Association between socioeconomic status and risk of hospitalization due to child maltreatment in the USA

2018 ◽  
Vol 67 (2) ◽  
pp. 346-349 ◽  
Author(s):  
Sehyr Imran ◽  
Chad Cross ◽  
Samrat U Das
Keyword(s):  
Socioeconomic Status ◽  
Child Maltreatment ◽  
Hospital Mortality ◽  
Age Groups ◽  
International Classification Of Diseases ◽  
Primary Diagnosis ◽  
Hospitalized Children ◽  
Incidence And Mortality ◽  
Classification Of Diseases ◽  
The Usa

Child maltreatment remains a significant problem in the USA. There is a dearth of literature examining the association of socioeconomic status (SES) and incidence of child maltreatment among hospitalized children across the entire USA. Our aim was to study the association between SES and incidence and mortality from child maltreatment among hospitalized children in the USA. We used 2013–2014 data from the Nationwide Inpatient Sample, a discharge database representative of all hospitals in the USA. International Classification of Diseases-9 codes for general child maltreatment were used to identify patients discharged with a primary diagnosis of child maltreatment. Trends in the incidence and outcomes of child maltreatment were compared with SES based on quartiles (Qx) of median household income. In 2013–2014, there were a total of about 2.3 million pediatric discharges. Out of these, a total of 8985 had a primary diagnosis of child maltreatment. Approximately 40 per cent of the cases were from families with the lowest SES (Q1). In-hospital mortality was 2.4 per cent in Q1 (lowest SES) compared with 0.4 per cent in Q4 (highest SES). We conclude that children from lower SES households have a higher incidence of child maltreatment and have worse outcomes, including significantly higher in-hospital mortality among hospitalized children. This trend was generally consistent across all age groups and ethnicities. To our knowledge, this is the first report studying the association between SES and children with child maltreatment among hospitalized children across the entire USA.

scholarly journals RISK TERRITORIES OF PRIMARY INCIDENCE AND MORTALITY OF THE ADULT POPULATION, DEFINED BY THE FACTORS OF THE ENVIRONMENT (ON THE EXAMPLE OF THE REPUBLIC OF KOMI)

2020 ◽  
Vol 70 (4/2020) ◽  
pp. 54-71
Author(s):  
A. S. Shcherbakova (Ponomareva) ◽  
Keyword(s):  
Adult Population ◽  
Age Groups ◽  
International Classification Of Diseases ◽  
Komi Republic ◽  
Living Environment ◽  
The State ◽  
Incidence And Mortality ◽  
Classification Of Diseases ◽  
The Republic ◽  
The Relationship

. Modern realities taking place in the world prove that the quality of the living environment affects the health and mortality of the population. The Federal Service for Supervision of Consumer Rights Protection and Human Wellbeing in Russia conducts social and hygienic monitoring in all constituent entities of the country, but not in the context of regional municipalities. The state reports “On the state of sanitary and epidemiological welfare in the Russian Federation” do not provide a report on the relationship between the factors of water, atmospheric air, soil and the incidence of the population by age groups. Obvious gaps in the reports dictate the need to assess the relationship between the indicators of the environment and the incidence of the population in the municipalities of the region. After all, each region of Russia has its own uniqueness and its own environment. The object of the research is the Komi Republic, where the analysis of the causes of illness and mortality in the whole republic carried out now. An assessment of the primary morbidity and mortality of the adult population according to the International Classification of Diseases — 10 revisions to identify risk areas for all municipalities of the Komi Republic for 2014–2019 is given. For this, a rating calculation method applied. The prevailing classes of diseases identified and analyzed. The research results formulated.

scholarly journals Garbage codes as causes of death and quality of mortality statistics in Belo Horizonte, Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Ishitani ◽  
R Teixeira ◽  
D Abreu ◽  
L Paixão ◽  
E França
Keyword(s):  
Causes Of Death ◽  
Health Planning ◽  
Age Groups ◽  
International Classification Of Diseases ◽  
Mortality Statistics ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Hospital Deaths ◽  
Belo Horizonte

