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Ray, Markqayne, Elyse Swallow, Kavita Gandhi, Christopher Carley, Vanja Sikirica, Travis Wang, Nicolae Done, James Signorovitch i Arash Mostaghimi. "Chronic Myeloid Leukemia: Part I—Real-World Treatment Patterns, Healthcare Resource Utilization, and Associated Costs in Later Lines of Therapy in the United States". Journal of Health Economics and Outcomes Research 9, nr 2 (29.07.2022): 11–18. http://dx.doi.org/10.36469/jheor.2022.36229.
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Background: Alopecia areata (AA) is an autoimmune disease of hair loss affecting people of all ages. Alopecia totalis (AT) and universalis (AU) involve scalp and total body hair loss, respectively. AA significantly affects quality of life, but evidence on the economic burden in adolescents is limited. Objectives: To assess healthcare resource utilization (HCRU) and all-cause direct healthcare costs, including out-of-pocket (OOP) costs, of US adolescents with AA. Methods: IBM MarketScan® Commercial and Medicare databases were used to identify patients aged 12-17 years with ≥2 claims with AA/AT/AU diagnosis (prevalent cases), from October 1, 2015, to March 31, 2018, enrolled for ≥12 months before and after the first AA diagnosis (index). Patients were matched 1:3 to non-AA controls on index year, demographics, plan type, and Charlson Comorbidity Index. Per patient per year HCRU and costs were compared post-index. Results: Patients comprised 130 AT/AU adolescents and 1105 non-AT/AU adolescents (53.8% female; mean age, 14.6 years). Post-index, AT/AU vs controls had more outpatient (14.5 vs 7.1) and dermatologist (3.6 vs 0.3) visits, higher mean plan costs ($9397 vs $2267), including medical ($7480 vs $1780) and pharmacy ($1918 vs $487) costs, and higher OOP costs ($2081 vs $751) (all P<.001). The non-AT/AU cohort vs controls had more outpatient (11.6 vs 8.0) and dermatologist (3.4 vs 0.4) visits, higher mean plan costs ($7587 vs $4496), and higher OOP costs ($1579 vs $805) (all P<.001). Discussion: This large-sample, real-world analysis found that adolescents with prevalent AA had significantly higher HCRU and all-cause costs than matched controls. The greater burden was driven by more frequent outpatient visits, and higher payer medical and pharmacy costs in comparison with controls. Oral corticosteroid use was higher among patients with AT/AU; topical and injectable corticosteroid use was higher for non-AT/AU. Although the data preclude the identification of AA-attributable costs, the matched-control design allows an estimation of incremental all-cause costs associated with AA. Conclusions: Adolescents with AA incurred substantial incremental healthcare costs, with greater costs incurred among those with AT/AU. Study findings suggest that AA incurs costs as a medical condition with a high burden on adolescent patients and health plans.
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Stovall, R., E. Kersey, J. LI, R. Baker, C. Anastasiou, A. Palmowski, G. Schmajuk, L. S. Gensler i J. Yazdany. "POS0665 INCIDENCE RATE AND FACTORS ASSOCIATED WITH FRACTURES AMONG ADULTS WITH ANKYLOSING SPONDYLITIS IN THE UNITED STATES". Annals of the Rheumatic Diseases 82, Suppl 1 (30.05.2023): 612–13. http://dx.doi.org/10.1136/annrheumdis-2023-eular.1161.
