scholarly journals Medical Conditions Predictive of Self-Reported Poor Health: Retrospective Cohort Study

10.2196/13018 ◽  
2020 ◽  
Vol 6 (1) ◽  
pp. e13018
Author(s):  
M Soledad Cepeda ◽  
Jenna Reps ◽  
David M Kern ◽  
Paul Stang
Keyword(s):  
Health Status ◽  
Reproductive Tract ◽  
Poor Health ◽  
Chronic Obstructive ◽  
Medical Conditions ◽  
Reproductive Tract Infections ◽  
Obstructive Pulmonary Disease ◽  
Tract Infections ◽  
Demyelinating Disorders ◽  
The Impact

Background Identifying the medical conditions that are associated with poor health is crucial to prioritize decisions for future research and organizing care. However, assessing the burden of disease in the general population is complex, lengthy, and expensive. Claims databases that include self-reported health status can be used to assess the impact of medical conditions on the health in a population. Objective This study aimed to identify medical conditions that are highly predictive of poor health status using claims databases. Methods To determine the medical conditions most highly predictive of poor health status, we used a retrospective cohort study using 2 US claims databases. Subjects were commercially insured patients. Health status was measured using a self-report health status response. All medical conditions were included in a least absolute shrinkage and selection operator regression model to assess which conditions were associated with poor versus excellent health. Results A total of 1,186,871 subjects were included; 61.64% (731,587/1,186,871) reported having excellent or very good health. The leading medical conditions associated with poor health were cancer-related conditions, demyelinating disorders, diabetes, diabetic complications, psychiatric illnesses (mood disorders and schizophrenia), sleep disorders, seizures, male reproductive tract infections, chronic obstructive pulmonary disease, cardiomyopathy, dementia, and headaches. Conclusions Understanding the impact of disease in a commercially insured population is critical to identify subjects who may be at risk for reduced productivity and job loss. Claims database studies can measure the impact of medical conditions on the health status in a population and to assess changes overtime and could limit the need to collect prospective collection of information, which is slow and expensive, to assess disease burden. Leading medical conditions associated with poor health in a commercially insured population were the ones associated with high burden of disease such as cancer-related conditions, demyelinating disorders, diabetes, diabetic complications, psychiatric illnesses (mood disorders and schizophrenia), infections, chronic obstructive pulmonary disease, cardiomyopathy, and dementia. However, sleep disorders, seizures, male reproductive tract infections, and headaches were also part of the leading medical conditions associated with poor health that had not been identified before as being associated with poor health and deserve more attention.

scholarly journals Medical Conditions Predictive of Self-Reported Poor Health: Retrospective Cohort Study (Preprint)

2018 ◽  
Author(s):  
M Soledad Cepeda ◽  
Jenna Reps ◽  
David M Kern ◽  
Paul Stang
Keyword(s):  
Health Status ◽  
Reproductive Tract ◽  
Poor Health ◽  
Chronic Obstructive ◽  
Medical Conditions ◽  
Reproductive Tract Infections ◽  
Obstructive Pulmonary Disease ◽  
Tract Infections ◽  
Demyelinating Disorders ◽  
The Impact

BACKGROUND Identifying the medical conditions that are associated with poor health is crucial to prioritize decisions for future research and organizing care. However, assessing the burden of disease in the general population is complex, lengthy, and expensive. Claims databases that include self-reported health status can be used to assess the impact of medical conditions on the health in a population. OBJECTIVE This study aimed to identify medical conditions that are highly predictive of poor health status using claims databases. METHODS To determine the medical conditions most highly predictive of poor health status, we used a retrospective cohort study using 2 US claims databases. Subjects were commercially insured patients. Health status was measured using a self-report health status response. All medical conditions were included in a least absolute shrinkage and selection operator regression model to assess which conditions were associated with poor versus excellent health. RESULTS A total of 1,186,871 subjects were included; 61.64% (731,587/1,186,871) reported having excellent or very good health. The leading medical conditions associated with poor health were cancer-related conditions, demyelinating disorders, diabetes, diabetic complications, psychiatric illnesses (mood disorders and schizophrenia), sleep disorders, seizures, male reproductive tract infections, chronic obstructive pulmonary disease, cardiomyopathy, dementia, and headaches. CONCLUSIONS Understanding the impact of disease in a commercially insured population is critical to identify subjects who may be at risk for reduced productivity and job loss. Claims database studies can measure the impact of medical conditions on the health status in a population and to assess changes overtime and could limit the need to collect prospective collection of information, which is slow and expensive, to assess disease burden. Leading medical conditions associated with poor health in a commercially insured population were the ones associated with high burden of disease such as cancer-related conditions, demyelinating disorders, diabetes, diabetic complications, psychiatric illnesses (mood disorders and schizophrenia), infections, chronic obstructive pulmonary disease, cardiomyopathy, and dementia. However, sleep disorders, seizures, male reproductive tract infections, and headaches were also part of the leading medical conditions associated with poor health that had not been identified before as being associated with poor health and deserve more attention.

