6,033 results match your criteria insured patients

Utilization Trends and Disparities in Adolescent Bariatric Surgery in the United States 2009-2017.

Child Obes 2021 Oct 12. Epub 2021 Oct 12.

Department of Surgery, Division of Pediatric Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.

Current reports of adolescent bariatric surgery underutilization for treating severe obesity do not comprehensively assess the extent of existing disparities. We sought to describe national trends in adolescent bariatric surgery over a 9-year period and investigate previously described ethnoracial-, insurance-, income-, and geographic-based disparities. A cross-sectional analysis of adolescents aged 10-19 years who underwent bariatric surgery from 2009 to 2017 was conducted using Healthcare Cost and Utilization Kids' Inpatient Database and National Inpatient Sample Databases. Read More

View Article and Full-Text PDF
October 2021

Retrospective descriptive analysis of a managed care population with obesity.

Curr Med Res Opin 2021 Oct 13:1-20. Epub 2021 Oct 13.

Baylor Scott & White Health, Temple TX 76508, USA.

Objectives: To reveal the extent of obesity in a single healthcare system and provide a blueprint for other health systems to perform similar analyses, this study describes characteristics and weight change patterns of patients classified with overweight and obesity at a large integrated delivery network (IDN) in the South-Central United States.

Methods: A descriptive, observational, retrospective study was conducted using electronic medical records and claims data. Patients were ≥18 years old, body mass index (BMI) ≥27 kg/m, and continuously enrolled in the IDN plan for ≥6 months before and ≥12 months after the index date. Read More

View Article and Full-Text PDF
October 2021

Racial Disparities in Children, Adolescents, and Young Adults with Hodgkin Lymphoma Enrolled in the New York State Medicaid Program.

J Adolesc Young Adult Oncol 2021 Oct 8. Epub 2021 Oct 8.

Center for Oncology Hematology Outcomes Research and Training (COHORT) and Division of Hematology and Oncology, University of California Davis School of Medicine, Sacramento, California, USA.

We examined the impact of race/ethnicity and age on survival in a publicly insured cohort of children and adolescent/young adults (AYA; 15-39 years) with Hodgkin lymphoma, adjusting for chemotherapy using linked Medicaid claims. We identified 1231 Medicaid-insured patients <1-39 years diagnosed with classical Hodgkin lymphoma between 2005 and 2015, in the New York State Cancer Registry. Chemotherapy regimens were based on contemporary therapeutic regimens. Read More

View Article and Full-Text PDF
October 2021

Can Adherence to and Persistence with Inhaled Long-acting Bronchodilators Improve the Quality of Life in Patients with Chronic Obstructive Pulmonary Disease? Results from a German Disease Management Program.

Clin Drug Investig 2021 Oct 12. Epub 2021 Oct 12.

Munich Center of Health Sciences (MC-Health), Institute for Health Economics and Management, Ludwig-Maximilians-Universität München, Ludwigstraße 28 RG, 80539, Munich, Germany.

BACKGROUND AND OBJECTIVE: Adherence to and persistence with inhaled long-acting bronchodilators (ILAB), is commonly considered to be a relevant driver of perceived health-related quality of life (HRQoL) in chronic obstructive pulmonary disease (COPD), but the topic is rarely studied with real-world data. Using survey and health insurance claims data, this study investigates the effect of adherence to and persistence with ILAB on EQ-5D-5L visual analog scale (VAS) in ILAB users who were enrolled in the German disease management programs (DMP) for COPD.

Methods: Included ILAB users were aged ≥ 18 years, continuously insured with AOK Bavaria and enrolled in the DMP for COPD. Read More

View Article and Full-Text PDF
October 2021

Insurance Status and Travel Distance to Single Treatment Facility Predictive of Mastectomy.

J Surg Res 2021 Oct 7;270:22-30. Epub 2021 Oct 7.

College of Medicine, Department of Surgery, Division of Outcomes Research and Quality, The Pennsylvania State University, Hershey, Pennsylvania. Electronic address:

Background: We evaluated the impact of insurance status and travel distance on the receipt of total mastectomy without reconstruction (TM) compared to breast conserving surgery with radiation (BCT) for early-stage breast cancer (BC) patients who received care at a single facility. We hypothesized that, lack of insurance and increased travel distance would be predictive of TM over BCT and disparities would vary by different races and/or ethnicities.

Methods: Using the National Cancer Database from 2010-2017, we examined surgical patients with stage I or II BC, who received care at one facility. Read More

View Article and Full-Text PDF
October 2021

Epidemiology, comorbidities, and healthcare utilization of patients with chronic urticaria in Germany.