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BackgroundAdults with ankylosing spondylitis (AS), also known as radiographic axial spondyloarthritis, are at a significantly increased risk of fracture relative to the general population. While some studies have evaluated the risk of fracture in AS, we do not have European or U.S. population-level studies assessing different fracture types performed within the last three decades.ObjectivesWe evaluated the incidence rate and factors associated with fractures among those with AS using linked data from the national U.S. Rheumatology Informatics System for Effectiveness (RISE) registry and Medicare claims.MethodsData were derived from RISE, a large, national electronic health record-based registry, which was linked to Medicare claims from 2016-2018. Patients were required to have at least two visits for AS with a rheumatology provider, ≥ 30 days apart, prior to the baseline period of the study and at least one Medicare claim. One year of baseline characteristics was collected from both RISE and Medicare claims. Subjects were considered to have a historical fracture (vs. an incident fracture) if a fracture occurred prior to the index date. Patients were followed over time for incident fractures after the index date. Fractures were defined by ICD codes. We examined all fractures, including those of the vertebrae, sternum/ribs, shoulder/clavicle/upper arm/elbow, distal forearm/wrist/hand, pelvis/hip/femur, knee/lower leg, and ankle/foot. First, we calculated the combined incidence of fracture and incidence by fracture type. Second, logistic regression models were constructed to identify factors associated with fracture, including age, sex, race or ethnic group, national area deprivation index, dual-eligibility for Medicare (healthcare for adults aged 65+ and some people with certain conditions/disabilities) and Medicaid (healthcare for those with limited income and resources), Charlson comorbidity index, body mass index, smoking status, osteoporosis diagnosis, historical fracture (fracture prior to index date), and use of glucocorticoids and opioids.ResultsWe identified 1,426 adults with AS in RISE who were also observable in Medicare. The mean (SD) age was 69.4 years (9.8), 44.3% were female, and 77.3% were non-Hispanic White. Fractures occurred in 197 AS adults (Table 1). The overall incidence rate of fractures among adults with AS was 76.7 (95% CI 66.4-88.6) per 1,000 person-years. The most common fracture was vertebral with an incidence rate of 23.9 per 1,000 person-years (95% CI 18.6-30.7), followed by distal forearm/wrist/hand with an incidence rate of 17.4 per 1,000 person-years (95% CI 13.0-23.4). Age 85+ (OR 3.64, 95% CI 1.79-7.40), historical fracture (OR 5.18, 95% CI 3.40-7.89), and use of opioid drugs (OR 2.20, 95% CI 1.52-3.19) conferred increased odds of fracture; sex did not (Figure 1).ConclusionIn this large U.S. sample of older adults with AS, vertebral fractures were the most common followed by distal forearm/wrist/hand fractures. Those who were older, had a historical fracture and used opioids had higher odds of fracture. Men and women were equally likely to have a fracture. Since chronic opioid use was associated with fracture in AS, this high-risk population should be considered for interventions to mitigate risk.Table 1.Incidence rate of fractures by type.First FractureN (%)Incidence Rate per 1,000 person-years95% CIAny Fracture197/1,42676.766.4-88.6By Fracture Type*Vertebral61 (25.7)23.918.6-30.7Distal forearm/wrist/hand45 (19.0)17.413.0-23.4Ankle/foot33 (14.0)12.89.1-18.0Pelvis/hip/femur29 (12.2)11.27.8-16.1Sternum/ribs25 (10.5)9.66.5-14.3Shoulder/clavicle/upper arm/elbow24 (10.1)9.36.2-13.8Knee/lower leg20 (8.4)7.75.0-11.9*Subject’s first fracture within a category were included in the counts by fracture type. Subjects can appear in more than one fracture type category if another fracture occurred in a different location. Data displays 237 unique fractures in 197 participants.Figure 1.Model adjusted for all variables shown in the Figure 1.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsRachael Stovall: None declared, Emma Kersey: None declared, Jing Li: None declared, Rahaf Baker: None declared, Christine Anastasiou: None declared, Andriko Palmowski: None declared, Gabriela Schmajuk: None declared, Lianne S. Gensler Consultant of: AbbVie, Acelyrin, Eli Lilly, Fresenius Kabi, Janssen, Novartis, Pfizer, and UCB Pharma, Grant/research support from: Novartis and UCB Pharma, Jinoos Yazdany Consultant of: Astra Zeneca, Pfizer, Aurinia, Grant/research support from: Astra Zeneca, BMS Foundation, Gilead and Aurinia.
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Schlesinger, N., N. L. Edwards, S. Clark i P. Lipsky. "AB1173 RHEUMATOLOGIST CARE IS ASSOCIATED WITH FEWER EMERGENCY ROOM VISITS BY PERSONS WITH GOUT". Annals of the Rheumatic Diseases 79, Suppl 1 (czerwiec 2020): 1877.1–1877. http://dx.doi.org/10.1136/annrheumdis-2020-eular.2340.
