scholarly journals Babesiosis Occurrence among the U.S. Medicare Beneficiaries Ages 65 and Older, During 2006-2017: Overall, and by State and County of Residence

Author(s):  
Mikhail Menis ◽  
Barbee I Whitaker ◽  
Michael Wernecke ◽  
Yixin Jiao ◽  
Anne Eder ◽  
...  

Abstract Background Human babesiosis is a mild-to-severe parasitic infection that poses health concerns especially in older and other at-risk populations. The study objective was to assess babesiosis occurrence among the U.S. Medicare beneficiaries, ages 65 and older, during 2006-2017. Methods Our retrospective claims-based study utilized Medicare databases. Babesiosis cases were identified using recorded diagnosis codes. The study estimated rates (per 100,000 beneficiary-years) overall, by year, diagnosis month, demographics, state and county of residence. Results Nationwide, 19,469 beneficiaries had babesiosis recorded, a rate of 6 per 100,000 person-years, ranging from 4 in 2006 to 9 in 2017 (p<0.05). The highest babesiosis rates were in: Massachusetts (62), Rhode Island (61), Connecticut (51), New York (30), and New Jersey (19). The highest rates by county were in: Nantucket, MA (1,089); Dukes, MA (236); Barnstable, MA (213); and Dutchess, NY (205). Increasing rates, from 2006 through 2017 (p<0.05), were identified in multiple states, including states previously considered non-endemic. New Hampshire, Maine, Vermont, Pennsylvania, and Delaware saw rates increase by several times. Conclusion Our 12-year study shows substantially increasing babesiosis diagnosis trends, with highest rates in well-established endemic states. It also suggests expansion of babesiosis infections in other states and highlights the utility of real-world evidence.

2009 ◽  
Vol 14 (2) ◽  
pp. 13-16
Author(s):  
Christopher R. Brigham ◽  
Jenny Walker

Abstract The AMAGuides to the Evaluation of Permanent Impairment (AMA Guides) is the most widely used basis for determining impairment and is used in state workers’ compensation systems, federal systems, automobile casualty, and personal injury, as well as by the majority of state workers’ compensation jurisdictions. Two tables summarize the edition of the AMA Guides used and provide information by state. The fifth edition (2000) is the most commonly used edition: California, Delaware, Georgia, Hawaii, Kentucky, New Hampshire, Idaho, Indiana, Iowa, Kentucky, Massachusetts, Nevada, North Dakota, Ohio, Vermont, and Washington. Eleven states use the sixth edition (2007): Alaska, Arizona, Louisiana, Mississippi, Montana, New Mexico, Oklahoma, Pennsylvania, Rhode Island, Tennessee, and Wyoming. Eight states still commonly make use of the fourth edition (1993): Alabama, Arkansas, Kansas, Maine, Maryland, South Dakota, Texas, and West Virginia. Two states use the Third Edition, Revised (1990): Colorado and Oregon. Connecticut does not stipulate which edition of the AMA Guides to use. Six states use their own state specific guidelines (Florida, Illinois, Minnesota, New York, North Carolina, and Wisconsin), and six states do not specify a specific guideline (Michigan, Missouri, Nebraska, New Jersey, South Carolina, and Virginia). Statutes may or may not specify which edition of the AMA Guides to use. Some states use their own guidelines for specific problems and use the Guides for other issues.


2008 ◽  
Vol 35 (2) ◽  
pp. 145-179 ◽  
Author(s):  
George C. Romeo ◽  
James J. McKinney

Joseph Hardcastle was one of the foremost authorities on subjects connected with the mathematics of finance and other topics in accounting in the late 19th and early 20th centuries. As a teacher, author, and leader in the profession, he figured prominently in the elevation of accountancy. Hardcastle is relatively unknown in the literature except for having the distinction of scoring the highest grades on the first CPA exam in New York in 1896. However, he was well respected during his time as one of the premier theorists in accounting and was awarded an honorary degree of Master of Letters by New York University. Because of his prolific writings, his teaching of future accountants, and his interactions with members of the Institute of Accounts, he had a strong impact on the “science of accounts,” the dominant accounting theory in the U.S. at the turn of the century.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sanchi Malhotra ◽  
Imran Masood ◽  
Noberto Giglio ◽  
Jay D. Pruetz ◽  
Pia S. Pannaraj

Abstract Background Chagas disease is a pathogenic parasitic infection with approximately 8 million cases worldwide and greater than 300,000 cases in the United States (U.S.). Chagas disease can lead to chronic cardiomyopathy and cardiac complications, with variable cardiac presentations in pediatrics making it difficult to recognize. The purpose of our study is to better understand current knowledge and experience with Chagas related heart disease among pediatric cardiologists in the U.S. Methods We prospectively disseminated a 19-question survey to pediatric cardiologists via 3 pediatric cardiology listservs. The survey included questions about demographics, Chagas disease presentation and experience. Results Of 139 responses, 119 cardiologists treat pediatric patients in the U.S. and were included. Most providers (87%) had not seen a case of Chagas disease in their practice; however, 72% also had never tested for it. The majority of knowledge-based questions about Chagas disease cardiac presentations were answered incorrectly, and 85% of providers expressed discomfort with recognizing cardiac presentations in children. Most respondents selected that they would not include Chagas disease on their differential diagnosis for presentations such as conduction anomalies, myocarditis and/or apical aneurysms, but would be more likely to include it if found in a Latin American immigrant. Of respondents, 87% agreed that they would be likely to attend a Chagas disease-related lecture. Conclusions Pediatric cardiologists in the U.S. have seen very few cases of Chagas disease, albeit most have not sent testing or included it in their differential diagnosis. Most individuals agreed that education on Chagas disease would be worth-while.


2020 ◽  
Vol 11 ◽  
pp. 215013272098062
Author(s):  
Sharon Attipoe-Dorcoo ◽  
Rigoberto Delgado ◽  
Dejian Lai ◽  
Aditi Gupta ◽  
Stephen Linder

Introduction Mobile clinics provide an efficient manner for delivering healthcare services to at-risk populations, and there is a need to understand their economics. This study analyzes the costs of operating selected mobile clinic programs representing service categories in dental, dental/preventive, preventive care, primary care/preventive, and mammography/primary care/preventive. Methods The methodology included a self-reported survey of 96 mobile clinic programs operating in Texas, North Carolina, Georgia, and Florida; these states did not expand Medicaid and have a large proportion of uninsured individuals. Data were collected over an 8-month period from November 2016 to July 2017. The cost analyses were conducted in 2018, and were analyzed from the provider perspective. The average annual estimated costs; as well the costs per patient in each mobile clinic program within different service delivery types were assessed. Costs reported in the study survey were classified into recurrent direct costs and capital costs. Results Results indicate that mean operating costs range from about $300 000 to $2.5 million with costs increasing from mammography/primary care/preventive delivery to dental/preventive. The majority of mobile clinics provided dental care followed by dental/preventive. The cost per patient visit for all mobile clinic service types ranged from $65 to $529, and appears to be considerably less than those reported in the literature for fixed clinic services. Conclusion The overall costs of all delivery types in mobile clinics were lower than the costs of providing care to Medicare beneficiaries in federally funded health centers, making mobile clinics a sound economic complement to stationary healthcare facilities.


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