Ekonomi Bölümü Koleksiyonu

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A Comparative Analysis of the Health Care Utilization and Costs of Patients Diagnosed With and Without Liver Cancer in the Us Medicare Population
(2017) Ogbomo, A.; Lin, Y.; Keshishian, A; Xie, L; Yuce, H; Başer, Onur
...
Spatial Distribution of the Total Number of Medical Devices in Turkey: a Classification Analysis
(2016) Cinaroğlu, S.; Başer, Onur
Objectives: The unbalanced distribution of medical technologies and devices between rural and urban areas is a major problem for developing countries including Turkey. After the establishment of Public Hospital Unions (PHUs) in Turkey, legislative changes were made to improve the autonomy of public hospitals. This study utilizes spatial analysis to assess the distribution of medical device use in Turkey using PHUs as a decision making unit. Methods: Data from the PHUs’ statistics year book for the year 2014 was assessed. The total number of PHUs is 89. A Hierarchical cluster analysis was performed to classify PHUs according to the total number of medical devices. The Euclidean distance measure and Wards methods were used in the analysis for classification. Results: Study results show that, in Turkey, PHUs were categorized into two clusters based on the total number of medical devices available. Regarding the spatial distribution of the clusters, the first cluster represents PHUs in rural areas, and the second represents PHUs located in urban areas of Turkey. PHUs representing large cities with high population density were included in one cluster, and all other PHUs were included in the second. Statistical test results indicated that the two clusters differ according to the total number of magnetic resonance imaging (MRI: t= -14.10, p< 0.01), computed tomography (CT) scan (t= -15.75, p< 0.01), mammography (t= -11.40, p< 0.01), ultrasonography (t= -14.62, p< 0.01), and electrocardiography (EKG; t= -12.29, p< 0.01) equipment available. Conclusions: It is advisable for health policy makers and health technology assessment authorities in Turkey to focus on the differences between rural and urban areas of the country when determining the need for medical devices.
Citation - WoS: 13
Citation - Scopus: 14
Economic Outcomes in Patients With Chemotherapy-Naive Metastatic Castration-Resistant Prostate Cancer Treated With Enzalutamide or Abiraterone Acetate Plus Prednisone
(Springer, 2020) Lechpammer, Stanislav; Ramaswamy, Krishnan; Wang, Li; Mardekian, Jack; George, Daniel J.; Sandin, Rickard; Schultz, Neil M.; Başer, Onur; Huang, Ahong
Introduction: Prostate cancer (PC) is the second leading cause of cancer death among US men and accounts for considerable healthcare expenditures. We evaluated economic outcomes in men with chemotherapy-naı¨ve metastatic castration-resistant PC (mCRPC) treated with enzalutamide or abiraterone acetate plus prednisone (abiraterone). Methods: We performed a retrospective analysis on 3174 men (18 years or older) utilizing the Veterans Health Administration (VHA) database from 1 April 2014 to 31 March 2018. Men with mCRPC were included if they had at least one pharmacy claim for enzalutamide or abiraterone (ﬁrst claim date = index date) following surgical or medical castration, had no chemotherapy treatment within 12 months prior to the index date, and had continuous VHA enrollment for at least 12 months pre- and post-index date. Men were followed until death, disenrollment, or end of study and were 1:1 propensity score matched (PSM). All-cause and PC-related resource use and costs per patient per month (PPPM) in the 12 months post index were compared between matched cohorts. Results: We identiﬁed 1229 men with mCRPC prescribed enzalutamide and 1945 prescribed abiraterone with mean ages of 74 and 73 years, respectively. After PSM, each cohort had 1160 patients. The enzalutamide cohort had fewer all-cause (2.51 vs 2.86; p\0.0001) and PC-related outpatient visits (0.86 vs 1.03; p\0.0001), with corresponding lower all-cause ($2588 vs $3115; p\0.0001) and PC-related ($1356 vs $1775; p\0.0001) PPPM outpatient costs compared with the abiraterone cohort. Allcause total costs (medical and pharmacy) PPPM ($8085 vs $9092; p = 0.0002) and PC-related total costs PPPM ($6321 vs $7280; p\0.0001) were signiﬁcantly lower in the enzalutamide cohort compared with the abiraterone cohort. Conclusions: Enzalutamide-treated men with chemotherapy-naı ¨ve mCRPC had signiﬁcantly lower resource utilization and healthcare costs compared with abiraterone-treated men. Plain Language Summary: Plain language summary available for this article.