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Background:Gout is one of the most common inflammatory arthropathies. By searching a large administrative data base (Symphony Integrated Dataverse), we found that persons with acute gout see a rheumatologist infrequently, whereas less than 50% of advanced gout patients are seen by a rheumatologist. Notably, however, gout patients seen by rheumatologists have more frequent urate measurements and are prescribed urate lowering therapy more frequently. This study sought to determine whether involvement of a rheumatologist in gout care had a positive impact on health outcomesObjectives:To determine whether involvement of a rheumatologist had a positive impact on health outcomes of patients with gout.Methods:We carried out a retrospective analysis to identify persons with gout over an approximately 3-year period from October 2015 to December 2018. This study used data from the Truven Marketscan®database, an administrative database covering over 190 million patients across the United States and based on fully adjudicated and paid insurance claims. Patients were identified as having gout if they were >18 years of age and had at least two medical claims for the diagnosis of gout on different days, separated by at least 3 months. Patients with acute gout were identified by ICD-10 code M10.*, chronic nontophaceous gout (M1A.***0), tophaceous gout (M1A.***1) and uncontrolled gout (M10.*, M1A.*), the latter manifested by three gout codes (any) in the primary diagnosis position and three urate measurements within the same calendar year. Particular attention was placed on Emergency Room (ER) visits by individuals in each category and by individuals who had been evaluated by a rheumatologist.Results:We identified 284,877 gout patients. The median age was 59.2 years and 79.0% were male. Of the 230,998 persons coded as acute gout, 10.7% were seen by a rheumatologist, whereas 26.9% of the 32,942 coded as chronic nontophaceous gout, 47.2% of the 7,723 coded as tophaceous gout and 43.6% of the13,514 coded as uncontrolled gout were seen by a rheumatologist. In each gout category, the frequency of ER visits was significantly reduced in persons who had been seen by a rheumatologist (Table 1). In acute gout, the frequencies of ER visits in those with and without rheumatologist care were 5.6% vs 6.6% (p<0.001), respectively. In chronic nontophaceous gout it was 5.5% vs 6.7% (p=0.001); in tophaceous gout it was 10.3% vs 14.7% (p<0.001); and in uncontrolled gout it was 12.8% vs 19.0%, respectively. If the frequencies of rheumatologist-associated gout patient ER visits were applied to all gout subjects, there would have been 3,088 less ER visits in this cohort of gout patients.Table 1.Rheumatology BreakdownEmergency Room VisitsPopulationOverall NW/ RheumatologyPatients%With Gout ER Visit (%)p-value (comparing %)ER Visits* Per PatientAcute Gout230,698Yes24,63810.68%1373 (5.57%)<0.0011.47No206,06089.32%13632 (6.62%)1.53Non-Tophaceous Chronic32,942Yes8,86326.90%486 (5.48%)<0.0011.95No24,07973.10%1601 (6.65%)2.39Tophaceous Chronic7,723Yes3,64847.24%376 (10.31%)<0.0012.78No4,07552.76%597 (14.65%)2.89Uncontrolled13,514Yes5,88643.55%753 (12.79%)<0.0012.06No7,62856.45%1452 (19.04%)2.56* ER Visits are only included in this analysis if the primary diagnosis code on the claim is a gout code (M10.X, M1A.X)Conclusion:There appears to be a positive impact of rheumatologist involvement in the care of gout patients, manifested by a significant decrease in the frequency of ER visits. Considering the inconvenience and cost of ER visits, rheumatologist care may have a significant impact on the well-being of gout patients and on the overall cost of their care.Disclosure of Interests:Naomi Schlesinger Grant/research support from: Pfizer, Amgen, Consultant of: Novartis, Horizon Therapeutics, Selecta Biosciences, Olatec, IFM Therapeutics, Mallinckrodt Pharmaceuticals, N. Lawrence Edwards Consultant of: Horizon Therapeutics, Takeda Pharmaceuticals US, Aclaris Therapeutics, Atom Biosciences, Sanders Clark: None declared, Peter Lipsky Consultant of: Horizon Therapeutics
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Houtchens, Maria K., Natalie C. Edwards, Gary Schneider, Kevin Stern i Amy L. Phillips. "Pregnancy rates and outcomes in women with and without MS in the United States". Neurology 91, nr 17 (28.09.2018): e1559-e1569. http://dx.doi.org/10.1212/wnl.0000000000006384.
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ObjectiveTo compare pregnancy prevalence and complications in women with and without multiple sclerosis (MS).MethodsThis retrospective US administrative claims study used data from January 1, 2006, to June 30, 2015. All data for women with MS were included. A nationally representative 5% random sample from approximately 58 million women without MS was used to compute the dataset. Annual pregnancy rates, identified via diagnosis/procedure codes and adjusted for covariates, were estimated via logistic regression. Claims for pregnancy and labor/delivery complications were compared using propensity score matching.ResultsFrom 2006 to 2014, the adjusted proportion of women with MS and pregnancy increased from 7.91% to 9.47%; the adjusted proportion without MS and with pregnancy decreased from 8.83% to 7.75%. The difference in linear trend (0.17% increase and 0.15% decrease in per-annum pregnancy rates) was significant (t statistic = 7.8; p < 0.0001). After matching (n = 2,115 per group), a higher proportion of women with MS than without had claims for premature labor (31.4% vs 27.4%; p = 0.005), infection (13.3% vs 10.9%; p = 0.016), cardiovascular disease (3.0% vs 1.9%; p = 0.028), anemia/acquired coagulation disorders (2.5% vs 1.3%; p = 0.007), neurologic complications (1.6% vs 0.6%; p = 0.005), sexually transmitted diseases (0.4% vs 0.1%; p = 0.045), acquired fetal damage (27.8% vs 23.5%; p = 0.002), and congenital fetal malformations (13.2% vs 10.3%; p = 0.004).ConclusionsPregnancy rates in this population of women with MS have been increasing. High rates of claims for several peripartum complications were observed in women with and those without MS. Claims data provide knowledge of interactions patients have with the health care system and are valuable initial exploratory analyses.
