scholarly journals Incremental Dental Expenditures Associated With Diabetes Among Noninstitutionalized U.S. Adults Aged ≥18 Years Old in 2016–2017

2021 ◽  
Author(s):  
Yu Chen ◽  
Ping Zhang ◽  
Elizabeth T. Luman ◽  
Susan O. Griffin ◽  
Deborah B. Rolka
Keyword(s):  
Dental Care ◽  
Private Insurance ◽  
Dental Service ◽  
Medical Expenditures ◽  
Preventive Dental Care ◽  
Surgical Services ◽  
The Us ◽  
Service Type ◽  
The Difference ◽  
Design And Methods

<b>OBJECTIVE</b> <div><p>Diabetes is associated with poor oral health, but incremental expenditures for dental care associated with diabetes in the U.S. are unknown. We aimed to quantify these incremental expenditures per person and for the nation. </p> <p><b>RESEARCH DESIGN AND METHODS</b></p> <p>We analyzed data from 46,633 non-institutionalized adults aged ≥18 years old who participated in the 2016–2017 Medical Expenditures Panel Survey. We used two-part models to estimate dental expenditures per person in total, by payment source, and by dental service type, controlling for sociodemographic characteristics, health status, and geographic variables. Incremental expenditure was the difference in predicted expenditure for dental care between adults with and without diabetes. The total expenditure for the US was the expenditure per person multiplied by the estimated number of people with diabetes. Expenditures were adjusted to 2017 US dollars.</p> <p><b>RESULTS</b></p> <p>The mean adjusted annual diabetes-associated incremental dental expenditure was $77 per person and $1.9 billion for the nation. Fifty-one percent ($40) and 39% ($30) of this incremental expenditure were paid out-of-pocket and by private insurance; 69% ($53) of the incremental expenditure was for restorative/prosthetic/surgical services; and adults with diabetes had lower expenditure for preventive services than those without (incremental -$7). Incremental expenditures were higher in older adults, non-Hispanic whites, and people with higher levels of income and education. </p> <p><b>CONCLUSIONS</b></p> <p>Diabetes is associated with higher dental expenditures. These results fill a gap in the estimates of total medical expenditures associated with diabetes in the US and highlight the importance of preventive dental care among people with diabetes.</p></div>

scholarly journals Long-haul COVID: Healthcare Utilization and Medical Expenditures 6 Months Post-diagnosis

2021 ◽  
Author(s):  
Owen Fleming
Keyword(s):  
Healthcare Utilization ◽  
Age Groups ◽  
Population Based ◽  
Medical Expenditures ◽  
Urgent Care ◽  
Research Database ◽  
Surgical Services ◽  
The Us ◽  
The Mean

Abstract Background Despite evidence that long-term COVID-19 symptoms may persist for up to a year, their implications for healthcare utilization and costs 6 months post-diagnosis remain unexplored. Methods Our objective is to determine for how many months post-diagnosis healthcare utilization and costs of COVID-19 patients persist above pre-diagnosis levels and explore response heterogeneity across age groups. This population-based retrospective cohort study followed COVID-19 patients’ healthcare utilization and costs from January 2019 through March 2021 using claims data provided by the COVID-19 Research Database. The patient population includes 328,777 individuals infected with COVID-19 during March-September 2020 and whose last recorded claim was not hospitalization with severe symptoms. We measure the monthly number and costs of total visits and by telemedicine, preventive, urgent care, emergency, immunization, cardiology, inpatient or surgical services and established patient or new patient visits. Results The mean (SD) total number of monthly visits and costs pre-diagnosis were .4805 (4.2035) and 130.67 (1,216.66) dollars compared with 1.1998 (8.5184) visits and 341.7576 (2,439.5581) dollars post-diagnosis. COVID-19 diagnosis associated with .7338 (95% CI, 0.7175 to 0.7500 visits; P < .001) more total healthcare visits and an additional $215.40 (95% CI, 210.76 to 220.00; P<.001) in monthly costs. Excess monthly utilization and costs for individuals under 19 years old subside after 5 months to .021 visits and $3.7, persist at substantial levels for all other groups and most pronounced among individuals 50-59 (.236 visits and $78.60) and 60-69 (.196 visits and $73.10) years old. Conclusions This study found that COVID-19 diagnosis was associated with increased healthcare utilization and costs 6 months post-diagnosis. These findings imply a prolonged burden to the US healthcare system from medical encounters of COVID-19 patients and increased spending.

scholarly journals RESULTS OF THE STUDY PEDIATRIC DENTISTS’ ACTIVITY ACCORDING TO EUROPEAN INDICATORS

2019 ◽  
Vol 15 (2) ◽  
pp. 68-73
Author(s):  
Лариса Кисельникова ◽  
Larisa Kisel'nikova ◽  
Мария Мирошкина ◽  
Mariya Miroshkina ◽  
Татьяна Зуева ◽  
...  
Keyword(s):  
Job Satisfaction ◽  
Service Quality ◽  
Private Sector ◽  
Dental Care ◽  
Dental Materials ◽  
Dental Service ◽  
Preventive Dental Care ◽  
Pediatric Dentists ◽  
Preventive Dental ◽  
Public Clinics

