Abstract 15772: Cardiovascular Hospitalizations and Procedures Plummet Nationwide During Covid-19 - an Analysis of US Medical Claims

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Monica R Shah ◽  
Tanya F Partridge ◽  
Xiaoqing Xue ◽  
Justin L Gregg
Keyword(s):  
Claims Data ◽  
Private Insurance ◽  
National Level ◽  
Regional Studies ◽  
Bayesian Hierarchical ◽  
Medical Claims ◽  
Equivalent Time ◽  
Time Period ◽  
The Us ◽  
National Trends

Introduction: Regional studies have reported a decline in cardiovascular (CV) hospitalizations and procedures with the onset of the coronavirus disease-2019 (COVID-19) pandemic. Factors may include patient reluctance to seek care and de-prioritization of approvals for CV admissions by hospitals. We wanted to assess these observations at a national level. Hypothesis: To examine national trends in CV hospitalizations for acute myocardial infarction (AMI), unstable angina (USA), and heart failure (HF), as well as left heart catheterizations (LHC), using US medical claims data. Methods: We interrogated IQVIA US Claims data, a verified source, from Jan 2019 to May 2020 (214 million patients; 76% private insurance claims, 19% Medicare claims, 5% Medicaid claims). Since confirmed COVID-19 cases in the US began rising in Mar 2020, this was used as reference point to identify cohorts for comparison. Trends in volumes of hospitalizations for key CV events (AMI, USA, and HF) and LHC were compared from Mar 1 to May 8, 2020 to the equivalent time period in 2019. We used a Bayesian hierarchical model to assess trends. Results: From Mar to May 2020, compared to 2019, there were significantly fewer hospitalizations for: key CV events (1,110,492 vs. 1,487,558; p=0.0016); AMI (277,615 vs. 412,235; p=0.0002); USA (1,007 vs. 1,688, p=0.1245); and, HF (831,870 vs. 1,073,635; p=0.0036). There were significantly fewer LHC (118,393 vs. 221,701; p=0.0002). As shown in the Figure, there was a significant decline in CV hospitalizations in 2020 compared to 2019. Conclusions: During the COVID-19 pandemic, CV hospitalizations have declined significantly in the US. We observed an ~25% drop in CV hospitalizations and an ~50% drop in LHC. To the best of our knowledge, this is the first national evaluation of trends in CV care during COVID-19 and validate concerns that acute CV care in the US has been delayed or deferred, potentially foreshadowing a surge of CV complications in the future.

scholarly journals Demonstrating the Use of High-Volume Electronic Medical Claims Data to Monitor Local and Regional Influenza Activity in the US

PLoS ONE ◽  
2014 ◽  
Vol 9 (7) ◽  
pp. e102429 ◽  
Author(s):  
Cécile Viboud ◽  
Vivek Charu ◽  
Donald Olson ◽  
Sébastien Ballesteros ◽  
Julia Gog ◽  
...  
Keyword(s):  
Claims Data ◽  
High Volume ◽  
Medical Claims ◽  
The Us ◽  
Influenza Activity

National Trends in Pediatric Admissions for Diabetic Ketoacidosis, 2006-2016

2021 ◽  
Author(s):  
Estelle M Everett ◽  
Timothy P Copeland ◽  
Tannaz Moin ◽  
Lauren E Wisk
Keyword(s):  
Diabetic Ketoacidosis ◽  
Urban Areas ◽  
Private Insurance ◽  
The Us ◽  
Pediatric Populations ◽  
Trends Over Time ◽  
Nationally Representative ◽  
Demographic Subgroups ◽  
National Trends ◽  
Mean Charge