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Goyal, Ravi K., Keith L. Davis, Isabelle Cote, Nadjat Mounedji i James A. Kaye. "Increased Incidence of Thromboembolic Event Rates in Patients Diagnosed with Polycythemia Vera: Results from an Observational Cohort Study". Blood 124, nr 21 (6.12.2014): 4840. http://dx.doi.org/10.1182/blood.v124.21.4840.4840.
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Abstract Background: Polycythemia vera (PV) is a rare hematologic neoplasm with significant morbidities. Blood hyperviscosity reflected by elevated hematocrit (HCT) levels is believed to contribute to most disease symptoms and complications including thrombotic events (TE), which are among the most serious clinical manifestations of PV. Concurrent with ongoing Phase III trials in PV, this study assesses treatment patterns, TE event rates, and direct costs associated with PV in real-world practice settings. Preliminary results on incidence of TE events in a privately insured US population are presented here. Methods: Data for this retrospective observational study were taken from the MarketScan database containing medical and drug utilization data for ~40 million unique individuals enrolled in employer-sponsored private health insurance plans in the United States. Patients with at least two claims of a PV diagnosis (International Classification of Diseases, 9th Clinical Modification [ICD-9-CM] code 238.4) at least 30 days apart, between July 1, 2008 and December 31, 2011, were selected for study inclusion. Using propensity score (PS) methods, we identified a non-PV control group matched with PV cases on demographics and comorbidities. PS matching is frequently used in observational studies to achieve balance on observed covariates between cases and controls. Incident TE events were identified using ICD-9 diagnosis codes and were assessed from the index date (first PV diagnosis) until the earliest of plan disenrollment or end of the database. Both fatal and nonfatal events were included, although a distinction could not be ascertained in these data. The TE event rate was defined as the number of unique patients with a new TE occurrence (i.e., incident cases) per 1000 person-years (PYs) of observation time. Unadjusted TE event rates and incident rate ratios (RR) expressing the increased frequency of events in PV cases relative to controls were estimated for overall (i.e., any), cerebral, arterial, and venous TE events. Kaplan-Meyer (KM) analyses were performed to estimate time to event for each of the event categories listed above. Results: The cohort comprised 8,124 PV patients with mean age of 51 years; 71% of patients were male. Table 1 describes the quality of balance between cases and matched controls for selected variables that differed significantly before PS matching. As shown in Figure 1, TE event rates were significantly higher among PV cases compared to matched controls (overall: 14.3 vs. 4.9/1000 PYs [RR 2.90 (95% CI: 2.28-3.68)], cerebral: 3.5 vs. 1.3/1000 PYs [RR 2.66 (95% CI: 1.66-4.24)], arterial: 6.9 vs. 2.4/1000 PYs [RR 3.16 (95% CI: 2.05-4.87)], and venous: 4.7 vs. 1.5/1000 PYs [RR 2.94 (95% CI: 2.08-4.15)]). KM analyses showed that event probabilities over time were significantly higher among PV cases (Figure 2). Due to high censoring in both the groups, median time to TE event could not be calculated. However, among those with an event, median time to event was shorter (but not statistically significant) among PV cases compared to controls for overall (7.0 vs. 9.7 months [P=0.0817]), cerebral (8.5 vs. 13.1 months [P=0.0634]), and arterial (9.2 vs. 14.7 months [P=0.0768]), but slightly higher for venous (5.3 vs. 4.8 months [P=0.5583]). Conclusion: Patients with PV have significantly higher rate of TE events compared with matched controls. This rate may be higher in patients with HCT > 45%. Further analyses in this ongoing study will assess patient level predictors of cardiovascular and TE events and their impact on overall economic burden of PV. Table 1. Comparison of Baseline Characteristics between PV Cases and Matched Controls PV Cases (n=8124) Control (n=8124) P-value ‡ Percent Age Group (years) <18 1.7 1.7 0.24 18 - 44 19.9 19.0 45 - 59 58.4 59.9 60 - 64 20.1 19.4 Gender Male 71.5 71.2 0.65 Geographic region North Central 20.6 20.9 0.48 North East 16.5 16.7 South 40.8 41.1 West 19.2 18.1 Unknown 3.0 3.2 Year of diagnosis 2008 17.3 17.6 0.16 2009 27.7 29.0 2010 27.5 27.2 2011 27.5 26.2 Charlson comorbidity index (CCI) score (mean [SD]) 0.8 (1.4) 0.7 (1.4) 0.00 Note: Other covariates in the PS estimation include payer type, plan type, employment status, and relationship to employee. ‡ P-values based on McNemar's test for categorical variables and Wilcoxon Signed Rank Sum test for continuous variables. Figure 1 Figure 1. Figure 2 Figure 2. Disclosures Goyal: Novartis Pharmaceuticals Corp: Employee of RTI Health Solutions, which received research funding for this work. Other. Davis:Novartis Pharmaceuticals Corporation: Research Funding. Mounedji:Novartis Pharma: Employment. Kaye:Novartis Pharmaceuticals Corp: Employee of RTI Health Solutions, which received research funding for this work. Other.
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Ranavaya, Mohammed I., i James B. Talmage. "Impairment and Disability Compensation Systems in the United States". Guides Newsletter 4, nr 6 (1.11.1999): 1–13. http://dx.doi.org/10.1001/amaguidesnewsletters.1999.novdec01.
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Abstract Although several states use the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) when they evaluate individuals with impairments and disabilities, various disability systems exist in the United States. Disability and compensation systems have arisen to ensure that disadvantaged members of society with a medically determinable impairment, which may lead to a disability, have recourse to compensation from various sources, including state and federal workers’ compensation laws, veterans’ benefits, social welfare programs, and legal avenues. Each of these has differing definitions of disability, entitlement, benefits, procedures of claims application, adjudication, and the roles and relative weights assigned to medical vs administrative deliberations. Workers’ compensation statutes were enacted because of inadequacies of recovery from claims for injured workers under common law. Workers’ compensation is a no-fault system adopted to resolve the dilemmas of tort claims by providing automatic coverage to employees injured during the course of employment; in exchange for coverage, employees forego the right to sue the employer except for wanton neglect. Other workers’ compensation programs in the United States include the Federal Employees Compensation Act; the Federal Employers Liability Act (railroads); the Jones Act (Merchant Marine Act); the Longshore and Harbor Workers’ Compensation Act; the Department of Veterans Affairs; Social Security; and private, long-term disability insurance.
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ZELNER, J. L., C. MULLER i J. J. FEIGENBAUM. "Racial inequality in the annual risk of Tuberculosis infection in the United States, 1910–1933". Epidemiology and Infection 145, nr 9 (24.04.2017): 1797–804. http://dx.doi.org/10.1017/s0950268817000802.
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SUMMARYTuberculosis (TB) mortality rates in the USA fell rapidly from 1910 to 1933. However, during this period, racial disparities in TB mortality in the nation's expanding cities grew. Because of long delays between infection and disease, TB mortality is a poor indicator of short-term changes in transmission. We estimated the annual risk of TB infection (ARTI) in 11 large US cities to understand whether rising inequality in mortality reflected rising inequality in ARTI using city-level TB mortality data compiled by the US Department of Commerce from 1910 to 1933. We estimated ARTI for African-Americans and whites using pediatric extrapulmonary TB mortality data for African-Americans and whites in our panel of cities. We also estimated age-adjusted pulmonary TB mortality rates for these cities. We find that the ratio of ARTI for African-Americans vs. whites increased from 2·1 (95% CI = 1·7, 2·4) in 1910 to 4·2 (95% CI = 3·4, 5·2) in 1933. This change mirrored the increasing inequality in age-adjusted pulmonary TB mortality during this period. These findings may reflect the combined effects of migration, inequality in access to care, increasing population density, and racial residential segregation in northern cities during this period.
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Buckner, Tyler W., Iryna Bocharova, Kaitlin Hagan, Arielle G. Bensimon, Hongbo Yang, Eric Q. Wu, Eileen K. Sawyer i Nanxin Li. "Health care resource utilization and cost burden of hemophilia B in the United States". Blood Advances 5, nr 7 (8.04.2021): 1954–62. http://dx.doi.org/10.1182/bloodadvances.2020003424.
