scholarly journals Economic Evaluation Applied to Health Policy in New Zealand

2021 ◽  
Author(s):  
◽  
William Guy Scott
Keyword(s):  
Health Policy ◽  
Hospital Admissions ◽  
Disease Incidence ◽  
Incidence Rates ◽  
Data Set ◽  
Aggregated Data ◽  
Study Approach ◽  
Incidence Data ◽  
Additional Information ◽  
First Case

<p>Data available in the public domain are frequently aggregated to preserve confidentiality and to reduce a database to a manageable size. Drawing conclusions from such data may lead to inappropriate policy advice. The aims of this paper are to show how the aggregation of data to form rates may obscure important information and lead to misinterpretation of results. Suggestions are offered on ways in which this problem may be addressed. We also highlight the need to seek additional information in order to clarify findings. We used a case study approach by drawing on illustrative examples to highlight some problems encountered when using aggregated data about population. The focus is on health policy. Two types of problem were discussed in the cases chosen, but a common resolution was appropriate. In the first case policies based on the assumption that hospital admissions equate with disease incidence would be different from policies framed on actual incidence data. In the second, incidence rates changed when they were disaggregated to gender and age-specific rates. Policies formulated from analysis of aggregated data would be different form those based on disaggregated data. In the cases studied, the variables of gender, age and ethnicity influence incidence rates and must not be ignored. Researchers are recommended to study the data-set in the most disaggregated form available, and to check how data have been defined, collected and recorded, before preparing summary tables and graphs. Additional research or data from another source may be needed to clarify findings.</p>

scholarly journals Economic Evaluation Applied to Health Policy in New Zealand

2021 ◽  
Author(s):  
◽  
William Guy Scott
Keyword(s):  
Health Policy ◽  
Hospital Admissions ◽  
Disease Incidence ◽  
Incidence Rates ◽  
Data Set ◽  
Aggregated Data ◽  
Study Approach ◽  
Incidence Data ◽  
Additional Information ◽  
First Case

<p>Data available in the public domain are frequently aggregated to preserve confidentiality and to reduce a database to a manageable size. Drawing conclusions from such data may lead to inappropriate policy advice. The aims of this paper are to show how the aggregation of data to form rates may obscure important information and lead to misinterpretation of results. Suggestions are offered on ways in which this problem may be addressed. We also highlight the need to seek additional information in order to clarify findings. We used a case study approach by drawing on illustrative examples to highlight some problems encountered when using aggregated data about population. The focus is on health policy. Two types of problem were discussed in the cases chosen, but a common resolution was appropriate. In the first case policies based on the assumption that hospital admissions equate with disease incidence would be different from policies framed on actual incidence data. In the second, incidence rates changed when they were disaggregated to gender and age-specific rates. Policies formulated from analysis of aggregated data would be different form those based on disaggregated data. In the cases studied, the variables of gender, age and ethnicity influence incidence rates and must not be ignored. Researchers are recommended to study the data-set in the most disaggregated form available, and to check how data have been defined, collected and recorded, before preparing summary tables and graphs. Additional research or data from another source may be needed to clarify findings.</p>

scholarly journals COVID19 epidemic growth rates have declined since early March in U.S. regions with active hospitalized case surveillance

2020 ◽  
Author(s):  
Rajiv Bhatia
Keyword(s):  
Growth Rates ◽  
Cumulative Incidence ◽  
Hospital Admissions ◽  
Disease Incidence ◽  
Incidence Rates ◽  
Harmonic Mean ◽  
Surveillance Program ◽  
Incidence Data ◽  
The Us ◽  
Mortality Incidence

