scholarly journals Pandemic-related declines in hospitalization for non-COVID-19-related illness in the United States from January through July 2020

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262347
Author(s):  
Jennifer L. Nguyen ◽  
Michael Benigno ◽  
Deepa Malhotra ◽  
Farid Khan ◽  
Frederick J. Angulo ◽  
...  
Keyword(s):  
United States ◽  
Age Groups ◽  
The United States ◽  
Geographic Region ◽  
Large Hospital ◽  
Healthcare Database ◽  
Respiratory Illnesses ◽  
Diagnostic Categories ◽  
Public Health Officials ◽  
Us Census

Background The COVID-19 pandemic, caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has substantially impacted healthcare utilization worldwide. The objective of this retrospective analysis of a large hospital discharge database was to compare all-cause and cause-specific hospitalizations during the first six months of the pandemic in the United States with the same months in the previous four years. Methods Data were collected from all hospitals in the Premier Healthcare Database (PHD) and PHD Special Release reporting hospitalizations from January through July for each year from 2016 through 2020. Hospitalization trends were analyzed stratified by age group, major diagnostic categories (MDCs), and geographic region. Results The analysis included 286 hospitals from all 9 US Census divisions. The number of all-cause hospitalizations per month was relatively stable from 2016 through 2019 and then fell by 21% (57,281 fewer hospitalizations) between March and April 2020, particularly in hospitalizations for non-respiratory illnesses. From April onward there was a rise in the number of monthly hospitalizations per month. Hospitalizations per month, nationally and in each Census division, decreased for 20 of 25 MDCs between March and April 2020. There was also a decrease in hospitalizations per month for all age groups between March and April 2020 with the greatest decreases in hospitalizations observed for patients 50–64 and ≥65 years of age. Conclusions Rates of hospitalization declined substantially during the first months of the COVID-19 pandemic, suggesting delayed routine, elective, and emergency care in the United States. These lapses in care for illnesses not related to COVID-19 may lead to increases in morbidity and mortality for other conditions. Thus, in the current stage of the pandemic, clinicians and public-health officials should work, not only to prevent SARS-CoV-2 transmission, but also to ensure that care for non-COVID-19 conditions is not delayed.

scholarly journals Clinical and Pregnancy Outcomes of COVID-19 Among Hospitalized Pregnant Women in the United States

2021 ◽  
Author(s):  
Christina M Ackerman ◽  
Jennifer L Nguyen ◽  
Swapna Ambati ◽  
Maya Reimbaeva ◽  
Birol Emir ◽  
...  
Keyword(s):  
United States ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Negative Impact ◽  
Invasive Mechanical Ventilation ◽  
Age Groups ◽  
The United States ◽  
Supplemental Oxygen ◽  
Healthcare Database ◽  
The Impact

Abstract Background Pregnant women with coronavirus disease 19 (COVID-19) may be at greater risk of poor maternal and pregnancy outcomes. This retrospective analysis reports clinical and pregnancy outcomes among hospitalized pregnant women with COVID-19 in the United States. Methods The Premier Healthcare Database – Special Release was used to examine the impact of COVID-19 among pregnant women aged 15–44 years who were hospitalized and who delivered compared with pregnant women without COVID-19. Outcomes evaluated were COVID-19 clinical progression, including the use of supplemental oxygen therapy, intensive care unit admission, critical illness, receipt of invasive mechanical ventilation/extracorporeal membrane oxygenation, and maternal death, and pregnancy outcomes, including preterm delivery and stillbirth. Results Overall, 473,902 hospitalized pregnant women were included, of whom 8584 (1.8%) had a COVID-19 diagnosis (mean [SD] age 28.4 [6.1] years; 40% Hispanic). The risk of poor clinical and pregnancy outcomes was greater among pregnant women with COVID-19 compared with pregnant women without a COVID-19 diagnosis in 2020; the risk of poor clinical and pregnancy outcomes increased with increasing age. Hispanic and Black non-Hispanic women were consistently observed to have the highest relative risk of experiencing poor clinical or pregnancy outcomes across all age groups. Conclusions Overall, COVID-19 had a significant negative impact on maternal health and pregnancy outcomes. These data help inform clinical practice and counselling to pregnant women regarding the risks of COVID-19. Clinical studies evaluating the safety and efficacy of vaccines against severe acute respiratory syndrome coronavirus 2 in pregnant women are urgently needed.

scholarly journals Patterns of care and clinical outcomes with cytarabine-anthracycline induction chemotherapy for AML patients in the United States

