Ekonomi Bölümü Koleksiyonu

Permanent URI for this collectionhttps://hdl.handle.net/20.500.11779/1936

Browse

Now showing 1 - 20 of 56

Citation - WoS: 1
Pnd29 - a Retrospective Analysis of the Economic Burden Among Patients Diagnosed With Chronic Migraine Using the Veterans Health Administration Medical Data
(2015) Mao, X; Shrestha, S; Başer, Onur; Wang, L
OBJECTIVES: To evaluate the health care resource utilization and costsamong patients diagnosed with chronic migraine (CM) in the Veterans HealthAdministration (VHA) medical dataset. METHODS: Patients diagnosed with CMwere identified (International Classification of Diseases, 9th Revision, ClinicalModification diagnosis code 346.XX) using the VHA dataset from October 1, 2008through September 30, 2010. The initial diagnosis date was designated as the indexdate. Patients without CM with the same age, gender and region (comparison cohort)were matched using a randomly chosen index date to minimize selection bias.Patients in both cohorts were at least age 18 years and had continuous medicaland pharmacy benefits for 1 year before and after the index date. One-to-one propensity score matching (PSM) was used to compare health care costs and utilizations between the CM and the comparison cohorts, and was adjusted for baselinedemographic and clinical characteristics. Pain scores were also included to investigate wellness after CM diagnosis. RESULTS: After risk-adjustment by PSM, 123,241patients in each cohort were matched. Significantly more CM patients had inpatientadmissions (6.44% vs. 1.75%, p<0.0001) and emergency room (ER; 14.42% vs. 5.50%,p<0.0001), outpatient office (68.80% vs. 42.15%, p<0.0001), outpatient (69.30% vs.42.91%, p<0.0001) and pharmacy visits (70.84% vs. 41.43%, p<0.0001) compared tothose without CM. Accordingly, CM patients also incurred higher costs for inpatient admissions and ER, office, outpatient and pharmacy visits compared to thosewithout CM. Total costs incurred by CM patients were $4,776, almost triple that of patients without CM ($1,756). There were more CM patients with accompanying painat all levels (mild: 19.53% vs. 0.16%; moderate: 13.10% vs. 0.10%; severe: 16.20% vs.0.12%; all p<0.0001). CONCLUSIONS: CM patients in the VHA population had substantial health care resource utilization, incurred higher costs and suffered worsepain compared to those without the disease.
Prs23 - a Descriptive Analysis of Patient Characteristics and Health Care Burden Associated With Chronic Obstructive Pulmonary Disease in the Us Medicare Population
(2015) Xie, L.; Kariburyo, M. Furaha; Wang, Y; Başer, Onur
Objectives: To evaluate the patient characteristics and health care burden associated with chronic obstructive pulmonary disease (COPD) in the U.S. Medicarepopulation. Methods: COPD patients were identified (International Classificationof Disease, 9th Revision, Clinical Modification [ICD-9-CM] codes: 491.xx, 492.xx and496.xx) using U.S. national Medicare claims from 01JAN2007 to 31DEC2010. The firstdiagnosis date was designated as the index date. Patients were required to: a) be age?65 years on the index date; b) have continuous medical and pharmacy benefits for 12months pre-index date (baseline period); c) have continuous enrollment for 12 monthspost-index date (follow-up period), unless there was earlier evidence of death; and d)have no COPD diagnosis pre-index date. The outcomes of interest included medicationuse, including a long-acting beta agonist (LABA) or LABA/inhaled corticosteroid (ICS)combination, mortality and health care resource utilization and costs. Results: Atotal of 543,249 COPD patients were identified. Patients were, on average, age 78 years.Most patients were white (94%) and resided in the South U.S. region (41%). The averageCharlson Comorbidity Index score was 3.23, and hypertension (67%), diabetes (28%),congestive heart failure (21%) and chronic pulmonary disease (20%) were the mostfrequently diagnosed comorbidities. A 13.82% mortality rate was observed