Citation - WoS: 18
Citation - Scopus: 18
Guns and Homicides: a Multiscale Geographically Weighted Instrumental Variables Approach
(Wiley, 2019) Bilgel, Fırat
This article assesses the locally varying effects of gun ownership levels on total and gun homicide rates in the contiguous United States using cross-sectional county data for the period 2009–2015. Employing a multiscale geographically weighted instrumental variables regression that takes into account spatial nonstationarity in the processes and the endogenous nature of gun ownership levels, estimates show that gun ownership exerts spatially monotonically negative effects on total and gun homicide rates, indicating that there are no counties supporting the “more guns, more crime” hypothesis for these two highly important crime categories. The number of counties in the contiguous United States where the “more guns, less crime” hypothesis is confirmed is limited to at least 1258 counties (44.8% of the sample) with the strongest total homicide-decreasing effects concentrated in southeastern Texas and the deep south. On the other hand, stricter state gun control laws exert spatially monotonically negative effects on gun homicide rates with the strongest effects concentrated in the southern tip of Texas extending toward the deep south.
Citation - WoS: 8
Citation - Scopus: 8
The Use of Decomposition Methods in Real-World Treatment Benefits Evaluation for Patients With Type 2 Diabetes Initiating Different Injectable Therapies: Findings From the Initiator Study
(2017) Ke, Xuehua; Buysman, Erin; Wei, Wenhui; Xie, Lin; Grabner, Michael; Brekke, Lee; Başer, Onur
Background: Determining characteristics of patients likely to benefit from a particular treatment could help physicians set personalized targets. OBJECTIVES: To use decomposition methodology on real-world data to identify the relative contributions of treatment effects and patients' baseline characteristics. METHODS: Decomposition analyses were performed on data from the Initiation of New Injectable Treatment Introduced after Antidiabetic Therapy with Oral-only Regimens (INITIATOR) study, a real-world study of patients with type 2 diabetes started on insulin glargine (GLA) or liraglutide (LIRA). These analyses investigated relative contributions of differences in baseline characteristics and treatment effects to observed differences in 1-year outcomes for reduction in glycated hemoglobin A1c (HbA1c) and treatment persistence. RESULTS: The greater HbA1c reduction seen with GLA compared with LIRA (-1.39% vs. -0.74%) was primarily due to differences in baseline characteristics (HbA1c and endocrinologist as prescribing physician; P < 0.050). Patients with baseline HbA1c of 9.0% or more or evidence of diagnosis codes related to mental illness achieved greater HbA1c reductions with GLA, whereas patients with baseline polypharmacy (6-10 classes) or hypogylcemia achieved greater reductions with LIRA. Decomposition analyses also showed that the higher persistence seen with GLA (65% vs. 49%) was mainly caused by differences in treatment effects (P < 0.001). Patients 65 years and older, those with HbA1c of 9.0% or more, those taking three oral antidiabetes drugs, and those with polypharmacy of more than 10 classes had higher persistence with GLA; patients 18 to 39 years and those with HbA1c of 7.0% to less than 8.0% had higher persistence with LIRA. CONCLUSIONS: Although decomposition does not demonstrate causal relationships, this method could be useful for examining the source of differences in outcomes between treatments in a real-world setting and could help physicians identify patients likely to respond to a particular treatment. Copyright (C) 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
The Role of Stakeholder Engagement in E-Health and the Use of Big Data To Predict Health Outcomes
(2017) Cinaroğlu, S.; Başer, Onur
...
Socio-Economic Status and Self-Rated Health: Are They Good Predictors of Income? an Analysis of Survey Panel Data From Turkey
(2016) Çınaroğlu, Songül; Başer, Onur
...