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Abstract Hemophilia B is a rare congenital blood disorder characterized by factor IX deficiency. Clinical profiles of hemophilia B range from mild to severe forms of the disease. The objective of this study was to characterize the economic burden associated with differing clinical profiles of hemophilia B from a US health system perspective. Using the IBM MarketScan database (June 2011-February 2019), a claims-based algorithm was developed to identify 4 distinct profiles (mild, moderate, moderate-severe, and severe) in adult males with hemophilia B based on the frequency of hemorrhage events and factor IX replacement claims. Mean annual health care resource use (HRU) and costs were statistically compared between patients with hemophilia B (N = 454) and 1:1 demographic-matched controls (N = 454), both overall and with stratification by clinical profile. Compared with matched controls, patients with hemophilia B had a significantly higher comorbidity burden (Charlson Comorbidity Index, mean ± standard deviation [SD]: 0.9 ± 1.7 vs 0.3 ± 0.9, P < .001). Across all clinical profiles, patients with hemophilia B had significantly higher HRU vs matched controls (mean ± SD: 0.3 ± 0.6 vs 0.1 ± 0.3 inpatient admissions; 0.6 ± 1.2 vs 0.2 ± 0.6 emergency department visits; 17.7 ± 22.9 vs 8.0 ± 11.0 outpatient visits; all P < .001). Annual total health care costs per patient among patients with hemophilia B were more than 25-fold higher vs matched controls (mean ± SD: $201 635 ± $411 530 vs $7879 ± $29 040, respectively, P < .001). Annual total health care costs per patient increased with increasing severity (mean ± SD: mild, $80 811 ± $284 313; moderate, $137 455 ± $222 021; moderate-severe, $251 619 ± $576 886; severe, $632 088 ± $501 270). The findings of this study highlight the substantial burden of illness associated with hemophilia B.
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Vekeman, Francis, Marjolaine Gauthier-Loiselle, Elizabeth Faust, Patrick Lefebvre, Raquel Lahoz, Mei Sheng Duh i Patricia Sacco. "Patient and Caregiver Burden Associated With Fragile X Syndrome in the United States". American Journal on Intellectual and Developmental Disabilities 120, nr 5 (1.09.2015): 444–59. http://dx.doi.org/10.1352/1944-7558-120.5.444.
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Abstract This study evaluated the incremental healthcare costs associated with Fragile X syndrome (FXS) for patients and their caregivers. Using administrative healthcare claims data (1999-2012), subjects with ≥ 1 FXS diagnosis (ICD-9-CM: 759.83) were matched 1:5 with non-FXS controls using high-dimensional propensity scores. Costs and resource utilization were examined. Among employees, payment for disability leave and absenteeism were also examined. We identified 590 FXS and 2,950 non-FXS individuals along with 647 and 2,611 caregivers, respectively. FXS patients and their caregivers experienced higher all-cause direct costs compared to control cohorts (total[SD]: $14,677[46,752] vs. $6,103[26,081]; $5,259[19,360] vs. $2,120[6,425], respectively, p < 0.05). Employed FXS patients and caregivers had higher indirect costs compared to their controls (total[SD]: $4,477[5,161] vs. $1,751[2,556]; $2,641[4,238] vs. $1,211[1,936], respectively, p < 0.05).
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Birnbaum, H., R. Ben-Hamadi, D. Kelley, M. Hsieh, B. Seal, P. Cremieux i P. Greenberg. "Assessing the Relationship Between Compliance with Antidepressant Therapy and Costs Among Employees in the United States". European Psychiatry 24, S1 (styczeń 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)70731-x.