2020 ◽  
Vol 4 (8) ◽  
pp. 1615-1623 ◽  
Author(s):  
Amer M. Zeidan ◽  
Nikolai A. Podoltsev ◽  
Xiaoyi Wang ◽  
Chi Zhang ◽  
Jan Philipp Bewersdorf ◽  
...  
Keyword(s):  
United States ◽  
Resource Utilization ◽  
Induction Chemotherapy ◽  
Standard Of Care ◽  
The United States ◽  
Geographic Region ◽  
Adult Patients ◽  
Remission Induction ◽  
Hospital Death ◽  
Healthcare Database

Abstract Cytarabine-anthracycline based intensive induction chemotherapy (IC) remains the standard of care for remission induction among fit patients with newly diagnosed acute myeloid leukemia (AML) in the United States (US). However, the mortality rate outside of clinical IC trials, predictors of death, and resource utilization during admission for IC have not been thoroughly examined. We used the Premier Healthcare database to identify adult patients (aged 18-89 years) treated with cytarabine-anthracycline-based IC during their first recorded inpatient stay for AML during the contemporary period of 2010 to 2017. We identified factors associated with inpatient death or discharge to hospice, using multivariable logistic regression models. We also assessed the patterns of inpatient healthcare resource utilization. A total of 6442 patients with AML from 313 hospitals who were treated with IC were identified. Median age was 61 years (interquartile range [IQR], 50-68 years), and 56% were men. Median length of stay was 29 (IQR, 25-38) days, with rates of in-hospital death and discharge to hospice of 12.3% and 3.7% (17.9% and 6.3% among patients aged ≥65 years), respectively. Predictors of in-hospital death or discharge to hospice included older age, geographic region, and lower hospital volume. During admission, 28.0%, 12.6%, and 4.0% of patients required treatment in intensive care units, mechanical ventilation, and dialysis, respectively. Despite improvements in supportive care in the contemporary era, inpatient mortality during first hospitalization for adult patients with AML treated with IC in the US remains high particularly among older patients.

scholarly journals Incidence of Benign Meningiomas in the United States: Current and Future Trends

2021 ◽  
Author(s):  
Sonia Bhala ◽  
Douglas R Stewart ◽  
Victoria Kennerley ◽  
Valentina I Petkov ◽  
Philip S Rosenberg ◽  
...  
Keyword(s):  
United States ◽  
Age Groups ◽  
Cancer Registries ◽  
Health Impact ◽  
The United States ◽  
Birth Cohorts ◽  
Benign Meningioma ◽  
Case Count ◽  
Future Burden ◽  
Rate Ratios

Abstract Background Benign meningiomas are the most frequently reported central nervous system tumors in the United States (US), with increasing incidence in past decades. However, the future trajectory of this neoplasm remains unclear. Methods We analyzed benign meningioma incidence of cases identified by any means (eg, radiographically with or without microscopic confirmation) in US Surveillance Epidemiology and End Results (SEER) cancer registries among 35–84-year-olds during 2004–2017 by sex and race/ethnicity using age-period-cohort (APC) models. We employed APC forecasting models to glean insights regarding the etiology, distribution, and anticipated future (2018–2027) public health impact of this neoplasm. Results In all groups, meningioma incidence overall increased through 2010, then stabilized. Temporal declines were statistically significant overall and in most groups. JoinPoint analysis of cohort rate-ratios identified substantial acceleration in White men born after 1963 (from 1.1% to 3.2% per birth year); cohort rate-ratios were stable or increasing in all groups and all birth cohorts. We forecast that meningioma incidence through 2027 will remain stable or decrease among 55–84-year-olds but remain similar to current levels among 35–54-year-olds. Total meningioma burden in 2027 is expected to be approximately 30,470 cases, similar to the expected case count of 27,830 in 2018. Conclusions Between 2004–2017, overall incidence of benign meningioma increased and then stabilized or declined. For 2018–2027, our forecast is incidence will remain generally stable in younger age groups but decrease in older age groups. Nonetheless, the total future burden will remain similar to current levels because the population is aging.

Firearm Injuries Affecting the Pediatric Population

PEDIATRICS ◽  
1992 ◽  
Vol 89 (4) ◽  
pp. 788-790
Author(s):  
Keyword(s):  
United States ◽  
Children And Adolescents ◽  
Pediatric Population ◽  
Age Groups ◽  
Unintentional Injury ◽  
The United States ◽  
Male Adolescents ◽  
Firearm Injuries ◽  
Group 2 ◽  
Developed Nations

