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.

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 Widespread Belief That Organic and Additive-Free Tobacco Products are Less Harmful Than Regular Tobacco Products: Results From the 2017 US Health Information National Trends Survey

2019 ◽  
Vol 21 (7) ◽  
pp. 970-973 ◽  
Author(s):  
Jennifer L Pearson ◽  
Meghan Moran ◽  
Cristine D Delnevo ◽  
Andrea C Villanti ◽  
M Jane Lewis
Keyword(s):  
Health Information ◽  
Smoking Status ◽  
Tobacco Product ◽  
Tobacco Products ◽  
Logistic Regression Models ◽  
The Us ◽  
Widespread Belief ◽  
Nationally Representative ◽  
Never Smokers ◽  
National Trends

Abstract Significance US smokers of Natural American Spirit, a brand marketed as “organic” and “additive-free,” are more likely than other cigarette smokers to believe that their brand might be less harmful than other brands. This article (1) describes the prevalence of belief that “organic” and “additive-free” tobacco is less harmful than regular tobacco products in the US population and (2) describes the sociodemographic characteristics of adults who believe tobacco products with these descriptors are less harmful. Methods Data were drawn from the 2017 Health Information National Trends Survey (HINTS), a nationally representative survey of US adults. Logistic regression models were used to examine correlates of the belief that “organic” or “additive-free” tobacco products are less harmful than regular tobacco products. Results Overall, 26.7% of US adults and 45.3% of adult smokers believe that “organic” tobacco products are less harmful than regular tobacco products. Similarly, 35.2% of US adults and 47.1% of smokers believe that “additive-free” tobacco products are less harmful. When examining gender, age, education, race/ethnicity, sexual orientation, and smoking status, only age (adjusted odds ratio [aOR] ~0.98, 95% confidence interval [CI]: 0.97, 0.99 for both outcomes) and smoking status (current vs. never smokers, aOR ~1.78, 95% CI 1.03, 3.07 for both outcomes) were correlates of believing that “organic” or “additive-free” tobacco is less harmful than regular tobacco products. Conclusions Belief that “organic” and “additive-free” tobacco products are less harmful than other products is widespread. Younger adults and current smokers are most likely to be misinformed by “organic” or “additive-free” tobacco product descriptors. Implications Belief that “organic” and “additive-free” tobacco products are less harmful than other products is widespread among US adults and most prevalent among smokers. Removal of terms that incorrectly imply reduced harm may correct current and future consumers’ misperceptions about the brand.

scholarly journals Calorie labelling on the menu: extent and disparities in use at sit down restaurants in the United States

2021 ◽  
Vol 8 (7) ◽  
pp. 3215
Author(s):  
Teresia N. Mbogori ◽  
Kylan B. Freeland
Keyword(s):  
Secondary Data ◽  
The United States ◽  
Health Concern ◽  
Major Health ◽  
Telephone Interviews ◽  
Income Disparities ◽  
The Us ◽  
Health Related ◽  
Nationally Representative ◽  
National Trends

Background: Obesity remains a major health concern all over the world. The Food and Drug Administration in 2018 enacted a policy that required all food chain restaurants with more than 20 establishments to include calorie information on their menus. Very few studies have assessed the effects of this policy since its enactment.Methods: A secondary data analysis was conducted using the Health Information National Trends Survey (HINTS-5 Cycle 3), a nationally-representative survey administered by the National Cancer Institute (NCI). Data were collected using telephone interviews between January and May 2019. Regression models were used to determine the relationships between demographic and health related variables and the use of calorie information on the menu.Results: Forty six percent of the participants (n=5438) stated that they noticed calorie information on the menu. Among those who noticed the information, 65%, 37% and 44% reported that they ordered fewer calories, fewer items, or smaller sizes respectively, while 4%, 2%, and 2% reported that they ordered more calories, more items or larger sizes. Men were less likely to report seeing calorie information on the menu as compared to women (OR 0.70; CI: 0.56-0.89). Similarly, when compared to those between 18-45 years old, those 75 years and older were 33% less likely to report seeing this information (OR: 0.67 CI: 0.46-0.98). The odds of noticing calorie information on the menu increased with increase in education and income.Conclusions: Gender, age education, and income disparities exist in the use of calorie information among restaurant goers in the US. More targeted education is needed to ensure that the policy attains its intended goal.

scholarly journals Prevalence of Hepatitis C Testing Among Non-Institutionalized Individuals in the US, NHIS 2013-2017