Abstract Background and Objectives Diabetic ketoacidosis (DKA) rates in the US are rising. Prior studies suggest higher rates in younger populations, but no studies have evaluated national trends in pediatric populations and differences by subgroups. As such, we sought to examine national trends in pediatric DKA. Methods We used the 2006, 2009, 2012, and 2016 Kids’ Inpatient Database (KID) to identify pediatric DKA admissions among a nationally-representative sample of admissions youth ≤20 years-old. We estimate DKA admission per 10,000 admissions and per 10,000 population, charges, length of stay (LOS), and trends over time among all hospitalizations and by demographic subgroups. Regression models were used to evaluate differences in DKA rates within subgroups overtime. Results Between 2006 and 2016, there were 149,535 admissions for DKA. Unadjusted DKA rate per admission increased from 120.5 (95%CI:115.9–125.2) in 2006 to 217.7 (95%CI:208.3–227.5) in 2016. The mean charge per admission increased from $14,548 (95%CI:$13,971–$15,125) in 2006 to $20,997 (95%CI:$19,973–$22,022) in 2016, while mean LOS decreased from 2.51 (95%CI:2.45–2.57) to 2.28 (95%CI:2.23–2.33) days. Higher DKA rates occurred among 18-20 year-old, females, Black youth, without private insurance, with lower incomes, and from non-urban areas. Young adults, men, those without private insurance, and from non-urban areas had greater increases in DKA rates across time. Conclusions Pediatric DKA admissions have risen by 40% in the US and vulnerable subgroups remain at highest risk. Further studies should characterize the challenges experienced by these groups, to inform interventions to mitigate their DKA risk and to address the rising DKA rates nationally.

scholarly journals Mandated Health Insurance and Provider Reimbursement via Private Insurance

2017 ◽  
Vol 4 ◽  
pp. 233339281668720 ◽  
Author(s):  
Andrew Friedson ◽  
Allison Marier
Keyword(s):  
Health Insurance ◽  
Affordable Care Act ◽  
Low Income ◽  
Private Insurance ◽  
National Level ◽  
Potential Outcomes ◽  
Preventative Care ◽  
Physician Reimbursement ◽  
Patient Protection ◽  
The Us

In 2006, Massachusetts passed a reform that required individuals to purchase health insurance and provided subsidized health insurance to low-income individuals. The US Patient Protection and Affordable Care Act (ACA) was modeled after this reform, making Massachusetts an ideal place to look at potential outcomes from the ACA. Postreform, the proportion of the health-insured population in Massachusetts greatly increased, which potentially changed physician reimbursement for procedures as usage of care, particularly preventative care for children increased. We find that reimbursement for well-infant visits rose temporarily by approximately 4% the year after the reform but that the effective price increase did not persist. It is likely that this lack of persistence is due to an increase in the supply of physicians. This has important implications for the ACA, as expanding physician capacity is more difficult on a national level.

Use of near-real-time medical claims data to generate timely vaccine coverage estimates in the US: The dynamics of PCV13 vaccine uptake

Vaccine ◽  
2013 ◽  
Vol 31 (50) ◽  
pp. 5983-5988 ◽  
Author(s):  
Cynthia Schuck-Paim ◽  
Robert Taylor ◽  
David Lindley ◽  
Keith P. Klugman ◽  
Lone Simonsen
Keyword(s):  
Real Time ◽  
Claims Data ◽  
Vaccine Coverage ◽  
Vaccine Uptake ◽  
Medical Claims ◽  
The Us

scholarly journals Methodology Using Pharmacy And Medical Claims Data To Evaluate Real-World Outcomes And Costs Of Ivf Treatment In The Us

2015 ◽  
Vol 18 (3) ◽  
pp. A16
Author(s):  
F.A. Corvino ◽  
A. Surinach ◽  
J.C. Locklear ◽  
A.M. Howe ◽  
B. Hayward ◽  
...  
Keyword(s):  
Real World ◽  
Claims Data ◽  
Medical Claims ◽  
The Us

World Economy: Prospects and Barriers for Recovery

2012 ◽  
pp. 61-83 ◽  
Author(s):  
M. Ershov
Keyword(s):  
World Economy ◽  
Western World ◽  
Short Time Period ◽  
Market Segments ◽  
Junk Bonds ◽  
The Past ◽  
Time Period ◽  
The Us ◽  
Global Liquidity ◽  
Short Time

According to the latest forecasts, it will take 10 years for the world economy to get back to “decent shape”. Some more critical estimates suggest that the whole western world will have a “colossal mess” within the next 5–10 years. Regulators of some major countries significantly and over a short time‑period changed their forecasts for the worse which means that uncertainty in the outlook for the future persists. Indeed, the intensive anti‑crisis measures have reduced the severity of the past problems, however the problems themselves have not disappeared. Moreover, some of them have become more intense — the eurocrisis, excessive debts, global liquidity glut against the backdrop of its deficit in some of market segments. As was the case prior to the crisis, derivatives and high‑risk operations with “junk” bonds grow; budget problems — “fiscal cliff” in the US — and other problems worsen. All of the above forces the regulators to take unprecedented (in their scope and nature) steps. Will they be able to tackle the problems which emerge?

