254,227 results match your criteria insurance


Association of the apoptotic marker APO1/Fas with children's predisposing factors for metabolic syndrome and with mean platelet volume.

J Pediatr Endocrinol Metab 2021 Aug 2. Epub 2021 Aug 2.

Laboratory of Biology and Biochemistry, Faculty of Health Sciences, Department of Nursing, University of Peloponnese, Tripoli, Greece.

Background: Apoptosis antigen 1/FAS receptor (APO1/Fas) signaling in endothelial cells plays a significant role in angiogenesis while increased mean platelet volume (MPV) is an important marker for platelet activation. We investigated the possible correlation between APO1/Fas and both metabolic parameters and platelet activity (indicated by the MPV) in a healthy pediatric population.

Methods: One hundred and eighty-five children, aged 5-17 years old, were enrolled in the study. Read More

View Article and Full-Text PDF

Added burden of major depressive disorder on cardiovascular morbidity and mortality among patients with cardiovascular disease and the modifying effects of antidepressants: A national retrospective cohort study.

J Affect Disord 2021 Jul 22;294:580-585. Epub 2021 Jul 22.

Department of Healthcare Administration, Asia University, Taiwan; Department of Psychology, Asia University, Taiwan. Electronic address:

Background: To evaluate the likelihood of a future cardiovascular event (i.e., in-hospital mortality or cardiovascular disease [CVD] complications/interventions) among patients with CVD and major depressive disorder (MDD) compared to those without MDD, and the antidepressant use on future cardiovascular events between the two groups. Read More

View Article and Full-Text PDF

Clinical characteristics and sick leave associated with infectious mononucleosis in a real-world setting in Germany.

Int J Clin Pract 2021 Jul 31:e14690. Epub 2021 Jul 31.

IQVIA, Frankfurt, Germany.

Infectious mononucleosis (IM), mainly caused by the Epstein-Barr virus, can result in prolonged symptoms. The objective of this study was to look at the length of sick leave, diagnosis of IM, treatment, and comorbidities in a real-world setting in Germany. This retrospective, cross-sectional study used electronic medical record data from office-based practices in Germany and included patients with an initial confirmed diagnosis of IM between the January 1, 2016 and December 31, 2018. Read More

View Article and Full-Text PDF

Health systems, population and patient challenges for achieving universal health coverage for hypertension in Ghana.

Health Policy Plan 2021 Jul 31. Epub 2021 Jul 31.

Department of Management Science, Strathclyde Business School, University of Strathclyde, 199 Cathedral Street, Glasgow G4 0QU, UK.

Ghana has signed on to the United Nations Sustainable Development Goal to achieve universal health coverage (UHC), ensuring that all individuals receive the health care they require without financial hardship. Achieving that goal is a difficult task in any setting. The challenges are further exacerbated by a changing disease landscape, as the burden of non-communicable diseases (NCDs) is increasing and creating a dual burden along with infectious diseases. Read More

View Article and Full-Text PDF

Racial and Socioeconomic Disparities in Breast Cancer Outcomes within the AJCC Pathologic Prognostic Staging System.

Ann Surg Oncol 2021 Jul 30. Epub 2021 Jul 30.

Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.

Background: Non-Hispanic black (NHB) women and those of lower socioeconomic status (SES) have inferior breast cancer outcomes compared with non-Hispanic white (NHW) women and those of higher SES. We examined racial and SES disparities in breast cancer survival within the AJCC 8th edition pathologic prognostic staging system.

Methods: Using the Surveillance, Epidemiology and End Results Program, we identified patients diagnosed with invasive breast cancer from 2010 to 2015, with follow-up through 2016. Read More

View Article and Full-Text PDF

Evaluation of the need for cytoreduction and its potential carcinogenicity in children and young adults with myeloproliferative neoplasms.

Ann Hematol 2021 Jul 30. Epub 2021 Jul 30.

Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam-si, 13620, Gyeonggi-do, Republic of Korea.

