Health Care Utilization and Costs by Metabolic Syndrome Risk Factors

2009 ◽  
Vol 7 (4) ◽  
pp. 305-314 ◽  
Author(s):  
D.M. Boudreau ◽  
D.C. Malone ◽  
M.A. Raebel ◽  
P.A. Fishman ◽  
G.A. Nichols ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Metabolic Syndrome ◽  
Health Care Utilization ◽  
Care Utilization

scholarly journals ASSESSING RISK FOR ENDOMETRIAL CANCER AMONG HISPANIC FEMALES AGE 50 YEARS AND OLDER

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S460-S460
Author(s):  
Ana Rodriguez ◽  
Yong-Fang Kuo ◽  
Enshuo Hsu
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Endometrial Cancer ◽  
Health Care Utilization ◽  
Gynecological Cancer ◽  
Signs And Symptoms ◽  
Care Utilization ◽  
Common Symptom ◽  
Hispanic Females ◽  
History Of

Abstract Endometrial cancer is the most common gynecological cancer in the US, with most women diagnosed between 55 and 64 years old. Seventy-five percent of women with endometrial cancer are postmenopausal, and the most common symptom is postmenopausal bleeding. Only a few studies have addressed the lack of knowledge and awareness of risk factors and/or health care utilization for early signs and symptoms of endometrial cancer. The objective of this study was to evaluate health care utilization among Hispanic women aged ≥50 years who are at risk for endometrial cancer. This retrospective cohort study used a combination of diagnosis and procedure codes from UTMB’s electronic health records to identify Texas Hispanic females who had a health encounter at ≥50 years of age between 2012 and 2016. Risk factors included conditions/treatments affecting hormone levels, age, body mass index, diabetes, gravidity, parity, family history of endometrial or colorectal cancer, previous diagnosis of breast or ovarian cancer or endometrial hyperplasia, smoking or alcohol use, and treatment with radiation therapy in the pelvis area. Multivariate logistic regression models evaluated for predictors of endometrial cancer. The study included 11,563 Hispanic females aged ≥50 years (median age=57). Most women were overweight. Currently, we identified 705 Hispanic females (6.1%) with possible endometrial cancer with validation underway. Females who have a history of vaginal spotting/bleeding, pelvic bleeding, and pelvic pain are at higher risk for endometrial cancer. It is important for physicians to educate patients on recognizing the signs and symptoms of endometrial cancer.

Opioid Prescribing for Proximal Row Carpectomy versus Four-Corner Arthrodesis

2021 ◽  
Author(s):  
Thomas E. Moran ◽  
Sheriff D. Akinleye ◽  
Alex J. Demers ◽  
Grace L. Forster ◽  
Brent R. DeGeorge
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Emergency Department ◽  
Health Care Utilization ◽  
Hospital Readmissions ◽  
Emergency Department Visits ◽  
Prescribing Patterns ◽  
Care Utilization ◽  
Proximal Row Carpectomy ◽  
Opioid Prescribing

Abstract Background Proximal row carpectomy (PRC) and four-corner arthrodesis (4-CA) represent motion-sparing procedures for addressing degenerative wrist pathologies. While both procedures demonstrate comparable functional outcomes, postoperative pain presents a surgical challenge that often necessitates the use of opioids. Objectives The aim of this study was to (1) compare opioid prescribing patterns surrounding PRC and 4-CA, (2) identify risk factors predisposing patients to increased perioperative and prolonged postoperative opioids, and (3) examine the association between opioids and perioperative health care utilization. Patients and Methods PearlDiver Patients Records Database was used to retrospectively identify patients undergoing primary PRC and 4-CA between 2010 and 2018. Patient demographics, comorbidities, prescription drug usage, and perioperative health care utilization were evaluated. Perioperative opioid prescriptions and post-operative opioid prescriptions were recorded. Logistic regression analysis evaluated the association of patient risk factors. Results There was no significant difference in perioperative (PRC [odds ratio {OR}: 0.84, p = 0.788]; 4-CA [OR: 0.75, p = 0.658]) or prolonged postoperative opioid prescriptions (PRC [OR: 0.95, p = 0.927]; 4-CA [OR: 0.99, p = 0.990]) between PRC and 4-CA. Chronic back pain and use of benzodiazepines or anticonvulsants were associated with increased risks of prolonged postoperative opioids. Prolonged postoperative opioids presented increased risks of emergency department visits (OR: 2.09, p = 0.019) and hospital readmissions (OR: 10.2, p = 0.003). Conclusion No significant differences exist in the prescription of opioids for PRC versus 4-CA. Both procedures have high amounts of prolonged postoperative opioid use, which is associated with increased risks of emergency department visits and hospital readmissions. Level of Evidence This is a level III, retrospective comparative study.