Citation - WoS: 7
Citation - Scopus: 7
Exchange Rates and Firm Survival: an Examination With Turkish Firm-Level Data
(Elsevier, 2016) Toraganlı, Nazlı; Yazgan, Mustafa Ege
Micro-level empirical research has begun to obtain important results on the effects of currency variations on firms’ survival. The literature has, however, lacked a detailed analysis of the effects of exchange rates on firms’ survival behavior in emerging markets due to a scarcity of firm-level information. Using a firm-level dataset, we investigate the impact of currency appreciation on the survival behavior of Turkish firms in the manufacturing industries for 2002–2009. Our results suggest that real exchange rate appreciation decreases the probability of survival in the manufacturing industries. We also find that high-productivity firms have a higher probability of survival than low- productivity firms following an appreciation of the exchange rate. Our findings indicate that the negative effect of a 1% real appreciation of the domestic currency on the survival probability of a given firm ranges from 4.5 to 9%, providing evidence for the vulnerability of developing countries to exchange rate movements. This evidence indicates that, especially for emerging market economies, economic events and policies leading to an appreciation in the domestic currency should be managed cautiously.
Citation - WoS: 9
Citation - Scopus: 11
A Value-Adding Approach To Reliability Under Preventive Maintenance Costs and Its Applications
(2014) Dubey, Rameshwar; Kılıç, Erdem; Ali, Sadia Samar; Weber, Gerhard Wilhelm
No equipment (system) can be perfectly reliable in spite of the utmost care and best efforts on the part of the designer, decision-maker and manufacturer. The two sides of maintenance are corrective and preventive maintenance. It is generally assumed that a preventive maintenance action is less costly than a repair maintenance action. We examine this proposition in detail on the basis of a failure-time model that relates conformance quality to reliability. Illustratively, we present reliability in the context of contracts with asymmetric information. The model shows how to overcome information rents through price distortions and quantity rationing. The paper ends with a conclusion and an outlook to future studies.
Citation - WoS: 182
Citation - Scopus: 213
Valuable Virality
(2017) Berger, Jonah; Akpınar, Ezgi
Given recent interest in social media, many brands now create content that they hope consumers will view and share with peers. While some campaigns indeed go "viral," their value to the brand is limited if they do not boost brand evaluation or increase purchase. Consequently, a key question is how to create valuable virality, or content that is not only shared but also beneficial to the brand. Share data from hundreds of real online ads, as well as controlled laboratory experiments, demonstrate that compared with informative appeals (which focus on product features), emotional appeals (which use drama, mood, music, and other emotion-eliciting strategies) are more likely to be shared. Informative appeals, in contrast, boost brand evaluations and purchase because the brand is an integral part of the ad content. By combining the benefits of both approaches, emotional brand-integral ads boost sharing while also bolstering brand-related outcomes. The authors' framework sheds light on how companies can generate valuable virality and the mechanisms underlying these effects.
Pmh1 - Healthcare Utilization and Costs of Serotonin Syndrome With Concomitant Use of Serotonergic Agents
(2015) Wang, Z.; Xie, L.; Nguyen, C; Alley, S.; Başer, Onur
OBJECTIVES: Serotonin syndrome (SS) is an adverse drug reaction that may occurin patients receiving monotherapy or combinations of serotonergic agents (SAs).This study examined healthcare utilization and costs of SS in two different populations. METHODS: Adult (age ?18 years) patients prescribed SAs were identifiedusing the Veterans Health Administration (VHA) dataset (01OCT2008-30SEPT2012) andthe IMS PharMetrics Plus dataset (01JAN2010-31DEC2013). Patients with continuoushealth plan enrollment 12 months pre-index date, defined as the first SA prescription claim date, were included and observed until death, disenrollment or the end ofthe study period. Patients were assigned to cohorts based on drug exposure: singlemonoamine oxidase inhibitor (MAOI) drug, MAOI drugs in combination with otherSAs, single non-MAOI SA, and multiple non-MAOI SAs (2, 3, 4, and ?5 SAs). Outcomesof interest were annual incidences of SS event (ICD-9-CM: 333.99) and associatedhealth care utilization and costs.
