Hospitalizations with TB, California, 2009–2017

2021 ◽  
Vol 25 (8) ◽  
pp. 640-647
Author(s):  
A. Readhead ◽  
G. Cooksey ◽  
J. Flood ◽  
P. Barry
Keyword(s):  
State Level ◽  
The United States ◽  
Primary Diagnosis ◽  
Discharge Data ◽  
Asian Pacific Islander ◽  
Hospitalization Costs ◽  
Working Age ◽  
Hospital Stays ◽  
Asian Pacific ◽  
The Cost

BACKGROUND: Hospitalization is a costly event that affects more than half of all TB patients in the United States. State-level hospitalization data are crucial in estimating the cost of TB disease and the financial impact of preventing TB.METHODS: We used California administrative hospital discharge data from 2009 to 2017 to characterize TB hospitalizations in comparison with non-neonatal, non-maternal hospitalizations. TB hospitalization was defined as a hospitalization with a TB ICD-9/10 code as the primary diagnosis. We estimated hospitalization costs in 2017 dollars from reported charges using cost-to-charge ratios.RESULTS: In comparison to persons hospitalized for other conditions, persons hospitalized for TB in 2017 were more likely to be male, of working age, and Asian/Pacific Islander. The median cost for TB hospitalizations was US$22,807 vs. US$11,568 for other hospitalizations. The median length of stay for TB hospitalizations was 12 days compared to 3 days for other hospitalizations. Medicaid was expected to pay for 50% of TB hospitalizations costing US$21,438,208.CONCLUSIONS: Societal cost estimates of TB hospitalization should be updated to reflect long hospital stays and the disproportionate burden on working age persons. This analysis enhances our understanding of the high cost of TB care and underscores the costs averted if TB cases are prevented.

scholarly journals Hospitalizations for Acute Salicylate Intoxication in the United States

2020 ◽  
Vol 9 (8) ◽  
pp. 2638
Author(s):  
Charat Thongprayoon ◽  
Tananchai Petnak ◽  
Wisit Kaewput ◽  
Michael A. Mao ◽  
Karthik Kovvuru ◽  
...  
Keyword(s):  
United States ◽  
Hospital Mortality ◽  
Resource Use ◽  
Kidney Failure ◽  
The United States ◽  
Primary Diagnosis ◽  
Asian Pacific Islander ◽  
Suicidal Attempts ◽  
Salicylate Intoxication ◽  
Asian Pacific

Background: The objective of this study was to describe inpatient prevalence, characteristics, outcomes, and resource use for acute salicylate intoxication hospitalizations in the United States. Methods: A total of 13,805 admissions with a primary diagnosis of salicylate intoxication from 2003 to 2014 in the National Inpatient Sample database were analyzed. Prognostic factors for in-hospital mortality were determined using multivariable logistic regression. Results: The overall inpatient prevalence of salicylate intoxication among hospitalized patients was 147.8 cases per 1,000,000 admissions in the United States. The average age was 34 ± 19 years. Of these, 35.0% were male and 65.4% used salicylate for suicidal attempts. Overall, 6% required renal replacement therapy. The most common complications of salicylate intoxication were electrolyte and acid-base disorders, including hypokalemia (25.4%), acidosis (19.1%), and alkalosis (11.1%). Kidney failure (9.3%) was the most common observed organ dysfunction. In-hospital mortality was 1.0%. Increased in-hospital mortality was associated with age ≥30, Asian/Pacific Islander race, diabetes mellitus, hyponatremia, ventricular arrhythmia, kidney failure, respiratory failure, and neurological failure, while decreased in-hospital mortality was associated with African American and Hispanic race. Conclusion: hospitalization for salicylate intoxication occurred in 148 per 1,000,000 admissions in the United States. Several factors were associated with in-hospital mortality.

scholarly journals Depression Increases Stroke Hospitalization Cost: An Analysis of 17,010 Stroke Patients in 2008 by Race and Gender

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Baqar Husaini ◽  
Robert Levine ◽  
Linda Sharp ◽  
Van Cain ◽  
Meggan Novotny ◽  
...  
Keyword(s):  
Black Males ◽  
Primary Diagnosis ◽  
Stroke Patients ◽  
Discharge Data ◽  
Race And Gender ◽  
Hospitalization Costs ◽  
And Gender ◽  
The Cost ◽  
The Impact ◽  
Detection Of Depression