Treatment of venous leg ulcers using bilayered living cellular construct

2020 ◽  
Vol 9 (13) ◽  
pp. 907-918
Author(s):  
Aseel Bin Sawad ◽  
Fatema Turkistani
Keyword(s):  
Healthcare System ◽  
Cost Savings ◽  
Standard Of Care ◽  
Healthcare Resource Utilization ◽  
Psychological Status ◽  
Leg Ulcers ◽  
Venous Leg Ulcers ◽  
Time Period ◽  
The Us ◽  
Economic Analyses

Background: Venous leg ulcers (VLUs) present a significant economic burden on the US healthcare system and payers (US$14.9 billion). Aim: To evaluate the quality of life (QoL) of patients with VLUs; to analyze the limitations of standard of care (SOC) for VLUs; and to explain how using bilayered living cellular construct (BLCC) with SOC for treatment of VLUs can help heal more VLUs faster (than using SOC alone) as well as help improve QoL and help reduce the burden on the US healthcare system and payers. Materials & methods: This is a review study. The search was conducted in February 2020 by way of electronic databases to find relevant articles that provided information related to QoL of patients with VLUs, limitations of SOC for VLUs and economic analyses of using BLCC for treatment of VLUs. Results: VLUs impact patients’ physical, functional and psychological status and reduce QoL. A total 75% of VLU patients who used SOC alone failed to achieve healing in a timely fashion, which led to increased healthcare costs and healthcare resource utilization. Although the upfront cost is high, the greater effectiveness of BLCC offsets the added cost of the product during the time period of the studies. Therefore, BLCC helps to improve the QoL of VLU patients. As an example, for every 100 VLU patients in a healthcare plan, the use of BLCC can create cost savings of US$1,349,829.51. Conclusion: Payers’ coverage of BLCC results in reduction of the overall medical cost for treating VLU patients.

scholarly journals Variability of springtime transpacific pollution transport during 2000–2006: the INTEX-B mission in the context of previous years

2010 ◽  
Vol 10 (3) ◽  
pp. 1345-1359 ◽  
Author(s):  
G. G. Pfister ◽  
L. K. Emmons ◽  
D. P. Edwards ◽  
A. Arellano ◽  
T. Campos ◽  
...  
Keyword(s):  
Transport Model ◽  
Pollution Transport ◽  
Chemistry Transport Model ◽  
Pollution Levels ◽  
Annual Variability ◽  
Source Regions ◽  
Time Period ◽  
The Pacific ◽  
The Us ◽  
Transport Experiment

Abstract. We analyze the transport of pollution across the Pacific during the NASA INTEX-B (Intercontinental Chemical Transport Experiment Part B) campaign in spring 2006 and examine how this year compares to the time period for 2000 through 2006. In addition to aircraft measurements of carbon monoxide (CO) collected during INTEX-B, we include in this study multi-year satellite retrievals of CO from the Measurements of Pollution in the Troposphere (MOPITT) instrument and simulations from the chemistry transport model MOZART-4. Model tracers are used to examine the contributions of different source regions and source types to pollution levels over the Pacific. Additional modeling studies are performed to separate the impacts of inter-annual variability in meteorology and dynamics from changes in source strength. Interannual variability in the tropospheric CO burden over the Pacific and the US as estimated from the MOPITT data range up to 7% and a somewhat smaller estimate (5%) is derived from the model. When keeping the emissions in the model constant between years, the year-to-year changes are reduced (2%), but show that in addition to changes in emissions, variable meteorological conditions also impact transpacific pollution transport. We estimate that about 1/3 of the variability in the tropospheric CO loading over the contiguous US is explained by changes in emissions and about 2/3 by changes in meteorology and transport. Biomass burning sources are found to be a larger driver for inter-annual variability in the CO loading compared to fossil and biofuel sources or photochemical CO production even though their absolute contributions are smaller. Source contribution analysis shows that the aircraft sampling during INTEX-B was fairly representative of the larger scale region, but with a slight bias towards higher influence from Asian contributions.