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Objective:Assess effects of antidepressant compliance on healthcare and workplace costs.Methods:Using workplace survey data for 2 large employers’ healthcare claims (2004-2006), patient selection criteria considered depression diagnosis and antidepressant claims history. Employed respondents working in the past month were categorized by Medication Possession Ratio into compliance groups by quartiles; bottom/top quartiles were defined as compliant/non-compliant. Direct (medical/drug) costs were measured as insurer payments to providers; indirect (absenteeism/presenteeism) costs were based on one-month recall of workplace performance (hours worked/missed, self-rated performance), estimated as (hours missed x self-reported hourly income). Annualized, inflation-adjusted (2006) costs were compared between compliant/non-compliant groups using multivariate models controlling for baseline characteristics. Analyses were conducted for all patients and a subsample of diagnosed depression patients.Results:Among all patients (n=1,224), medical costs were numerically lower for compliant vs. non-compliant patients ($4,857 vs. $5,926, p=0.221); drug costs were significantly higher for compliant patients ($2,329 vs. $1,570, p=0.001). Indirect costs were not statistically different between compliant/non-compliant patients ($22,278 vs. $20,714, p=0.237). Among the depression subgroup (N=488), medical costs were numerically lower for compliant vs. non-compliant patients ($5,005 vs. $7,630, p=0.152) while drug costs were numerically higher for compliant patients ($2,550 vs. $1,829, p=0.153). Absenteeism costs were 30% lower for compliant patients ($7,725 vs. $11,040, p=0.038); presenteeism costs were not significantly different ($19,079 vs. $17,457, p=0.441).Conclusions:Absenteeism costs decrease significantly with compliance among depressed patients as do medical costs (not significantly). Further research is warranted regarding reason for poor antidepressant compliance and influence of compliance on costs.
Książki na temat "Claims vs. United States, 1910"
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United States. President (1989-1993 : Bush). Developments concerning national emergency with respect to Iran: Message from the President of the United States transmitting a report on developments since the last report of May 14, 1990, concerning the national emergency with respect to Iran, pursuant to 50 U.S.C. 1641(c). Washington: U.S. G.P.O., 1991.
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Observers, Multinational Force and. Claims: Agreement between the United States of America and the Multinational Force and Observers, effected by exchange of notes, signed at Rome May 3, 1990. [Washington, D.C.]: Dept. of State, 1994.
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Millman, Chad. The detonators: The secret plot to destroy America and an epic hunt for justice. New York: Little, Brown, 2006.
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Millman, Chad. The detonators: The secret plot to destroy America and an epic hunt for justice. New York, NY: Little, Brown, 2005.
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United States. Congress. House. Committee on Armed Services. Defense Policy Panel. Iran Air Flight 655 compensation: Hearings before the Defense Policy Panel of the Committee on Armed Services, House of Representatives, One Hundredth Congress, second session, hearings held August 3 and 4, September 9, and October 6, 1988. Washington: U.S. G.P.O., 1989.
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GOVERNMENT, US. International taxation: United States tax treaties. Colorado Springs, Colo: Shepard's/McGraw-Hill, 1993.
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United States. President (1989-1993 : Bush). Developments concerning the national emergency with respect to Iran: Communication from the President of the United States transmitting a report on developments since his last report of November 29, 1990, concerning the national emergency with respect to Iran, pursuant to 50 U.S.C. 1641(c). Washington: U.S. G.P.O., 1991.
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Judiciary, United States Congress House Committee on the. Merrill L. Johnson-Lannen: Report (to accompany H.R. 4634). [Washington, D.C.?: U.S. G.P.O., 1988.
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United States. Congress. House. Committee on the Judiciary. Merrill L. Johnson-Lannen: Report (to accompany H.R. 4634). [Washington, D.C.?: U.S. G.P.O., 1988.
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United States. Congress. House. Committee on the Judiciary. Merrill L. Johnson-Lannen: Report (to accompany H.R. 1862). [Washington, D.C.?: U.S. G.P.O., 1990.
Znajdź pełny tekst źródłaCzęści książek na temat "Claims vs. United States, 1910"
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Zhang, Kaiqiang. "Challenges of Arbitrators in Inter-State Cases: A Different Cattle of Fish?" W Cofola International 2021, 235–74. Brno: Masaryk University Press, 2021. http://dx.doi.org/10.5817/cz.muni.p210-8639-2021-9.
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Compared to those in international commercial and investment arbitration, arbitrator-challenge practi-ces in inter-state cases are abnormally rare. The reasons behind the asymmetric practices include the ideology towards the role of arbitrators (authority vs. expertise), the effectiveness of enforcement (whether the award can be executed in domestic courts or whether there exist preconditions), and the unique structure and function of the specific tribunals. By virtue of illustrating the rules and practi-ces of the ad hoc tribunal established under Annex VII of the United States Convention on the Law of the Sea, the Iran-United States Claims Tribunal, and the International Court of Justice, the current standard, “justifiable doubts to the impartiality and independence of arbitrators”, is not interpreted uniformly and somehow unreasonable. To overcome the phenomenon of fragmentation and other problems, the arbitrator-challenge rules in inter-state disputes should not be treated differently and should be harmonized with rules and case laws developed in international commercial and investment arbitration.
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Vandevelde, Kenneth J. "The State-State Disputes Provision". W U. S. International Investment Agreements, 701–34. Oxford University PressNew York, NY, 2009. http://dx.doi.org/10.1093/oso/9780195371376.003.0010.