Introduction Optimal pandemic monitoring and management requires unbiased and regionally specific estimates of disease incidence and epidemic growth. Methods I estimated growth rates and doubling times across a 22-week period of the SARS-COV-2 pandemic using hospital admissions incidence data collected through the US CDC COVID-NET surveillance program which operates in 98 U.S. counties located in 13 states. I cross validated the growth measures using mortality incidence data for the same regions and time periods. Results Between March 1 and August 8, 2020, two distinct waves of epidemic activity occurred. During the first wave in the COVID-NET monitoring regions, the harmonic mean of the maximum weekly growth rate was 534% (Median: 575; Range: 250 to 2250) and this maximum occurred in the second or third week of March in different regions. The harmonic mean of the minimum doubling time occurred with maximum growth rate and was 0.35 weeks (Median 0.36 weeks; Range: 0.22 to 0.55 weeks). The harmonic mean of the maximum incidence rate during the first wave of the epidemic was 8.5 hospital admissions per 100,000 people per week (Median: 9.2, Range: 4 to 40.5) and the peak of epidemic infection transmission associated with this maximum occurred on or before March 27, 2020 in eight of the 13 regions. Dividing the 22-week observed period into four intervals, the harmonic mean of the weekly hospitalization incidence rate was highest during the second interval (4.6 hospitalizations per week per 100,000), then fell during the third and fourth intervals. Growth rates declined from 101 percent per week in the first interval to 2.5 percent per week in the last. Doubling time have lengthened from 3/5th of a week in the first interval to 12.5 weeks in the last. Period by period, the cumulative incidence has grown primarily in a linear mode. The mean cumulative incidence of hospitalizations on Aug 8th, 2020 in the COVID-NET regions is 96 hospitalizations per 100,000. Regions which experienced the highest maximum weekly incidence rates or greatest cumulative incidence rates in the first wave, generally, but not uniformly, observed the lower incidence rates in the second wave. Growth measures calculated based on mortality incidence data corroborate these findings. Conclusions Declining epidemic growth rates of SARS-COV-2 infection appeared in early March in the first observations of nationwide hospital admissions surveillance program in multiple U.S. regions. A sizable fraction of the U.S. population may have been infected in a cryptic February epidemic acceleration phase. To more accurately monitor epidemic trends and inform pandemic mitigation planning going forward, the US CDC needs measures of epidemic disease incidence that better reflect clinical disease and account for large variations in case ascertainment strategies over time.

scholarly journals High incidence and prevalence of MS in Møre and Romsdal County, Norway, 1950–2018

2020 ◽  
Vol 7 (3) ◽  
pp. e713 ◽  
Author(s):  
Johannes Sverre Willumsen ◽  
Jan Harald Aarseth ◽  
Kjell-Morten Myhr ◽  
Rune Midgard
Keyword(s):  
Multiple Sclerosis ◽  
Observational Study ◽  
Population Based ◽  
Incidence Rates ◽  
Prevalence Rates ◽  
Data Set ◽  
Aggregated Data ◽  
Western Norway ◽  
High Incidence ◽  
Average Annual Incidence

ObjectiveTo determine prevalence and longitudinal trends in incidence of MS in Møre and Romsdal County, Western Norway, from 1950 to 2018.MethodsRetrospective longitudinal population-based observational study. All patients diagnosed, or living, with MS in Møre and Romsdal were identified as incident or prevalent cases from local, regional, and national sources. We compiled the data in the Norwegian Multiple Sclerosis Registry and Biobank and used the aggregated data set to calculate incidence and prevalence rates using population measures obtained from Statistics Norway.ResultsOn January 1, 2018, the estimated prevalence was 335.8 (95% CI, 314.1–358.5) per 100,000 inhabitants, with a female:male ratio of 2.3. From 1950 through 2017, we observed a considerable (p < 0.001) increase in average annual incidence rates from 2.1 (95% CI, 1.3–3.3) to 14.4 (95% CI, 11.9–17.3) per 100,000. From 2005 through 2017, the incidence among women increased from 17.1 (95% CI, 14.0–20.7) to 23.2 (95% CI, 18.7–28.5) per 100,000, whereas the incidence among men declined from 10.3 (95% CI, 7.9–13.2) to 5.9 (95% CI, 3.4–8.8) per 100,000.ConclusionMøre and Romsdal County in Western Norway has the highest prevalence of MS reported in Norway. The incidence has steadily increased since 1950, and during the latest 15 years, we observed opposing trends in sex-specific incidence rates.

scholarly journals Incidence and completeness of notification of Legionnaires' disease in The Netherlands: covariate capture–recapture analysis acknowledging regional differences

2007 ◽  
Vol 136 (4) ◽  
pp. 540-550 ◽  
Author(s):  
N. A. H. VAN HEST ◽  
C. J. P. A. HOEBE ◽  
J. W. DEN BOER ◽  
J. K. VERMUNT ◽  
E. P. F. IJZERMAN ◽  
...  
Keyword(s):  
The Netherlands ◽  
Incidence Rate ◽  
Regional Differences ◽  
Hospital Admissions ◽  
Disease Incidence ◽  
Incidence Rates ◽  
Average Annual Incidence ◽  
Capture Recapture ◽  
Legionnaires Disease ◽  
Log Linear

