Ekonomi Bölümü Koleksiyonu

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  • Article
    Citation - WoS: 27
    Citation - Scopus: 30
    Prevalence of Mastocytosis and Hymenoptera Venom Allergy in the United States
    (Mosby-Elsevier, 2021-11-01) Volertas, Sofija; Akın, Cem; Khokhar, Dilawar; Schuler, Charles F; Chen, Lu; Yüce, Huseyin; Montejo, Jenny M; Başer, Onur
    Background : Mastocytosis is a risk factor for hymenoptera venom anaphylaxis (HVA). Current guidelines recommend measuring tryptase in HVA patients and that those with mastocytosis pursue lifelong venom immunotherapy (VIT). Available data on HVA and mastocytosis largely derives from European single-center studies and the prevalence of HVA with and without mastocytosis in the United States (US) is unknown.Objective : We sought to determine the prevalence of HVA and mastocytosis in the US using an insurance claims database and evaluate the impact of mastocytosis on VIT in HVA patients in a US cohort. Methods :The IBM Watson Database, consisting of insurance claims from approximately 27 million US patients in 2018, was queried to identify patients with HVA and/or mastocytosis. Further, a retrospective study of 161 patients undergoing VIT between 2015 – 2018 at the University of Michigan (U-M) was conducted. Results :In the IBM Watson Database, the prevalence of HVA was 167 per 100,000 (0.167%) and the prevalence of mastocytosis 10 per 100,000 (0.010%) overall and 97 per 100,000 (0.097%) among those with HVA. Mastocytosis showed a 9.7-fold increase among HVA patients versus the general population. In the U-M cohort, 2.6% of VIT patients had mastocytosis. Tryptase level did not correlate with venom reaction severity but was higher in patients with systemic VIT reactions. Conclusions :We observed a lower US HVA prevalence than previously reported. Mastocytosis was more common in US HVA patients, though at lower rates than previously reported. In VIT patients there was no correlation between tryptase level and reaction severity. Key words :Tryptasevenom allergyvenom immunotherapyanaphylaxismastocytosismast cell activation syndromemast cell disease Abbreviations Hymenoptera venom allergyHVAUnited StatesUSVenom immunotherapyVITMast Cell DiseaseMCDAmerican Academy of Allergy, Asthma, and Immunology
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    Mortality and Prevalence of Major Depressive Disorder in the Us Medicare Population From 2008-2013
    (2016) Bashyal, R; Du, H; Wang, L; Yuce, H; Başer, Onur
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    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
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    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.
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    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
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    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, Onur
    Objectives: To examine the health care resource utilization and economic burdenof rheumatoid arthritis (RA) using the Routine Assessment of Patient Index Data3 (RAPID3).
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    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, Onur
    To 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.