duringthe first year of the follow-up period. Post-index LABA medications, including arfomoterol (0.55%), formoterol (0.25%) and salmeterol (0.32%) were prescribed to 1.10%of the population. Identified LABA/ICS combinations included budesonide/formoterol(1.97%) and fluticasone/salmeterol (10.02%). High health care resource utilization wasencountered for Medicare carrier (99.40%), pharmacy (90.27%), outpatient (76.52%)and inpatient visits (48.83%). The main cost drivers were inpatient ($10,645), Medicarecarrier ($4,888), outpatient ($3,322) and skilled nursing facility ($2,695) costs, resultingin $25,397 in total health care costs. Conclusions: U.S. Medicare patients have ahigh COPD-related health care burden
Citation - WoS: 4
Citation - Scopus: 4
Effects of Vaccination and the Spatio-Temporal Diffusion of Covid-19 Incidence in Turkey
(John Wiley and Sons Inc, 2022) Bilgel, Fırat; Karahasan, Burhan Can
This study assesses the spatio-temporal impact of vaccination efforts on Covid-19 incidence growth in Turkey. Incorporating geographical features of SARS-CoV-2 transmission, we adopt a spatial Susceptible–Infected–Recovered (SIR) model that serves as a guide of our empirical specification. Using provincial weekly panel data, we estimate a dynamic spatial autoregressive (SAR) model to elucidate the short- and the long-run impact of vaccination on Covid-19 incidence growth after controlling for temporal and spatio-temporal diffusion, testing capacity, social distancing behavior and unobserved space-varying confounders. Results show that vaccination growth reduces Covid-19 incidence growth rate directly and indirectly by creating a positive externality over space. The significant association between vaccination and Covid-19 incidence is robust to a host of spatial weight matrix specifications. Conspicuous spatial and temporal diffusion effects of Covid-19 incidence growth were found across all specifications: the former being a severer threat to the containment of the pandemic than the latter.
Citation - WoS: 10
Citation - Scopus: 12
Elevated White Blood Cell Levels and Thrombotic Events in Patients With Polycythemia Vera: a Real-World Analysis of Veterans Health Administration Data
(Elsevier Inc., 2019) Wang, Li; Parasuraman, Shreekant V.; Sulena Shrestha; Paranagama, Dilan C.; Yu, Jingbo; Scherber, Robyn Marie; Başer, Onur
Background: Patients with polycythemia vera (PV) have a substantial risk of thrombotic events (TEs). The objective of the present analysis was to describe the association between white blood cell (WBC) levels and occurrence of TEs among patients with PV from a large real-world population. Patients and Methods: The present retrospective analysis using Veterans Health Administration claims data (October 1, 2005, to September 30, 2012) evaluated adult patients assigned to 4 WBC count categories (WBC count < 7.0, 7.0-8.4, 8.5 to < 11.0, and ≥ 11.0 × 109/L) to compare the risk of TEs (reference, WBC count, < 7.0 × 109/L group). Analysis was performed using a Cox proportional hazards model, considering WBC status as a time-dependent covariate. Results: Of the 1565 patients with PV included in the present analysis, the WBC count was < 7.0 × 109/L for 428 (27.3%), 7.0 to 8.4 × 109/L for 375 (24.0%), 8.5 to < 11.0 × 109/L for 284 (18.1%), and ≥ 11.0 × 109/L for 478 (30.5%). Of the 1565 patients, 390 (24.9%) had experienced a TE during the study period. The mean follow-up ranged from 3.6 to 4.5 years. Compared with the reference group (WBC count < 7.0 ×109/L), the hazard ratio for TEs was 1.10 (95% confidence interval [CI], 0.82-1.48; P = .5395), 1.47 (95% CI, 1.10-1.96; P = .0097), and 1.87 (95% CI, 1.44-2.43; P < .0001) for patients with a WBC count of 7.0 to 8.4, 8.5 to < 11.0, and ≥ 11.0 ×109/L, respectively. Conclusion: A positive, significant association between an increased WBC count of ≥ 8.5 ×109/L and the occurrence of TEs was observed in patients with PV. The potential thrombogenic role of WBCs in patients with PV