SUMMARYTo estimate incidence and completeness of notification of Legionnaires' disease (LD) in The Netherlands in 2000 and 2001, we performed a capture–recapture analysis using three registers: Notifications, Laboratory results and Hospital admissions. After record-linkage, 373 of the 780 LD patients identified were notified. Ascertained under-notification was 52·2%. Because of expected and observed regional differences in the incidence rate of LD, alternatively to conventional log-linear capture–recapture models, a covariate (region) capture–recapture model, not previously used for estimating infectious disease incidence, was specified and estimated 886 LD patients (95% confidence interval 827–1022). Estimated under-notification was 57·9%. Notified, ascertained and estimated average annual incidence rates of LD were 1·15, 2·42 and 2·77/100 000 inhabitants respectively, with the highest incidence in the southern region of The Netherlands. Covariate capture–recapture analysis acknowledging regional differences of LD incidence appears to reduce bias in the estimated national incidence rate.

scholarly journals Increase in Invasive Group A Streptococcal Disease and Emergence of Mucoid Strains in a Pediatric Population: February–June 2017

2019 ◽  
Vol 6 (7) ◽  
Author(s):  
Lorne W Walker ◽  
Lindsay Montoya ◽  
Sopio Chochua ◽  
Bernard Beall ◽  
Michael Green
Keyword(s):  
Whole Genome Sequencing ◽  
Genome Sequencing ◽  
Hospital Admissions ◽  
Disease Incidence ◽  
Tertiary Care ◽  
Incidence Rates ◽  
Screening Tests ◽  
Whole Genome ◽  
Invasive Group ◽  
Group A

Abstract Background Infection with group A Streptococcus (GAS) can cause severe systemic and locally invasive disease. Invasive group A streptococcal (iGAS) disease incidence varies both seasonally and year-to-year, and it may exhibit clustered outbreaks. We observed an upswing in iGAS cases at a tertiary care Children’s Hospital, prompting further characterization of local iGAS disease. Methods Cases of iGAS disease were abstracted from the medical record by manual chart review of all positive screening tests and cultures for GAS over a 4-year span. Incidence rates per 1000 hospital admissions and per 100 positive GAS tests were calculated and compared. Selected isolates were further characterized by whole-genome sequencing. Results Significant year-to-year differences in per-admission iGAS incidence rate were observed in February and June, although per-positive test incidence rates were not significantly different. Whole-genome sequencing revealed 2 dominant serotypes—emm3 and emm6—with high rates of mucoid phenotype and systemic bacteremia. Conclusions We document a significant but transient increase in iGAS disease incidence in 2 months of 2017. Genome sequencing revealed 2 dominant serotypes associated with mucoid phenotypes and severe disease, highlighting the dynamic nature of iGAS disease pattern.

Work-related Musculoskeletal Disorders in Emergency Medical Personnel

2020 ◽  
pp. 42-45
Author(s):  
L.M. Karamova ◽  
V.O. Krasovskiy ◽  
D.M. Vagapova ◽  
N.V. Vlasova ◽  
A.S. Khafizova ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Musculoskeletal Disorders ◽  
Disease Incidence ◽  
Medical Personnel ◽  
Incidence Rates ◽  
Connective Tissue Disorders ◽  
Ambulance Personnel ◽  
Occupational Risk Factors ◽  
Emergency Medical ◽  
Emergency Medical Personnel

Relevance. The importance of studying and analyzing contribution of occupational risk factors in musculoskeletal disorders among emergency medical personnel is related to high disease incidence rates and work specifics. The objective of our research envisaged formalization of information obtained for the analysis and assessment of occupational risks of developing musculoskeletal and connective tissue disorders in ambulance personnel. Results. According to professional medical examination results, musculoskeletal and connective tissue disorders ranked second among all diagnosed diseases. The relative risk of developing those disorders was 70% indicating the link between them and transport vibration (category 1) affecting the backbone during long trips in ambulance cars.