Prs12 - Mortality and Rehospitalization Rates Among Hospitalized Pneumonia Patients in the Us Medicare Population
(2015) Li, L.; Shrestha, S.; Başer, Onur; Yuce, H; Wang, L
Objectives: To examine the mortality and rehospitalization rates among hospitalized U.S. Medicare patients diagnosed with pneumonia. Methods: Using U.S.Medicare data, 30-day and 1-year mortality rates as well as rehospitalization rateswere calculated for patients with a primary diagnosis of pneumonia (InternationalClassification of Diseases, 9th Revision, Clinical Modification [ICD-9-CM] codes480.0-483.99 or 485-487) or a secondary discharge diagnosis of pneumonia witha primary diagnosis of respiratory failure (ICD-9-CM code 518.81) or sepsis (038.xx). Patients with continuous enrollment in a fee-for-service Medicare healthplan throughout the calendar year, and at least 2 years prior, were included inthe study. Age- and gender-adjusted readmission rates were calculated by directstandardization of the U.S. population age ?65 years in 2010 using gender-specificage groups. Results: The 30-day and 1-year mortality rates increased by 5.9% (17 to18 per 1,000 person-years) and 13.2% (38 to 43 per 1,000 person-years), respectively,from 2008 to 2012. The overall adjusted readmission rates were 3.82% in 2008, 3.93%in 2009, 3.98% in 2010 and 2011, and 3.17% in 2012. Men had higher readmission ratesthan women for all study years except 2011. Patients age 65-69 years had the highestreadmission rates in 2008 (4.47%), 2009 (4.59%) and 2011 (4.77%). In 2010, patients age70-74 years (4.41%), and in 2012, patients who were age 75-79 years (3.73%) had thehighest readmission rates. Black patients had the highest readmission rates in 2008(5.08%), North American Natives in 2009 (4.86%), other race in 2010 (5.87%), Hispanicsin 2011 (5.70%) and North American Natives in 2012 (7.11%). Conclusions: AmongU.S. Medicare beneficiaries diagnosed with pneumonia, mortality rates were higherfrom 2009 to 2012 than in 2008. Overall, hospital readmission rates were lower in2012 than 2008, after adjusting for age and gender. Readmission rates varied acrossrace and age groups.
Citation - WoS: 10
Citation - Scopus: 12
The Topography and Sources of Multidimensional Poverty in Turkey
(Springer, 2021) Karahasan, Burhan Can; Bilgel, Fırat
Economic inequality and poverty have been extensively analyzed in monetary terms. However, other aspects of poverty, such as education, health, environment and standards of living are important factors, essential for human well-being and capabilities. Using a host of non-monetary aspects of poverty, this paper sheds light on the geographical distribution of multidimensional poverty in Turkey. Results from survey data highlight that the regional distribution non-monetary dimensions of poverty is conspicuously different than that of relative monetary poverty in Turkey. Unlike the relative monetary poverty rate, multidimensional poverty measurement reflects the regional underdevelopment problem of Turkey. On the contrary, once monetary poverty is considered in absolute terms, multidimensional and absolute monetary poverty have a similar geographical pattern. Moreover, the decomposition analyses point out that females, old disabled and socially excluded individuals suffer the most from multidimensional poverty. Our combined results show that the isolated eastern regions realize the highest poverty and deprivation at each decomposition level.
