Providing a Diabetes Foot Care Service: Lessons from the Veterans Health Affairs in the United States

2006 ◽  
pp. 108-115
Author(s):  
Jeffrey M. Robbins
Keyword(s):  
United States ◽  
Care Service ◽  
The United States ◽  
Veterans Health ◽  
Foot Care

The economic burden of vertigo and dizziness in the United States

2020 ◽  
pp. 1-10
Author(s):  
Jeremy S. Ruthberg ◽  
Chandruganesh Rasendran ◽  
Armine Kocharyan ◽  
Sarah E. Mowry ◽  
Todd D. Otteson
Keyword(s):  
United States ◽  
Health Care ◽  
Economic Burden ◽  
Clinical Characteristics ◽  
Care Service ◽  
Adult Population ◽  
Health Care Service ◽  
The United States ◽  
Medical Expenditures ◽  
Limited Information

BACKGROUND: Vertigo and dizziness are extremely common conditions in the adult population and therefore place a significant social and economic burden on both patients and the healthcare system. However, limited information is available for the economic burden of vertigo and dizziness across various health care settings. OBJECTIVE: Estimate the economic burden of vertigo and dizziness, controlling for demographic, socioeconomic, and clinical comorbidities. METHODS: A retrospective analysis of data from the Medical Expenditures Panel Survey (2007–2015) was performed to analyze individuals with vertigo or dizziness from a nationally representative sample of the United States. Participants were included via self-reported data and International Classification of Diseases, 9th Revision Clinical Modification codes. A cross-validated 2-component generalized linear model was utilized to assess vertigo and dizziness expenditures across demographic, socioeconomic and clinical characteristics while controlling for covariates. Costs and utilization across various health care service sectors, including inpatient, outpatient, emergency department, home health, and prescription medications were evaluated. RESULTS: Of 221,273 patients over 18 years, 5,275 (66% female, 34% male) reported either vertigo or dizziness during 2007–2015. More patients with vertigo or dizziness were female, older, non-Hispanic Caucasian, publicly insured, and had significant clinical comorbidities compared to patients without either condition. Furthermore, each of these demographic, socioeconomic, and clinical characteristics lead to significantly elevated costs due to having these conditions for patients. Significantly higher medical expenditures and utilization across various healthcare sectors were associated with vertigo or dizziness (p <  0.001). The mean incremental annual healthcare expenditure directly associated with vertigo or dizziness was $2,658.73 (95% CI: 1868.79, 3385.66) after controlling for socioeconomic and demographic characteristics. Total annual medical expenditures for patients with dizziness or vertigo was $48.1 billion. CONCLUSION: Vertigo and dizziness lead to substantial expenses for patients across various healthcare settings. Determining how to limit costs and improve the delivery of care for these patients is of the utmost importance given the severe morbidity, disruption to daily living, and major socioeconomic burden associated with these conditions.

Transformation of the US Veterans Health Administration

2006 ◽  
Vol 1 (2) ◽  
pp. 99-105 ◽  
Author(s):  
Jonathan B. Perlin
Keyword(s):  
United States ◽  
Health Care ◽  
Veterans Health Administration ◽  
The United States ◽  
Veterans Affairs ◽  
United States Department ◽  
Veterans Health ◽  
Department Of Veterans Affairs ◽  
Health Administration ◽  
The Us

Ten years ago, it would have been hard to imagine the publication of an issue of a scholarly journal dedicated to applying lessons from the transformation of the United States Department of Veterans Affairs Health System to the renewal of other countries' national health systems. Yet, with the recent publication of a dedicated edition of the Canadian journal Healthcare Papers (2005), this actually happened. Veterans Affairs health care also has been similarly lauded this past year in the lay press, being described as ‘the best care anywhere’ in the Washington Monthly, and described as ‘top-notch healthcare’ in US News and World Report's annual health care issue enumerating the ‘Top 100 Hospitals’ in the United States (Longman, 2005; Gearon, 2005).

scholarly journals Implementation evaluation of academic detailing on naloxone prescribing trends at the United States Veterans Health Administration