supports the continued inclusion of WBC count control in disease management and evaluation of the response to therapy. © 2019 The AuthorsPatients with polycythemia vera (PV) have a substantial risk of thrombotic events (TEs). In the present retrospective analysis using Veterans Health Administration claims data, 25% of 1565 patients experienced a TE during follow-up. We observed a positive, significant association between white blood cell (WBC) counts ≥ 8.5 × 109/L and TE occurrence (reference, WBC count < 7.0 × 109/L), supporting continued inclusion of WBC count control in disease management. © 2019 The Authors
Pdb44 - Health Care Resource Utilization and Costs Among Diabetes Patients Residing in Long-Term Care Facilities
(2015) Huang, A; Shrestha, S; Başer, Onur; Yuce, H; Wang, L
OBJECTIVES: To evaluate health care resource utilization and costs among diabetespatients residing in long-term care facilities. METHODS: Patients diagnosed withdiabetes (International Classification of Diseases, 9th Revision, Clinical Modificationdiagnosis codes 250.x0, 250.x2) were identified using the Long-Term Care MinimumData Set (MDS) linked to 5% Medicare data from 01JAN2009 through 31DEC2010. Theinitial diagnosis date was designated as the index date. A comparison cohort wascreated for patients without diabetes, using 1:1 propensity score matching (PSM)to control for age, region, gender and baseline Charlson Comorbidity Index score.The index date for the comparison cohort was randomly chosen to reduce selection bias. Patients in both cohorts were required to be age ?65 years, have at leasttwo consecutive quarterly assessments documented in MDS data 6 months priorto the index date and have continuous medical and pharmacy benefits for 1-yearpre- and post-index date. Health care resource utilization and costs were comparedbetween the diabetes and comparison cohorts. RESULTS: After applying PSM, 783patients were included in each cohort, and baseline characteristics were balanced.Diabetes patients had a higher percentage of inpatient (31.29% vs. 22.73%, p=0.0001),skilled nursing facility (SNF, 31.55% vs. 22.73%, p<0.001), durable medical equipment (27.46% vs. 16.48%, p<0.0001) and pharmacy visit claims (93.10% vs. 88.76%,p=0.0028) compared to those without diabetes. Patients in the diabetes cohort alsoincurred significantly higher inpatient ($5,801 vs. $3,071, p<0.0001), SNF ($5,532 vs.$3,244, p<0.0001), carrier claim ($3,118 vs. $2,437, p=0.0002) and pharmacy visit costs($5,040 vs. $4,275, p=0.0005) than those in the comparison cohort. CONCLUSIONS:Patients diagnosed with diabetes had significantly higher health care resource utilization and costs than those without diabetes.
Citation - WoS: 5
Citation - Scopus: 3
Exports, Real Exchange Rates and Dollarization: Empirical Evidence From Turkish Manufacturing Firms
(Springer, 2019) Karamollaoğlu, Nazlı; Yalçın, Cihan
We attempt to uncover the relationship between the real exchange rates and exports shares of manufacturing firms in Turkey by taking into account FX exposures and various firm characteristics. We use a large panel of manufacturing firms to carry out an empirical analysis for the period 2002–2010. Contrary to macro-evidence, firm-level empirical evidence suggests that a depreciation of the Turkish lira seems to favor the external competitiveness of firms in general. We document that a real depreciation of the Turkish lira has a positive impact on export shares and its impact is muted to some extent for firms operating in sectors that use imported inputs intensively. In addition, we estimate that export shares increase as a result of real depreciation for firms having low (naturally hedged) and moderate FX debt-to-export ratios. We do not confirm a strong balance sheet channel where a depreciation of the currency may harm firms’ export performance due to currency mismatch. On the contrary, FX borrowing is estimated to support export performance probably due to undermining finance constraints.
