Disparities in Oral Nutritional Supplement Usage and Dispensing Patterns across Primary Care in Ireland: ONSPres Project

When treating malnutrition, oral nutritional supplements (ONSs) are advised when optimising the diet is insufficient; however, ONS usage and user characteristics have not been previously analysed. A retrospective secondary analysis was performed on dispensed pharmacy claim data for 14,282 anonymised adult patients in primary care in Ireland in 2018. Patient sex, age, residential status, ONS volume (units) and ONS cost (EUR) were analysed. The categories of ‘Moderate’ (<75th centile), ‘High’ (75th–89th centile) and ‘Very High’ ONS users (≥90th centile) were created. The analyses among groups utilised t-tests, Mann–Whitney U tests and chi-squared tests. This cohort was 58.2% female, median age was 76 years, with 18.7% in residential care. The most frequently dispensed ONS type was very-high-energy sip feeds (45% of cohort). Younger males were dispensed more ONSs than females (<65 years: median units, 136 vs. 90; p < 0.01). Patients living independently were dispensed half the volume of those in residential care (112 vs. 240 units; p < 0.01). ‘Moderate’ ONS users were dispensed a yearly median of 84 ONS units (median cost, EUR 153), ‘High’ users were dispensed 420 units (EUR 806) and ‘Very High’ users 892 yearly units (EUR 2402; p < 0.01). Further analyses should focus on elucidating the reasons for high ONS usage in residential care patients and younger males.

The Public Health Insurance Coverage of Novel Targeted Anticancer Medicines in China—In Favor of Whom? A Retrospective Analysis of the Insurance Claim Data

Objectives: This study took Fuzhou city as a case, described how the public health insurance coverage policy in 2016 of novel anti-lung cancer medicines benefited patients, and who benefited the most from the policy in China.Methods: This was a retrospective study based on health insurance claim data with a longitudinal analysis of the level and trend changes of the monthly number of patients to initiate treatment with the novel targeted anti-lung cancer medicines gefitinib and icotinib before and after health insurance coverage. The study also conducted a multivariate linear regression analysis to predict the potential determinants of the share of patient out-of-pocket (OOP) expenditure for lung cancer treatment with the study medicines.Results: The monthly number of the insured patients in Fuzhou who initiated the treatment with the studied novel targeted anti-lung cancer medication abruptly increased by 26 in the month of the health insurance coverage (95% CI: 14–37, p &lt; 0.01) and kept at an increasing level afterward (p &lt; 0.01). By controlling the other factors, the shares of OOP expenditure for lung cancer treatment of the patients who were formal employee program enrollees not entitled to government-funded supplementary health insurance coverage and resident program enrollees were 18.3% (95% CI: 14.1–22.6) and 26.7% (95% CI: 21.0–32.4) higher than that of the patients who were formal employee program enrollees with government-funded supplementary health insurance coverage.Conclusion: The public health insurance coverage of novel anti-lung cancer medicines benefited patients generally. To enable that patients benefit from this policy more equally and thoroughly, in order to achieve the policy goal of not to leave anyone behind, it is necessary to strengthen the benefits package of the resident program and to optimize the current financing mechanism of the public health insurance system.

Maternal and Neonatal Risk Factors Affecting the Occurrence of Neurodevelopmental Disorders: A Population-Based Nationwide Study

To investigate the maternal and neonatal risk factors related to pregnancy and birth affecting the occurrence of neurodevelopmental disorders to their children using the medical claim data for the whole population. The study was conducted on all the babies born in Korea from 2005 to 2009 based on data from the National Health Information Database. All birth records were tracked from birth to December 31, 2015. To analyze factors related to the mother, data related to the mother of the newborn were collected. Increased maternal age was found to increase the risk of cerebral palsy (adjusted odds ratio [aOR] = 1.46, 95% confidence interval [CI] [1.22, 1.75]) and autism spectrum disorder (aOR = 1.48, 95% CI [1.25, 1.76]), while lowering the risk of intellectual disability (aOR = 1.83, 95% CI [1.33, 2.53]) and speech and language impairment (aOR = 1.41, 95% CI [1.08, 1.83]) compared with the reference group aged 25 to 29 years old. The incidence affected by socioeconomic factors varied according to the types of disorders. Among various risk factors, prematurity or low birth weight, problems associated with amniotic fluid or amniotic membrane, preeclampsia or eclampsia, and cesarean section affect the incidence of neurodevelopmental disorders. To reduce the incidence or severity of neurodevelopmental disorders, a better understanding of the risk factors of neurodevelopmental disorders is important. The results of this study can be used as basic data to help such understanding.