Abstract Background Quality of cause-of-death information is fundamental for health planning. Traditionally, this quality has been assessed by the analysis of ill-defined causes from chapter XVIII of the International Classification of Diseases - 10th revision (ICD-10). However, studies have considered other useless diagnoses for public health purposes, defined, in conjunction with ill-defined causes, as garbage codes (GC). In Brazil, despite the high completeness of the Mortality Information System, approximately 30% of deaths are attributable to GCs. This study aims to analyze the frequency of GCs in Belo Horizonte municipality, the capital of Minas Gerais state, Brazil. Methods Data of deaths from 2011 to 2013 in Belo Horizonte were analyzed. GCs were classified according to the GBD 2015 study list. These codes were classified in: a) GCs from chapter XVIII of ICD-10 (GC-R), and b) GC from other chapters of ICD-10 (GC-nonR). Proportions of GC were calculated by sex, age, and place of occurrence. Results In Belo Horizonte, from the total of 44,123 deaths, 5.5% were classified as GC-R. The majority of GCs were GC-nonR (25% of total deaths). We observed a higher proportion of GC in children (1 to 4 years) and in people aged over 60 years. GC proportion was also higher in females, except in the age-groups under 1 year and 30-59 years. Home deaths (n = 7,760) had higher proportions of GCs compared with hospital deaths (n = 30,182), 36.9% and 28.7%, respectively. The leading GCs were the GC-R other ill-defined and unspecified causes of death (ICD-10 code R99)), and the GCs-nonR unspecified pneumonia (J18.9), unspecified stroke (I64), and unspecified septicemia (A41.9). Conclusions Analysis of GCs is essential to evaluate the quality of mortality information. Key messages Analysis of ill-defined causes (GC-R) is not sufficient to evaluate the quality of information on causes of death. Causes of death analysis should consider the total GC, in order to advance the discussion and promote adequate intervention on the quality of mortality statistics.

Abstract 16199: Trend of Hypertensive Emergencies in Atrial Fibrillation Hospitalization; National Estimate

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Mae'n Al-Dabbas ◽  
Jay Shah ◽  
devina adalja ◽  
Archana Gundabolu ◽  
Ashish Kumar ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
International Classification Of Diseases ◽  
Primary Diagnosis ◽  
Hypertensive Emergency ◽  
P Value ◽  
National Inpatient Sample ◽  
Common Risk Factor ◽  
The Past ◽  
Classification Of Diseases

Introduction: Hypertension has been reported as one of the most common risk factor causing atrial fibrillation (AF). Also, hypertension is associated with more persistent AF. However the epidemiology for incidence of hypertensive emergency in AF hospitalization is not well documented. Hypothesis: We hypothesize that frequency of hypertensive emergency has been increasingly associated with Atrial fibrillation. Methods: National inpatient sample from 2005 -2015 was used for the present analysis. Patients over 18 years, with AF as the primary diagnosis were identified using International Classification of Diseases, Ninth Revision-Clinical Modification (ICD-9-CM) code, 427.31. Patients with hypertensive emergency were identified using ICD-9-CM code. 401.0, 402.0, 403.0, 404.0, 405.0. Results: A total of 4,988,269 AF patients over 18 years of age were included in the present analysis. Of these hospitalization 49,423 had hypertensive emergency during hospitalizations and the rest 4,938,846 had no hypertensive emergency. There was a monotonic increase in the trend of rates of hypertensive emergency per 1000 AF hospitalizations, from 2005 - 2015. (P value <0.001) [Figure 1]. Conclusion: There has been a significant increase in the rates of hypertensive emergency among AF hospitalization, over the past decade. Further research is needed to investigate the reason for this increased trend.

Association of age with risk of major depression among patients with chronic kidney disease over midlife: a nationwide cohort study in Taiwan

2018 ◽  
Vol 31 (08) ◽  
pp. 1171-1179 ◽  
Author(s):  
Shih-Feng Chen ◽  
Yu-Huei Chien ◽  
Pau-Chung Chen ◽  
I-Jen Wang
Keyword(s):  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Major Depression ◽  
Kidney Disease ◽  
Comparison Group ◽  
Age Groups ◽  
International Classification Of Diseases ◽  
Classification Of Diseases ◽  
The Impact

ABSTRACTBackground:The impact of age on the development of depression among patients with chronic kidney disease (CKD) at stages before dialysis is not well known. We aimed to explore the incidence of major depression among predialysis CKD patients of successively older ages through midlife.Methods:We conducted a retrospective cohort study using the longitudinal health insurance database 2005 in Taiwan. This study investigated 17,889 predialysis CKD patients who were further categorized into study (i.e. middle and old-aged) groups and comparison group aged 18–44. The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) was applied for coding diseases.Results:The group aged 75 and over had the lowest (hazard ratio [HR] 0.47; 95% confidence interval [CI] 0.32–0.69) risk of developing major depression, followed by the group aged 65–74 (HR 0.67; 95% CI 0.49–0.92), using the comparison group as reference. The adjusted survival curves showed significant differences in cumulative major depression-free survival between different age groups. We observed that the risk of major depression development decreases with higher age. Females were at a higher risk of major depression than males among predialyasis CKD patients.Conclusions:The incidence of major depression declines with higher age in predialysis CKD patients over midlife. Among all age groups, patients aged 75 and over have the lowest risk of developing major depression. A female preponderance in major depression development is present. We suggest that depression prevention and therapy should be integrated into the standard care for predialysis CKD patients, especially for those young and female.

