Ekonomi Bölümü Koleksiyonu
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Article Citation - WoS: 18Citation - Scopus: 18Adding 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, OnurTo 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.Article Citation - WoS: 44Citation - Scopus: 67Adoption and Use of Learning Management Systems in Education: the Role of Playfulness and Self-Management(MDPI [Commercial Publisher], 2021) Akküçük, Ulaş; Balkaya, SelenThis article investigates the factors affecting primary and secondary education teachers' behavioral intention to adopt learning management systems (LMSs). Information technology (IT) innovations have the power to change the way we work, educate, learn, and basically the way we live. The effect of IT innovations on education makes it critical to understand the current usage situation of LMSs and the factors affecting their adoption by teachers. The unified theory of acceptance and use of technology (UTAUT) was extended with factors from education and game-based learning literature. In order to see the effect of individual- and organizational-level characteristics, multi-group structural equation modeling (SEM) analysis was conducted and discrepancies in relationships were reported. Evaluation of users and non-users and teachers of different fields were also compared to each other. The findings of this study not only contribute to theory through the development and testing of a thorough model relating technology features and individual characteristics to behavioral intention to use, but also offer strong implications for practitioners who would like to increase LMS usage and create a more effective learning environment.Article Citation - WoS: 17Citation - Scopus: 23Benefit of Early Discharge Among Patients With Low-Risk Pulmonary Embolism(2017) Wang, Li; Wells, Phil; Fermann, Gregory J; Peacock, W. Frank; Schein, Jeff; Coleman, Craig I; Crivera, Concetta; Başer, OnurClinical guidelines recommend early discharge of patients with low-risk pulmonary embolism (LRPE). This study measured the overall impact of early discharge of LRPE patients on clinical outcomes and costs in the Veterans Health Administration population. Adult patients with >= 1 inpatient diagnosis for pulmonary embolism (PE) (index date) between 10/2011-06/2015, continuous enrollment for >= 12 months pre-and 3 months post-index date were included. PE risk stratification was performed using the simplified Pulmonary Embolism Stratification Index. Propensity score matching (PSM) was used to compare 90-day adverse PE events (APEs) [recurrent venous thromboembolism, major bleed and death], hospital-acquired complications (HACs), healthcare utilization, and costs among short (<= 2 days) versus long length of stay (LOS). Net clinical benefit was defined as 1 minus the combined rate of APE and HAC. Among 6,746 PE patients, 95.4% were men, 22.0% were African American, and 1,918 had LRPE. Among LRPE patients, only 688 had a short LOS. After 1:1 PSM, there were no differences in APE, but short LOS had fewer HAC (1.5% vs 13.3%, 95% CI: 3.77-19.94) and bacterial pneumonias (5.9% vs 11.7%, 95% CI: 1.24-3.23), resulting in better net clinical benefit (86.9% vs 78.3%, 95% CI: 0.84-0.96). Among long LOS patients, HACs (52) exceeded APEs (14 recurrent DVT, 5 bleeds). Short LOS incurred lower inpatient ($2,164 vs $5,100, 95% CI: $646.8-$5225.0) and total costs ($9,056 vs $12,544, 95% CI: $636.6-$6337.7). LRPE patients with short LOS had better net clinical outcomes at lower costs than matched LRPE patients with long LOS.Article Citation - WoS: 15Citation - Scopus: 18Consumer Confidence and Economic Activity: a Factor Augmented Var Approach(Taylor & Francis, 2016) Kılıç, Erdem; Çankaya, SerkanThis study aims to analyse the effects of the consumer confidence on economic activity for the USmarket. We use the empirical factor-augmented vector autoregression (FAVAR) method, whichenables us to incorporate a wide range of economic activity factors into the analysis. Theconsumer confidence index (CCI) is chosen as the principal variable that is presumed to representthe degree of optimism on the state of economic activity. The results show that consumerconfidence and economic activity are strongly correlated for manufacturing-related factors,such as industrial production and inventories. We also observe strong relation among CCI andpersonal consumption expenditures, as well as housing market variables.Article Citation - WoS: 4Citation - Scopus: 6Does the Unification of Health Financing Affect the Distribution Pattern of Out-Of Health Expenses in Turkey?