scholarly journals The Impact of COPD in Trends of Urinary Tract Infection Hospitalizations in Spain, 2001–2018: A Population-Based Study Using Administrative Data

2020 ◽  
Vol 9 (12) ◽  
pp. 3979
Author(s):  
Javier de Miguel-Diez ◽  
Romana Albaladejo-Vicente ◽  
Domingo Palacios-Ceña ◽  
David Carabantes-Alarcon ◽  
José Javier Zamorano-Leon ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Protective Factor ◽  
Multivariable Analysis ◽  
Population Based ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Men And Women ◽  
Tract Infections ◽  
The Impact ◽  
Over Time

(1) Background: To examine trends in incidence and outcomes of urinary tract infections (UTIs) among men and women with or without chronic obstructive pulmonary disease (COPD), and to identify the predictors for in-hospital mortality (IHM). (2) Methods: We included patients (aged ≥40 years) who were hospitalized with UTIs between 2001 and 2018. Data were collected from the Spanish National Hospital Discharge Database. (3) Results: We identified 748,458 UTI hospitalizations, 6.53% with COPD. The UTIs incidence increased over time. It was 1.55 times higher among men COPD patients than among non-COPD men (incidence rate ratio (IRR) 1.55; 95% CI 1.53–1.56). The opposite happened in women with COPD compared to non-COPD women (IRR 0.30; 95% CI 0.28–0.32). IHM was higher in men with COPD than non-COPD men (5.58% vs. 4.47%; p < 0.001) and the same happened in women (5.62% vs. 4.92%; p < 0.001). The risk of dying increased with age and comorbidity, but the urinary catheter was a protective factor among men (OR 0.75; 95% CI 0.64–0.89). Multivariable analysis showed a significant reduction in the IHM over time for men and women with COPD. Suffering from COPD only increased the risk of IHM among men (OR 1.07; 95% CI 1.01–1.13). (4) Conclusions: The incidence of UTIs increased over time. Suffering COPD increased the risk of IHM among men, but not among women.

scholarly journals When people do not ‘Zol’: Reduced emergency centre attendance of patients with chronic obstructive pulmonary disease during coronavirus disease 2019 lockdown with the accompanying tobacco sales ban in South Africa

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Piero Saieva ◽  
Louis S. Jenkins
Keyword(s):  
South Africa ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Prevalence Rate ◽  
Chronic Obstructive ◽  
Western Cape ◽  
Western Cape Province ◽  
Obstructive Pulmonary Disease ◽  
Tract Infections ◽  
The Impact

The coronavirus disease 2019 (COVID-19) pandemic has spread throughout the world, with devastating effects of the virus as well as the repercussions of the resulting ‘lockdowns’. South Africa went into a national lockdown in March 2020 to mitigate the impact of the virus. This included a ban on the sales of tobacco and electronic cigarette products. The ban has been a highly contentious issue in South Africa, discussed worldwide, which has drawn many criticisms. The prevalence rate of smoking in South Africa was around 21.5%, with the Western Cape province having a prevalence rate of 39%. We compared the number of chronic obstructive pulmonary disease (COPD) presentations at a large regional referral hospital in the Western Cape province from January to August 2019 with the same period in 2020. Electronic emergency centre data showed a reduction of 69.28% in COPD presentations. To control for some confounders for the same period, we also reviewed patients presenting with urinary tract infections, which showed only a 30.60% reduction. This notable reduction in COPD presentations reduced service pressure of emergency centre and most likely benefitted patients’ health. Further research and policies are needed to ensure ongoing reduction in the prevalence of smoking.

scholarly journals Patterns and Predictors of Recovery from Poor Health Status Measured with the Chronic Obstructive Pulmonary Disease (COPD) Assessment Test in Patients with Stable COPD: A Longitudinal Study

2019 ◽  
Vol 8 (7) ◽  
pp. 946 ◽  
Author(s):  
Francesc Medina-Mirapeix ◽  
Roberto Bernabeu-Mora ◽  
Maria Piedad Sánchez-Martínez ◽  
Mariano Gacto-Sánchez ◽  
Rodrigo Martín San Agustín ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Health Status ◽  
Pulmonary Disease ◽  
Negative Impact ◽  
Handgrip Strength ◽  
Poor Health ◽  
Chronic Obstructive ◽  
Poor Health Status ◽  
Obstructive Pulmonary Disease ◽  
Copd Assessment Test