Myeloproliferative neoplasms are rare at a young age, and few reports have described the disease characteristics and outcomes in this group. This study aimed to elucidate the clinical course of essential thrombocythemia (ET) and polycythemia vera (PV) in children and young adults aged <39 years focusing on thromboembolic events (TE) and second primary malignancies (SPMs). A total of 990 patients who were diagnosed from 2008 to 2017 were included by analyzing the Health Insurance Review and Assessment Service database in Korea. Read More

View Article and Full-Text PDF

Differential Impact of Home Nurse Contact After Discharge by Financial Strain, Primary Care Access, and Medical Complexity.

Hosp Pediatr 2021 Jul 30. Epub 2021 Jul 30.

James M. Anderson Center for Health System Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

Background: The Hospital to Home Outcomes (H2O) trials examined the effectiveness of postdischarge nurse support on reuse after pediatric discharge. Unexpectedly, children randomly assigned to a nurse visit had higher rates of reuse than those in the control group. Participants in randomized control trials are heterogeneous. Read More

View Article and Full-Text PDF

Evaluation of direct costs associated with the management of clinical stage of malaria in children under five years old in Gabon.

Malar J 2021 Jul 30;20(1):334. Epub 2021 Jul 30.

University of Bordeaux, Population Health of Bordeaux, Inserm U1219, EMOS team. ISPED, 146 rue Léo-Saignat, 33076, Bordeaux cedex, France.

Background: Malaria is one of the leading causes of morbidity and mortality in African countries. It is one of the leading causes of hospital visits and hospitalization in pediatric wards for children under 5 years old. Interestingly however, the economic burden of this disease remains unknown in these endemic countries including Gabon. Read More

View Article and Full-Text PDF

Medical code prediction via capsule networks and ICD knowledge.

BMC Med Inform Decis Mak 2021 Jul 30;21(Suppl 2):55. Epub 2021 Jul 30.

College of Computer Science and Technology, Dalian University of Technology, Dalian, China.

Background: Clinical notes record the health status, clinical manifestations and other detailed information of each patient. The International Classification of Diseases (ICD) codes are important labels for electronic health records. Automatic medical codes assignment to clinical notes through the deep learning model can not only improve work efficiency and accelerate the development of medical informatization but also facilitate the resolution of many issues related to medical insurance. Read More

View Article and Full-Text PDF

The trend of direct medical costs and associated factors in patients with chronic hepatitis B in Guangzhou, China: an eight-year retrospective cohort study.

BMC Med Inform Decis Mak 2021 Jul 30;21(Suppl 2):71. Epub 2021 Jul 30.

School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.

Background: Although the expenses of liver cirrhosis are covered by a critical illness fund under the current health insurance program in China, the medical costs associated with hepatitis B virus (HBV) related diseases is not well addressed. In order to provide evidence to address the problem, we investigated the trend of direct medical costs and associated factors in patients with chronic HBV infection.

Methods: A retrospective cohort study of 65,175 outpatients and 12,649 inpatients was conducted using a hospital information system database for the period from 2008 to 2015. Read More

View Article and Full-Text PDF

Association between urine cotinine and depressive symptoms in non-smokers: National representative sample in Korea.

J Affect Disord 2021 Jul 16;294:527-532. Epub 2021 Jul 16.

Department of psychiatry, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea. Electronic address:

Background: Secondhand smoke (SHS) exposure is known to have negative effects on mental as well as physical health. However, the association between SHS and mental health problems has not been assessed in non-smokers. To evaluate the association of exposure to tobacco smoke and depressive symptoms, and that of the prevalence of having depressive symptoms and urinary cotinine (UCo) concentrations in non-exposed subjects. Read More

View Article and Full-Text PDF

Family health spillovers: evidence from the RAND health insurance experiment.

Authors:
Michal Hodor

J Health Econ 2021 Jul 17;79:102505. Epub 2021 Jul 17.

Tel Aviv University, Coller School of Management, Israel. Electronic address:

I study how family spillovers shape healthcare consumption through two main sources: a learning channel whereby family members share information about their health insurance and the effectiveness of healthcare, and a behavioral channel whereby risk perception and habits are shared and transmitted. I exploit two types of sudden health shocks to identify a causal effect operating through each channel: a spouse's non-fatal heart attack or stroke and a severe injury to a child. I incorporate these shocks into an event-study framework to quantify the effect of spillovers on healthcare consumption of a non-injured adult family member. Read More

View Article and Full-Text PDF

Comparing Artificial Intelligence and Traditional Methods to Identify Factors Associated with Pediatric Asthma Readmission.