In the United States approximately 30 000 people die from firearm injuries each year. Many more are wounded. In the mid 1980s, more than 3000 of the dead were children and adolescents aged 1 to 19 years.1 In 1989 nearly 4000 firearm deaths were among children 1 to 19 years of age, accounting for 12% of all deaths in that age group.2 All of these deaths or injuries affect other children because the victims who are killed or wounded are frequently relatives, neighbors, or friends. Comparison data for childhood age groups demonstrate that in 1987, 203 children aged 1 to 9 years, 484 children aged 10 to 14 years, and 2705 adolescents aged 15 to 19 years died as a result of firearm injuries.1 Firearm deaths include unintentional injuries, homicides, and suicides. Among the 1- to 9-year-olds, half of the deaths were homicides and half were unintentional. Among the 10- to 14-year-olds, one third of the deaths were homicides, one third were suicides, and one third were unintentional. Among the 15- to 19-year-olds, 48% were homicides, 42% were suicides, and 8% were unintentional.1 Firearm homicides are the leading cause of death for some US subpopulations, such as urban black male adolescents and young adults.3 Table 1 indicates how firearms contributed to the deaths of children and adolescents (homicides, suicides, and all causes) in 1987. Table 2 illustrates the unusual scale of firearm violence affecting young people in the United States compared with other developed nations.4 Firearm injuries are the fourth leading cause of unintentional injury deaths to children younger than 15 years of age in the US.5

Limitation of Private Attending Pediatricians' Neonatal Intensive Care Privileges in Level III Institutions Throughout the United States

PEDIATRICS ◽  
1994 ◽  
Vol 94 (2) ◽  
pp. 190-193
Author(s):  
Rita G. Harper ◽  
Concepcion G. Sia ◽  
Regina Spinazzola ◽  
Raul A. Wapnir ◽  
Shahnaz Orner ◽  
...  
Keyword(s):  
United States ◽  
Intensive Care ◽  
Health Care Providers ◽  
Curriculum Design ◽  
Neonatal Intensive Care ◽  
District Of Columbia ◽  
The United States ◽  
Geographic Region ◽  
Neonatal Intensive Care Units ◽  
Care Providers

Objective. To determine the privileges of Private Attending Pediatricians (PAP) in caring for newborns requiring intensive (ITC), intermediate (IMC), or continuing (CC) care in Level III neonatal intensive care units (NICUs) throughout the United States. Design. A two-page mail questionnaire was sent to 429 Level III NICUs to obtain the statement best describing the PAPs' privileges, the number of PAP, and some of the PAPs' functions. Level III NICUs were classified by geographic region as Eastern, Central, or Western United States. Results. Responses were received from 301 NICUs (70%) representing 48 states, the District of Columbia, and >9000 PAP. Twenty-two institutions had no PAP. In the remaining 279 institutions, 96% (267/279) had restricted the PAPs' privileges partially or completely. In 32% (88/279), the PAP were not allowed to render any type of NICU care. In 18% (51/279) of the institutions, the PAP were allowed to render CC only. In 27% (76/279) of the institutions, the PAP were allowed to render IMC and CC only. Limitation of PAPs' privileges were reported in all geographic areas in the U.S., were more pronounced in the Eastern than the Central or Western sections of the country, and were noted in institutions with small (≤10) as well as large (≥60) numbers of PAP. Limitation of PAPs' privileges was determined by the PAP him/herself in many institutions. Proficiency in resuscitation was considered to be a needed skill. Communication with parents of an infant under the care of a neonatologist was encouraged. Conclusions. The PAPs' privileges were limited partially or completely in most Level III NICUs. Knowledge of this restricted role impacts significantly on curriculum design for pediatric house officers, number and type of health care providers required for Level III NICUs and future house officer's career choices.

scholarly journals Firework-related injuries treated at emergency departments in the United States during the COVID-19 pandemic in 2020 compared to 2018–2019

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Nathan Maassel ◽  
Abbie Saccary ◽  
Daniel Solomon ◽  
David Stitelman ◽  
Yunshan Xu ◽  
...  
Keyword(s):  
United States ◽  
Census Data ◽  
The United States ◽  
Population Based ◽  
Emergency Department Visits ◽  
Consumer Product Safety Commission ◽  
Injury Surveillance System ◽  
Time Period ◽  
National Estimates ◽  
Us Census

Abstract Background Despite a national decrease in emergency department visits in the United States during the first 10 months of the pandemic, preliminary Consumer Product Safety Commission data indicate increased firework-related injuries. We hypothesized an increase in firework-related injuries during 2020 compared to years prior related to a corresponding increase in consumer firework sales. Methods The National Electronic Injury Surveillance System (NEISS) was queried from 2018 to 2020 for cases with product codes 1313 (firework injury) and narratives containing “fireworks”. Population-based national estimates were calculated using US Census data, then compared across the three years of study inclusion. Patient demographic and available injury information was also tracked and compared across the three years. Firework sales data obtained from the American Pyrotechnics Association were determined for the same time period to examine trends in consumption. Results There were 935 firework-related injuries reported to the NEISS from 2018 to 2020, 47% of which occurred during 2020. National estimates for monthly injuries per million were 1.6 times greater in 2020 compared to 2019 (p < 0.0001) with no difference between 2018 and 2019 (p = 0.38). The same results were found when the month of July was excluded. Firework consumption in 2020 was 1.5 times greater than 2019 or 2018, with a 55% increase in consumer fireworks and 22% decrease in professional fireworks sales. Conclusions Firework-related injures saw a substantial increase in 2020 compared to the two years prior, corroborated by a proportional increase in consumer firework sales. Increased incidence of firework-related injuries was detected even with the exclusion of the month of July, suggesting that the COVID-19 pandemic may have impacted firework epidemiology more broadly than US Independence Day celebrations.