Objective. This analysis focuses on the effect of depression on the cost of hospitalization of stroke patients.Methods. Data on 17,010 stroke patients (primary diagnosis) were extracted from 2008 Tennessee Hospital Discharge Data System. Three groups of patients were compared: (1) stroke only (SO,n=7,850), (2) stroke + depression (S+D,n=3,965), and (3) stroke + other mental health diagnoses (S+M,n=5,195).Results. Of all adult patients, 4.3% were diagnosed with stroke. Stroke was more prevalent among blacks than whites (4.5% versus 4.2%,P<0.001) and among males than females (5.1% versus 3.7%,P<0.001). Nearly one-quarter of stroke patients (23.3%) were diagnosed with depression/anxiety. Hospital stroke cost was higher among depressed stroke patients (S+D) compared to stroke only (SO) patients ($77,864 versus $47,790,P<0.001), and amongS+D, cost was higher for black males compared to white depressed males ($97,196 versus $88,115,P<0.001). Similar racial trends in cost emerged amongS+Dfemales.Conclusion. Depression in stroke patients is associated with increased hospitalization costs. Higher stroke cost among blacks may reflect the impact of comorbidities and the delay in care of serious health conditions. Attention to early detection of depression in stroke patients might reduce inpatient healthcare costs.

Abstract 18272: The Increasing Proportion of Acute Myocardial Infarction Represented by the Uninsured: a Growing Financial Burden in the United States

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Bethany Doran ◽  
Yu Guo ◽  
Jinfeng Xu ◽  
Sripal Bangalore
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Health Insurance ◽  
Financial Burden ◽  
Insurance Coverage ◽  
The United States ◽  
The Us ◽  
Hospital Stays ◽  
Nationally Representative ◽  
The Cost

Introduction: Under the provisions of the Affordable Care Act, insurance coverage will markedly increase with the Congressional Budgetary Office estimating the number of insured to increase by approximately 13 million in 2014 and 25 million in 2016. However, approximately 31 million non-elderly US citizens are expected to remain without health insurance in 2016. Acute myocardial infarction (AMI) remains a source of significant morbidity and mortality, as well as cost to society. No prior studies have examined temporal rates of uninsured among patients presenting with an AMI using a nationally representative database. Hypothesis: We tested the hypothesis that the proportion of uninsured individuals with AMI and cost of uninsured to society will vary by year. Methods: We used the Nationwide Inpatient Sample (NIS), which contains estimates from approximately 8 million hospital visits and information related to number of discharges, aggregate charges, and principal diagnoses of all patients discharged in the US. We calculated the percentage of acute myocardial infarction by insurance status, and the sum of all charges of hospital stays in the US adjusted for inflation. Results: The cost to society due to acute myocardial infarction in the uninsured increased substantially from 1997 to 2012, with total cost in 1997 of $852,596,272 and $3,446,893,954 in 2012 after adjustment for inflation. In addition, although rates of AMI decreased in the general population (from 268.6/100,000 individuals in 1997 to 193.8/100,000 individuals in 2012), the proportion of individuals with AMI who were uninsured increased (from 3.83% in 1997 to 7.37% in 2012). Conclusions: The proportion of those experiencing AMI who are uninsured is rising, as is cost to society. It remains to be seen what the effects of expanding health insurance will have on the rate of AMI as well as proportion of AMI represented by the uninsured.

Racial and socioeconomic disparities in follicular lymphoma survival.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18173-e18173
Author(s):  
Richard Stephen Sheppard ◽  
Adewumi Adekunle ◽  
Stefani Beale ◽  
Meena Ahluwalia
Keyword(s):  
Socioeconomic Status ◽  
Follicular Lymphoma ◽  
Low Socioeconomic Status ◽  
Survival Rates ◽  
The United States ◽  
Rank Test ◽  
Men And Women ◽  
Low Socioeconomic ◽  
Asian Pacific Islander ◽  
Asian Pacific