(Wiley, 2019) Çınaroğlu, Songül; Başer, OnurTurkey has implemented health reforms for over a decade and has taken significant steps toward unifying health financing. This study investigated the financial burden associated with out-of-pocket (OOP) expenditures under universal health coverage, using national 2003–2015 household budget data from the Turkish Statistical Institute. Progress was evaluated using Kakwani–Suits indices and Lorenz concentration curves. The results indicate that overall, more than a decade after its unification, redistribution of wealth in the Turkish health financing system has benefitted the wealthy but not the poor. Both curve and index approaches (Kakwani index 2003 = -0.50; 2015 = -0.44) reveal an increasingly regressive pattern of OOP health expenditures. The effective use of fiscal space and good political leadership are essential for the successful continuation of reforms to combat poverty in Turkey.Article Citation - WoS: 13Citation - Scopus: 14Economic 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, AhongIntroduction: 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.Article Citation - WoS: 2Citation - Scopus: 2Effects of Covid-19 Lockdowns on Social Distancing in Turkey(Oxford University Press, 2022) Bilgel, FıratThis paper elucidates the causal effect of lockdowns on social distancing behaviour in Turkey by adopting an augmented synthetic control and a factor-augmented model approach for imputing counterfactuals. By constructing a synthetic control group that reproduces pre-lockdown trajectory of mobility of the treated provinces and that accommodates staggered adoption, the difference between the counterfactual and actual mobility of treated provinces is assessed in the post-lockdown period. The analysis shows that in the short run following the onset of lockdowns, outdoor mobility would have been about 17–53 percentage points higher on average in the absence of lockdowns, depending on social distancing measure. However, residential mobility would have been about 12 percentage points lower in the absence of lockdowns. The findings are corroborated using interactive fixed effects and matrix completion counterfactuals that accommodate staggered adoption and treatment reversals.Article Citation - WoS: 3Citation - Scopus: 3Effects of Vaccination and the Spatio-Temporal Diffusion of Covid-19 Incidence in Turkey(John Wiley and Sons Inc, 2022) Bilgel, Fırat; Karahasan, Burhan CanThis 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.Article Citation - WoS: 6Citation - Scopus: 6Exchange Rates and Firm Survival: an Examination With Turkish Firm-Level Data(Elsevier, 2016) Toraganlı, Nazlı; Yazgan, Mustafa EgeMicro-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.Article Citation - WoS: 5Citation - Scopus: 3Exports, Real Exchange Rates and Dollarization: Empirical Evidence From Turkish Manufacturing Firms(Springer, 2019) Karamollaoğlu, Nazlı; Yalçın, CihanWe 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.Article Citation - WoS: 1Citation - Scopus: 1Great Recession and News Shocks: Evidence Based on an Estimated Dsge Model(Springer, 2021) Nebioğlu, DenizThis paper examines whether productivity news shocks were among the drivers of the Great Recession. To do this, the Smets and Wouters (Am Econ Rev 97(3):586–606, 2007. https://doi.org/10.1257/aer.97.3.586) model is extended by a generalized preference specification which allows for scaling wealth effects on the labor supply. The resulting model is estimated using Bayesian methods which draw upon the US data from the period 1965Q2 to 2014Q3. There are four main results: (i) Estimation of the model is inconclusive regarding the degree of wealth elasticity of the labor supply. As a result, two complementary versions of the model prevail, each of which has differing implications for the transmission and the quantitative importance of exogenous shocks. (ii) When the degree of wealth elasticity of the labor supply is low, news shocks replace risk premium shocks, suggesting that news shocks are one possible reason for fluctuations in US business cycles. (iii) When the Great Recession period is analyzed through the lenses of the two complementary versions of the model, two explanations emerge as potential reasons behind the deepening of the crisis: worsening credit conditions as well as the collapse of over-optimistic expectations regarding future productivity. (iv) For both model specifications, general developments in productivity are estimated to be positive. Therefore, productivity slowdown is not considered to be among the reasons for the emergence or persistence of the Great Recession.Article Citation - WoS: 17Citation - Scopus: 17Guns and Homicides: a Multiscale Geographically Weighted Instrumental Variables Approach(Wiley, 2019) Bilgel, FıratThis 