Ekonomi Bölümü Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/20.500.11779/1936
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Conference Object Pih13 - Examining the Fracture-Related Cost Burden and Health Care Resource Utilization Post-Menopause in the Us Medicare Population(Elsevier Science Inc, 2015-05-01) Xie, L; Keshishian, A; Du, J; Başer, OnurObjectives: 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.Conference Object Pcn62 - Assessing the Economic Burden and Health Care Resource Utilizations of Us Medica Re Patients With Myeloproliferative Neoplasms(Elsevier Science Inc, 2015) Keshishian, A; Du, J; Xie, L; Başer, OnurOBJECTIVES: 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.Conference Object Assessing the Economic Burden and Health Care Utilization of Attention Deficit/Hyperactivity Disorder Among Us Medicaid Patients(2016) Zhang Q; Zhao, Y; Keshishian, A; Xie, L; Yuce, H; Başer, Onur...Conference Object Evaluation of the Burden of Parkinson’s Disease in Medicare and Linked Long Term Care Populations(2015) Xie, L; Tan, H; Ogbomo, A; Wang, Y; Başer, Onur; Yuce H.Objectives: To examine the economic burden and health care utilization forpatients diagnosed with Parkinson’s disease using linked data from Medicare andthe Long Term Care (LTC) Minimum Data Set (MDS). Methods: Patients wereincluded in the study if they had at least one diagnosis claim for Parkinson’s disease(International Classification of Diseases, 9thRevision, Clinical Modification code 332.xx) during the identification period (01JUL2008-31DEC2010). The first Parkinson’s disease diagnosis claim date was designated as the index date. Patients were requiredto be age ?65 and have continuous health plan enrollment with medical benefitsfor 6 months pre- and post-index date. Residents in a LTC facility were defined asstudy patients using two quarterly assessments recorded in the MDS during the6-month baseline period. Demographic and clinical characteristics and follow-uphealth care costs and utilizations were described. Results: After 1:1 matching,1,620 patients were included in each group (disease and control patients), and thebaseline characteristics were well-balanced. Patients with Parkinson’s diseasewere more likely to have inpatient stays (14.26% vs. 9.51%, p<0.0001), outpatientvisits (47.72% vs. 41.11%, p=0.0002), skilled nursing facility (SNF) visits (20.37% vs.4.51%, p<0.0001), hospice visits (8.64% vs. 1.36%, p<0.0001), and part D pharmacyvisit (62.65% vs. 53.33%, p<0.0001). Compared to control patients, higher all-causehealth care costs were also observed for Parkinson’s disease patients, includinginpatient costs ($2,451 vs. $1,301, p<0.0001), SNF costs ($2,503 vs. $778, p<0.0001),hospice costs ($1,164 vs. $245, p<0.0001), total outpatient costs ($4,477 vs. $1,304,p<0.0001), pharmacy costs ($695 vs. $1,399, p<0.0001) and total costs ($9,775 vs.$5,314, p<0.0001). Conclusions: During a period of 12 months, patients diagnosed with Parkinson’s disease had higher health care utilization and costs thanmatched control patients.Conference Object Venous Thromboembolism Recurrence and Bleeding Risk Among Cancer Patients Using a Large Commercial Database(2015) Masseria, C; Kariburyo, M. Furaha; Mardekian, J; Lee, C; Ravee, Y; Phatak, H; Başer, Onur; Hamilton, M; Xie, L...Conference Object Real-World Comparison of Major Bleeding Risk Among Untreated Non-Valvular Atrial Fibrillation Patients and Those Initiating Apixaban, Dabigatran, Rivaroxaban, or Warfarin(2016) Amin, Alpesh; Keshishian, A; Xie, L; Başer, Onur; Price, K; Lien Vo; Mardekian, J; Mendoza, M; Singhal, S; Patel, C; Odell, K; Trocio J.Background: Recent large randomized controlled trials have shown that novel oral anticoagulants (NOACs) are at least as effective as warfarin for risk reduction of stroke in patients with non-valvular atrial fibrillation (NVAF) and are associated with similar or lower rates of bleeding. The study aim was to compare major bleeding risk among untreated NVAF patients to those initiating apixaban, dabigatran, rivaroxaban or warfarinConference Object Retrospective Analysis of the Economic Burden of Patients Diagnosed With Congestive Heart Failure in the California Medicaid Population(2016) Ogbomo, A; Zhao, Y; Kariburyo, M. Furaha; Xie, L; Yuce, H; Başer, Onur...Article Citation - WoS: 13Citation - Scopus: 13Therapeutically 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(Wiley, 2014-12-04) Wei, W.; Gill, J.; Ye, F; Xie, L; Levin, P.; Miao, R.; Başer, OnurAims: 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.Conference Object Examining the Health Care Resource Utilization and Economic Burden Among Rheumatoid Arthritis Patients With Different Routine Assessment of Patient Index Data 3 Scores: a Probabilistic Matching Study(2016) Kariburyo, F; Du, J; Xie, L; Başer, OnurObjectives: To examine the health care resource utilization and economic burdenof rheumatoid arthritis (RA) using the Routine Assessment of Patient Index Data3 (RAPID3).Conference Object Assessing the Economic Burden of Rheumatoid Arthritis Patients With Different Clinical Disease Activity Index Scores: a Probabilistic Matching Study(2016) Kariburyo, F; Du, J; Xie, L; Başer, OnurTo evaluate the health care resource utilization and economic burdenof rheumatoid arthritis (RA) based on the Clinical Disease Activity Index(CDAI). Adult patients diagnosed with RA (International Classificationof Diseases, Ninth Revision, Clinical Modification code 714.xx) were identified froma large claims database and a RA registry from 2006-2015. Patients identified wereprobabilistically matched with a 1:1 ratio based on age, gender, state, and indexyear. The first RA diagnosis date was designated as the index date. Patients wererequired to have continuous health plan enrollment with medical and pharmacybenefits for 12 months post-index date (follow-up period). Patients were classifiedas having high (> 22), moderate (> 10 to ≤ 22), or low disease activity (> 2.8 to ≤ 10),or in remission (0 to ≤ 2.8) based on CDAI scores. All-cause and RA-related healthcare costs and utilization during the follow-up period were assessed. A total of 3,749 matched RA patients were identified, and 24.11%, 31.93%, and26.91% had high, moderate, and low disease activity, respectively, and 17.04% werein remission. RA patients were, on average, age 57 years, 76% were female, andmost resided in Washington (77%), with average all-cause total costs of $27,008and RA-related costs of $5,262 during the 12-month follow-up period. The averagenumber of office visits was higher for patients with high disease activity (12.31),followed by 11.79, 11.71, and 11.59 for patients with moderate disease activity, lowdisease activity, and for those in remission. Primary cost drivers were outpatientand pharmacy costs, resulting in total all-cause costs of $28,054, $27,285, $26,633,and $25,600, and total RA-related costs of $5,511, $5,280, $4,893, and $5,461 forpatients with high, moderate, and low disease activity, and for those in remission,respectively. RA patients with high disease activity, measured byCDAI score, have a substantial economic burden.
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