Ekonomi Bölümü Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/20.500.11779/1936
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Conference Object Pnd30 - Health Care Resource Utilizations and Costs Among Migraine Patients in the Us Medicaid Population(Elsevier Science Inc, 2015) Huang, A; Shrestha, S; Başer, Onur; Yuce H.; Wang, Li; Yuce, H.OBJECTIVES: To examine the health care resource utilizations and costs amongmigraine patients in the U.S. Medicaid population. METHODS: Migraine patientswere identified (International Classification of Disease, 9th Revision, ClinicalModification [ICD-9-CM] diagnosis code 346) using Medicaid data from January 01,2009 through December 31, 2009. The first diagnosis date was designated as theindex date, and patients were required to have at least a 1-year baseline (pre-indexdate) and 1-year follow-up (post-index date) period. A comparison cohort was created for patients without a migraine diagnosis during the study period, using 1:1propensity score matching to control for age, region, gender and baseline CharlsonComorbidity Index score. The comparison cohort’s index date was chosen at random to minimize selection bias. Patients in both cohorts were required to be age?18 years and have continuous medical and pharmacy benefits 1-year pre- andpost-index date. Study outcomes (health care resource utilizations and costs) werecompared between the migraine and comparison cohorts. RESULTS: After applyingPSM, 380,751 patients were assigned to each cohort, and baseline characteristicswere well-balanced. A higher percentage of patients with migraines had inpatientstays (21.53% vs. 11.00%, p<0.0001), other therapy (99.88% vs. 65.78%, p<0.001) andpharmacy visit claims (90.52% vs. 48.35%, p<0.0001), compared to those without amigraine diagnosis. The patients in the migraine cohort also incurred significantlyhigher other therapy ($4,111 vs. $2,312, p<0.0001) and pharmacy visit costs ($1,074vs. $512, p<0.0001) than those in the comparison cohort. CONCLUSIONS: Migrainepatients incurred significantly higher costs and had higher health care resourceutilizations than those without migrainesConference Object Citation - WoS: 2Pcv58 - Long-Term Economic Burden Associated With Cardiovascular Events Among High-Risk Patients With Hyperlipidemia(Elsevier Science Inc, 2015-05-01) Fox, Kathleen M; Wang, Li; Gandra, S. R; Quek, R. G. W; Li, L; Başer, OnurObjectives: This study evaluated the economic burden associated with new cardiovascular events (CVEs) for 3 years post-CVE among high-risk patients diagnosedwith hyperlipidemia. Methods: A retrospective cohort study was conductedamong high-risk hyperlipidemic patients with and without a new CVE, using IMSLifeLink PharMetrics Plus data 01/01/2006-06/30/2012. CVEs included primary inpatient claims for myocardial infarction, unstable angina, ischemic stroke, transientischemic attack, revascularization and heart failure. Patients were assigned torisk cohorts based on history of CVE and coronary heart disease risk equivalent(CHD RE) condition. Propensity score matching was applied to compare healthcarecosts among patients with and without new CVEs, ranging from 1 month (acutephase) to 3 years post-CVE date. Results: A total of 21,482 matched patientswere included in the history of CVE cohort and 181,228 in the CHD RE cohort.Hyperlipidemic patients with new CVEs were, on average, aged 65-72 years, bothcohorts had 65.2% male and 74.7-84.4% had hypertension (most common baselinecomorbidity). Total costs per patient per month (PPPM) were significantly higheramong patients with versus without new CVEs during the acute phase (history ofCVE: $27,247 vs. $1,586; CHD RE: $30,742 vs. $914; p<0.0001) and remained higherduring years 1, 2 and 3, respectively, post-CVE among patients in the history of CVEcohort ($2,603 vs. $1,252; $2,055 vs. $1,191; $2,061 vs. $1,166, p<0.0001) and CHD REcohort ($1,926 vs. $844; $1,535 vs. $850; $1,475 vs. $853, p<0.0001). Significant costdifferences were observed between patients with and without new CVEs in bothcohorts, including inpatient, outpatient, emergency room and pharmacy visit costsPPPM, during 1-3 years post-CVE. Conclusions: Healthcare costs for high-riskpatients with new CVEs remained significantly higher than for matched patients without CVEs for up to 3 years post-CVE, imposing a significant economic burdenon U.S. commercial payers.Conference Object Pms38 - Demographic Distribution and Economic Burden of Patients Diagnosed With Rheumatoid Arthritis in the Us Medicare Population(Elsevier Science Inc, 2015) Li, L; Mao, X; Shrestha, S; Başer, Onur; Yuce H.; Wang, Li; Yuce, H.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.Article Citation - WoS: 3Citation - Scopus: 3Cancer Chemotherapy Treatment Patterns and Febrile Neutropenia in the Us Veterans Health Administration(Elsevier Science Inc, 2014-09-01) Wang, Li; Dale, David C; Barron, Richard; Langeberg, Wendy J; Başer, OnurBackground: The Veterans Health Administration (VHA) is the largest integrated health care system in the United States and a major cancer care provider. Objective: To use VHA database to conduct a population-based study of patterns of myelosuppressive chemotherapy use and to assess the incidence and management of febrile neutropenia (FN) among VHA patients with lung, colorectal, or prostate cancer or non-Hodgkin lymphoma (NHL). Methods: Data were extracted for the initial myelosuppressive chemotherapy course for 27,899 patients who began treatment in the period 2006 to 2011. FN-related costs were defined as claims containing FN diagnosis. Results: Most patients were men (98.0%); most were 65 years or older (55.8%). Patients received a mean 3.4 to 3.9 chemotherapy cycles/course (median cycle duration 34-43 days). The incidence of FN among patients with lung, colorectal, or prostate cancer or NHL was 10.2%, 4.6%, 5.4%, and 17.3%, respectively. Primary or secondary prophylactic antibiotics/colony-stimulating factors were received by 21% and 12% of patients, respectively. Antibiotics were more commonly given as primary or secondary prophylaxis for patients with lung, colorectal, and prostate cancer; colony-stimulating factors were more common for patients with NHL. Among patients with FN, those with lung cancer had the highest inpatient mortality (10%); patients with NHL had the highest costs ($24,571) and the longest hospital length of stay (15.4 days). Conclusions: VHA cancer care was generally consistent with National Comprehensive Cancer Network recommendations; however, compared with the general population, chemotherapy cycles were longer, combination chemotherapy was used less, and treatment to prevent FN was used less, differences that may be attributed to the unique VHA patient population. The impact of these practices warrants further investigation.