Citation - WoS: 1
Pcv5 - Clinical Outcomes and Treatment Patterns of Venous Thromboembolism Among Cancer Patients in a Large Commercial Database
(2015) Masseria, C; Kariburyo, M. Furaha; Mardekian, J; Başer, Onur
OBJECTIVES: Describe venous thromboembolism (VTE) treatment patterns and clinical outcomes among cancer patients. METHODS: Adult patients (age >18 years)with ?2 VTE diagnosis claims (ICD-9-CM codes) in an outpatient setting or oneVTE diagnosis in an inpatient setting were selected from the Humedica database(01JAN2008-31MAR2014). Continuous health plan enrollment 6 months pre-indexdate (VTE diagnosis) was required. Cancer patients (ICD-9 codes for cancer diagnosis, medication use, radiation therapy, or surgery) were differentiated from activecancer patients (ICD-9 codes for cancer diagnosis and treatment) based on diagnosiscodes during baseline period. VTE treatment patterns with low molecular weightheparin (LMWH), unfractionated heparin (UFH), fondaparinux and oral anticoagulants (OACs) were evaluated. Incidence rate (in person-years) was calculated forclinical outcomes: VTE recurrence, bleeding, major bleeding and clinically relevantnon-major bleeding. RESULTS: Patients with active cancer were on average sicker(Charlson Comorbidity Index score: 6.7 vs. 2.9) and had higher proportions of numerous comorbid conditions, including respiratory disease (52.7% vs. 40.4%), hepaticdisease (14.9% vs. 6.1%) and baseline bleeding (30.4% vs. 17.8%) compared to allcancer patients. More than 70% of cancer patients were prescribed anticoagulants,and the majority received a combination of parenteral andoral anticoagulant treatment. A higher proportion of active cancer patients received only parenteral anticoagulant compared to all cancer patients (26.1% vs. 16.2%), and LMWH was themost commonly prescribed parenteral anticoagulant. The incidence rate of VTErecurrence (24.7 vs. 14.3 per 100 person-years) and major bleeding events (31.2 vs.15.9 per 100 person-years) was higher among active cancer patients than all VTEcancer patients. CONCLUSIONS: Approximately 30% of VTE cancer patients didnot receive any anticoagulation, with difference in treatment patterns betweenVTE cancer and active cancer patients. Active cancer patients had higher incidencerates of VTE recurrence and bleeding events compared to all VTE cancer patients.
Citation - WoS: 18
Citation - Scopus: 18
Adding Rapid-Acting Insulin or Glp-1 Receptor Agonist To Basal Insulin: Outcomes in a Community Setting
(2015) Dalal, Mehul R; DiGenio, Andres; Xie, Lin; Başer, Onur
To evaluate real-world outcomes in patients with type 2 diabetes mellitus (T2DM)receiving basal insulin, who initiate add-on therapy with a rapid-acting insulin (RAI) or aglucagon-like peptide 1 (GLP-1) receptor agonist.Data were extracted retrospectively from a U.S. health claims database. Adults withT2DM on basal insulin who added an RAI (basal+RAI) or GLP-1 receptor agonist (basal+GLP-1) were included. Propensity score matching (1 up to 3 ratio) was used to control for differencesin baseline demographics, clinical characteristics, and health resource utilization. Endpointsincluded prevalence of hypoglycemia, pancreatic events, all-cause and diabetes-relatedresource utilization, and costs at 1 year follow-up. Overall, 6,718 matched patients were included: 5,013 basal+RAI and 1,705basal+GLP1. Patients in both groups experienced a similar proportion of any hypoglycemicevent (P = .4079). Hypoglycemic events leading to hospitalization were higher in the basal+RAIcohort (2.7% vs. 1.8%; P = .0444). The basal+GLP-1 cohort experienced fewer all-cause(13.55% vs. 18.61%; P<.0001) and diabetes-related hospitalizations (11.79% vs. 15.68%;P<.0001). The basal+GLP-1 cohort had lower total all-cause health care costs ($18,413 vs.$20,821; P = .0002), but similar diabetes-related costs ($9,134 vs. $8,985; P<.0001) comparedwith the basal+RAI cohort. Add-on therapy with a GLP-1 receptor agonist in T2DM patients receiving basalinsulin was associated with fewer hospitalizations and lower total all-cause costs compared withadd-on therapy using a RAI, and could be considered an alternative to a RAI in certain patientswith T2DM, who do not achieve effective glycemic control with basal insulin.