Acad Pediatr 2021 Jul 27. Epub 2021 Jul 27.

Department of Pediatrics, University of Miami Miller School of Medicine, and Holtz Children's Hospital, Jackson Health System, Miami, FL.

Objective: To identify and contrast risk factors for six-month pediatric asthma readmissions using traditional models (Cox proportional-hazards and logistic regression) and artificial neural-network modeling.

Methods: This retrospective cohort study of the 2013 Nationwide Readmissions Database included children 5-18 years old with a primary diagnosis of asthma. The primary outcome was time to asthma readmission in the Cox model, and readmission within 180 days in logistic regression. Read More

View Article and Full-Text PDF

Epidemiology of pyogenic liver abscesses in Germany: Analysis of incidence, risk factors and mortality rate based on routine data from statutory health insurance.

United European Gastroenterol J 2021 Jul 30. Epub 2021 Jul 30.

Division of Gastroenterology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany.

Background: Pyogenic liver abscesses (PLAs) represent potentially life-threatening abdominal conditions that require immediate diagnosis and therapy. European and American incidence figures vary between one and 15 per 100,000 per year. Structured epidemiological data for European countries are not available. Read More

View Article and Full-Text PDF

Variation in Hospital Performance Measures from the Turkey Ministry of Health.

Int J Qual Health Care 2021 Jul 30. Epub 2021 Jul 30.

Precision Vaccines Program, Department of Pediatrics, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA.

Background: The Turkish healthcare system has seen broad population-based improvements in expanded health insurance coverage and access to healthcare services. Hospital performance in this national system is understudied. We aimed to identify trends in hospital performance over time following implementation of the Health Transformation Program and describe how regional outcomes correlate with regional vital statistics. Read More

View Article and Full-Text PDF

Association between blood pressure categories and cardiovascular disease mortality in China.

PLoS One 2021 30;16(7):e0255373. Epub 2021 Jul 30.

Department of Epidemiology and Biostatistics, Peking University Health Science Center, Beijing, China.

Background: Blood pressure (BP) categories are useful to simplify preventions in public health, and diagnostic and treatment approaches in clinical practice. Updated evidence about the associations of BP categories with cardiovascular diseases (CVDs) and its subtypes is warranted.

Methods And Findings: About 0. Read More

View Article and Full-Text PDF

Epiglottitis in Patients With Preexisting Autoimmune Diseases: A Nationwide Case-Control Study in Taiwan.

Ear Nose Throat J 2021 Jul 30:1455613211033689. Epub 2021 Jul 30.

Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi.

Objectives: The role of autoimmune diseases on the risk for acute epiglottitis remains uncertain. This study aimed to delineate the association between epiglottitis and autoimmune diseases using population database.

Methods: A population-based retrospective study was conducted to analyze claims data from Taiwan National Health Insurance Research Database collected over January, 2000, to December, 2013. Read More

View Article and Full-Text PDF

[Intervertebral disc-related occupational diseases of the lumbar and cervical spines].

Internist (Berl) 2021 Jul 30. Epub 2021 Jul 30.

Zentrum für Orthopädie, Unfallchirurgie und Paraplegiologie, Konservative Orthopädie und Gutachtenambulanz, Universitätsklinikum Heidelberg, Schlierbacher Landstr. 200a, 69118, Heidelberg, Deutschland.

Intervertebral disc-related diseases of the cervical and lumbar spine are considered to be occupational diseases, if the occupational and medical prerequisites are fulfilled and the causal connection between the prerequisites is likely. The working conditions include occupational burdens with long-term lifting and carrying of heavy loads or long-term activities in an extremely bent position of the torso, long-term carrying of heavy loads on the shoulders and long-term effects of whole-body vibration in a sitting position. A medical prerequisite is fulfilled by a damage pattern with chronic lower back or neck pain and damage of the cervical or lumbar vertebrae in a conform manner. Read More

View Article and Full-Text PDF

Analyzing Patient Secure Messages Using a Fast Health Care Interoperability Resources (FIHR)-Based Data Model: Development and Topic Modeling Study.