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Abstract The United States has used arbitration as an important means of state-state dispute resolution virtually since it attained independence. The Jay Treaty, the 1794 Friendship, Commerce, and Navigation (FCN) Treaty between the United States and England, contained an arbitration clause that covered disputes involving, among other things, the confiscation of property. Between 1799 and 1804, that clause resulted in more than 500 arbitral awards. The United States continued to use arbitration as an occasional means of settling property disputes throughout the nineteenth century. The United States–Mexican Mixed Claims Commission of 1868, for example, arbitrated more than 2000 claims between 1871 and 1876. One commentator has estimated that between 1829 and 1910, the United States entered into approximately 40 arbitrations with Latin American countries alone.
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Woodward, Jude. "Can China rise peacefully?" W The US vs China. Manchester University Press, 2017. http://dx.doi.org/10.7228/manchester/9781526121998.003.0003.
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The case that China must be contained rests on the premise that it is – or is about to – engage in a coercive expansion of its influence in ‘Central Asia, the South China Sea, the internet and outer space’ and it is only a matter of time before China tries ‘to push the United States out of the Asia-Pacific region, much the way the United States pushed the European great powers out of the Western hemisphere in the 19th century’. China’s rise is cast as dangerous for the security of its neighbours and world peace, with the only guarantee of regional and global stability the maintenance of the leading role of the US, particularly in Asia itself. This chapter examines the truth of these claims in the light of the China’s own explanation of the direction of its foreign policy. It argues that while China’s foreign policy has become more emphatic in pursuing its international interests, especially relating to trade and energy security, that there is a great deal of difference between greater confidence in pursuing China’s national interests and a new aggressive stance.
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Block, Fred L. "Afterword". W Capitalism, 202–14. University of California Press, 2018. http://dx.doi.org/10.1525/california/9780520283220.003.0008.
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This afterword develops a brief critique of the way analysts and activists on the left continue to use the concept of capitalism. My main argument is that the term “capitalism” was effectively stolen by the right wing in the 1970s and 1980s and infused with a meaning that emphasizes capitalism’s durability and its unchanging nature. So when those on the left use the term, they inadvertently reinforce the problematic claims of their political opponents. A similar episode of linguistic larceny happened earlier. Between 1890 and 1910, political thinkers in England and the United States effectively stole the term “liberalism” and redefined it from “economic liberalism” to “political liberalism.”...
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Manning, Carrie. "Tax and Expenditure Limitations vs. an Expanding Social Contract". W Taxing Democracy, 65–90. Policy Press, 2023. http://dx.doi.org/10.1332/policypress/9781529215564.003.0004.
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The last half-century in the United States has been marked by two highly consequential and starkly contrasting social movements: the civil rights movement and the conservative tax revolt. Together, they help illustrate the two principal claims of this book. First, tax bargains set at the time of state consolidation tend to become ‘taken for granted’ arrangements that inscribe the scope and roles of the state and the boundaries of the political community entitled to protection and services from the state. The tax bargain entrenches the political and economic power of dominant actors at the time the bargain is set, and those advantages gain momentum and widen the gap between them and others not privileged by the tax bargain and the social contract it supported. Second, when those understandings are challenged at ‘critical junctures’ by social or political mobilization that seeks to expand the role of the state and the political community, the tax bargain serves as a rally point and a concrete policy tool to support an agenda of resistance to change. This chapter describes the conservative tax revolt, and specifically the tax and expenditure limitations it championed, as a tool of resistance to an expanded social contract.
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Lang, Andrew F. "Causes". W A Contest of Civilizations, 73–124. University of North Carolina Press, 2021. http://dx.doi.org/10.5149/northcarolina/9781469660073.003.0004.
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This chapter surveys the principal political events that contributed to the crisis of Union. Rather than portraying a sectional South vs. a nationalist North (an old historiographical trope long displaced by current scholarship), the chapter features slaveholders, antislavery activists, and multiracial abolitionists all laying claim to the American Union. Proponents of slavery considered the United States unique because most of the world by mid-century had abolished forms of unfree labor. Only in the Union, so went the thinking, could slavery thrive and expand. But antislavery critics argued that a slaveholding Union violated the spirit of the American founding, tarnishing the republic’s unique democracy. Competing claims to American exceptionalism rooted in irreconcilable debates about slavery gave voice to Lincoln’s belief that “a house divided against itself cannot stand.” The Union had to be either all slave or all free, a proposition that the political system strained to resolve.