Citation - WoS: 2
The Relationship Between Medical Innovation and Health Expenditures
(2016) Çınaroğlu, Songül; Guzel, E; Başer, Onur
Objectives: It is widely accepted that medical innovation includes many costly activities, and that it is a key driver of rising health care expenditures. Understanding the relationship between medical innovation and health care expenditures is critical for health policy makers to effectively make resource allocation decisions. This study seeks to investigate the relationship between medical innovation and health care expenditures. Methods: We assessed data from the World Intellectual Property Organization and World Bank statistics for the year 2014, which included data from 72 countries. The number of patent publications in the categories of medical technology, biotechnology, and pharmaceuticals were included as medical innovation indicators; public heath, health care costs per capita, and total health care costs (percentage of gross domestic product [GDP]) were included as indicators of health care-related expenditures. A canonic correlation analysis (CCA) was performed to examine the degree of association between the sets of medical innovation and health care expenditure variables. Results: Study results indicate that there is a strong positive correlation between medical innovation and health care expenditure variables (rc= 0.68, p<0.001). Conclusions: In light of this study, health policy makers should manage the relationship between medical innovation and health care expenditures with a focus on accessibility. Improved communication channels in the social system, increased international cooperation, and the determination of a proper balance between the benefits and costs of innovation may help to continue improving medical innovation and enhance health care accessibility. We hope that the study results offer an increased awareness of the relationship and balance between innovation and expenditure, and will help to create an improved health system.
Citation - WoS: 2
Pnd43 - Adherence and Persistence To Anti-Epileptic Drugs Among Us Veterans Diagnosed With Epilepsy
(2015) Velez, F. F.; Başer, Onur; Xie, L.
OBJECTIVES: To evaluate patient adherence and persistence to anti-epileptic drug(AED) monotherapy. METHODS: Adult patients (age>18 years) with ?2 epilepsydiagnosis claims (ICD-9-CM:345) or one epilepsy diagnosis claim and one claim forother convulsion (ICD-9-CM: 780.39) were selected from the U.S. Veterans HealthAdministration database (01OCT2008-30SEPT2013). Patients were required tohave ?1 AED prescription post-epilepsy diagnosis, and the first AED prescription claim date was designated as the index date. Continuous health plan enrollment12 months pre- and post-index date was required. Patients were assigned to fourmonotherapy AED cohorts based on drug class: sodium channel blockers (SCs),gamma-aminobutyric acid analogs (GABAs), synaptic vesicle protein 2A binding(SV2) and multiple mechanisms (MMs). Adherence was assessed using the proportion of days covered (PDC) and persistence was defined as days to discontinuation with an allowable treatment gap of 45 days without the index AED. Logisticand Cox proportional hazards models were used to compare the results amongthe cohorts. RESULTS: Patients in the SC cohort had significantly lower baselineCharlson Comorbidity Index scores (1.82), indicating that they were healthier thanthose in the GAMA (2.08, p<0.001) and SV2 (2.46, p<0.001) cohorts. Patients in the SCcohort were significantly less likely to have a baseline psychiatric disorder (37.6%)than those in the GABA (63.8%, p<0.001) and MM (52.1%, p<0.001) cohorts. Patientstreated with GABAs (OR=0.44, p<0.001) and MMs (OR=0.63, p<0.001) were significantly less likely to adhere to their medications (PDC <80%) than those treatedwith SC. Furthermore, patients treated with GABAs (hazard ratio [HR]=1.74; 95%confidence interval [CI]=1.59-1.90) and MMs (HR=1.18; 95% CI=1.07-1.29) were morelikely to discontinue treatment during the follow-up period compared to those in theSC cohort. CONCLUSIONS: Patients treated with Sodium channel blockers are morelikely adhere to treatment and have lower discontinuation of AED monotherapythan those treated with GABAs and MMs.
Citation - WoS: 5
Citation - Scopus: 5
Health Outcomes Among Patients Diagnosed With Schizophrenia in the Us Veterans Health Administration Population Who Transitioned From Once-Monthly To Once-Every Paliperidone Palmitate: an Observational Retrospective Analysis
(Springer, 2019) Khouyr, Antoine El; Wang, Li; Joshi, Kruti; Patel, Charmi; Başer, Onur; Huang, Ahong
There is limited literature on treatment patterns, healthcare resource utilization (HRU), and costs among patients who transition from once-monthly paliperidone palmitate (PP1M) to once-every-3-month paliperidone palmitate (PP3M) in a real-world setting. Hence, this study compared treatment patterns, HRU, and costs 12-month pre- and post-PP3M transition among Veteran’s Health Administration (VHA) patients with schizophrenia.