J Med Internet Res 2021 Jul 30;23(7):e26770. Epub 2021 Jul 30.

Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, MN, United States.

Background: Patient portals tethered to electronic health records systems have become attractive web platforms since the enacting of the Medicare Access and Children's Health Insurance Program Reauthorization Act and the introduction of the Meaningful Use program in the United States. Patients can conveniently access their health records and seek consultation from providers through secure web portals. With increasing adoption and patient engagement, the volume of patient secure messages has risen substantially, which opens up new research and development opportunities for patient-centered care. Read More

View Article and Full-Text PDF

Email Patient-Provider Communication and Cancer Screenings Among US Adults: Cross-sectional Study.

JMIR Cancer 2021 Jul 30;7(3):e23790. Epub 2021 Jul 30.

Center for Health Promotion and Prevention Research, Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX, United States.

Background: The growth of electronic medical records and use of patient portals have allowed for patients and health care providers to communicate via email and direct messaging between health care visits. Email patient-provider communication (PPC) may enhance traditional face-to-face PPC by allowing patients to ask questions, receive clear explanations, engage in shared decision-making, and confirm their understanding between in-person visits. Despite increasing trends in the use of email PPC since the early 2000s, few studies have evaluated associations between email PPC and the uptake of preventive services. Read More

View Article and Full-Text PDF

Appropriate definition of diabetes using an administrative database: a cross-sectional cohort validation study.

J Diabetes Investig 2021 Jul 30. Epub 2021 Jul 30.

Department of Diabetes and Endocrinology, Nara Medical University, Nara, Japan.

The purpose of this study was to quantify errors in the diagnosis of diabetes for use in the national database, using a sufficient population size. A claims database constructed by the JMDC (JMDC Inc.; Tokyo, Japan), using standardized disease classifications and anonymous record linkage, was used in this validation study. Read More

View Article and Full-Text PDF

Health services utilization, out-of-pocket expenditure, and underinsurance among insured non-elderly cancer survivors in the United States, 2011-2015.

Cancer Med 2021 Jul 30. Epub 2021 Jul 30.

Population Informatics Laboratory, Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station, TX, USA.

Background: High out-of-pocket (OOP) expenditure and inadequate insurance coverage may adversely affect cancer survivors. We aimed to characterize the extent and correlates of healthcare utilization, OOP expenditures, and underinsurance among insured cancer survivors.

Methods: We used 2011-2015 Medical Expenditure Panel Survey data to identify a nationally representative sample of insured non-elderly adult (age 18-64 years) cancer survivors. Read More

View Article and Full-Text PDF

Measuring the quality of dental care among privately insured children in the United States.

Health Serv Res 2021 Jul 29. Epub 2021 Jul 29.

Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA.

Objective: To examine whether quality of dental care varies by age and over time and whether community-level characteristics explain these patterns.

Data Source: Deidentified medical and dental claims from a commercial insurer from January 2015 to December 2019.

Study Design: A retrospective cohort study. Read More

View Article and Full-Text PDF

Care of the Postpartum Patient in the Emergency Department: A Systematic Review with Implications for Maternal Mortality.

Am J Perinatol 2021 Jul 29. Epub 2021 Jul 29.

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama.

Objective:  Approximately one-third of maternal deaths occur postpartum. Little is known about the intersection between the postpartum period, emergency department (ED) use, and opportunities to reduce maternal mortality. The primary objectives of this systematic review are to explore the incidence of postpartum ED use, identify postpartum disease states that are evaluated in the ED, and summarize postpartum ED use by race/ethnicity and payor source. Read More

View Article and Full-Text PDF

Development of a Primary Care Transitions Clinic in an Academic Medical Center.

J Gen Intern Med 2021 Jul 29. Epub 2021 Jul 29.

Brigham Health Physician's Organization, 75 Francis Street, Boston, MA, 02215, USA.

Introduction: Transitions of care experiences leave patients vulnerable to adverse outcomes, including readmissions, worsening symptoms, and reductions in functional status.

Aim: To describe and evaluate a primary care transitions clinic that serves patients with medical and/or social needs that must be addressed prior to establishment of primary care.

