2018: (1) driver licensing histories, (2) traffic-related citations and suspensions, (3) police-reported crashes, (4) birth certificates, (5) death certificates and (6) hospital discharges (emergency department, inpatient and outpatient). We also linked to electronic health records of all NJ patients of the Children’s Hospital of Philadelphia network, census tract-level indicators (using geocoded residential addresses) and state-wide Medicaid/Medicare data. We used several metrics to evaluate the quality of the linkage process.ResultsAfter the linkage process was complete, the NJ-SHO data warehouse included linked records for 22.3 million distinct individuals. Our evaluation of this linkage suggests that the linkage was of high quality: (1) the median match probability—or likelihood of a match being true—among all accepted pairs was 0.9999 (IQR: 0.9999–1.0000); and (2) the false match rate—or proportion of accepted pairs that were false matches—was 0.0063.ConclusionsThe resulting NJ-SHO warehouse is one of the most comprehensive and rich longitudinal sources of injury data to date. The warehouse has already been used to support numerous studies and is primed to support a host of rigorous studies in the field of injury prevention.

Abstract 14598: Multiple Arterial Coronary Bypass Grafting is Associated With Improved Survival in Females

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Derrick Tam ◽  
Rodolfo Rocha ◽  
Jiming Fang ◽  
Maral Ouzounian ◽  
Joanna Chikwe ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Administrative Databases ◽  
Rank Test ◽  
Bypass Grafting ◽  
Female Patients ◽  
Significant Difference ◽  
Arterial Grafting

Introduction: Multiple arterial grafting (MAG) in coronary artery bypass grafting (CABG) is associated with improved survival and freedom from major adverse cardiac and cerebrovascular events (MACCE) in observational studies of mostly males. It is not known whether the MAG is beneficial in females. Herein, we compared the late clinical outcomes of MAG versus single arterial grafting (SAG) in females undergoing CABG for multivessel coronary artery disease (CAD) Methods: Clinical and administrative databases for Ontario, Canada, were linked to obtain all female patients with angiographic evidence of left main, triple, or double vessel disease undergoing isolated non-emergent primary CABG from 2008-2019. Baseline characteristics were compared and 1:1 propensity score matching was performed to account for differences. 30-day mortality was compared in the matched groups. Late mortality and MACCE ( composite of stroke, myocardial infarction, repeat revascularization, and death) was compared between the matched groups with a stratified log rank test and Cox-proportional hazard model. Results: In total 2,961 and 7,954 females underwent CABG with MAG and SAG respectively for multivessel CAD. Prior to propensity-score matching, compared to SAG, those that underwent MAG were younger (66.0 vs. 68.9 years) and had less comorbidities. After propensity-score matching, 2,446 well-matched pairs were formed. In matched patients, there was no significant difference in 30-day mortality (1.6% vs 1.8%, P=0.43) between MAG and SAG. The median and maximum follow-up was 5.0 and 11.0 years respectively. Over the entire follow-up, MAG was associated with improved survival (Figure, hazard ratio (HR): 0.85, 95% confidence interval (CI): 0.75-0.98) and freedom from MACCE (HR: 0.85, 95%CI: 0.76-0.95). Conclusions: MAG was associated with improved survival and freedom from MACCE and should be considered for female patients with good life expectancy requiring CABG.

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