scholarly journals Increasing Age Has Limited Impact on Risk of Clostridium difficile Infection in an Elderly Population

2018 ◽  
Vol 5 (7) ◽  
Author(s):  
Margaret A Olsen ◽  
Dustin Stwalley ◽  
Clarisse Demont ◽  
Erik R Dubberke
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Clostridium Difficile ◽  
Health Care Utilization ◽  
Clostridium Difficile Infection ◽  
Elderly Population ◽  
Univariate Analysis ◽  
Model Performance ◽  
Care Utilization ◽  
Increased Risk

Abstract Background Numerous studies have found increased risk of Clostridium difficile infection (CDI) with increasing age. We hypothesized that increased CDI risk in an elderly population is due to poorer overall health status with older age. Methods A total of 174 903 persons aged 66 years and older coded for CDI in 2011 were identified using Medicare claims data. The comparison population consisted of 1 453 867 uninfected persons. Potential risk factors for CDI were identified in the prior 12 months and organized into categories, including infections, acute noninfectious conditions, chronic comorbidities, frailty indicators, and health care utilization. Multivariable logistic regression models with CDI as the dependent variable were used to determine the categories with the biggest impact on model performance. Results Increasing age was associated with progressively increasing risk of CDI in univariate analysis, with 5-fold increased risk of CDI in 94–95-year-old persons compared with those aged 66–67 years. Independent risk factors for CDI with the highest effect sizes included septicemia (odds ratio [OR], 4.1), emergency hospitalization(s) (OR, 3.9), short-term skilled nursing facility stay(s) (OR, 2.7), diverticulitis (OR, 2.2), and pneumonia (OR, 2.1). Exclusion of age from the full model had no impact on model performance. Exclusion of acute noninfectious conditions followed by frailty indicators resulted in lower c-statistics and poor model fit. Further exclusion of health care utilization variables resulted in a large drop in the c-statistic. Conclusions Age did not improve CDI risk prediction after controlling for a wide variety of infections, other acute conditions, frailty indicators, and prior health care utilization.

scholarly journals Prevalence, Risk Factors, Activity Limitation and Health Care Utilization of an Obese Population-Based Sample with Chronic Obstructive Pulmonary Disease

2012 ◽  
Vol 19 (3) ◽  
pp. e18-e24 ◽  
Author(s):  
Nicholas T Vozoris ◽  
Denis E O’Donnell
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Health Care ◽  
Health Care Utilization ◽  
Activity Limitation ◽  
Care Utilization ◽  
Chronic Obstructive ◽  
Obesity Prevalence ◽  
Obstructive Pulmonary Disease ◽  
Prevalence Of Obesity

