scholarly journals Developing a Standardized and Reusable Method to Link Distributed Health Plan Databases to the National Death Index: Methods Development Study Protocol

10.2196/21811 ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. e21811
Author(s):  
Candace C Fuller ◽  
Wei Hua ◽  
Charles E Leonard ◽  
Andrew Mosholder ◽  
Ryan Carnahan ◽  
...  
Keyword(s):  
Cause Of Death ◽  
Health Plan ◽  
Distributed Database ◽  
Use Case ◽  
Health Plans ◽  
National Death Index ◽  
Future Studies ◽  
Risk Of Death ◽  
Safety Surveillance ◽  
Multiple Health

Background Certain medications may increase the risk of death or death from specific causes (eg, sudden cardiac death), but these risks may not be identified in premarket randomized trials. Having the capacity to examine death in postmarket safety surveillance activities is important to the US Food and Drug Administration’s (FDA) mission to protect public health. Distributed networks of electronic health plan databases used by the FDA to conduct multicenter research or medical product safety surveillance studies often do not systematically include death or cause-of-death information. Objective This study aims to develop reusable, generalizable methods for linking multiple health plan databases with the Centers for Disease Control and Prevention’s National Death Index Plus (NDI+) data. Methods We will develop efficient administrative workflows to facilitate multicenter institutional review board (IRB) review and approval within a distributed network of 6 health plans. The study will create a distributed NDI+ linkage process that avoids sharing of identifiable patient information between health plans or with a central coordinating center. We will develop standardized criteria for selecting and retaining NDI+ matches and methods for harmonizing linked information across multiple health plans. We will test our processes within a use case comprising users and nonusers of antiarrhythmic medications. Results We will use the linked health plan and NDI+ data sets to estimate the incidences and incidence rates of mortality and specific causes of death within the study use case and compare the results with reported estimates. These comparisons provide an opportunity to assess the performance of the developed NDI+ linkage approach and lessons for future studies requiring NDI+ linkage in distributed database settings. This study is approved by the IRB at Harvard Pilgrim Health Care in Boston, MA. Results will be presented to the FDA at academic conferences and published in peer-reviewed journals. Conclusions This study will develop and test a reusable distributed NDI+ linkage approach with the goal of providing tested NDI+ linkage methods for use in future studies within distributed data networks. Having standardized and reusable methods for systematically obtaining death and cause-of-death information from NDI+ would enhance the FDA’s ability to assess mortality-related safety questions in the postmarket, real-world setting. International Registered Report Identifier (IRRID) DERR1-10.2196/21811

scholarly journals Developing a Standardized and Reusable Method to Link Distributed Health Plan Databases to the National Death Index: Methods Development Study Protocol (Preprint)

2020 ◽  
Author(s):  
Candace C Fuller ◽  
Wei Hua ◽  
Charles E Leonard ◽  
Andrew Mosholder ◽  
Ryan Carnahan ◽  
...  
Keyword(s):  
Cause Of Death ◽  
Health Plan ◽  
Distributed Database ◽  
Use Case ◽  
Health Plans ◽  
National Death Index ◽  
Future Studies ◽  
Risk Of Death ◽  
Safety Surveillance ◽  
Multiple Health