Recent recommendations for chronic obstructive pulmonary disease (COPD) suggest that evaluation and management should focus on patient health status. Despite the frequency of poor health status and its negative impact on patients with COPD, little is known about how poor or non-poor health status persists and/or remits over time or what factors might predict recovery from a poor health status. The aim was to determine the likelihood of transitioning between poor and non-poor health status in patients with stable COPD followed for 2 years and to investigate factors that might predict recovery from poor health status. We prospectively included 137 patients with stable COPD (mean age, 66.9 years ± 8.3). Health status was measured at baseline and after 1 and 2 years with the COPD assessment test (CAT). Higher scores indicated worse health status, and 10 was the cut-off score for discriminating between non-poor and poor health status. The likelihoods of annual transitions to new episodes and recovery were calculated. We evaluated demographic, non-respiratory, and respiratory variables as potential predictors with generalized estimating equations. At baseline, 37 patients (27%) reported non-poor health status. Within the group of patients displaying poor health status at the beginning of the year, 176 annual transitions were identified during the study period: 15.9% were transitions to recovery from poor health status. In contrast, of the 70 transitions from a starting non-poor health status, 32.4% worsened. Predictors of transitions to recovery were: current non-smoker status (odds ratio (OR) = 3.88; 95% confidence interval (CI): 0.64–5.54) and handgrip strength (OR = 1.08; 95% CI: 1.00–1.16). This study suggests that self-reported health status, measured with the CAT, has a dynamic nature in patients with COPD. Annual transitions towards recovery from poor health status are most likely among current non-smoking patients and those with high handgrip strength.

scholarly journals Physician-patient communication in the prevention of female reproductive tract infections: some limitations

2000 ◽  
Vol 16 (1) ◽  
pp. 249-253 ◽  
Author(s):  
María Y. Makuch ◽  
Neury José Botega ◽  
Luis Bahamondes
Keyword(s):  
Reproductive Tract ◽  
Complete Information ◽  
Female Reproductive Tract ◽  
Reproductive Tract Infections ◽  
Tubal Infertility ◽  
The Public ◽  
Reproductive Tract Infection ◽  
Purposeful Sampling ◽  
Tract Infections ◽  
The Impact

The objective of this study was to describe the information that women with tubal infertility recalled having received from physicians when they consulted for a reproductive tract infection (RTI) and the information physicians reported having provided to women consulting for RTIs. Interviews were conducted with 16 women presenting primary tubal infertility selected on the basis of purposeful sampling criteria. Also, 15 physicians working in the public health network in the city of Campinas, Brazil, were selected at random and interviewed. Analysis of the women's statements concerning previous RTI-related medical consultations showed that they did not recall having received any information on either prevention or the impact of RTI on their reproductive future. Analysis of interviews with physicians showed that the information they provided to women consulting for RTIs was incomplete and unclear. The information women recalled having received and that which physicians remembered having provided at the time of treating a patient with RTI was similar. In conclusion, these women lacked adequate or complete information and that it was probably not possible for them to adopt measures to avoid repetition of RTI and minimize risk of tubal infertility.

scholarly journals Assessing the Impact of Pulmonary Rehabilitation on Functional Status in Chronic Obstructive Pulmonary Disease

Thorax ◽  
2007 ◽  
Author(s):  
Louis Laviolette ◽  
Jean Bourbeau ◽  
Sarah Bernard ◽  
Yves Lacasse ◽  
Véronique Pepin ◽  
...  
Keyword(s):  
Health Status ◽  
Pulmonary Rehabilitation ◽  
Chronic Obstructive ◽  
Endurance Test ◽  
Endurance Time ◽  
Obstructive Pulmonary Disease ◽  
Walking Test ◽  
Baseline Values ◽  
The Impact ◽  
Cycle Endurance

Rationale - The optimal way of assessing the impact of pulmonary rehabilitation on functional status in chronic obstructive pulmonary disease (COPD) is currently unknown. The minimal clinically important difference for the constant workrate cycling exercise also needs to be investigated to facilitate its interpretation. Objective – Evaluate the changes in the 6-minute walking test and in the constant workrate cycle endurance test immediately following and 1-year after pulmonary rehabilitation, along with the importance of these changes in term of health status in patients with COPD. Methods - Patients with COPD (age: 65  8 years, mean  SD; FEV1: 45  15 % predicted) were recruited from a multicenter prospective cohort study and were evaluated at baseline, immediately after a pulmonary rehabilitation program (n=157) and at 1 year (n=106). The 6-min walking test and the cycle endurance test were performed at each evaluation. Health status was evaluated with the St. Georges Respiratory Questionnaire. Measurements and Main Results - Following pulmonary rehabilitation, cycle endurance time increased (198  352s, p<0.0001) and stayed over baseline values at 1 year (p<0.0001). The 6-minute walking distance also showed improvements following rehabilitation (25  52m, p<0.0001) but returned to baseline values at the 1 year follow-up. Changes in cycle endurance time were more closely associated with changes in health status than those of the 6-min walking test. A 100-200s improvement in the cycle endurance time was associated with clinically meaningful changes in the St. Georges Respiratory Questionnaire scores. conclusions - The cycle endurance test was more responsive that the 6-min walking test to detect improvement in exercise tolerance following pulmonary rehabilitation and was also better correlated with improvements in health status. An improvement in the cycle endurance time ranging from 100-200s appeared to be clinically meaningful.

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