Pcv50 - a Retrospective Analysis of Health Care Resource Utilization and the Economic Burden Among Us Long-Term Care Facility Patients Diagnosed With Stroke
(2015) Huang, A; Shrestha, S; Başer, Onur; Yuce, H; Wang, L
Objectives: To assess the economic burden and health care resource utilization among patients in long-term care facilities who were diagnosed withstroke. Methods: Patients diagnosed with stroke (International Classification ofDiseases, 9th Revision, Clinical Modification diagnosis codes 433, 434 and 436) wereidentified using the Long Term Care Minimum Data Set (MDS) linked to 5% Medicaredata from 01JAN2009 through 31DEC2010. The initial diagnosis date was designatedas the index date. Patients without a stroke diagnosis (control cohort) were matchedto stroke patients, and 1:1 propensity score matching (PSM) was used to control forage, region, gender and baseline Charlson Comorbidity Index score. The index datefor the control cohort was randomly chosen to reduce selection bias. Patients inboth cohorts were required to be age ?65 years, have at least two consecutive quarterly assessments documented in MDS data 6 months prior to the index date andhave continuous medical and pharmacy benefits 1 year before and after the indexdate. Results: Once PSM was applied, 1,014 patients were included in each cohort,and baseline characteristics were balanced. A higher percentage of stroke patientshad inpatient admissions (40.34% vs. 23.37%, p<0.0001), outpatient visits (92.31%vs. 89.45%, p=0.0253), skilled nursing facility (SNF; 37.67% vs. 28.21%, p<0.0001) anddurable medical equipment (DME) claims (30.47% vs. 22.09%, p<0.0001) than thosein the control cohort. Stroke patients also incurred considerably higher inpatient($7,068 vs. $3,418, p<0.0001), outpatient ($3,545 vs. $2,539, p<0.0001), SNF ($8,036 vs.$3,695, p<0.0001), DME ($394 vs. $235, p=0.0023) and carrier claim costs ($3,606 vs.$2,489, p<0.0001) than those without a stroke diagnosis. Conclusions: Patientsdiagnosed with stroke had considerably higher health care resource utilization andcosts than those in the control cohort.
Pms38 - Demographic Distribution and Economic Burden of Patients Diagnosed With Rheumatoid Arthritis in the Us Medicare Population
(2015) Li, L; Mao, X; Shrestha, S; Başer, Onur; Yuce H.; Wang, Li
OBJECTIVES: To determine the demographic distribution and health care burden ofpatients diagnosed with rheumatoid arthritis (RA) using Medicare fee-for-service(FFS) data. METHODS: A retrospective analysis was performed using the 100%Medicare FFS datasets from October 1, 2008 through December 31, 2012. Patientsdiagnosed with RA were identified using International Classification of Diseases,9th Revision, Clinical Modification diagnosis code 714, and the first diagnosis datewas designated as the index date. All patients were required to have continuousmedical and pharmacy benefits 1 year pre- (baseline period) and post-index date(follow-up period). Health care resource utilization and costs during the baseline andfollow-up periods were calculated. RESULTS: Using Medicare FFS data, 112,550 RApatients were identified. The average age at diagnosis was 76 years, and 72.54% ofpatients were women and 83.94% were white. The most common baseline comorbidities were diabetes (35.48%), followed by chronic obstructive pulmonary disease(30.83%) and cerebrovascular disease (21.50%). During the follow-up period, 66.35%of patients had inpatient admissions, 49.01% had emergency room visits, 87.93%had outpatient office visits, 87.93% had outpatient visits and 61.67% had pharmacyvisits and costs were, on average, $26,510, $256, $4,204, $4,460 and $6,249, respectively. The average total costs incurred by RA patients were $37,219. The five mostcommonly-prescribed medications prescribed to treat RA were prednisone (3.40%),levothyroxine sodium (2.63%), hydrocodone bit/acetaminophen (2.39%), furosemide(2.13%) and omeprazole (2.13%). CONCLUSIONS: RA patient demographic distributions and RA-related health care cost information was obtained and the mostcommonly prescribed medications to treat RA were identified.

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