The Seasonal End of Human Coronavirus Hospital Admissions with Implications for SARS-CoV-2 (Preprint)

2020 ◽  
Author(s):  
Alan T Evangelista
Keyword(s):  
Hospital Admissions ◽  
Disease Incidence ◽  
Influenza Viruses ◽  
Seasonal Effects ◽  
Human Coronavirus ◽  
Enveloped Virus ◽  
Multiplex Pcr Assay ◽  
Contact Transmission ◽  
Human Coronaviruses

UNSTRUCTURED The seasonality of influenza viruses and endemic human coronaviruses was tracked over an 8-year period to assess key epidemiologic reduction points in disease incidence for an urban area in the northeast United States. Patients admitted to a pediatric hospital with worsening respiratory symptoms were tested using a multiplex PCR assay from nasopharyngeal swabs. The additive seasonal effects of outdoor temperatures and indoor relative humidity (RH) were evaluated. The 8-year average peak activity of human coronaviruses occurred in the first week of January, when droplet and contact transmission was enabled by the low indoor RH of 20-30%. Previous studies have shown that an increase in RH to 50% has been associated with markedly reduced viability and transmission of influenza virus and animal coronaviruses. As disease incidence was reduced by 50% in early March, to 75% in early April, to greater than 99% at the end of April, a relationship was observed from colder temperatures in January with a low indoor RH to a gradual increase in outdoor temperatures in April with an indoor RH of 45-50%. As a lipid-bound, enveloped virus with similar size characteristics to endemic human coronaviruses, SARS-CoV-2 should be subject to the same dynamics of reduced viability and transmission with increased humidity. In addition to the major role of social distancing, the transition from lower to higher indoor RH with increasing outdoor temperatures could have an additive effect on the decrease in SARS-CoV-2 cases in May. Over the 8-year period of this study, human coronavirus activity was either zero or >99% reduction in the months of June through September, and the implication would be that SARS-Cov-2 may follow a similar pattern. INTERNATIONAL REGISTERED REPORT RR2-doi.org/10.1101/2020.05.15.20103416

scholarly journals National Temporal Trend Analysis of Infective Endocarditis among Patients Infected with HIV in Spain (1997–2014): A Retrospective Study

2019 ◽  
Vol 8 (8) ◽  
pp. 1167 ◽  
Author(s):  
Maria Fe Muñoz-Moreno ◽  
Pablo Ryan ◽  
Alejandro Alvaro-Meca ◽  
Jorge Valencia ◽  
Eduardo Tamayo ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Infective Endocarditis ◽  
Hospital Admissions ◽  
Downward Trend ◽  
Coagulase Negative Staphylococci ◽  
Data Set ◽  
Gram Negative ◽  
Epidemiological Trend ◽  
Incidence And Mortality ◽  
Significant Downward Trend

Background: People living with human immunodeficiency virus (HIV) (PLWH) form a vulnerable population for the onset of infective endocarditis (IE). We aimed to analyze the epidemiological trend of IE, as well as its microbiological characteristics, in PLWH during the combined antiretroviral therapy era in Spain. Methods: We performed a retrospective study (1997–2014) in PLWH with data obtained from the Spanish Minimum Basic Data Set. We selected 1800 hospital admissions with an IE diagnosis, which corresponded to 1439 patients. Results: We found significant downward trends in the periods 1997–1999 and 2008–2014 in the rate of hospital admissions with an IE diagnosis (from 21.8 to 3.8 events per 10,000 patients/year; p < 0.001), IE incidence (from 18.2 to 2.9 events per 10,000 patients/year; p < 0.001), and IE mortality (from 23.9 to 5.5 deaths per 100,000 patient-years; p < 0.001). The most frequent microorganisms involved were staphylococci (50%; 42.7% Staphylococcus aureus and 7.3% coagulase-negative staphylococci (CoNS)), followed by streptococci (9.3%), Gram-negative bacilli (8.3%), enterococci (3%), and fungus (1.4%). During the study period, we found a downward trend in the rates of CoNS (p < 0.001) and an upward trends in streptococci (p = 0.001), Gram-negative bacilli (p < 0.001), enterococci (p = 0.003), and fungus (p < 0.001) related to IE, mainly in 2008–2014. The rate of community-acquired IE showed a significant upward trend (p = 0.001), while the rate of health care-associated IE showed a significant downward trend (p < 0.001). Conclusions: The rates of hospital admissions, incidence, and mortality related to IE diagnosis in PLWH in Spain decreased from 1997 to 2014, while other changes in clinical characteristics, mode of acquisition, and pathogens occurred over this time.