BACKGROUND Certain medications may increase the risk of death or death from specific causes (eg, sudden cardiac death), but these risks may not be identified in premarket randomized trials. Having the capacity to examine death in postmarket safety surveillance activities is important to the US Food and Drug Administration’s (FDA) mission to protect public health. Distributed networks of electronic health plan databases used by the FDA to conduct multicenter research or medical product safety surveillance studies often do not systematically include death or cause-of-death information. OBJECTIVE This study aims to develop reusable, generalizable methods for linking multiple health plan databases with the Centers for Disease Control and Prevention’s National Death Index Plus (NDI+) data. METHODS We will develop efficient administrative workflows to facilitate multicenter institutional review board (IRB) review and approval within a distributed network of 6 health plans. The study will create a distributed NDI+ linkage process that avoids sharing of identifiable patient information between health plans or with a central coordinating center. We will develop standardized criteria for selecting and retaining NDI+ matches and methods for harmonizing linked information across multiple health plans. We will test our processes within a use case comprising users and nonusers of antiarrhythmic medications. RESULTS We will use the linked health plan and NDI+ data sets to estimate the incidences and incidence rates of mortality and specific causes of death within the study use case and compare the results with reported estimates. These comparisons provide an opportunity to assess the performance of the developed NDI+ linkage approach and lessons for future studies requiring NDI+ linkage in distributed database settings. This study is approved by the IRB at Harvard Pilgrim Health Care in Boston, MA. Results will be presented to the FDA at academic conferences and published in peer-reviewed journals. CONCLUSIONS This study will develop and test a reusable distributed NDI+ linkage approach with the goal of providing tested NDI+ linkage methods for use in future studies within distributed data networks. Having standardized and reusable methods for systematically obtaining death and cause-of-death information from NDI+ would enhance the FDA’s ability to assess mortality-related safety questions in the postmarket, real-world setting. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/21811

Health Plan Switching among Members of the Federal Employees Health Benefits Program

2005 ◽  
Vol 42 (3) ◽  
pp. 255-265 ◽  
Author(s):  
Adam Atherly ◽  
Curtis Florence ◽  
Kenneth E. Thorpe
Keyword(s):  
Managed Care ◽  
Health Plan ◽  
Switching Costs ◽  
Health Benefits ◽  
Health Plans ◽  
Federal Employees ◽  
Negatively Associated ◽  
Factors Associated ◽  
Preferred Provider Organizations

This paper examines factors associated with switching health plans in the Federal Employees Health Benefits Program. Switching plans is not uncommon, with 12% of members switching plans annually. Individuals switch out of plans with premium increases and benefit decreases relative to other plans in the market. Switching is negatively associated with age due to increasing switching costs associated with age rather than decreasing premium sensitivity. Individuals in preferred provider organizations are less likely to switch, but are more responsive to premium increases than those in the managed care sector. Those who do switch plans are likely to switch to a different plan in the same sector.

scholarly journals Comparison of cause of death between Australian and New Zealand Dialysis and Transplant Registry and the Australian National Death Index

Nephrology ◽  
2019 ◽  
Vol 24 (3) ◽  
pp. 322-329 ◽  
Author(s):  
Matthew P Sypek ◽  
Kathryn B Dansie ◽  
Phil Clayton ◽  
Angela C Webster ◽  
Stephen Mcdonald
Keyword(s):  
New Zealand ◽  
Cause Of Death ◽  
National Death Index ◽  
Transplant Registry

Engagement with Social Media Platforms via Mobile Apps for Improving Quality of Personal Health Management

2014 ◽  
Vol 16 (1) ◽  
pp. 73-89 ◽  
Author(s):  
Sinjini Mitra ◽  
Rema Padman
Keyword(s):  
Social Media ◽  
Health Plan ◽  
Health Management ◽  
Mobile Apps ◽  
Blood Pressure Level ◽  
Health Condition ◽  
Health Plans ◽  
Health And Wellness ◽  
Health Related ◽  
Social Media Platforms

Patient engagement in self health and wellness management has been identified as an important goal in improving health outcomes. As a result, the use of mobile and social media for health and wellness promotion is gathering considerable momentum. Several early adopting health plans and provider organizations have begun to design and pilot social and mobile media platforms to empower members to enhance self management of health and wellness goals. Based on a member survey of a large health plan in Pennsylvania, the authors identify factors that are significantly associated with member interest in adopting such technology platforms for obtaining health related information and services. Analysis of relevant data from more than 4,000 responses from health plan members indicate significant effects of several factors such as age, gender, general health condition (including presence of chronic conditions like diabetes and high blood pressure), level of computer and social media usage and frequency of engaging in different online activities such as banking, shopping, and emailing. This analysis allows us to identify important consumer segments that are correlated with professed willingness to use applications and programs offered by the health plan. Besides, the authors also develop statistical models to predict people's odds of adopting health-related mobile apps and identify the significant predictors thereof. The authors anticipate that these insights can assist health plans to develop and deploy targeted services and tools through integration of mobile and social media platforms for health and wellness management.