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.Article Citation - WoS: 5Citation - Scopus: 5Health 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, AhongThere 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.Article Citation - WoS: 6Citation - Scopus: 7Hematocrit Levels and Thrombotic Events in Patients With Polycythemia Vera: an Analysis of Veterans Health Administration Data(Springer, 2019) Parasuraman, Shreekant; Robyn Scherber; Jingbo Yu; Li Wang; Dilan Paranagama; Sulena Shrestha; Başer, OnurPatients with polycythemia vera (PV) have a high incidence of thrombotic events (TEs), contributing to a greater mortality risk than the general population. The relationship between hematocrit (HCT) levels and TE occurrence among patients with PV from the Veterans Health Administration (VHA) was evaluated to replicate findings of the CYTO-PV trial with a real-world patient population. This retrospective study used VHA medical record and claims data from the first claim with a PV diagnosis (index) until death, disenrollment, or end of study, collected between October 1, 2005, and September 30, 2012. Patients were aged ? 18 years at index, had ? 2 claims for PV (ICD-9-CM code, 238.4) ? 30 days apart during the identification period, continuous health plan enrollment from 12 months pre-index until end of study, and ? 3 HCT measurements per year during follow-up. This analysis focused on patients with no pre-index TE, and with all HCT values either < 45% or ? 45% during the follow-up period. The difference in TE risk between HCT groups was assessed using unadjusted Cox regression models based on time to first TE. Patients (N = 213) were mean (SD) age 68.9 (11.5) years, 98.6% male, and 61.5% white. TE rates for patients with HCT values < 45% versus ? 45% were 40.3% and 54.2%, respectively. Among patients with ? 1 HCT before TE, TE risk hazard ratio was 1.61 (95% CI, 1.03–2.51; P = 0.036). This analysis of the VHA population further supports effective monitoring and control of HCT levels < 45% to reduce TE risk in patients with PV.Article Citation - WoS: 44Citation - Scopus: 45Population Density Index and Its Use for Distribution of Covid-19: a Case Study Using Turkish Data(Elsevier, 2020) Başer, OnurSince March 2020, many countries around the world have been experiencing a large outbreak of a novel coronavirus (2019-nCoV). Because there is a higher rate of contact between humans in cities with higher population weighted densities, Covid-19 spreads faster in these areas. In this study, we examined the relationship between population weighted density and the spread of Covid-19. Using data from Turkey, we calculated the elasticity of Covid-19 spread with respect to population weighted density to be 0.67 after controlling for other factors. In addition to the density, the proportion of people over 65, the per capita GDP, and the number of total health care workers in each city positively contributed to the case numbers, while education level and temperature had a negative effect. We suggested a policy measure on how to transfer health care workers from different areas to the areas with a possibility of wide spread.Article Citation - WoS: 12Citation - Scopus: 12Risk of Venous Thromboembolism After New Onset Heart Failure(Nature Research, 2019) Smilowitz, Nathaniel R.; Wang, Li; Berger, Jeffrey S.; Zhao, Qi; Shrestha, Sulena; Başer, OnurNew-onset heart failure (HF) is associated with cardiovascular morbidity and mortality. It is uncertain to what extent HF confers an increased risk of venous thromboembolism (VTE). Adults >= 65 years old hospitalized with a new diagnosis of HF were identified from Medicare claims from 2007-2013. We identified the incidence, predictors and outcomes of VTE in HF. We compared VTE incidence during follow-up after HF hospitalization with a corresponding period 1-year prior to the HF diagnosis. Among 207,535 patients with a new HF diagnosis, the cumulative incidence of VTE was 1.4%, 2.5%, and 10.5% at 30 days, 1 year, and 5 years, respectively. The odds of VTE were greatest immediately after newonset HF and steadily declined over time (OR 2.2 [95% CI 2.0-2.3], OR 1.5 [1.4-1.7], and OR 1.2 [1.2-1.3] at 0-30 days, 4-6 months, and 7-9 months, respectively). Over 26-month follow-up, patients with HF were at two-fold higher risk of VTE than patients without HF (adjusted HR 2.31 [2.18-2.45]). VTE during follow-up was associated with long-term mortality (adjusted HR 1.60, 95% CI 1.56-1.64). In conclusion, patients with HF are at increased risk of VTE early after a new HF diagnosis. VTE in patients with HF is associated with long-term mortality.Article Understanding Covid-19 Mobility Through Human Capital: a Unified Causal Framework(Springer, 