scholarly journals Analysis of 220 Years of Floodplain Population Dynamics in the US at Different Spatial Scales

Water ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 141
Author(s):  
Firoza Akhter ◽  
Maurizio Mazzoleni ◽  
Luigia Brandimarte
Keyword(s):  
Population Dynamics ◽  
Large Scale ◽  
Spatial Scales ◽  
National Level ◽  
State Level ◽  
Economic Activities ◽  
Protection Measures ◽  
Management Planning ◽  
The Us ◽  
Over Time

In this study, we explore the long-term trends of floodplain population dynamics at different spatial scales in the contiguous United States (U.S.). We exploit different types of datasets from 1790–2010—i.e., decadal spatial distribution for the population density in the US, global floodplains dataset, large-scale data of flood occurrence and damage, and structural and nonstructural flood protection measures for the US. At the national level, we found that the population initially settled down within the floodplains and then spread across its territory over time. At the state level, we observed that flood damages and national protection measures might have contributed to a learning effect, which in turn, shaped the floodplain population dynamics over time. Finally, at the county level, other socio-economic factors such as local flood insurances, economic activities, and socio-political context may predominantly influence the dynamics. Our study shows that different influencing factors affect floodplain population dynamics at different spatial scales. These facts are crucial for a reliable development and implementation of flood risk management planning.

Is the firearm epidemic in the US getting worse?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Tedesco ◽  
K Y C Adja ◽  
F Rallo ◽  
C Reno ◽  
M P Fantini ◽  
...  
Keyword(s):  
Suicide Attempts ◽  
National Level ◽  
Gun Violence ◽  
Public Health Issue ◽  
Western World ◽  
Diagnostic Code ◽  
The Us ◽  
Icd 10 ◽  
Ed Visits ◽  
Annual Decline

Abstract Background The US is the least regulated firearm market in the Western world and firearm violence is a major public health issue. Firearms account for 40,000 deaths in the US annually, which is higher than other high-income countries. Although most of the gun-related deaths in the US are the result of suicide attempts and self-inflicted injuries, nearly 40% of them come from accidents, assaults, or police intervention. Methods We measured the number of non-self-inflicted firearm-related ED visits, by including patients discharged with diagnostic ICD-9-CM (ICD-10 for 2016) codes of accidents, assaults or legal intervention resulting in firearm injuries between 2006-2016. We used data from the Healthcare Cost and Utilization Project (HCUPnet). From the CDC Wide-ranging Online Data for Epidemiologic Research we obtained data on non-suicidal firearm-related deaths over the period 2006-2017. To identify the cause of death we used the ICD-10 codes. Temporal changes of rates of ED visits and deaths were evaluated using Joinpoint Software. Results In 2006 there were a total of 79,998 ED visits with a diagnostic code of firearm-related injury, and this number showed a non-significant 2.7% annual decline between 2006-2013 (p = 0.06) followed by a significant 19.4% annual increase between 2013-2016 (p < 0.05), resulting in 111.305 visits in 2016. The number of non-suicidal firearm-related deaths showed a significant 2.2% annual decline between 2006-2014 (p < 0.05), followed by a significant 10.3% APC (p < 0.05) between 2014-2017. Conclusions Data showed steady rates until 2013 and a striking increasing trend starting from 2013. Firearm-related deaths followed the same trends. Our data show that in the last four detectable years there has been a new concerning wave of gun violence and consequently a higher number of fatalities. Analysis limitations: we used national-level aggregate data and coding accuracy may be not consistent nationwide. Key messages In the last four detectable years there has been a new concerning wave of gun violence and consequently a higher number of fatalities nationwide. The US firearm related deaths epidemic urges for new policies and preventive measures, such as stricter background checks and restrictions on guns ownership.

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