Relevance of the topic. There are a number of European indicators to monitor the dental healthcare system including C.3 (Satisfaction with service quality) and C.4 (Satisfaction with pay). High job satisfaction among the personnel leads to an increase in effective functioning of the whole organization. However, there are few data on such indicators for clinicians/dentists in Russia. Aim ― to study the level of job satisfaction of pediatric dentists, especially the satisfaction with service quality and pay. Methods and materials. The satisfaction of pediatric dentists was measured according to two European indicators (C.3 and C.4) of dental healthcare monitoring. 232 dentists (aged 22―65 years old) working for clinics of different type of ownership in Moscow and Moscow regions were interviewed. Such factors as the dentist’s age, the level of satisfaction with dental materials, instruments and equipment, the type of ownership were under study. Results. The study showed dependence of C.3 and C.4 on the factors mentioned above. 81,2 % of the dentists of private clinics were satisfied with the treatment and 72,9 % ― with the preventive dental care provided for their patients. In public clinics this proportion was 77,3 and 58,4 %. Meanwhile, the older the dentist was the less satisfaction with the dental service he had: 77,9 % of the dentists of 22―39 years old and only 50 % of those of 60 years old. The satisfaction with preventive dental care was getting lower too: from 65 to 39,6 %. 91,6 % of dentists working for the private sector were satisfied with pay compared with only 41,5 % in public clinics. This figure tended to go down with a rise of the dentist’s age. Conclusion: the dentists of 22―30 years old working for the private sector showed the highest level of job satisfaction

scholarly journals THU0442 GOUT AND HEART FAILURE IN THE US: A NATIONAL PERSPECTIVE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 458.2-458
Author(s):  
G. Singh ◽  
M. Sehgal ◽  
A. Mithal
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Confidence Intervals ◽  
Burden Of Illness ◽  
Average Length ◽  
Private Insurance ◽  
Significant Risk ◽  
Case Fatality ◽  
The United States ◽  
The Us

Background:Heart failure (HF) is the eighth leading cause of death in the US, with a 38% increase in the number of deaths due to HF from 2011 to 2017 (1). Gout and hyperuricemia have previously been recognized as significant risk factors for heart failure (2), but there is little nationwide data on the clinical and economic consequences of these comorbidities.Objectives:To study heart failure hospitalizations in patients with gout in the United States (US) and estimate their clinical and economic impact.Methods:The Nationwide Inpatient Sample (NIS) is a stratified random sample of all US community hospitals. It is the only US national hospital database with information on all patients, regardless of payer, including persons covered by Medicare, Medicaid, private insurance, and the uninsured. We examined all inpatient hospitalizations in the NIS in 2017, the most recent year of available data, with a primary or secondary diagnosis of gout and heart failure. Over 69,800 ICD 10 diagnoses were collapsed into a smaller number of clinically meaningful categories, consistent with the CDC Clinical Classification Software.Results:There were 35.8 million all-cause hospitalizations in patients in the US in 2017. Of these, 351,735 hospitalizations occurred for acute and/or chronic heart failure in patients with gout. These patients had a mean age of 73.3 years (95% confidence intervals 73.1 – 73.5 years) and were more likely to be male (63.4%). The average length of hospitalization was 6.1 days (95% confidence intervals 6.0 to 6.2 days) with a case fatality rate of 3.5% (95% confidence intervals 3.4% – 3.7%). The average cost of each hospitalization was $63,992 (95% confidence intervals $61,908 - $66,075), with a total annual national cost estimate of $22.8 billion (95% confidence intervals $21.7 billion - $24.0 billion).Conclusion:While gout and hyperuricemia have long been recognized as potential risk factors for heart failure, the aging of the US population is projected to significantly increase the burden of illness and costs of care of these comorbidities (1). This calls for an increased awareness and management of serious co-morbid conditions in patients with gout.References:[1]Sidney, S., Go, A. S., Jaffe, M. G., Solomon, M. D., Ambrosy, A. P., & Rana, J. S. (2019). Association Between Aging of the US Population and Heart Disease Mortality From 2011 to 2017. JAMA Cardiology. doi:10.1001/jamacardio.2019.4187[2]Krishnan E. Gout and the risk for incident heart failure and systolic dysfunction. BMJ Open 2012;2:e000282.doi:10.1136/bmjopen-2011-000282Disclosure of Interests: :Gurkirpal Singh Grant/research support from: Horizon Therapeutics, Maanek Sehgal: None declared, Alka Mithal: None declared

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