scholarly journals Importation of Entamoeba histolytica and predominance of Klebsiella pneumoniae in liver abscesses: a 7-year retrospective cohort study from the United Arab Emirates

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Hussam Mousa ◽  
Ghada Salameh Mohammed Al-Bluwi ◽  
Zainab Fathi Mohammed Al Drini ◽  
Huda Imam Gasmelseed ◽  
Jamal Aldeen Alkoteesh ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
United Arab Emirates ◽  
Liver Abscess ◽  
Hospital Admissions ◽  
Indian Subcontinent ◽  
Pyogenic Liver Abscess ◽  
Primary Diagnosis ◽  
Incidence Rates ◽  
Liver Abscesses ◽  
Potential Risk Factors

Abstract Background There is a dearth of information on liver abscesses in the United Arab Emirates. Herein, we describe the clinical features of liver abscesses and determine their incidence rates and clinical outcomes. Methods We retrospectively reviewed the clinical charts of adult patients with a primary diagnosis of liver abscess at a major hospital over a 7-year period. Results Amongst 45 patients, 82.2% (37/45) had a pyogenic liver abscess (PLA) and 17.8% (8/45) had amoebic liver abscesses (ALA). Overall, patients were young (median age 42 years, IQR 35–52), mostly males (77.8%, 35/45) from the Indian subcontinent (55.6%, 25/45), presented with fever (88.9%, 40/45) and abdominal pain (88.9%, 40/45), and had a solitary abscess on imaging (71.1% (32/45). Crude annual incidence rates were 35.9/100,000 hospital admissions (95% CI 26.2–48.0) and 5.9/100,000 inhabitants (95% CI 4.3–7.9). All ALA patients were from the Indian subcontinent (100%, 8/8). Klebsiella pneumoniae was the most frequent pathogen in PLA (43.2% [16/37], 95% CI 27.1–60.5%). The hospital stay was shorter in ALA (7.5 days, IQR 7–8.5) than in PLA (14 days, IQR 9–17). No deaths were recorded within 30 days of hospitalisation. Conclusions ALA was exclusively seen in migrants from the Indian subcontinent, suggesting importation. Further research to characterise K. pneumoniae isolates and assess potential risk factors is needed.

scholarly journals Trends in Hospital Admissions for Chronic Obstructive Pulmonary Disease in Men and Women in SPAIN, 1998 to 2018

2021 ◽  
Vol 10 (7) ◽  
pp. 1529
Author(s):  
Domingo Orozco-Beltrán ◽  
Juan Manuel Arriero-Marin ◽  
Concepción Carratalá-Munuera ◽  
Juan J. Soler-Cataluña ◽  
Adriana Lopez-Pineda ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Hospital Admissions ◽  
Chronic Obstructive ◽  
Annual Percent Change ◽  
Data Set ◽  
Obstructive Pulmonary Disease ◽  
Men And Women ◽  
Admission Rates ◽  
Percent Change

The prevalence of chronic obstructive pulmonary disease (COPD) is rising faster in women in some countries. An observational time trends study was performed to assess the evolution of hospital admissions for COPD in men and women in Spain from 1998 to 2018. ICD-9 diagnostic codes (490–492, 496) from the minimum basic data set of hospital discharges were used. Age-standardised admission rates were calculated using the European Standard Population. Joinpoint regression models were fitted to estimate the annual percent change (APC). In 2018, the age-standardised admission rate per 100,000 population/year for COPD was five times higher in men (384.8, 95% CI: 381.7, 387.9) than in women (78.6, 95% CI: 77.4, 79.9). The average annual percent change (AAPC) was negative over the whole study period in men (−1.7%/year, 95% CI: −3.1, −0.2) but positive from 2010 to 2018 (1.1%/year, 95% CI: −0.8, 2.9). In women, the APC was −6.0% (95%CI: −7.1, −4.9) from 1998 to 2010, but the trend reversed direction in the 2010–2018 period (7.8%/year, 95% CI: 5.5, 10.2). Thus, admission rates for COPD decreased from 1998 to 2010 in both men and women but started rising again until 2018, modestly in men and sharply in women.

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