Setting: Brigham Health, an academic medical center in Boston, MA. Read More

View Article and Full-Text PDF

Patient and Provider Perspectives on Acceptability, Access, and Adherence to 17-Alpha-Hydroxyprogesterone Caproate for Preterm Birth Prevention.

Womens Health Rep (New Rochelle) 2021 27;2(1):295-304. Epub 2021 Jul 27.

PolicyLab, Children's Hospital of Philadelphia and Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.

Preterm birth (PTB) is a pressing maternal and child health issue with long-standing racial inequities in outcomes and care provision. 17-Alpha-hydroxyprogesterone caproate (17OHPC) has been one of few clinical interventions for recurrent PTB prevention. Little is known about the factors influencing successful administration and receipt of 17OHPC among mothers in the Medicaid program. Read More

View Article and Full-Text PDF

Risk factor control across the spectrum of cardiovascular risk: Findings from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

Am J Prev Cardiol 2021 Mar 13;5:100147. Epub 2021 Jan 13.

Department of Hospital Medicine, San Francisco VA Medical Center, San Francisco, CA, USA.

Background: Presence of cardiovascular disease (CVD) risk factors (RFs) should prompt patients and their providers to work aggressively towards controlling those that are modifiable. The extent to which a greater CVD RF burden is related to CVD RF control in a contemporary and diverse Hispanic/Latino population is not well-understood.

Methods: Using multicenter community-based data from the Hispanic Community Health Study/Study of Latinos, we assessed the self-reported prevalence of hypertension, hypercholesterolemia, diabetes, and prevalent CVD (ischemic heart disease or stroke). Read More

View Article and Full-Text PDF

Real-world utilization of pharmacotherapy with new evidence-based cardiovascular indications in an academic preventive cardiology practice.

Am J Prev Cardiol 2021 Mar 5;5:100144. Epub 2021 Jan 5.

Center for Preventive Cardiology, Knight Cardiovascular Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA.

Objective: To determine the real-world use of pharmacotherapy with new evidence-based cardiovascular indications in an academic Preventive Cardiology Clinic.

Methods: A retrospective study of patients seen in our Center for Preventive Cardiology (CPC) and who received a new prescription, according to Food and Drug Administration (FDA) approved indications, for one of the following pharmacotherapies with new evidence-based cardiovascular indications from May 2019 to May 2020: proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i), eicosapentaenoic acid (EPA), sodium-glucose cotransporter 2 inhibitors (SGLT2i), and glucagon-like peptide-1 receptor agonists (GLP-1 RA). Treatment endpoints were prescription patterns, medication access, patient out-of-pocket expenses, medication tolerability, and clinical cardiovascular events while on these therapies. Read More

View Article and Full-Text PDF

Prevalence, treatment, and control of severe hyperlipidemia.

Am J Prev Cardiol 2020 Sep 13;3:100079. Epub 2020 Aug 13.

Duke Clinical Research Institute, Durham, NC, USA.

Objective: To identify the prevalence, treatment, and low-density lipoprotein cholesterol (LDL-C) control of individuals with LDL-C ≥190 ​mg/dL in contemporary clinical practice.

Methods: We included adults (age ≥18 years) with LDL-C ≥190 ​mg/dL, at least one LDL-C level drawn from 255 health systems participating in Cerner HealthFacts database (2000-2017, n ​= ​4,623,851), and a detailed examination within Duke University Health System (DUHS, 2015-2017, n ​= ​267,710). Factors associated with LDL-C control were evaluated using multivariable logistic regression modeling. Read More

View Article and Full-Text PDF
September 2020

Spatial distribution of in- and out-of-hospital mortality one year after acute myocardial infarction in France.

Am J Prev Cardiol 2020 Jun 17;2:100037. Epub 2020 Jul 17.

Biostatistics and Bioinformatics (DIM), University Hospital, Dijon, France.

Objective: To describe the spatial distribution of acute myocardial infarction (AMI) mortality in France in association with the socio-economic characteristics of the patient's place of residence.

Methods: In this population-based study, we included patients hospitalized for AMI identified according to ICD-10 codes, using data from the national health insurance database from January 1, 2013 to December 31, 2014. In- and out-of-hospital deaths were identified over a period of 1 year following the first hospital stay for AMI. Read More

View Article and Full-Text PDF