OBJECTIVE: To estimate the prevalence and determine the risk factors and health associations among individuals with combined chronic obstructive pulmonary disease and obesity.METHODS: Canadian national health survey data from 1994 to 2007 (n=650,000) were used. The presence of COPD was based on health professional-diagnosed self-report. The presence of obesity, defined by body mass index ≥30 kg/m2, was identified using self-reported and measured height and weight. Hospitalization, homecare use, physical activity assessments and socioeconomic data were all self-reported.RESULTS: In 2005, the prevalence of obesity in COPD (n=3470) and non-COPD (n=92,237) individuals was 24.6% and 17.1%, respectively (P<0.0001). In contrast to the non-COPD group, in which obesity prevalence increased by 38% over 14 years, obesity prevalence increased by only 5% in people with COPD over this same time period. Female sex was the only independent risk factor for obesity in COPD. Previous smoking, residing in Atlantic Canada and the Territories, and low education level were independent risk factors for obesity in the non-COPD group, but not in the COPD group. The odds of physical activity limitation and health care utilization were significantly higher among obese individuals with COPD compared with nonobese COPD and obese non-COPD groups.CONCLUSIONS: The prevalence of obesity was higher in COPD, and exceeded that of the larger non-COPD group throughout the 13-year observation period. The presence of obesity in COPD was associated with significantly higher risk of severe activity limitation and increased health care utilization. The combination of obesity and COPD has major implications for health care delivery that has not been previously appreciated.

scholarly journals PHP81 Association of Health Risk Factors With Health Care Utilization and Cost in an Employed Population

2012 ◽  
Vol 15 (4) ◽  
pp. A27
Author(s):  
K.M. Gorman ◽  
M.E. Snell ◽  
Q. Hou ◽  
L.C. Kaspin ◽  
R.M. Miller
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Health Risk ◽  
Health Care Utilization ◽  
Care Utilization ◽  
Health Risk Factors

scholarly journals Risk Factors Associated With Health Care Utilization and Costs of Patients Undergoing Lower Extremity Joint Replacement

2018 ◽  
Vol 2 (3) ◽  
pp. 248-256 ◽  
Author(s):  
Meghan A. Knoedler ◽  
Molly M. Jeffery ◽  
Lindsey M. Philpot ◽  
Sarah Meier ◽  
Jehad Almasri ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Lower Extremity ◽  
Health Care Utilization ◽  
Joint Replacement ◽  
Care Utilization ◽  
Factors Associated

Health Care Utilization and Associated Economic Burden of Postoperative Surgical Site Infection after Spinal Surgery with Follow-Up of 24 Months

2021 ◽  
Author(s):  
Nicholas Dietz ◽  
Mayur Sharma ◽  
Shawn Adams ◽  
Beatrice Ugiliweneza ◽  
Dengzhi Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Health Care ◽  
Congestive Heart Failure ◽  
Health Care Utilization ◽  
Spinal Surgery ◽  
Care Utilization ◽  
Site Infection ◽  
Intravenous Drug Use

Abstract Background Surgical site infection (SSI) may lead to vertebral osteomyelitis, diskitis, paraspinal musculoskeletal infection, and abscess, and remains a significant concern in postoperative management of spinal surgery. SSI is associated with greater postoperative morbidity and increased health care payments. Methods We conducted a retrospective analysis using MarketScan to identify health care utilization payments and risk factors associated with SSI that occurs postoperatively. Known patient- or procedure-related risk factors were searched across those receiving spine surgery who developed postoperative infection. Results A total of 33,061 patients who developed infection after spinal surgery were identified in Marketscan. Overall payments at 6 months, including index hospitalization for those with infection, were $53,573 and $46,985 for the cohort with no infection. At 24 months, the infection group had overall payments of $83,280 and $66,221 for no infection. Risk factors with largest effect size most likely to contribute to infection versus no infection were depression (4.6%), diabetes (3.7), anemia (3.3%), two or more levels (2.8%), tobacco use (2.2%), trauma (2.1%), neoplasm (1.8%), congestive heart failure (1.3%), instrumentation (1.1%), renal failure (0.9%), intravenous drug use (0.8%), and malnutrition (0.5%). Conclusions SSIs were associated with significant health care utilization payments at 24 months of follow-up. The following clinical and procedural risk factors appear to be predictive of postoperative SSI: depression, diabetes, anemia, two or more levels, tobacco use, trauma, neoplasm, congestive heart failure, instrumentation, renal failure, intravenous drug use, and malnutrition. Interpretation of modifiable and nonmodifiable risk factors for infection informs surgeons of expected postoperative course and preoperative risk for this most common and deleterious postoperative complication to spinal surgery.

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