scholarly journals FSMB Census of Licensed Physicians in the United States, 2018

2019 ◽  
Vol 105 (2) ◽  
pp. 7-23 ◽  
Author(s):  
Aaron Young ◽  
Humayun J. Chaudhry ◽  
Xiaomei Pei ◽  
Katie Arnhart ◽  
Michael Dugan ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Medical School ◽  
Census Data ◽  
Medical Schools ◽  
The United States ◽  
Geographic Region ◽  
Physician Workforce ◽  
Care Needs ◽  
State Medical Boards

ABSTRACT There are 985,026 physicians with Doctor of Medicine (MD) and Doctor of Osteopathic Medicine (DO) degrees licensed to practice medicine in the United States and the District of Columbia, according to physician census data compiled by the Federation of State Medical Boards (FSMB). These qualified physicians graduated from 2,089 medical schools in 167 countries and are available to serve a U.S. national population of 327,167,434. While the percentage of physicians who are international medical graduates have remained relatively stable over the last eight years, the percentage of physicians who are women, possess a DO degree, have three or more licenses, or are graduates of a medical school in the Caribbean have increased by varying degrees during that same period. This report marks the fifth biennial physician census that the FSMB has published, highlighting key characteristics of the nation's available physician workforce, including numbers of licensees by geographic region and state, type of medical degree, location of medical school, age, gender, specialty certification and number of active licenses per physician. The number of licensed physicians in the United States has been growing steadily, due in part to an expansion in the number of medical schools and students during the past two decades, even as concerns of a physician shortage to meet health care demands persist. The average age of licensed physicians continues to increase, and more licensed physicians appear to be specialty certified, though the latter finding may reflect more comprehensive reporting. This census was compiled using the FSMB's Physician Data Center (PDC), which collects, collates and analyzes physician data directly from the nation's state medical and osteopathic boards and is uniquely positioned to provide a comprehensive snapshot of information about licensed physicians. A periodic national census of this type offers useful demographic and licensure information about the available physician workforce that may be useful to policy makers, researchers and related health care organizations to better understand and address the nation's health care needs.

Workforce demographics and unit structure in paediatric cardiac critical care in the United States

2021 ◽  
pp. 1-5
Author(s):  
Robin V. Horak ◽  
Shasha Bai ◽  
Bradley S. Marino ◽  
David K. Werho ◽  
Leslie A. Rhodes ◽  
...  
Keyword(s):  
United States ◽  
Critical Care ◽  
Heart Surgery ◽  
Age Groups ◽  
The United States ◽  
Work Hours ◽  
Full Time ◽  
Full Time Equivalent ◽  
Unit Structure ◽  
Cardiac Critical Care

Abstract Objective: To assess current demographics and duties of physicians as well as the structure of paediatric cardiac critical care in the United States. Design: REDCap surveys were sent by email from May till August 2019 to medical directors (“directors”) of critical care units at the 120 United States centres submitting data to the Society of Thoracic Surgeons Congenital Heart Surgery Database and to associated faculty from centres that provided email lists. Faculty and directors were asked about personal attributes and clinical duties. Directors were additionally asked about unit structure. Measurements and main results: Responses were received from 66% (79/120) of directors and 62% (294/477) of contacted faculty. Seventy-six percent of directors and 54% of faculty were male, however, faculty <40 years old were predominantly women. The majority of both groups were white. Median bed count (n = 20) was similar in ICUs and multi-disciplinary paediatric ICUs. The median service expectation for one clinical full-time equivalent was 14 weeks of clinical service (interquartile range 12, 16), with the majority of programmes (86%) providing in-house attending night coverage. Work hours were high during service and non-service weeks with both directors (37%) and faculty (45%). Conclusions: Racial and ethnic diversity is markedly deficient in the paediatric cardiac critical care workforce. Although the majority of faculty are male, females make up the majority of the workforce younger than 40 years old. Work hours across all age groups and unit types are high both on- and off-service, with most units providing attending in-house night coverage.

Food texture experiences across age groups in 4–36‐month‐old children in the United States

2021 ◽  
Author(s):  
Victoria A. Surette ◽  
Sarah Smith‐Simpson ◽  
Lisa R. Fries ◽  
Carolyn F. Ross
Keyword(s):  
United States ◽  
Age Groups ◽  
The United States ◽  
Food Texture
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