e18173 Background: Follicular Lymphoma (FL) is a the second most common Non Hodgkin's Lymphoma (NHL) diagnosed in the United States with 2.6 per 100,000 men and women per year from 2011 to 2015 when age adjusted as per the National Cancer Institute with the number of deaths of 0.5 per 100,000 men and women per year. It known that FL is one of the most clinically indolent NHL and due to this, survival rates are generally more favorable when compared to other B Cell Lymphomas. With this study, we aim to analyse socioeconomic and racial disparities in the survival rates for FL. Methods: The authors identified patients diagnosed with FL between 1973 and 2015 using the Surveillance, Epidemiology, and End Results (SEER) database. Overall survival was estimated and compared between racial/ethnic groups using the log-rank test. Our outcome variables were 1-year, 5-year and mortality. Our independent variables were race and socioeconomic status. We controlled for age, demographic characteristics, time of diagnosis, pathological classification, treatment and socioeconomic status. Results: A total of 66 127 patients were identified; 90% of the patients were White, 4% Black, and 4% Asian. We noted significant differences in disease presentation, socioeconomic status, and outcomes. Asian/Pacific Islander had the lowest survival with a mean of 228 survival months, Blacks had a mean survival months of 237, and Whites had a mean survival months of 234. Conclusions: Disparities exist in the care and outcomes of FL. A low socioeconomic status is correlated with decreased survival.

scholarly journals GERM-04. PRIMARY INTRACRANIAL GERM CELL TUMORS ARE MORE PREVALENT AMONG PEDIATRIC PATIENTS OF ASIAN/PACIFIC ISLANDER RACE/ETHNICITY IN THE UNITED STATES

2021 ◽  
Vol 23 (Supplement_1) ◽  
pp. i16-i17
Author(s):  
Nayan Lamba ◽  
Bryan Iorgulescu
Keyword(s):  
Pediatric Patients ◽  
Pacific Islander ◽  
Germ Cell Tumors ◽  
The United States ◽  
Asian Pacific Islander ◽  
Intracranial Germ Cell Tumors ◽  
Hispanic Patients ◽  
Race Ethnicity ◽  
Asian Pacific ◽  
The U.S

Abstract Introduction Primary intracranial germ cell tumors (GCTs) appear to be more prevalent among pediatric patients in eastern Asia than in the U.S. Herein we use cancer registry data to evaluate whether GCT prevalence differs by race/ethnicity among U.S. pediatric patients. Methods Pediatric patients (age≤14) presenting between 2004–2017 with a primary intracranial GCT were identified by ICD-O-3 histological and topographical coding from the National Cancer Database (comprising &gt;70% of cancers newly-diagnosed cancers in the U.S.), and categorized by NICHD age stages. Patients’ age, sex, race/ethnicity, and overall survival, and tumor location and size were evaluated. Results 889 pediatric patients with primary intracranial GCTs were identified, which were overwhelmingly male (64.8%) and pure germinomas (64.0%). Non-germinomatous (24.5%) and mixed (11.5%) tumor types were in the minority. Overall, primary GCTs comprised 4.9% of intracranial tumors in pediatric males and 2.9% of intracranial tumors in pediatric females. Asian/Pacific Islander pediatric patients in the U.S. had a notably higher prevalence of GCTs: among Asian/Pacific Islander males, 10.6% of all brain tumors were GCTs, compared to only 4.5% in White non-Hispanic patients, 2.8% in Black non-Hispanic patients, and 6.0% in Hispanic patients. Despite the much lower prevalence of GCTs among female patients overall, this predominance also persisted for Asian/Pacific Islander females, among whom 7.5% of brain tumors were GCTs, compared to only 2.5% in White non-Hispanic patients, 2.4% in Black non-Hispanic patients, and 4.1% in Hispanic patients. Overall, 9.4% of pediatric primary intracranial GCTs occurred in patients of Asian/Pacific Islander race/ethnicity, in contrast to 4.0% of diffuse astrocytic/oligodendroglial tumors, 2.8% of other astrocytic tumors, or 4.6% of embryonal tumors. Conclusions Primary intracranial GCTs affect a substantially larger proportion of both male and female pediatric patients of Asian/Pacific Islander race/ethnicity in the United States.

