Browsing by Author "Wang, Y."

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Evaluating Fracture-Related Expenses and Health Care Resource Utilization Among Post-Menopausal Women in the Us Medicaid Population
(2015) Xie, L.; Keshishian, A; Wang, Y.; Başer, Onur
Objectives: Use of potentially inappropriate medications (PIMs) among the elderlyis a serious public health problem because it is intrinsically linked to increasedmorbidity and mortality, causing the high costs to public health systems. Objectivesof this study were to determine the prevalence and predictors of PIM prescribingin elderly inpatients using STOP and START criteria Methods: The prospectiveobservational study was carried at a private tertiary care hospital. Prescriptionsof elderly inpatients aged 60 years and above were collected and analyzed. PIMswere identified with the help of STOP and START criteria. Predictors associatedwith use of PIMs were identified by bivariate and multivariate logistic regressionanalysis. Results: The results were based on data of 60 patients. More than half(56%) were males and 50% were aged between 60–69 years with a mean averageage of 69 years. Mean number of diagnoses and medications were two and nine,respectively. A total of 18 (30%) patients were prescribed with at least 1 PIM accordingSTOP Criteria. Most commonly prescribed PIMs were systemic corticosteroids (29%)followed by theophyline (18%) and betablockers (10%). On multivariate regression,important predictors for PIM prescribing were found to polypharmacy, number ofdiagnoses. Co nclusions: The results show that PIMs prescribing is high in Indianelderly inpatients STOP and START criteria, it is more effective in identifying thePIMs. This study is ongoing and we will present the data upto 250 patents beforethe presentation
Pmh21 - Comparing the Healthcare Utilization and Costs of Early- and Late-Stage Alzheimer's Disease Patients Residing in Long-Term Care Facilities
(2015) Xie, L.; Keshishian, A; Wang, Y.; Başer, Onur
OBJECTIVES: To compare healthcare utilization and costs between early- andlate-stage Alzheimer’s disease (AD) patients residing in long-term care (LTC)facilities. METHODS: Patients diagnosed with AD (International Classification ofDiseases, 9th Revision, Clinical Modification [ICD-9-CM] code 331.0) were identifiedusing U.S. Medicare claims linked with the Long-Term Care Minimum Data Set (MDS)from 01JULY2008 through 31DEC2010. The first diagnosis date was designated asthe index date. Patients were required to be age ?65 years, with continuous medicaland pharmacy benefits for 6 months pre- and post-index date, and reside in an LTCfacility. Patients were categorized as early- or late-stage. Late-stage AD was definedby a cognitive performance scale score ?5 (range 0-6) and Activities of Daily Livingshort-form activities score ?10 points. Patients with and without AD were matchedbased on demographic and clinical characteristics, and 1:1 propensity score matching was used to compare follow-up all-cause and AD-related healthcare costs andutilizations. RESULTS: Before matching, late-stage AD patients (n=5,323) were lesslikely to be white (83.0% vs. 86.4%), male (16.4% vs. 21.7%) and have comorbid conditions measured by the Charlson Comorbidity Index score (3.55 vs. 4.83, p<0.001) thanearly-stage AD patients (n=20,023). After 1:1 matching, 3,804 patients were matchedfrom each cohort and baseline characteristics were balanced. Fewer late-stage ADpatients had skilled nursing facility admissions (25.3% vs. 29.8%, p<0.0001), but morehad hospice admissions (17.8% vs. 7.3%, p<0.0001) and pharmacy visits (85.8% vs.81.9%, p<0.0001) than early-stage AD patients. There were no significant differencesin total all-cause healthcare costs; however, late-stage AD patients incurred significantly higher disease-related total ($14,739 vs. $13,673, p=0.0242) and hospice costs($4,157 vs. $1,553, p<0.0001) compared to early-stage AD patients. CONCLUSIONS:Patients with late-stage AD incurred higher disease-related costs than those withearly-stage AD; however, there were no significant differences in total all-causehealthcare costs.