Abstract 14682: Impact of Atrial Fibrillation in Aortic Stenosis Patients: Insights From the United States Readmissions Database

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Shashank Shekhar ◽  
Anas M Saad ◽  
Toshiaki Isogai ◽  
Mohamed M Gad ◽  
Keerat Ahuja ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Aortic Stenosis ◽  
Hospital Mortality ◽  
Large Scale ◽  
International Classification Of Diseases ◽  
The United States ◽  
Large Scale Data ◽  
Classification Of Diseases

Introduction: Even though atrial fibrillation (AF) is present in >30% of patients with aortic stenosis (AS), it is not typically included in the decision-making algorithm for the timing or need for aortic valve replacement (AVR), either by transcatheter (TAVR) or surgical (SAVR) approaches. Large scale data on how AF affects outcomes of AS patients remain scarce. Methods: From the Nationwide Readmissions Database (NRD), we retrospectively identified AS patients aged ≥18years, with and without AF admitted between January and June in 2016 and 2017 (to allow for a six month follow up), using the International Classification of Diseases-10 th revision codes. Multivariable logistic regression was performed to examine the predictors of in-hospital mortality during index hospitalization. In-hospital complications and 6 month in-hospital mortality during any readmission after being discharged alive were compared in patients with and without AF, for patients undergoing TAVR, SAVR or no-AVR. Results: We identified 403,089 AS patients, of which 41% had AF. Patients with AF were older (median age in years: 83 vs. 79) and were more frequently females (52% vs. 48%; p<0.001). Table summarizes outcomes of AS patients with and without AF. TAVR in patients with AF was associated with higher in-hospital mortality and follow-up mortality as compared to patients without AF. Although AF did not influence in-hospital mortality in SAVR population, follow-up mortality was also significantly higher after SAVR in patients with AF compared to patients without AF. For patients not undergoing AVR, in-hospital and follow-up mortality were higher in AF population compared to no AF and was higher than patients undergoing AVR (Table). Conclusions: AF is associated with worse outcomes in patients with AS irrespective of treatment (TAVR, SAVR or no-AVR). More studies are needed to understand the implications of AF in AS population and whether earlier treatment of AS in patients with AF can improve outcomes.

160 The Impact of the Dependent Coverage Provision on Neurosurgical Population

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 240-240
Author(s):  
Matthew Decker ◽  
John David Mayfield ◽  
Paul Kubilis ◽  
Maryam Rahman
Keyword(s):  
Hospital Mortality ◽  
Age Groups ◽  
Primary Diagnosis ◽  
Cost Of Care ◽  
Hospital Length Of Stay ◽  
Control Cohort ◽  
Neurosurgical Patients ◽  
Comorbidity Index ◽  
Dependent Coverage ◽  
The Impact

Abstract INTRODUCTION The Dependent Coverage Provision (DCP), a provision of the Patient Protection and Affordable Care Act (ACA), enables dependents aged 19 25 to remain on parental insurance without restrictions. This increased access to health insurance for the population with the highest uninsured rate. Its impact has not been studied in neurosurgical population where the cost of care is disproportional based on insurance status. METHODS A National Inpatient Sampling database query was performed comparing an experimental (ages 19–25) and a control cohort (ages 27–33) and metrics before (January 2007 March 2009) and after DCP implementation (October 2011 December 2014). Those with a primary diagnosis of traumatic brain injury (TBI), ischemic or hemorrhagic stroke (Stroke) or primary brain tumor (Tumor) had the following metrics obtained: uninsured rate, comorbidity index, hospital length of stay (LOS), in-hospital mortality rates, and disposition status home. A difference-in-difference analysis was performed comparing the cohorts to assess direct effects of DCP. RESULTS >There was a significant decrease in the uninsured rate for TBI (p <.0001) and Stroke (p = .0019) patients but not for Tumor (p = .6663) patients after implementation of the DCP. There was no significant change in the comorbidity index, LOS, or in-hospital mortality for any diagnosis over the study period. An improvement occurred in these metrics in both age groups, however, the differences were insignificant. Lastly, there was an increase for the TBI control cohort to be discharged home (p = .0288) that was not observed elsewhere. CONCLUSION The DCP did decrease the uninsured rate in most neurosurgical patients. Other quality metrics were not different between the pre-DCP and post-DCP cohorts although both groups showed improvement in these metrics over time. The impact of the ACA on quality of care for neurosurgical patients should be further investigated.