J Eur Acad Dermatol Venereol 2021 Oct 8. Epub 2021 Oct 8.

Department of Dermatology, University Medical Center Mainz, Mainz, Germany.

Background: Comprehensive data on the epidemiology and comorbidities of chronic urticaria (CU) in Germany are either limited, or not contemporary.

Objectives: To investigate the epidemiology of CU, overall comorbidities and healthcare resource utilized by patients with CU in Germany, using an anonymized statutory health insurance (SHI) database.

Methods: Anonymized SHI claims research database of the Institute for Applied Health Research, Berlin [InGef] (01 January 2015─30 September 2018) was used to analyse insured individuals with a confirmed diagnosis of CU (ICD-10-GM codes). Read More

View Article and Full-Text PDF
October 2021

Comparative analysis of dental procedure mix in public and private dental benefits programs.

J Am Dent Assoc 2021 Oct 1. Epub 2021 Oct 1.

Background: There is little published research on whether public and private dental benefits plans affect the types of oral health care procedures patients receive. This study compares the dental procedure mix by age group (children, working-age adults, older adults), dental benefits type (Medicaid and Children's Health Insurance Program, private), and level of Medicaid dental benefits by state (emergency only, limited, extensive).

Methods: The authors extracted public dental benefits claims data from the 2018 Transformed Medicaid Statistical Information System. Read More

View Article and Full-Text PDF
October 2021

Increased Health Care Resource Utilization and Costs Associated with Herpes Zoster Among Patients Aged ≥50 Years with Chronic Obstructive Pulmonary Disease in the United States.

Chronic Obstr Pulm Dis 2021 Oct 1. Epub 2021 Oct 1.

Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota, United States.

Background: Patients with chronic obstructive pulmonary disease (COPD) are potentially at increased risk of herpes zoster (HZ). Little is known about the impact of an HZ episode on health care resource utilization (HRU) and costs among patients with COPD.

Methods: This retrospective cohort study of individuals aged ≥50 years in the United States (US) used administrative claims data from for commercially insured and Medicare Advantage members (2013-2018). Read More

View Article and Full-Text PDF
October 2021

Variation in Guideline-Based Prenatal Care in a Commercially Insured Population.

Am J Obstet Gynecol 2021 Oct 3. Epub 2021 Oct 3.

Delivery Decisions Initiative, Ariadne Labs, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; OptumLabs Visiting Fellow; Maven Clinic, New York, NY.

Background: Despite the importance of prenatal care, quality measurement efforts have focused on the number of prenatal visits, or prenatal care adequacy, rather than the services received. It is unknown whether receiving more prenatal visits is associated with receiving more guideline-based prenatal care services. The relationship between guideline-based prenatal care and patients' clinical and sociodemographic characteristics has also not been studied. Read More

View Article and Full-Text PDF
October 2021

Medical Service Use and Charges for Cancer Care in 2018 for Privately Insured Patients Younger Than 65 Years in the US.

JAMA Netw Open 2021 Oct 1;4(10):e2127784. Epub 2021 Oct 1.

Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania.

Importance: Currently, there are limited published data regarding resource use and spending on cancer care in the US.

Objective: To characterize the most frequent medical services provided and the associated spending for privately insured patients with cancer in the US.

Design, Setting, And Participants: This cohort study used data from the MarketScan database for the calendar year 2018 from a sample of 27. Read More

View Article and Full-Text PDF
October 2021

Impact of a Statewide Multi-Payer Patient-Centered Medical Home Program on Antihypertensive Medication Adherence.

Popul Health Manag 2021 Oct 4. Epub 2021 Oct 4.

Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.

Evidence suggests that the patient-centered medical home (PCMH) model of primary care improves management of chronic disease, but there is limited research contrasting this model's effect when financed by a single payer versus multiple payers, and among patients with different types of health insurance. This study evaluates the impact of a statewide medical home demonstration, the Maryland Multi-Payer PCMH Program (MMPP), on adherence to antihypertensive medication therapy relative to non-PCMH primary care and to the PCMH model when financed by a single payer. The authors used a difference-in-differences analytic design to analyze changes in medication possession ratio for antihypertensive medications among Medicaid-insured and privately insured non-elderly adult patients attributed to primary care practices in the MMPP ("multi-payer PCMHs"), medical homes in Maryland that participated in a regional PCMH program funded by a single private payer ("single-payer PCMHs"), and non-PCMH practices in Maryland. Read More

View Article and Full-Text PDF
October 2021

Exploring Factors Responsible for Delay in Pediatric Cochlear Implantation.