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Jae Eui Soh ◽  
Mohammed A. Khan ◽  
William W. Thompson ◽  
Lauren Canary ◽  
Claudia J. Vellozzi ◽  
...  
Keyword(s):  
United States ◽  
Hepatitis C ◽  
Baby Boomers ◽  
Baby Boomer ◽  
Private Insurance ◽  
Preventive Services ◽  
The United States ◽  
The Us ◽  
Nationally Representative ◽  
Baby Boomer Cohort

ObjectiveUsing a large nationally representative dataset, we estimated the prevalence of self-reported hepatitis C testing among individuals who were recommended to be tested (i.e., baby boomer cohort born between 1945 and 1965) by the CDC and United States Preventive Services Task Force.IntroductionHepatitis C virus (HCV) infection is the most common blood-borne disease in the US and the leading cause of liver-related morbidity and mortality. Approximately 3.5 million individuals in the US were estimated to have been living with hepatitis C in 2010 and approximately half of them were unaware that they were infected. Among HCV infected individuals, those born between 1945 and 1965 (usually referred to as the baby boomer cohort) represents approximately 75% of current cases. Because of the substantial burden of disease among this age group, CDC expanded its existing hepatitis C risk-based testing recommendations to include a one-time HCV antibody test for all persons born between 1945 and 1965. The United States Preventive Services Task Force (USPSTF) subsequently made the same recommendation in June 2013.DescriptionMethodsThe following question "Have you ever had a blood test for hepatitis C?" has been administered annually from 2013 through 2017 on the National Health Interview Survey (NHIS). The NHIS is a nationally representative cross-sectional face-to-face household interview of civilian noninstitutionalized individuals in the U.S. The NHIS survey uses a complex multistage probability design that includes stratification, clustering, and oversampling. We estimated the prevalence of hepatitis C testing for adults in the US during the study period from 2013 to 2017. In addition, we carried out stratified analyses comparing those with private insurance to those who did not have private insurance. We reported weighted estimates taking into account the NHIS survey design. The R statistical software (R Core Team, 2018) was used to estimate weighted prevalence estimates for hepatitis C testing.ResultsDuring the study period from 2013-2017, there were 148,674 adults who responded to the ever tested for hepatitis C question. In addition, 33.56% of these individuals were born between 1945 and 1965; among all adults, the weighted percentage of individuals that responded yes they had received a hepatitis C screening test was 12.82% (95% CI: 12.54-13.10%) while for baby boomers the estimate was 13.93% (95% CI: 13.51-14.35%).Figure 1 presents the annual trend in the hepatitis C test prevalence over the study period by birth cohorts. For both cohorts, there were significant increases over time in hepatitis C testing prevalence. The two trend lines began to diverge in 2015 with the baby boomer cohort reporting higher rates of hepatitis C testing. For the baby boomer cohort, there was also a substantial increase in reported hepatitis C testing in 2017 relative to 2016. Similar trends were found for the samples when we restricted the sample to only those with private insurance. Compared to the people with private insurance, the baby boomers with 'Non-private’ insurance, including Medicaid, Medicare, or military- government sponsored insurances, reported higher rates of testing.ConclusionAcross the five-year period from 2013 through 2017, we found increasing rates of self-reported hepatitis C testing among non-institutionalized U.S. adults. For the baby boomer cohort, we saw a substantial increase in testing in 2017, which was likely due in part, to increased awareness among both physicians and patients of the CDC and USPSTF recommendation to have all baby boomers tested. Efforts to increase the awareness of these recommendations should continue. Additional targeted promotions among hard to reach populations should also be considered.How the Moderator Intends to Engage the Audience in Discussions on the TopicThis panel will discuss strengths and weaknesses for monitoring hepatitis C testing using alternative data sources including self-reported data, insurance claims data, and laboratory testing data. 

The role of sexual identity in tobacco information–seeking behaviours and perceptions

2018 ◽  
Vol 78 (2) ◽  
pp. 203-213 ◽  
Author(s):  
Christopher W Wheldon ◽  
Leah Hoffman ◽  
Erin Keely O’Brien ◽  
Janine Delahanty ◽  
Xiaoquan Zhao ◽  
...  
Keyword(s):  
Health Information ◽  
Tobacco Use ◽  
Sexual Minority ◽  
Information Seeking ◽  
Cross Sectional ◽  
Information Campaigns ◽  
The Us ◽  
Nationally Representative ◽  
National Trends