Abstract 2311: Hospitalization Costs of Stroke among Adults 18-64 Years in the United States

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Guijing Wang ◽  
Zefeng Zhang ◽  
Carma Ayala ◽  
Diane Dunet ◽  
Jing Fang ◽  
...  
Keyword(s):  
United States ◽  
Ischemic Stroke ◽  
Late Effects ◽  
Average Cost ◽  
Hemorrhagic Stroke ◽  
The United States ◽  
Primary Diagnosis ◽  
Secondary Diagnosis ◽  
Hospitalization Costs ◽  
The Impact

Background and purpose: The average cost of stroke, a leading cause of death and serious long-term disability, has been estimated to range from $468 to $146,149 worldwide, and varies 20-fold in the United States. A robust cost estimate is needed for policy makers, public health researchers and practitioners to use as a reference in making resource allocation decisions and assessing cost-effectiveness of intervention programs. This study examined the hospitalization costs of stroke using a large administrative data. Methods: We identified 97,374 hospitalizations with a primary or secondary diagnosis of stroke from pooling 2006-2008 MarketScan inpatient datasets. We investigated the costs by stratifying the hospitalizations by stroke types (hemorrhagic ICD-9 430-432, ischemic ICD-9 433-434, ill-defined ICD-9 436-437, and late-effects ICD-9 438) and diagnosis status (primary and secondary). For hospitalizations with stroke as the primary diagnosis, we identified those with a secondary diagnosis of hypertension, ischemic heart disease (IHD), and diabetes. We used multiple regression models to estimate the impact of stroke types and diagnosis status on the costs controlling age, sex, geographic region, and Charlson Comorbidity Index (CCI). Results: Of the 97,374 hospitalizations (average cost $20,396 ±23,256), the number of hospitalizations with hemorrhagic, ischemic, ill-defined, and late-effects of stroke was 16,331, 62,637, 38,312, and 14,221 with an average cost of $32,035 ±32,046, $18,963 ±21,454, $19,430 ±22,159, and $18,946±19,891, respectively. Over 61% of the hospitalizations listed stroke as a secondary diagnosis only. Regression results showed that the costs increased by at least $962 per CCI unit increase (p<0.001). Hemorrhagic stroke cost $14,499 more than ischemic stroke (p<0.001). For hospitalizations with the primary diagnosis of stroke, those with a secondary diagnosis of IHD had higher costs than those without IHD, especially among those of ischemic stroke ($9835 higher, p<0.001), while hypertension and diabetes as a secondary diagnosis lowered the costs. Hospitalizations with a primary diagnosis of ischemic stroke had $3195 lower cost than those listed as secondary diagnosis, but hospitalizations with a primary diagnosis of hemorrhagic stroke had $8001 higher cost than those listed as a secondary diagnosis. Conclusions: The costs of stroke hospitalizations were high and varied greatly by stroke types, diagnosis status, and comorbidities. Stroke types and their comorbidities should be considered when developing cost-effective strategies for stroke prevention.

scholarly journals Costs of medical care for mesothelioma

Rare Tumors ◽  
2019 ◽  
Vol 11 ◽  
pp. 203636131986349 ◽  
Author(s):  
Eric Borrelli ◽  
Zachary Babcock ◽  
Stephen Kogut
Keyword(s):  
United States ◽  
Medical Care ◽  
Medical Cost ◽  
The United States ◽  
Healthcare Research ◽  
Cost Of Care ◽  
Discharge Data ◽  
System A ◽  
The Cost ◽  
Mean Cost

Malignant mesothelioma is a rare and devastating form of cancer with an increasing economic burden. We sought to describe the direct cost burden of mesothelioma to the US health system. A systematic literature review was performed to locate published estimates of the medical cost of mesothelioma. In addition, we performed an analysis of hospital discharge data from the National Inpatient Sample, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality. We also reviewed publicly available legal settlements. We found that published estimates of the cost of medical care for mesothelioma are sparse, and differ with respect to nation, timeframe, and types of cost included. For the year 2014 in the United States, we estimated a mean cost per mesothelioma hospitalization of US$24,124 (95% confidence interval: US$20,819–US$28,983) and a total cost for hospital care of US$44,214,835. In conclusion, we found that reports describing the direct medical cost of care for mesothelioma in the United States are lacking, yet the per-patient cost of care is substantial, as evidenced by analyses of inpatient care and legal settlements.

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