Otol Neurotol 2021 Sep 30. Epub 2021 Sep 30.

Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, University of California Division of Otolaryngology, Rady Children's Hospital, San Diego, California.

Objective: To identify and characterize demographic and socioeconomic factors associated with delays in cochlear implantation (CI) in children.

Study Design: Retrospective.

Setting: Tertiary pediatric CI referral center. Read More

View Article and Full-Text PDF
September 2021

Is Indonesia achieving universal health coverage? Secondary analysis of national data on insurance coverage, health spending and service availability.

BMJ Open 2021 Oct 4;11(10):e050565. Epub 2021 Oct 4.

Erasmus School for Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.

Objectives: To analyse the relationship between health need, insurance coverage, health service availability, service use, insurance claims and out-of-pocket spending on health across Indonesia.

Design: Secondary analysis of nationally representative quantitative data. We merged four national data sets: the National Socioeconomic Survey 2018, National Census of Villages 2018, Population Health Development Index 2018 and National Insurance Records to end 2017. Read More

View Article and Full-Text PDF
October 2021

Disparities in Pediatric Patient Portal Activation and Feature Use.

JAMIA Open 2021 Jul 29;4(3):ooab086. Epub 2021 Sep 29.

Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida, USA.

Objective: Disparities in adult patient portal adoption are well-documented; however, less is known about disparities in portal adoption in pediatrics. This study examines the prevalence and factors associated with patient portal activation and the use of specific portal features in general pediatrics.

Materials And Methods: We analyzed electronic health record data from 2012 to 2020 in a large academic medical center that offers both parent and adolescent portals. Read More

View Article and Full-Text PDF

Epidemiology of Meniscal Allograft Transplantation at Children's Hospitals in the United States.

Orthop J Sports Med 2021 Sep 29;9(9):23259671211034877. Epub 2021 Sep 29.

Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Background: Meniscal allograft transplantation (MAT) was developed with the goal of delaying the progression of degenerative disease in the setting of substantial meniscal deficiency. This may be especially important in children and adolescents; however, there is a paucity of literature on MAT in this population.

Purpose: To evaluate the epidemiology of MAT at pediatric hospitals in the United States, with specific attention to regional and characteristic trends. Read More

View Article and Full-Text PDF
September 2021

Total and Out-of-Pocket Costs of Procedures After Lung Cancer Screening in a National Commercially Insured Population: Estimating an Episode of Care.

J Am Coll Radiol 2021 Sep 30. Epub 2021 Sep 30.

Department of Radiology, University of Michigan.

Objective: Consequences of lung cancer screening (LCS) with low-dose chest CT in clinical settings, including procedures, costs, and complications, are incompletely understood. We evaluated downstream invasive procedures after LCS, total and out-of-pocket (OOP) costs of these procedures, and correlates of procedural rates and costs.

Methods: Using the Clinformatics Data Mart, we retrospectively included patients between ages 55 and 79 years receiving LCS between 2015 and 2017. Read More

View Article and Full-Text PDF
September 2021

Out-of-pocket costs for commercially insured patients with localized prostate cancer.

Urol Oncol 2021 Sep 30. Epub 2021 Sep 30.

Department of Urology, Vanderbilt University Medical Center, Nashville, TN.

Purpose: Financial toxicity is an underappreciated component of cancer survivorship. Treatment-specific out-of-pocket costs for patients undergoing localized prostate cancer treatment have not, to date, been described and may influence patient's decision making.

Methods: We performed a retrospective cohort study among commercially-insured patients in the United States with incident prostate cancer from 2013 to 2018. Read More

View Article and Full-Text PDF
September 2021

Insurance type is associated with appropriate use of surgical and adjuvant care for differentiated thyroid carcinoma.

Surgery 2021 Sep 30. Epub 2021 Sep 30.

Department of Surgery, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ. Electronic address:

Background: We aimed to characterize the association between differentiated thyroid cancer (DTC) patient insurance status and appropriateness of therapy (AOT) regarding extent of thyroidectomy and radioactive iodine (RAI) treatment.

Methods: The National Cancer Database was queried for DTC patients diagnosed between 2010 and 2016. Adjusted odds ratios (AOR) for AOT, as defined by the American Thyroid Association guidelines, and hazard ratios (HR) for overall survival (OS) were calculated. Read More

View Article and Full-Text PDF
September 2021

Financial Burden of Traumatic Injury Amongst the Privately Insured.