Incidence of Football Injuries and Complaints in Different Age Groups and Skill-Level Groups

2000 ◽  
Vol 28 (5_suppl) ◽  
pp. 51-57 ◽  
Author(s):  
Lars Peterson ◽  
Astrid Junge ◽  
Jiri Chomiak ◽  
Toni Graf-Baumann ◽  
Jiri Dvorak
Keyword(s):  
Continuing Education ◽  
Age Groups ◽  
International Classification Of Diseases ◽  
Fair Play ◽  
Skill Levels ◽  
Subsequent Performance ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Over Time

In this study, the incidence of football injuries and complaints as related to different age groups and skill levels was studied over the period of 1 year. All injuries and complaints as well as the amount of time players spent in training and games were recorded. All injured players were examined weekly by physicians, and all injuries were assessed according to the International Classification of Diseases (ICD-10), which describes them in terms of injury type and location, the treatment required, and the duration of subsequent performance limitations. A total of 264 players of different age groups and skill levels was observed for 1 year. Five hundred fifty-eight injuries were documented. Two hundred sixteen players had one or more injuries. Only 48 players (18%) had no injury. The average number of injuries per player per year was 2.1. Injuries were classified as mild (52%), moderate (33%), or severe (15%). Almost 50% of all injuries were contact injuries; half of all the contact injuries were associated with foul play. The majority of injuries were strains and sprains involving the ankle, knee, and lumbar spine. Nearly all players (91%) suffered from complaints related to football. Only 23 players reported no injuries and no complaints. Prevention programs, fair play, and continuing education in techniques and skills may reduce the incidence of injuries over time.

scholarly journals Acute Kidney Injury and In-Hospital Mortality: A Retrospective Analysis of a Nationwide Administrative Database of Elderly Subjects in Italy

2019 ◽  
Vol 8 (9) ◽  
pp. 1371 ◽  
Author(s):  
Fabbian ◽  
Savriè ◽  
De Giorgi ◽  
Cappadona ◽  
Di Simone ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Hospital Mortality ◽  
Kidney Injury ◽  
International Classification Of Diseases ◽  
Administrative Database ◽  
Elderly Subjects ◽  
Dialysis Treatment ◽  
The Third ◽  
Classification Of Diseases

Background: The aim of this study was to investigate the association between acute kidney injury (AKI) and in-hospital mortality (IHM) in a large nationwide cohort of elderly subjects in Italy. Methods: We analyzed the hospitalization data of all patients aged ≥65 years, who were discharged with a diagnosis of AKI, which was identified by the presence of the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM), and extracted from the Italian Health Ministry database (January 2000 to December 2015). Data regarding age, gender, dialysis treatment, and comorbidity, including the development of sepsis, were also collected. Results: We evaluated 760,664 hospitalizations, the mean age was 80.5 ± 7.8 years, males represented 52.2% of the population, and 9% underwent dialysis treatment. IHM was 27.7% (210,661 admissions): Deceased patients were more likely to be older, undergoing dialysis treatment, and to be sicker than the survivors. The population was classified on the basis of tertiles of comorbidity score (the first group 7.48 ± 1.99, the second 13.67 ± 2,04, and third 22.12 ± 4.13). IHM was higher in the third tertile, whilst dialysis-dependent AKI was highest in the first. Dialysis-dependent AKI was associated with an odds ratios (OR) of 2.721; 95% confidence interval (CI) 2.676–2.766; p < 0.001, development of sepsis was associated with an OR of 1.990; 95% CI 1.948–2.033; p < 0.001, the second tertile of comorbidity was associated with an OR of 1.750; 95% CI 1.726–1.774; p < 0.001, and the third tertile of comorbidity was associated with an OR of 2.522; 95% CI 2.486–2.559; p < 0.001. Conclusions: In elderly subjects with AKI discharge codes, IHM is a frequent complication affecting more than a quarter of the investigated population. The increasing burden of comorbidity, dialysis-dependent AKI, and sepsis are the major risk factors.