2019 ◽  
Vol 54 (5) ◽  
pp. 1055-1064 ◽  
Author(s):  
Mark Bounthavong ◽  
Emily Beth Devine ◽  
Melissa L. D. Christopher ◽  
Michael A. Harvey ◽  
David L. Veenstra ◽  
...  
Keyword(s):  
United States ◽  
Veterans Health Administration ◽  
The United States ◽  
Veterans Health ◽  
Academic Detailing ◽  
Health Administration ◽  
Implementation Evaluation ◽  
Prescribing Trends

Cataract surgery practice patterns in the United States Veterans Health Administration

2012 ◽  
Vol 38 (4) ◽  
pp. 705-709 ◽  
Author(s):  
Paul B. Greenberg ◽  
Annika Havnaer ◽  
Thomas A. Oetting ◽  
Francisco J. Garcia-Ferrer
Keyword(s):  
United States ◽  
Cataract Surgery ◽  
Practice Patterns ◽  
Veterans Health Administration ◽  
The United States ◽  
Veterans Health ◽  
Health Administration

scholarly journals 1164. County-Level Geographic Distribution of Extended-Spectrum Cephalosporin-Resistant Enterobacteriaceae Across Outpatient Settings of the Veterans Health Administration, 2000–2017

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S350-S351
Author(s):  
Michihiko Goto ◽  
Rajeshwari Nair ◽  
Daniel Livorsi ◽  
Marin Schweizer ◽  
Michael Ohl ◽  
...  
Keyword(s):  
United States ◽  
Veterans Health Administration ◽  
The United States ◽  
Incidence Rates ◽  
County Level ◽  
Veterans Health ◽  
Health Administration ◽  
Geographic Variability ◽  
Extended Spectrum ◽  
Outpatient Settings

Abstract Background Extended-spectrum cephalosporin resistance (ESCR) among Enterobacteriaceae has emerged globally over the last two decades, with increased prevalence in the community. Data from European countries and healthcare-associated isolates in the United States have demonstrated substantial geographic variability in the prevalence of ESCR, but community-onset isolates in the United States have been less studied. We aimed to describe geographic distribution and spread of ESCR among outpatient settings across the Veterans Health Administration (VHA) over 18 years. Methods We analyzed a retrospective cohort of all patients who had any positive clinical culture specimen for ESCR Enterobacteriaceae collected in an outpatient setting; ESCR was defined by phenotypic nonsusceptibility to at least one extended-spectrum cephalosporin agent or detection of an extended-spectrum β-lactamase. Patient-level data were grouped by county of residence, and the total number of unique patients who received care within VHA for each county was used as a denominator. We aggregated data by time terciles (2000–2005, 2006–2011, and 2012–2017), and overall and county-level incidence rates were calculated as the number of unique patients in each year with ESCR Enterobacteriaceae per person-year. Results During the study period, there were 1,980,095 positive cultures for Enterobacteriaceae from 870,797 unique patients across outpatient settings of VHA, from a total of 107,404,504 person-years. Among those, 136,185 cultures (6.9%) from 75,500 unique patients (8.7%) were ESCR. The overall incidence rate was 9.0 cases per 10,000 person-years, which increased from 6.3 per 10,000 person-years in 2000 to 14.6 per 10,000 person-years in 2017. County-level incidence rates ranged widely but increased overall (interquartile range [IQR] in 2000–2005: 0–6.7; 2006–2011: 0–9.1; 2012–2017: 3.1–14.3 per 10,000 person-years), with some geographic clustering (figure). Conclusion This study demonstrates that there has been geographic variation both in incidence rates and trends of ESCR Enterobacteriaceae in outpatient settings of VHA, which suggests the importance of tailoring local antibiotic-prescribing guidelines incorporating geographic variability in epidemiology. Disclosures M. Ohl, Gilead Sciences, Inc.: Grant Investigator, Research grant.

COVID-19 Infections Among Healthcare Personnel in the United States Veterans Health Administration, March – August, 2020

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Gina Oda ◽  
Aditya Sharma ◽  
Cynthia Lucero-Obusan ◽  
Patricia Schirmer ◽  
Pooja Sohoni ◽  
...  
Keyword(s):  
United States ◽  
Veterans Health Administration ◽  
The United States ◽  
Healthcare Personnel ◽  
Veterans Health ◽  
Health Administration
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