2023) Bilgel, Fırat; Karahasan, Burhan CanThis paper seeks to identify the causal impact of educational human capital on social distancing behavior at workplace in Turkey using district-level data for the period of April 2020 - February 2021. We adopt a unified causal framework, predicated on domain knowledge, theory-justified constraints anda data-driven causal structure discovery using causal graphs. We answer our causal query by employing machine learning prediction algorithms; instrumental variables in the presence of latent confounding and Heckman's model in the presence of selection bias. Results show that educated regions are able to distance-work and educational human capital is a key factor in reducing workplace mobility, possibly through its impact on employment. This pattern leads to higher workplace mobility for less educated regions and translates into higher Covid-19 infection rates. The future of the pandemic lies in less educated segments of developing countries and calls for public health action to decrease its unequal and pervasive impact.Article Unemployment Polarisation and Club Convergence in Türkiye(Wiley, 2025) Karahasan, Burhan CanTurkish economy has undergone massive transformation during the 2000s. Annual economic growth reached a peak of 10% in the early 2000s. However, the side effects of global financial crises and the internal macroeconomic imbalances shift the growth trajectory of T & uuml;rkiye into a new path of unstable economic growth. While macroeconomic consequences are densely discussed we know less about the adjustment of local labour markets. To fill this gap, we examine the club formation of Turkish regions by analysing their unemployment trajectories during the post 2000s. Our findings show that despite rapid economic growth Turkish regions get extremely polarised and form distinct convergence clubs. Remarkably polarisation is higher for the female population. Geographically, polarisation is in the form of an isolation for the least developed south-eastern regions and some of the developed urbanised western regions. Additionally, our robustness exercises indicate higher polarisation after 2013 as Turkish economic growth starts to become more volatile and less sustainable. Finally, our spatial extensions show that impact of spatial proximity has significant influence on the accurate extent of unemployment deprivation.Article Citation - WoS: 165Citation - Scopus: 196Valuable Virality(2017) Berger, Jonah; Akpınar, EzgiGiven 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.Article Citation - WoS: 2Citation - Scopus: 2Warfarin Discontinuation in Patientswith Unprovoked Venous Thromboembolism: a Large Us Insurance Database Analysis(2016) Mardekian, Jack; Liu, Xianchen; Phatak, Hemant; Xie, Lin; Tan, Wilson; Başer, Onur; Ramacciotti, EduardoThis study examined warfarin therapy discontinuation and its risk factors among patients with unprovoked venous thromboembolism (VTE) in the US clinical practice setting. Adult patients with unprovoked VTE were identified from the MarketScan claims database from January 1, 2006 to December 31, 2012. The index date was defined as the date of first VTE diagnosis. Patients were required to have no VTE diagnosis in the 6 months before index date and continuous health plan enrollment for 6 months before and 12 months after the index date. Warfarin discontinuation rates and adjusted hazard ratios (HRs) were reported. Of 21,163 eligible patients, 15,463 were diagnosed with deep vein thrombosis (DVT) only (73.1%), 5027 with pulmonary embolism (PE) only (23.7%), and 673 with DVT and PE (3.2%). The average duration of warfarin therapy was 5.2 months (SD = 3.0). During 1-year follow-up, 21.4% patients discontinued therapy within 3 months, 42.8% within 6 months, and 70.1% within 12 months. PE versus DVT [HR = 0.77, 95% confidence interval (CI) = 0.74-0.80], comorbid atrial fibrillation (HR = 0.73, 95% CI = 0.66-0.81), thrombophilia (HR = 0.62, 95% CI = 0.54-0.71), and age >40 years (41-65 years: HR = 0.86, 95% CI = 0.81-0.91; >65 years: HR = 0.82, 95% CI = 0.77-0.87) were significantly associated with reduced risk of warfarin discontinuation. Alcohol abuse/dependence (HR = 1.36, 95% CI = 1.20-1.55), cancer history (HR = 1.13, 95% CI = 1.07-1.19), bleeding (HR = 1.07, 95% CI = 1.01-1.15), and catheter ablation (HR = 1.10, 95% CI = 1.00-1.20) in the 6 months before index date were significantly associated with increased risk for warfarin discontinuation. In conclusion, nearly 1 of 4 patients with unprovoked VTE discontinued warfarin within 3 months. Three of 4 patients discontinued therapy within 1 year. Younger age and multiple clinical factors are associated with warfarin therapy discontinuation.