Citation - WoS: 15
Citation - Scopus: 14
Hepatic Decompensation in Patients With Hiv/Hepatitis B Virus (hbv)/Hepatitis C Virus (hcv) Triple Infection Versus Hiv/Hcv Coinfection and the Effect of Anti-Hbv Nucleos(t)ide Therapy
(2014) Wang, Li; Devine, Scott; Lo Re, Vincent, III; Olufade, Temitope; Başer, Onur
The incidence rate of hepatic decompensation was higher in patients with human immunodeficiency virus (HIV)/hepatitis B virus (HBV)/hepatitis C virus (HCV) triple infection than in those with HIV/HCV coinfection (24.1 vs 10.8 events per 1000 person-years; hazard ratio [HR], 1.89; 95% confidence interval [CI], 1.12–3.18). Compared with HIV/HCVinfected patients, the rate of decompensation was increased among HIV/HBV/HCV-infected patients receiving no anti-HBV therapy (HR, 2.48; 95% CI, 1.37–4.49) but not among those who did receive such therapy (HR, 1.09; 95% CI, .40–2.97)
Pih13 - Examining the Fracture-Related Cost Burden and Health Care Resource Utilization Post-Menopause in the Us Medicare Population
(2015) Xie, L; Keshishian, A; Du, J; Başer, Onur
Objectives: To examine the fracture-related cost burden and healthcareresource utilization among post-menopausal women in the U.S. Medicare population. Methods: Post-menopausal women were identified using InternationalClassification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) diagnosiscodes from the U.S. Medicare claims dataset from 01JAN2008 through 31DEC2012.The first fracture diagnosis date was designated as the index date. One year ofcontinuous health plan enrollment was required for all patients pre- and postindex date. A comparison group was created, identifying patients without fracturesof the same age, region, gender and index year and were matched to case patientsbased on baseline Charlson Comorbidity Index scores. A randomly chosen indexdate for the comparison group reduced selection bias. Healthcare costs and utilizations were compared using 1:1 propensity score matching (PSM). Results: Beforematching (n=182,124), patients with fractures were more likely to be white (92.6%vs. 85.8%), reside in the Northeast U.S. region (19.4% vs. 16.4%), and have diagnosis of depression (18.0% vs. 13.0%) and chronic obstructive pulmonary disease(26.3% vs. 23.3%). After 1:1 PSM, 65,549 patients were included in each cohort andbaseline characteristics were well-balanced. Significantly more post-menopausalwomen with fractures had inpatient admission (42.3% vs. 8.6%, p<0.0001), outpatient (80.3% vs. 48.7%, p<0.0001), home health agency (31.2% vs. 6.9%, p<0.0001)skilled nursing facility (SNF) (25.7% vs. 2.72%, p<0.0001) and hospice admission(1.4% vs. 1.0%, p<0.0001) claims. Higher healthcare resource utilization translated to higher costs for post-menopausal fracture patients, including inpatient($7,869 vs. $1,203, p<0.0001), outpatient ($1,928 vs. $622, p<0.0001), SNF ($5,980vs. $437, p<0.0001), hospice ($338 vs. $244, p<0.0001), pharmacy ($1,052 vs. $829,p<0.0001) and total costs ($23,097 vs. $5,247, p<0.0001), than for those in the comparison cohort. Conclusions: Post-menopausal women with fractures in theU.S. Medicare population had higher healthcare resource utilization and expenditures than those without fractures.
Demographic Distribution and Health Care Burden of Patients Diagnosed With Ankylosing Spondylitis in the Us Medicare Population
(2015) Mao, X; Li, L; Shrestha, S; Başer, Onur; Yuce, H; Wang, L
OBJECTIVES: To investigate the demographic distribution and health care burdenof patients diagnosed with ankylosing spondylitis (AS) using Medicare fee-forservice (FFS) data. METHODS: A retrospective analysis was performed using the100% Medicare FFS Datasets from October 1, 2008 through December 31, 2012.Patients diagnosed with AS were identified using International Classification ofDiseases, 9th Revision, Clinical Modification diagnosis code 720.0, and the firstdiagnosis date was designated as the index date. All patients were required tohave continuous medical and pharmacy benefits 1-year pre- (baseline period)and post-index date (follow-up period). Health care resource utilization and costsduring the baseline and follow-up periods were calculated. RESULTS: A total of8,990 AS patients were included in the study. The average age at diagnosis was 75years. Nearly 88.7% of patients were white, 62.97% were women and many residedin the South U.S. region (40.33%). The most common baseline comorbidities werechronic obstructive pulmonary disease (33.20%), diabetes (30.50%), cerebrovasculardisease (22.65%) and congestive heart failure (18.85%). During the follow-up period,73.04% of patients had inpatient admissions, 52.31% had emergency room visits,91.43% had outpatient office visits, 91.43% had outpatient visits and 57.67% hadpharmacy visits, resulting in average costs of, $37,077, $298, $5,397, $5,695 and$6,668, respectively. The average total costs were $49,440 during the follow-upperiod. The four most frequently prescribed medications for AS were prednisonehydrocodone (3.59%), bit/acetaminophen (3.17%), methotrexate sodium (2.79%)and levothyroxine sodium (2.42%). CONCLUSIONS: AS patient demographic andclinical characteristics in the Medicare population were assessed. Study patientswere often diagnosed with comorbid conditions, and had high health care utilization and costs.
