Ekonomi Bölümü Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/20.500.11779/1936
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Article Citation - WoS: 19Citation - Scopus: 20Guns and Homicides: a Multiscale Geographically Weighted Instrumental Variables Approach(Wiley, 2019-12-23) 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: 13Citation - Scopus: 13Risk of Venous Thromboembolism After New Onset Heart Failure(Nature Research, 2019-11-22) 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 Citation - WoS: 6Citation - Scopus: 6Health 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, 2019-08-08) Khouyr, Antoine El; Wang, Li; Joshi, Kruti; Patel, Charmi; Başer, Onur; Huang, Ahong; El Khoury, AntoineThere 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.Editorial Citation - WoS: 15Citation - Scopus: 14Hepatic 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(Oxford Univ Press Inc, 2014-06-18) Wang, Li; Devine, Scott; Lo Re, Vincent, III; Olufade, Temitope; Başer, Onur; Re, Vincent LoThe 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)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 Demographic Distribution and Health Care Burden of Patients Diagnosed With Ankylosing Spondylitis in the Us Medicare Population(Elsevier Science Inc, 2015-05-01) Mao, X; Li, L; Shrestha, S; Başer, Onur; Yuce, H; Wang, LOBJECTIVES: 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.Conference Object Psy14 - Evaluating Trends in Chronic Pain Prevalence in the United States Veterans Health Administration Population(Elsevier Science Inc, 2015-05-01) Li, L.; Shrestha, S.; Başer, Onur; Yuce, H; Wang, LOBJECTIVES: 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 priorConference 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 Pms37 - Health Care Cost Burden and Demographic Distribution of Patients Diagnosed With Psoriatic Arthritis in the Us Medicare Population(Elsevier Science Inc, 2015) Li, L; Mao, X; Shrestha, S; Başer, Onur; Yuce H.; Li Wang; Yuce, H.; Wang, L.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.Conference Object Pmh21 - Comparing the Healthcare Utilization and Costs of Early- and Late-Stage Alzheimer's Disease Patients Residing in Long-Term Care Facilities(Elsevier Science Inc, 2015-05-01) Xie, L.; Keshishian, A; Wang, Y.; Başer, OnurOBJECTIVES: 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.