scholarly journals Clustering of 27,525,663 Death Records from the United States Based on Health Conditions Associated with Death: An Example of big Health Data Exploration

2019 ◽  
Vol 8 (7) ◽  
pp. 922
Author(s):  
Daisy J.A. Janssen ◽  
Simon Rechberger ◽  
Emiel F.M. Wouters ◽  
Jos M.G.A. Schols ◽  
Miriam J. Johnson ◽  
...  
Keyword(s):  
United States ◽  
Palliative Care ◽  
End Of Life ◽  
Cause Of Death ◽  
The United States ◽  
Population Based ◽  
Health Conditions ◽  
Mortality Data ◽  
Self Organizing Map ◽  
Multiple Health

Background: Insight into health conditions associated with death can inform healthcare policy. We aimed to cluster 27,525,663 deceased people based on the health conditions associated with death to study the associations between the health condition clusters, demographics, the recorded underlying cause and place of death. Methods: Data from all deaths in the United States registered between 2006 and 2016 from the National Vital Statistics System of the National Center for Health Statistics were analyzed. A self-organizing map (SOM) was used to create an ordered representation of the mortality data. Results: 16 clusters based on the health conditions associated with death were found showing significant differences in socio-demographics, place, and cause of death. Most people died at old age (73.1 (18.0) years) and had multiple health conditions. Chronic ischemic heart disease was the main cause of death. Most people died in the hospital or at home. Conclusions: The prevalence of multiple health conditions at death requires a shift from disease-oriented towards person-centred palliative care at the end of life, including timely advance care planning. Understanding differences in population-based patterns and clusters of end-of-life experiences is an important step toward developing a strategy for implementing population-based palliative care.

Security in Health Information Systems

2011 ◽  
pp. 9-15
Author(s):  
Christina Ilioudi ◽  
Athina Lazakidou
Keyword(s):  
Information Technology ◽  
Information Systems ◽  
Health Information ◽  
Health Information Systems ◽  
Internet Technology ◽  
Health Plans ◽  
Health Providers ◽  
Web Based ◽  
Vital Component ◽  
Multiple Health

The development of Internet technology and Web-based applications made health information more accessible than ever before from many locations by multiple health providers and health plans. In this chapter, security in health information systems is put into perspective. The further penetration of information technology into healthcare is discussed, and it is concluded that information systems have already become a vital component, not only for the logistics of the healthcare institution but also for the rendering of care and cure.

scholarly journals Using the General Social Survey – National Death Index cohort to study the relationship between neighbourhood fear and mortality in the USA

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e030330
Author(s):  
Erin Grinshteyn ◽  
Peter Muennig ◽  
Roman Pabayo
Keyword(s):  
Fear Of Crime ◽  
General Social Survey ◽  
National Death Index ◽  
Social Survey ◽  
Time To Death ◽  
Risk Of Death ◽  
Increased Risk ◽  
Adjusted Model ◽  
The Relationship