Objective: To explore differences in tobacco information–seeking behaviours and perceptions between sexual minority and heterosexual (or ‘straight’) adults and to determine if these differences are mediated by tobacco use. Design: Cross-sectional national survey. Setting: Nationally representative probability-based surveys of adults 18 years of age or older in the US civilian non-institutionalised population. Methods: Data from respondents identifying as gay, lesbian, bisexual (LGB; n = 156) or straight ( n = 4,964) in the US National Cancer Institute’s Health Information National Trends Survey Food and Drug Administration cycles 1 and 2 (HINTS-FDA 2015, 2017) were analysed. We compared the responses of sexual minority and straight respondents aged 18 years and older concerning tobacco information-seeking behaviours and perceptions. Results: Sexual minority respondents were more likely than their straight counterparts to seek out tobacco health information, to look for information about e-cigarettes and to use the Internet for health information searches. Some of these differences were mediated by tobacco use. Sexual minority respondents were similar to their straight counterparts regarding perceptions of trust and confidence in tobacco health information, as well as perceptions of the hazards of tobacco use. Conclusion: Because sexual minority adults have higher rates of tobacco use and higher rates of tobacco information seeking than others, tobacco health information campaigns should consider carefully tailoring the messages directed towards sexual minority populations.

A comparison of risk factors for cigarette and e-cigarette use in the United States adult population.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 1546-1546
Author(s):  
Leo Chen ◽  
Nai Wen Wang ◽  
Winson Y. Cheung
Keyword(s):  
Risk Factors ◽  
Adult Population ◽  
The United States ◽  
Public Health Agencies ◽  
Increased Risk ◽  
Health Agencies ◽  
The Us ◽  
Quitting Smoking ◽  
Nationally Representative ◽  
National Trends

1546 Background: The US CDC and public health agencies have reported alarming increases in e-cigarette (ecig) use among youth, even as cigarette (cig) use among youth decline. In this study, other risk factors for cig and ecig use are compared. Methods: This study used data from the Health Information National Trends Survey 5 Cycle 1 survey, conducted in 2017. Univariate survey-weighted logistic regression analyzed responses as a nationally representative US population. Results: Inverted trends included being 35 or older (cig: OR=1.22, p<0.01; ecig: OR=0.79, p<0.01), being a student (cig: OR=0.77, p<0.01; ecig: OR=1.24, p<0.01) or retired (cig: OR=1.09, p<0.01; ecig: OR=0.89, p<0.01) compared to being employed, and being single (cig: OR=0.92, p<0.03; ecig: OR=1.18, p<0.01). Having considered quitting smoking was not significantly associated with ecig use. Conclusions: Segments of the US adult population educated with anti-tobacco campaigns may remain at increased risk for ecig use.[Table: see text]

scholarly journals Health Disparities in Calorie Knowledge and Confidence Among the U.S. Adult Population

2021 ◽  
Vol 12 ◽  
pp. 215013272110024
Author(s):  
Amy M. Lando ◽  
Martine S. Ferguson ◽  
Linda Verrill ◽  
Fanfan Wu ◽  
Olivia E. Jones-Dominic ◽  
...  
Keyword(s):  
Adult Population ◽  
Calorie Intake ◽  
Healthy Weight ◽  
Obesity Prevalence ◽  
Nutrition Survey ◽  
Chi Square ◽  
The Us ◽  
Chi Square Test ◽  
Nationally Representative ◽  
Demographic Subgroups

Purpose Obesity prevalence has reached an all-time high in the US, affecting >40% of the population. This study’s objective was to evaluate associations between demographics and self-reported calorie knowledge and self-perceived confidence in calorie knowledge (“calorie confidence”). The relationships between body mass index (BMI) and calorie knowledge and confidence were also explored. Methods We analyzed data from participants (n = 2171) in the crosssectional, nationally representative 2019 FDA Food Safety and Nutrition Survey using logistic regression to estimate adjusted odds ratios (AORs) and confidence intervals (95% CIs) for associations between BMI and calorie knowledge (correct/incorrect), calorie confidence (confident/not confident), and demographic characteristics, and the Wald chi square test to evaluate relationships between BMI and both calorie knowledge and confidence. Results Many of the same subgroups were more likely than others to report lack of calorie knowledge and lack of confidence in knowing the typical daily calorie intake needed to maintain a healthy weight [respective AORs (95% CIs): age (years), >60 vs 51-60, 1.7 (1.1-2.5), and 1.4 (1.0-2.0); sex, male vs female, 1.7 (1.3-2.3), and 1.7 (1.3-2.1); race/ethnicity, non-Hispanic Black vs non-Hispanic white, 3.4 (2.1-5.5), and 2.4 (1.6-3.8); education, ≤high school vs college grad, 1.5 (1.0- 2.3), and 1.9 (1.3-2.7)]. BMI was significantly correlated with calorie confidence ( P = .047), such that those reporting less confidence were more likely overweight or obese [underweight/healthy (BMI < 25): 29%, overweight (25 ≤ BMI < 30): 34%, obese (BMI ≥ 30): 37%]. Conclusion In certain demographic subgroups associations between calorie knowledge and confidence differed. Tailored education and outreach for these groups may help to address these disparities.