Ann Surg 2021 Sep 29. Epub 2021 Sep 29.

S-SPIRE, Department of Surgery, Division of General Surgery, Stanford University Health Research and Development, Veteran Affairs Palo Alto Health Care System.

Objective: We sought to evaluate the overall financial burden associated with traumatic injury amongst patients with private insurance and assess the effect of high deductible plans on out-of-pocket costs.

Summary Background Data: Traumatic injury can be a source of unexpected financial burden for households. However, the effect of increasing participation in higher cost-sharing private health insurance plans remains unknown. Read More

View Article and Full-Text PDF
September 2021

The direct and indirect costs of adult atopic dermatitis.

J Manag Care Spec Pharm 2021 Oct;27(10):1416-1425

IBM Watson Health, Cambridge, MA.

Atopic dermatitis is considered a childhood illness, and the direct and indirect health care burden of atopic dermatitis in adults is not fully understood. To measure the direct and indirect costs of atopic dermatitis among adults in 2018. This retrospective cohort study compared commercial and Medicare-insured adults with atopic dermatitis in 2018 with directly matched (1:3) adults without atopic dermatitis. Read More

View Article and Full-Text PDF
October 2021

Drug-dispensing limits within Medicaid during the COVID-19 pandemic.

J Manag Care Spec Pharm 2021 Oct;27(10):1489-1493

HealthPartners Institute, Minneapolis, MN.

The 1-month drug-dispensing limit is a common drug utilization tool used by state Medicaid agencies to control spending. Since the beginning of the COVID-19 pandemic, many states relaxed the 1-month dispensing limit restriction in order to align with social distancing recommendations. Yet, some states have not relaxed this limit and have differed substantially regarding the policies that have been implemented. Read More

View Article and Full-Text PDF
October 2021

Effects on annual income changes after radical radiotherapy versus after prostatectomy in patients with localized prostate cancer with a specific employment status: A web-based pilot study.

PLoS One 2021 30;16(9):e0258116. Epub 2021 Sep 30.

Department of Comprehensive Radiation Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

Men with localized prostate cancers are insured for undergoing radical radiotherapy or prostatectomy. However, limited information is available on the influence of cancer treatments on patients' employment status in Japan. Therefore, in this web-based survey, we aimed to compare the effects of post-treatment changes on the annual income of patients with prostate cancer after undergoing radical radiotherapy and prostatectomy and to identify the risk factors associated with the decrease in annual income. Read More

View Article and Full-Text PDF
September 2021

Diabetes Microvascular Disease Diagnosis and Treatment After High-Deductible Health Plan Enrollment.

Diabetes Care 2021 Sep 29. Epub 2021 Sep 29.

Department of Health Care Policy, Harvard Medical School, Boston, MA.

Objective: The Affordable Care Act mandates that primary preventive services have no out-of-pocket costs but does not exempt secondary prevention from out-of-pocket costs. Most commercially insured patients with diabetes have high-deductible health plans (HDHPs) that subject key microvascular disease-related services to high out-of-pocket costs. Brief treatment delays can significantly worsen microvascular disease outcomes. Read More

View Article and Full-Text PDF
September 2021

Practice Patterns and Patient Outcomes After Widespread Adoption of Remote Heart Failure Care.

Circ Heart Fail 2021 Sep 30:CIRCHEARTFAILURE121008573. Epub 2021 Sep 30.

Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA. (N.Y., P.G.B., Y.E., S.C., J.E.E., M.M.K.).

Background: An unprecedented shift to remote heart failure outpatient care occurred during the coronavirus disease 2019 (COVID-19) pandemic. Given challenges inherent to remote care, we studied whether remote visits (video or telephone) were associated with different patient usage, clinician practice patterns, and outcomes.

Methods: We included all ambulatory cardiology visits for heart failure at a multisite health system from April 1, 2019, to December 31, 2019 (pre-COVID) or April 1, 2020, to December 31, 2020 (COVID era), resulting in 10 591 pre-COVID in-person, 7775 COVID-era in-person, 1009 COVID-era video, and 2322 COVID-era telephone visits. Read More

View Article and Full-Text PDF
September 2021

The State of Nurse Anesthetist Practice and Policy: An Integrative Review.