Metabolic comorbidities among patients with peripheral artery disease: a national population-based study

Peripheral artery disease (PAD) is a chronic disease which is associated with old age. PAD was known as an age-related chronic condition. Metabolic comorbid conditions which include hypertension, diabetes, and hyperlipidemia can have negative impacts on blood vessels aggravating PAD in elderly patients. Therefore, metabolic comorbidities need be considered in order to develop intervention for patients with PAD. The aim of this study is to find the characteristics of PAD patients with metabolic comorbidities. This is a retrospective study that used the national claim data of South Korea from 2009 to 2018. The inclusion criteria were adults (20+) and patients diagnosed with PAD as a primary or secondary diagnosis from 2011 to 2017. The frequency of hypertension, hyperlipidemia, diabetes, and metabolic comorbidities in PAD patients was examined. In addition, the difference in the number of metabolic comorbidities according to sex was identified using the chi-squared test. Among the total PAD adult patients(n=8,478,876), the number of elderly patients over 60 years old was 4,124,592(48.7%). Among the total patients, PAD patients with hypertension were the most common at 958,329 (11.30%). Sex was significantly related to having metabolic comorbidities and women showed higher proportion of metabolic comorbidities compared to men (χ2 =5.02, p&lt;.001). As the frequency of PAD patients with hypertension were the highest, it is necessary to develop a health management program that considers metabolic comorbidities, especially hypertension, in order to manage PAD disease. In addition, there is a need for special interest in intervening metabolic conditions of female patients with PAD.

Recreational Marijuana Sales Legalization and Monday Work Injury Claims

An important stylized fact in the literature is that more Workers’ Compensation claims for difficult-to-diagnose injuries are filed on Monday than on any other day of the week. This paper studies the impact of recreational marijuana sales legalization on Monday work injury claims. Using restricted-use Workers’ Compensation claim data in Oregon and a Difference-in-Differences (DiD) model, I find the probability of overall Monday injuries increase by 4 percentage points after recreational marijuana sales legalization. The event study graphs suggest the medium-term effects appear to equal the short-term effects. Additionally, I do not find strong evidence to support those difficult-to-diagnose Monday injuries disproportionately increase after recreational marijuana sales legalization, suggesting a limited moral hazard of Monday injury claiming behavior after recreational marijuana sales legalization.

Pilot Study of an e-Cohort to Monitor Adverse Event for Patient with Hip Prostheses from Clinical Data Warehouse

Hip arthroplasty represents a large proportion of orthopaedic activity, constantly increasing. Automating monitoring from clinical data warehouses is an opportunity to dynamically monitor devices and patient outcomes allowing improve clinical practices. Our objective was to assess quantitative and qualitative concordance between claim data and device supply data in order to create an e-cohort of patients undergoing a hip replacement. We performed a single-centre cohort pilot study, from one clinical data warehouse of a French University Hospital, from January 1, 2010 to December 31, 2019. We included all adult patients undergoing a hip arthroplasty, and with at least one hip medical device provided. Patients younger than 18 years or opposed to the reuse of their data were excluded from the analysis. Our primary outcome was the percentage of hospital stays with both hip arthroplasty and hip device provided. The patient and stay characteristics assessed in this study were: age, sex, length of stay, surgery procedure (replacement, repositioning, change, or reconstruction), medical motif for surgery (osteoarthritis, fracture, cancer, infection, or other) and device provided (head, stem, shell, or other). We found 3,380 stays and 2,934 patients, 96.4% of them had both a hip surgery procedure and a hip device provided. These data from different sources are close enough to be integrated in a common clinical data warehouse.

Transfer of Clinical Drug Data to a Research Infrastructure on OMOP – A FAIR Concept

Generating evidence based on real-world data is gaining importance in research not least since the COVID-19 pandemic. The Common Data Model of Observational Medical Outcomes Partnership (OMOP) is a research infrastructure that implements FAIR principles. Although the transfer of German claim data to OMOP is already implemented, drug data is an open issue. This paper provides a concept to prepare electronic health record (EHR) drug data for the transfer to OMOP based on requirements analysis and descriptive statistics for profiling EHR data developed by an interdisciplinary team and also covers data quality issues. The concept not only ensures FAIR principles for research, but provides the foundation for German drug data to OMOP transfer.

Biodiversity with problem-based learning: impact on quality of students’ scientific argumentation

This study aims to determine the effect of problem-based learning (PBL) on the scientific argumentation of class X students at Senior High School in Indralaya, Indonesia, on biodiversity education. The research method was quasi-experimental with a non-equivalent control group research design. This research was conducted in class X-science-3 (n=33) as an experiment and X-science 4 (n=33) as a control at Senior High School in Indralaya, Indonesia. The data collection instrument was a test question that included scientific argumentation skills in essay questions and recorded class discussions. Data on writing scientific arguments are analyzed using cohesion and coherence, sentence effectiveness, concept correctness, critical analysis of problems and problem-solving. Data on the ability of scientific argumentation in writing and oral are also analyzed based on Toulmin's claim, data, warrant, backing, rebuttal, and qualifier. Furthermore, based on the Toulmin aspect, the students' quality level of scientific argumentation is determined. The result showed that the level of argumentation quality of students who applied the PBL model was mainly at level 3, while the control class was mainly at level 1. The effect being studied is significant. The PBL can significantly influence the ability of scientific argumentation in class X students at senior high school in Indralaya, Indonesia.