Psy14 - Evaluating Trends in Chronic Pain Prevalence in the United States Veterans Health Administration Population
(2015) Li, L.; Shrestha, S.; Başer, Onur; Yuce, H; Wang, L
OBJECTIVES: The current study examined chronic pain prevalence in the U.S. Veterans Health Administration (VHA) population. METHODS: The study sample was based on the VHA Medical SAS Datasets from fiscal year 2008 through 2012. All patients diagnosed with chronic pain throughout the study period were identified using International Classification of Diseases, 9th Revision, Clinical Modification diagnosis codes 338.2 and 338.4. The variation in the prevalence of chronic pain was assessed and categorized according to the pain scale. Pain score was determined using a scale ranging from 0 to 10 as reported by patients using the following categories: 1 to 4: mild, 5 to 6: moderate and ?7: severe pain. To identify prior prevalence cases, we restricted continuous enrollment throughout that fiscal year and at least 2 years prior
Pcn62 - Assessing the Economic Burden and Health Care Resource Utilizations of Us Medica Re Patients With Myeloproliferative Neoplasms
(2015) Keshishian, A; Du, J; Xie, L; Başer, Onur
OBJECTIVES: To examine the economic burden and health care resource utilization of myeloproliferative neoplasms (MPNs) in the U.S. Medicare population. METHODS: A retrospective data analysis was performed using the U.S.national Medicare claims from January 2008 through December 2012. MPN patientswere identified using International Classification of Disease 9th Revision ClinicalModification (ICD-9-CM) diagnosis codes 238.4, 238.71, 238.76 and 289.83. The diagnosis date was designated as the index date. A comparison cohort without a MPNdiagnosis was created for patients of the same age, region, gender, index year andbaseline Charlson Comorbidity Index score. A random index date was chosen forthe comparison cohort to reduce selection bias. Patients were required to havecontinuous medical and pharmacy benefits 1 year pre- and post-index date. Oneto-one propensity score matching (PSM) was performed to compare follow-uphealth care costs and utilizations between the cohorts, adjusting for demographicand clinical characteristics. RESULTS: Eligible patients (N=17,950) were identifiedfor the MPN and comparison cohorts. After 1:1 PSM, a total of 5,546 patients werematched from each cohort and baseline characteristics were well-balanced. MPNpatients had a higher percentage of health care resource utilizations, includingMedicare carrier (98.6% vs. 65.9%), Durable Medical Equipment (DME; 29.5% vs.14.4%), Home Health Agency (HHA; 12.4% vs. 5.0%), outpatient visits (76.6% vs.37.4%), inpatient hospitalizations (27.2% vs. 6.8%) and Skilled Nursing Facility (SNF;7.5% vs. 2.0%) visits than non-MPN patients. Patients diagnosed with MPNs alsoincurred significantly higher costs, including Medicare carrier ($3,872 vs. $1,283),DME ($266 vs. $91), HHA ($639 vs. $250), outpatient ($10,061 vs. $3,204), inpatient($5,449 vs. $1,054), pharmacy ($1,069 vs. $713) and total health care costs ($23,060vs. $7,076; p<0.0001). CONCLUSIONS: MPN patients had a higher burden of illnesscompared to non-MPN patients.
Pms37 - Health Care Cost Burden and Demographic Distribution of Patients Diagnosed With Psoriatic Arthritis in the Us Medicare Population
(2015) Li, L; Mao, X; Shrestha, S; Başer, Onur; Yuce H.; Li Wang
OBJECTIVES: To investigate the health care cost burden and demographic distributionof patients diagnosed with psoriatic arthritis (PSA) in the Medicare fee-for-service(FFS) Dataset. METHODS: A retrospective database analysis was performed usingthe 100% Medicare FFS Datasets from October 1, 2008 through December 31, 2012.Patients diagnosed with PSA were identified using International Classification ofDiseases, 9th Revision, Clinical Modification (ICD-9-CM) diagnosis code 696.0, andthe index date was the date of the initial diagnosis. All patients were required to havecontinuous medical and pharmacy benefits 1-year pre- and post-index date. Healthcare costs and utilization during the baseline (1 year before the diagnosis date) andfollow-up (1 year after the diagnosis date) periods were calculated. RESULTS: Usingthe aforementioned criteria, 11,324 PSA patients were identified. The average ageat diagnosis was 74 years, 66.10% of patients were women and almost 92.36% werewhite. The majority of patients resided in the South U.S. region (39.01%). Diabetes(33.84%), chronic obstructive pulmonary disease (29.04%) and cerebrovascular disease(17.36%) were the main comorbidities observed during the baseline period. Duringthe follow-up period, 62.96% of patients had inpatient admissions, 47.29% had emergency room visits, 91.67% had outpatient office visits, 91.67% had outpatient visitsand 58.03% had pharmacy visits, costing, on average, $23,960, $237, $5,015, $5,252and $7,335, respectively. The average total cost of PSA patients was $36,548. The fivemost commonly prescribed medications for PSA were methotrexate sodium (4.54%),prednisone (3.37%), levothyroxine sodium (2.59%), hydrocodone bit/acetaminophen(2.43%) and simvastatin (2.11%). CONCLUSIONS: PSA patient demographic and healthcare cost information was obtained and the most commonly prescribed PSA medications were identified.