AANA J 2021 Oct;89(5):403-412

is a professor at Boston College, Brookline, Massachusetts, and is the former head of the PhD program at the Oregon Health & Science University School of Nursing, Portland, Oregon. She has published extensively across the disciplines of nursing, gerontology, and psychology. Email:

The enactment of the Affordable Care Act in 2010 prompted the Institute of Medicine to release The Future of Nursing report to help guide the necessary changes in nursing to accommodate millions of newly insured individuals. A key point of the campaign was for advanced practice registered nurses (APRNs) to practice at the fullest extent of their licensure to meet the needs of the newly insured population. Certified Registered Nurse Anesthetists (CRNAs) experience the most restricted scope of practice among APRNs. Read More

View Article and Full-Text PDF
October 2021

Treatment with TNF-α inhibitors versus methotrexate and the association with dementia and Alzheimer's disease.

Alzheimers Dement (N Y) 2021 20;7(1):e12163. Epub 2021 Sep 20.

Janssen Research & Development LLC Titusville New Jersey USA.

Introduction: Peripheral inhibition of tumor necrosis factor (TNF)-α, outside of the central nervous system, may result in clinical improvement of Alzheimer's disease (AD) outcomes. TNF-α inhibitors (TNFIs) are effective treatments for various autoimmune conditions and may be effective for preventing and/or treating AD. The objective of this study was to compare the risk of dementia and AD in patients initiating methotrexate versus those initiating TNFIs. Read More

View Article and Full-Text PDF
September 2021

Follow-up colonoscopy after an abnormal stool-based colorectal cancer screening result: analysis of steps in the colonoscopy completion process.

BMC Gastroenterol 2021 Sep 28;21(1):356. Epub 2021 Sep 28.

Northwest Permanente Medical Group, Portland, OR, USA.

Background: Delays in receiving follow-up colonoscopy after an abnormal fecal immunochemical test (FIT) result are associated with increased colorectal cancer incidence and mortality. Little is known about patterns of follow-up colonoscopy completion in federally qualified health centers.

Methods: We abstracted the medical records of health center patients, aged 50-75 years, who had an abnormal FIT result between August 5, 2017 and August 4, 2018 (N = 711). Read More

View Article and Full-Text PDF
September 2021

Perspectives on barriers and facilitators to mental health support after a traumatic birth among a sample of primarily White and privately insured patients.

Gen Hosp Psychiatry 2021 Aug 28;73:46-53. Epub 2021 Aug 28.

Department of Psychiatry, University of Massachusetts Chan Medical School, 55 Lake Avenue, Worcester, MA 01655, United States; Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 55 Lake Avenue, Worcester, MA 01655, United States; Department of Obstetrics & Gynecology, University of Massachusetts Chan Medical School, 55 Lake Avenue, Worcester, MA 01655, United States; Department of Psychiatry, UMass Memorial Health Care, Worcester, MA 01655, United States. Electronic address:

Objective: To elicit the perspectives of individuals with a traumatic birth experience on barriers and facilitators to receiving mental health support in the postpartum period.

Methods: Individuals who experienced a traumatic birth within the last three years (n = 32) completed semi-structured phone interviews about their birth and postpartum experience. The Post-traumatic Stress Disorder Checklist for DSM-V (PCL-5), Patient Health Questionnaire (PHQ-8), and Generalized Anxiety Disorder scale (GAD-7) were administered. Read More

View Article and Full-Text PDF

Non-Visit-Based and Non-Infection-Related Antibiotic Use in the US: A Cohort Study of Privately Insured Patients During 2016-2018.

Open Forum Infect Dis 2021 Sep 1;8(9):ofab412. Epub 2021 Aug 1.

Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Background: Ambulatory antibiotic prescriptions without a clinic visit or without documentation of infection could represent overuse and contribute to adverse outcomes. We aim to describe US ambulatory antibiotic prescribing, including those without an associated visit or infection diagnosis.

Methods: We conducted an observational cohort study using data of all patients receiving antibacterial, antibiotic prescriptions from 04/01/2016 to 06/30/2018 in a large US private health insurance plan. Read More

View Article and Full-Text PDF
September 2021

Trends in Chronic Kidney Disease Care in the US by Race and Ethnicity, 2012-2019.

JAMA Netw Open 2021 Sep 1;4(9):e2127014. Epub 2021 Sep 1.

Division of Nephrology, University of California, San Francisco.

Importance: Significant racial and ethnic disparities in chronic kidney disease (CKD) progression and outcomes are well documented, as is low use of guideline-recommended CKD care.

Objective: To examine guideline-recommended CKD care delivery by race and ethnicity in a large, diverse population.

Design, Setting, And Participants: In this serial cross-sectional study, adult patients with CKD that did not require dialysis, defined as a persistent estimated glomerular filtration rate less than 60 mL/min/1. Read More

View Article and Full-Text PDF
September 2021