Cannabis use in Switzerland: The role of attribution of drug use to friends, urbanization and repression 1The study was supported by the Swiss Federal Office of Public Health (Bundesamt für Gesundheit BAG) Grant 316.96.5980.

2001 ◽  
Vol 60 (2) ◽  
pp. 99-107 ◽  
Author(s):  
Holger Schmid
Keyword(s):  
Drug Use ◽  
Urban Areas ◽  
Hierarchical Linear Model ◽  
Cannabis Use ◽  
School Aged Children ◽  
Structural Variables ◽  
Hbsc Study ◽  
Nationally Representative ◽  
Highly Correlated ◽  
Individual Use

Cannabis use does not show homogeneous patterns in a country. In particular, urbanization appears to influence prevalence rates, with higher rates in urban areas. A hierarchical linear model (HLM) was employed to analyze these structural influences on individuals in Switzerland. Data for this analysis were taken from the Switzerland survey of Health Behavior in School-Aged Children (HBSC) Study, the most recent survey to assess drug use in a nationally representative sample of 3473 15-year-olds. A total of 1487 male and 1620 female students indicated their cannabis use and their attributions of drug use to friends. As second level variables we included address density in the 26 Swiss Cantons as an indicator of urbanization and officially recorded offences of cannabis use in the Cantons as an indicator of repressive policy. Attribution of drug use to friends is highly correlated with cannabis use. The correlation is even more pronounced in urban Cantons. However, no association between recorded offences and cannabis use was found. The results suggest that structural variables influence individuals. Living in an urban area effects the attribution of drug use to friends. On the other hand repressive policy does not affect individual use.

scholarly journals Examining Recent Trends in the Racial Disparity Gap in Tap Water Consumption: NHANES 2011–2018

2021 ◽  
pp. 1-20
Author(s):  
Asher Y. Rosinger ◽  
Anisha I. Patel ◽  
Francesca Weaks
Keyword(s):  
Water Consumption ◽  
Tap Water ◽  
Ethnic Disparities ◽  
Prevalence Ratio ◽  
Bottled Water ◽  
Water Crisis ◽  
Cross Sectional ◽  
The Us ◽  
Recent Trends ◽  
Nationally Representative

Abstract Objective As tap water distrust has grown in the US with greater levels among Black and Hispanic households, we aimed to examine recent trends in not drinking tap water including the period covering the US Flint Water Crisis and racial/ethnic disparities in these trends. Design Cross-sectional analysis. We used log-binomial regressions and marginal predicted probabilities examined US nationally-representative trends in tap and bottled water consumption overall and by race/ethnicity. Setting The National Health and Nutrition Examination Survey data, 2011–2018. Participants Nationally-representative sample of 9,439 children aged 2-19 and 17,268 adults. Results Among US children and adults, respectively, in 2017-2018 there was a 63% (adjusted prevalence ratio [PR]:1.63, 95%CI: 1.25-2.12, p<0.001) and 40% (PR:1.40, 95%CI: 1.16-1.69, p=0.001) higher prevalence of not drinking tap water compared to 2013-2014 (pre-Flint Water Crisis). For Black children and adults, the probability of not drinking tap water increased significantly from 18.1% (95%CI: 13.4-22.8) and 24.6% (95%CI: 20.7-28.4) in 2013–14 to 29.3% (95%CI: 23.5-35.1) and 34.5% (95%CI: 29.4-39.6) in 2017–2018. Among Hispanic children and adults, not drinking tap water increased significantly from 24.5% (95%CI: 19.4-29.6) and 27.1% (95%CI: 23.0-31.2) in 2013-14 to 39.7% (95%CI: 32.7-46.8) and 38.1% (95%CI: 33.0-43.1) in 2017-2018. No significant increases were observed among Asian or white persons between 2013-14 and 2017-18. Similar trends were found in bottled water consumption. Conclusions This study found persistent disparities in the tap water consumption gap from 2011–2018. Black and Hispanics’ probability of not drinking tap water increased following the Flint Water Crisis.

Sign in / Sign up

Export Citation Format

Share Document