Citation - WoS: 10
Citation - Scopus: 12
Contagion Effects of U.s. Dollar and Chinese Yuan in Forward and Spot Foreign Exchange Markets
(Elsevier, 2017) Kılıç, Erdem
Financial contagion in forex markets is modeled by the application of a bivariate Hawkes stochastic jumpprocess. The self-exciting and mutually exciting properties of the jump-clustering model allow for illustratinginternal and cross-sectional transmission processes. The results obtained suggest stronger effects from US tomutual markets than in the reverse case. Cross-sectional excitation dynamics in the spot markets are larger thanin the forward markets. As a central result, we can observe that the results for the Hawkes-model parameters aremore significant in the forward markets. Transmission dynamics beyond volatility determine the likelihood ofcontagion occurrence. The significance of the decay parameters towards the long term jump intensities supportsthe importance of abrupt fluctuations in the contagion discourse.
Citation - WoS: 4
Citation - Scopus: 4
Economic Geography and Human Capital Accumulation in Turkey: Evidence From Micro-Data
(Routledge, 2021) Karahasan, Burhan Can; Bilgel, Fırat
This study examines the impact of market access on human capital accumulation in Turkey. Using individual-level data, the analysis explores the background of human capital accumulation, combining market accessibility, wages and human capital development. Upon the treatment of wages as an endogenous covariate of interest and overtime work as an exogenous source of variation, we find evidence that the impact of market access on human capital development vanishes in ways not predicted by the augmented New Economic Geography set-up for human capital accumulation. Findings confirm that economic policies may be effective in reducing regional variation in human capital endowments.
Understanding the Relationship Between Effectiveness and Outcome Indicators in Health Care
(2016) Çınaroğlu, Songül; Başer, Onur
...
Citation - WoS: 13
Citation - Scopus: 13
Therapeutically Interchangeable? a Study of Real-World Outcomes Associated With Switching Basal Insulin Analogues Among Us Patients With Type 2 Diabetes Mellitus Using Electronic Medical Records Data
(2015) Wei, W.; Gill, J.; Ye, F; Xie, L; Levin, P.; Miao, R.; Başer, Onur
Aims: To evaluate real-world clinical outcomes for switching basal insulin analogues [insulin glargine (GLA) and insulin detemir (DET)] among US patients with type 2 diabetes mellitus (T2DM). Methods: Using the GE Centricity Electronic Medical Records database, this retrospective study examined two cohorts: cohort 1, comprising patients previously on GLA and then either switching to DET (DET-S) or continuing with GLA (GLA-C); and cohort 2, comprising patients previously on DET and then either switching to GLA (GLA-S) or continuing with DET (DET-C). Within each cohort, treatment groups were propensity-score-matched on baseline characteristics. At 1-year follow-up, insulin treatment patterns, glycated haemoglobin (HbA1c) levels, hypoglycaemic events, weight and body mass index (BMI) were evaluated. Results: The analysis included 13 942 patients: cohort 1: n= 10 657 (DET-S, n= 1797 matched to GLA-C, n= 8860) and cohort 2: n= 3285 (GLA-S, n= 858 matched to DET-C, n= 2427). Baseline characteristics were similar between the treatment groups in each cohort. At 1-year follow-up, in cohort 1, patients in the DET-S subgroup were significantly less persistent with treatment, more likely to use a rapid-acting insulin analogue, had higher HbA1c values, lower HbA1c reductions and lower proportions of patients achieving HbA1c < 7.0 or < 8.0% compared with patients in the GLA-C subgroup, while hypoglycaemia rates and BMI/weight values and change from baseline were similar in the two subgroups. In cohort 2, overall, there were contrasting findings between patients in the GLA-S and those in the DET-C subgroup. Conclusions: This study showed contrasting results when patients with T2DM switched between basal insulin analogues, although these preliminary results may be subject to limitations in the analysis. Nevertheless, this study calls into question the therapeutic interchangeability of GLA and DET, and this merits further investigation.