ObjectivesFear of crime is associated with adverse mental health outcomes and reduced social interaction independent of crime. Because mental health and social interactions are associated with poor physical health, fear of crime may also be associated with death. The main objective is to determine whether neighbourhood fear is associated with time to death.Setting and participantsData from the 1978–2008 General Social Survey were linked to mortality data using the National Death Index (GSS-NDI) (n=20 297).MethodsGSS-NDI data were analysed to assess the relationship between fear of crime at baseline and time to death among adults after removing violent deaths. Fear was measured by asking respondents if they were afraid to walk alone at night within a mile of their home. Crude and adjusted HRs were calculated using survival analysis to calculate time to death. Analyses were stratified by sex.ResultsAmong those who responded that they were fearful of walking in their neighbourhood at night, there was a 6% increased risk of death during follow-up in the adjusted model though this was not significant (HR=1.06, 95% CI 0.99 to 1.13). In the fully adjusted models examining risk of mortality stratified by sex, findings were significant among men but not women. Among men, in the adjusted model, there was an 8% increased risk of death during follow-up among those who experienced fear at baseline in comparison with those who did not experience fear (HR=1.08, 95% CI 1.02 to 1.14).ConclusionsResearch has recently begun examining fear as a public health issue. With an identified relationship with mortality among men, this is a potential public health problem that must be examined more fully.

Burden of out-of-pocket spending among high-deductible health plan members with metastatic breast cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 1029-1029
Author(s):  
Christine Leopold ◽  
Anita K. Wagner ◽  
Fang Zhang ◽  
Christine Lu ◽  
Craig Earle ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Health Plan ◽  
Statistical Significance ◽  
Metastatic Breast ◽  
Health Plans ◽  
Region Of Residence ◽  
Monthly Total ◽  
High Deductible Health Plan ◽  
Enrollment Data

1029 Background: 50% of workers have high-deductible health plans (HDHP) that require major outofpocket (OOP) spending for cancerrelated care. The OOP burden among patients with advanced cancer in HDHPs is unknown. Our objective was to estimate OOP spending for women with metastatic breast cancer (mbc) stratified by health plan type. Methods: Our data source was administrative health insurance claims and enrollment data of members insured though a large national health plan. We included 7142 women age 25-64 with mbc who had at least 6 months enrollment before the diagnosis and at least 12 months followup. We used a time series design and plotted OOP spending stratified by HDHP vs low-deductible plan. Primary outcome measures included: (1) 20042012 calendar trends in total annual OOP spending, (2) monthly total OOP spending in the 6 months before and 24 months after women were diagnosed with mbc, and (3) monthly total OOP spending in the last 6 months of life. Plots were adjusted for age, socioeconomic status, race/ethnicity, and US region of residence, and we then conducted linear regression to assess for statistical significance of trends. Results: In 2004, average annual OOP spending for women with mbc cancer in low-deductible health plans was $1196.2 and increased to $2570 in 2012, a yearly increase of $159.2 (113.2205.2). For women in HDHP average OOP spending in 2004 amounted to $2648 and increased to $3736.4 in 2012, representing an annual increase of $160.4 per year (105.4215.4) Average OOP spending per person month peaked in the month of diagnosis to $1633.8 for women in HDHPs and to $643 among low-deductible plan members. Average OOP spending in the last 6 months of life were $285.7 per person month among low-plan ($1714.2 per 6 months) and $607.3 among HDHP ($3644 per 6 months). Conclusions: To our knowledge, this is the first analysis to estimate OOP spending for women with mbc accounting for enrollment in HDHPs versus low-deductible plans. We found that OOP spending is increasing over time and is high in the last 6 months of life. HDHP members with mbc faced much higher OOP spending than women in traditional plans across all analyses. Findings raise concerns that HDHPs could worsen access to mbc treatments.

Health Plan Choice and Information about Out-of-Pocket Costs: An Experimental Analysis

2001 ◽  
Vol 38 (1) ◽  
pp. 35-48 ◽  
Author(s):  
Michael Schoenbaum ◽  
Mark Spranca ◽  
Marc Elliott ◽  
Jay Bhattacharya ◽  
Pamela Farley Short
Keyword(s):  
Health Care ◽  
Health Plan ◽  
Good Health ◽  
Health Plans ◽  
Support Materials ◽  
Health Plan Choice ◽  
Plan Choice ◽  
Working Age ◽  
Care Costs ◽  
Out Of Pocket Costs