scholarly journals P.2.32 Change in employment status in survivors with occupational cancers

2019 ◽  
Vol 76 (Suppl 1) ◽  
pp. A95.2-A95
Author(s):  
Chung-ching Wang ◽  
Wei-liang Chen ◽  
Wei-Te Wu ◽  
LIOU Saou-Hsing
Keyword(s):  
Employment Status ◽  
Occupational Status ◽  
Age Groups ◽  
International Classification Of Diseases ◽  
Young Group ◽  
Income Change ◽  
Cancer Group ◽  
Younger Age ◽  
Classification Of Diseases

BackgroundThe aim of this study is to investigate the socio-demographic information and employment status for 2 years after diagnosis with occupational cancers.MethodIn the Labor Registry Cohort of Taiwan during the period 2004–2015, 86 workers diagnosed with occupational cancers were identified. The cancer group included all kind of cancer diagnosed during this period. The cancer diagnoses were recorded according to the International Classification of Diseases for Oncology. Sex, age, industrial classifications, and occupational status were registered for the year 2004. The person’s annual wage and salary income was registered in New Taiwan Dollar (NTD) and divided into tertiles of 16500–22800, 24000–40100, and 42000–43 900.ResultsThere were 86 eligible workers with occupational cancers in our cohort study. All eligible participants were categorized into 2 groups based on their work status. There were 61 unemployed survivors with mean age of 53.05±8.3 and 25 employed survivors with mean age of 46.2±9.2 (table 1). Employed survivors had younger age and lower salary income than unemployed survivors. At 2 year of follow-up (figure 1), there was substantial declined trend for employment percentage (from 100% to 29%). For change of salary income, increased percentage of salary income change was observed. In different age groups (figure 2), young group aged 28–45 years had significantly higher employment percentages than older groups aged 46–55 years and 56–71 years. Notably, there were elevated percentage of salary income change in older group aged 56–71 years.ConclusionOur study highlighted that the workers with occupational cancers had apparent dilemmas in the workplace 2 years after diagnosis.

scholarly journals Readmissions After Complex Cancer Surgery: Analysis of the Nationwide Readmissions Database

2018 ◽  
Vol 14 (6) ◽  
pp. e335-e345 ◽  
Author(s):  
Syed Nabeel Zafar ◽  
Adil A. Shah ◽  
Christine Nembhard ◽  
Lori L. Wilson ◽  
Elizabeth B. Habermann ◽  
...  
Keyword(s):  
Private Insurance ◽  
Lung Resection ◽  
Hospital Readmissions ◽  
International Classification Of Diseases ◽  
Primary Diagnosis ◽  
Cancer Surgery ◽  
Prolonged Length ◽  
Factors Associated ◽  
Diagnosis Codes ◽  
Classification Of Diseases

Purpose: Hospital readmissions after surgery are a focus of quality improvement efforts. Although some reflect appropriate care, others are potentially preventable readmissions (PPRs). We aim to describe the burden, timing, and factors associated with readmissions after complex cancer surgery. Methods: The Nationwide Readmissions Database (2013) was used to select patients undergoing a complex oncologic resection, which was defined as esophagectomy/gastrectomy, hepatectomy, pancreatectomy, colorectal resection, lung resection, or cystectomy. Readmissions within 30 days from discharge were analyzed. International Classification of Diseases (9th revision) primary diagnosis codes were reviewed to identify PPRs. Multivariable logistic regression analyses identified demographic, clinical, and hospital factors associated with readmissions. Results: Of the 59,493 eligible patients, 14% experienced a 30-day readmission, and 82% of these were deemed PPRs. Half of the readmissions occurred within the first 8 days of discharge. Infections (26%), GI complications (17%), and respiratory conditions (10%) accounted for most readmissions. Factors independently associated with an increased likelihood of readmission included Medicaid versus private insurance (odds ratio [OR], 1.32; 95% CI, 1.17 to 1.48), higher comorbidity score (OR, 1.5; 95% CI, 1.33 to 1.63), discharge to a facility (OR, 1.39; 95% CI, 1.29 to 1.51), prolonged length of stay (OR, 1.42; 95% CI, 1.32 to 1.52), and occurrence of a major in-hospital complication (OR, 1.24; 95% CI, 1.16 to 1.34). Conclusion: One in seven patients undergoing complex cancer surgery suffered a readmission within 30 days. We identified common causes of these and identified patients at high risk for such an event. These data can be used by physicians, administrators, and policymakers to develop strategies to decrease readmissions.

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