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.
Pmh15 - Prevalence and Incidence Rates Among Alcohol-Dependent Patients in the Us Medicare Population
(2015) Li, L,; Shrestha, S.; Başer, Onur; Yuce H.; Li Wang
OBJECTIVES: To examine incidence and prevalence rates among alcohol-dependentpatients in the U.S. Medicare population. METHODS: A prospective study was performed from 01JAN2008 through 31DEC2012 to determine the prevalence and incidence of patients diagnosed with alcohol dependence (International Classificationof Diseases, 9th Revision, Clinical Modification diagnosis code 303) in the U.S.Medicare population. Patients were required to have continuous enrollment in afee-for-service Medicare health plan during the calendar year and at least 2 yearsprior. The age- and gender-adjusted prevalence and incidence (overall and ageand gender-specific) rates of alcohol-dependent patients were calculated by directstandardization to the U.S. population age ?65 years in 2010. RESULTS: The annualadjusted overall prevalence rate increased from 0.30% in 2008 to 1.05% in 2012,whereas the annual overall incidence rate decreased from 0.30% in 2008 to 0.20%in 2012. Alcohol dependence prevalence and incidence rates were higher amongmen than women every year. Patients age 65-69 years had the highest prevalencerates during 2008 (0.43%) and 2009 (0.63%), whereas in 2010 (0.82%), 2011 (1.14%) and2012 (1.43%), patients age 70-74 years had the highest prevalence rates. Prevalencerates grew steadily among all age groups from 2008 to 2012. The highest alcoholdependence incidence rate was observed in the Virgin Islands (917.6 per 100,000person-years) in 2008, whereas in 2012, Wyoming (409.3 per 100,000 person-years)had the highest incidence rate. CONCLUSIONS: Increasing prevalence and decreas ing incidence of alcohol dependence was observed from 2008 to 2012. In addition,men were more likely to have alcohol dependence than women.
Pmh13 - Examining Prevalence, Incidence and Mortality Rates Among Opioid-Dependent Patients in the U.s. Medicare Population
(2015) Li, L.; Shrestha, S.; Başer, Onur; Yuce H.; Li Wang
OBJECTIVES: To examine incidence, prevalence and mortality rates among opioiddependent patients in the U.S. Medicare population. METHODS: A study was performed for the period from January 1, 2008 through December 31, 2012 to determinethe prevalence, incidence and mortality rates among opioid-dependent patients(International Classification of Diseases, 9th Revision, Clinical Modification diagnosis codes 304.0x and 304.7x) in the U.S. Medicare population. Patients who hadcontinuous fee-for-service Medicare health plan enrollment for the calendar yearand at least 2 years prior were selected for the study. Age- and gender-adjustedopioid dependence prevalence and incidence rates were calculated via direct standardization to the U.S. population age ?65 years in 2010 using gender-specific agegroups. RESULTS: The annual adjusted prevalence of opioid-dependent patientsincreased from 0.06% in 2008 to 0.35% in 2012. Incidence rates increased from 0.06%in 2008 to 0.10% in 2012. Prevalence rates were higher among women than men everyyear during the study period. Patients age 65-69 years had the highest prevalencerates during 2008 (0.09%), 2009 (0.16%), 2010 (0.22%) and 2011 (0.32%). However, in2012, patients who were age 70-74 years had the highest prevalence rates (0.43%).North American Natives had the highest prevalence of opioid dependence comparedto all other races. The highest incidence of opioid dependence was observed inNevada in 2008 (221.9 per 100,000 person-years) and 2012 (222.1 per 100,000 personyears). The 30-day and 1-year mortality rates decreased by 10.5% (3.8 to 3.4 per 1,000person-years) and 25.4% (17.3 to 12.9 per 1,000 person-years), respectively, from 2008to 2012. CONCLUSIONS: Opioid dependence incidence and prevalence decreasedfrom 2008 to 2012; however, opioid dependence-related mortality rates increased.
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

Browse

Browsing Ekonomi Bölümü Koleksiyonu by Scopus Q "Q1"