Many consumers are offered two or more employer-sponsored health insurance plans, and competition among health plans for subscribers is promoted as a mechanism for balancing health care costs and quality. Yet consumers may not receive the information necessary to make informed health plan choices. This study tests the effects on health plan choice of providing supplemental decision-support materials to inform consumers about expected health plan costs. Our main finding is that such information induces consumers to bear more risk, especially those in relatively good health. Thus our results suggest that working-age, privately insured consumers currently may be over-insuring for medical care.

scholarly journals Intestinal Parasites in Free-Living Puma concolor

2020 ◽  
Vol 48 ◽  
Author(s):  
Marco Aurélio Cunha Del Vechio ◽  
Edson Gerônimo ◽  
Enzo Emmerich Paula De Castro ◽  
Luciana Vieira Pinto Ribeiro ◽  
Rita De Cássia Lima Ribeiro ◽  
...  
Keyword(s):  
Cause Of Death ◽  
Animal Species ◽  
Puma Concolor ◽  
Intestinal Parasites ◽  
Science Museum ◽  
Wild Animals ◽  
Toxocara Cati ◽  
Free Living ◽  
Risk Of Death ◽  
In Captivity

Background: Studies on intestinal parasites in cougars Puma concolor are scarce, and most of the available information on the species has been derived from individuals in captivity. One of the greatest threats to the survival of wild cats is habitat loss caused by urban sprawl, agricultural matrix, and linear developments such as highways and railways, which expose animals to direct contact with humans and to a high risk of death. Given the lack of scientific data the objective of this study was to report on the occurrence of intestinal parasites in a cougar (P. concolor) specimen from the northwestern region of Paraná State, Brazil.Case: The carcass of a free-living cougar (P. concolor) individual was sent to the Interdisciplinary Science Museum (Museu Interdisciplinar de Ciências – MIC) of Paranaense University (Universidade Paranaense - UNIPAR); an individual was killed during a collision with an unidentified vehicle on highway PR-486, in the municipality of Mariluz (PR, Brazil). The geographical coordinates of the location where the animal was found are: 23°59′29″S, 53°8′47″W. This region is characterized by semi-deciduous seasonal forest remnants. After being identified on site and collected by the inspectors of the Paraná Environmental Institute (Instituto Ambiental do Paraná - IAP), the cadaver was donated to the MIC (by the IAP) for a necropsy to elucidate the cause of death. In this context, the cadaver was sent to the Animal Pathology section of the Department of Veterinary Medicine at UNIPAR. The animal was necropsied by performing the standard necropsy technique for carnivores: opening the intestine through the mesentery and exposing the mucosa from the duodenum to the colon. The necropsy showed that the cause of death was hypovolemic shock due to trauma. During necropsy, parasites in the intestinal lumen were visible to the naked eye. Parasites and feces were collected and stored in sterile flasks containing 10% formaldehyde and saline. The parasites were subjected to Faust and Hoffman techniques, micrometry, and morphological analysis, resulting in the identification of the roundworm Toxocara cati and the tapeworm Spirometra decipiens.Discussion: Identifying the roadkill species along highways is of paramount importance, since they are living very close to man and, consequently, reservoirs and disseminators of different infectious and parasitic zoonoses may be possible. Infection by protozoa and helminths in animals usually occurs by ingesting the infective form present in food or water. Toxocara cati and the tapeworm Spirometra decipiens were only reported in captivity before. Research on parasites in free-living wild animals is not common in the scientific literature and this is due to the difficulty of capturing this animal category as they live in difficult to access places such as forests and forests, therefore, research projects in partnership with museums are extremely important for the recognition of wild animal species that circulate in the region, in addition to the parasitic identification of these animals for future sanitary measures and for the preservation of the animal species in the environment. The Parasitological studies of wild animals are highly relevant for expanding this knowledge, especially considering the possible transfer risk of specific parasitic diseases to other animals, as well as to humans.

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