Dataset Information

Is the Economic Impact and Utilization of Imaging Studies for Pediatric Urolithiasis Across the United States Increasing?

ABSTRACT: To identify longitudinal trends of economic impact and resource utilization for management of pediatric urolithiasis using national databases.We analyzed the 2006-2012 Nationwide Emergency Department Sample and Nationwide Inpatient Sample. We used ICD-9 (International Classification of Diseases) codes to identify patients (?18 years) diagnosed with urolithiasis. Diagnostic imaging and surgeries were identified using ICD-9 and Current Procedural Technology codes. We abstracted demographic, imaging, procedure, and charge data. Weighted descriptive statistics were calculated to describe the population's demographics and economic expenditures by clinical setting and year.In total, 45,333 inpatient admissions (68% females) and 234,559 emergency department encounters (63% females) were identified. Most patients (84%) were teenagers and the southern region of the United States was the most common geographic region for all encounters (44%). There was no significant trend in number of urolithiasis encounters over the period studied. Utilization of all imaging techniques increased; in particular, computed tomography was used in 23% of encounters in 2006 and 40% in 2012 (P?

SUBMITTER: Young BJ

PROVIDER: S-EPMC4969138 | biostudies-literature | 2016 Aug

REPOSITORIES: biostudies-literature

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Is the Economic Impact and Utilization of Imaging Studies for Pediatric Urolithiasis Across the United States Increasing?

Young Brian J BJ Tejwani Rohit R Wang Hsin-Hsiao S HH Wolf Steven S Purves J Todd JT Wiener John S JS Routh Jonathan C JC

Urology 20160518

<h4>Objective</h4>To identify longitudinal trends of economic impact and resource utilization for management of pediatric urolithiasis using national databases.<h4>Methods</h4>We analyzed the 2006-2012 Nationwide Emergency Department Sample and Nationwide Inpatient Sample. We used ICD-9 (International Classification of Diseases) codes to identify patients (≤18 years) diagnosed with urolithiasis. Diagnostic imaging and surgeries were identified using ICD-9 and Current Procedural Technology codes. ...[more]

PMID: 27208819

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Project description:BackgroundDisparities in access to care cause negative health consequences for underserved populations. Economic disparities in structural heart disease (SHD) interventions are not well characterized.ObjectivesThe objective of this study was to evaluate economic disparities in the utilization and outcomes of SHD interventions in the United States.MethodsWe queried the National Inpatient Sample (2016-2020) to examine economic disparities in the utilization, in-hospital outcomes, length of stay, and cost of SHD interventions among patients ≥65 years of age. Outcomes were determined using logistic regression models.ResultsA total of 401,005 weighted hospitalizations for transcatheter aortic valve replacement, left atrial appendage occlusion, transcatheter mitral valve repair, and transcatheter mitral valve replacement were included. Utilization rates (number of procedures performed per 100,000 hospitalizations) were higher in patients with high income compared with medium and low income for transcatheter aortic valve replacement (559 vs 456 vs 338), left atrial appendage occlusion (148 vs 136 vs 99), transcatheter mitral valve repair (65 vs 54 vs 41), and transcatheter mitral valve replacement (7.7 vs 6.7 vs 1.2) (all P < 0.01). Low- and medium-income patients had distinctive demographic and clinical risk profiles compared with high-income patients. There were no significant differences in the adjusted in-hospital mortality, key complications, or length of stay between high-, medium-, and low-income patients following any of the 4 SHD interventions. High-income patients incurred a modestly higher cost with any of the 4 SHD interventions compared with medium- and low-income patients.ConclusionsEconomic disparities exist in the utilization of SHD interventions in the United States. Nonetheless, adjusted in-hospital outcomes were comparable among high-, medium-, and low-income patients. Multifaceted implementation strategies are needed to attenuate these utilization disparities.

Project description:Soybean (Glycine max L. Merrill) is an economically important commodity for United States agriculture. Nonetheless, the profitability of soybean production has been negatively impacted by soybean diseases. The economic impacts of 23 common soybean diseases were estimated in 28 soybean-producing states in the U.S., from 1996 to 2016 (the entire data set consisted of 13,524 data points). Estimated losses were investigated using a variety of statistical approaches. The main effects of state, year, pre- and post-discovery of soybean rust, region, and zones based on yield, harvest area, and production, were significant on "total economic loss" as a function of diseases. Across states and years, the soybean cyst nematode, charcoal rot, and seedling diseases were the most economically damaging diseases while soybean rust, bacterial blight, and southern blight were the least economically damaging. A significantly greater mean loss (51%) was observed in states/years after the discovery of soybean rust (2004 to 2016) compared to the pre-discovery (1996 to 2003). From 1996 to 2016, the total estimated economic loss due to soybean diseases in the U.S. was $95.48 billion, with $80.89 billion and $14.59 billion accounting for the northern and southern U.S. losses, respectively. Over the entire time period, the average annual economic loss due to soybean diseases in the U.S. reached nearly $4.55 billion, with approximately 85% of the losses occurring in the northern U.S. Low yield/harvest/production zones had significantly lower mean economic losses due to diseases in comparison to high yield/harvest/production zones. This observation was further bolstered by the observed positive linear correlation of mean soybean yield loss (in each state, due to all diseases considered in this study, across 21 years) with the mean state wide soybean production (MT), mean soybean yield (kg ha-1), and mean soybean harvest area (ha). Results of this investigation provide useful insights into how research, policy, and educational efforts should be prioritized in soybean disease management.

Project description:Rice blast (Magnaporthe oryzae) is a key concern in combating global food insecurity given the disease is responsible for approximately 30% of rice production losses globally-the equivalent of feeding 60 million people. These losses increase the global rice price and reduce consumer welfare and food security. Rice is the staple crop for more than half the world's population so any reduction in rice blast would have substantial beneficial effects on consumer livelihoods. In 2012, researchers in the US began analyzing the feasibility of creating blast-resistant rice through cisgenic breeding. Correspondingly, our study evaluates the changes in producer, consumer, and environmental welfare, if all the rice produced in the Mid-South of the US were blast resistant through a process like cisgenics, using both international trade and environmental assessment modeling. Our results show that US rice producers would gain 69.34 million dollars annually and increase the rice supply to feed an additional one million consumers globally by eliminating blast from production in the Mid-South. These results suggest that blast alleviation could be even more significant in increasing global food security given that the US is a small rice producer by global standards and likely experiences lower losses from blast than other rice-producing countries because of its ongoing investment in production technology and management. Furthermore, results from our detailed life cycle assessment (LCA) show that producing blast-resistant rice has lower environmental (fossil fuel depletion, ecotoxicity, carcinogenics, eutrophication, acidification, global warming potential, and ozone depletion) impacts per unit of rice than non-blast resistant rice production. Our findings suggest that any reduction in blast via breeding will have significantly positive impacts on reducing global food insecurity through increased supply, as well as decreased price and environmental impacts in production.

Dataset Information

Is the Economic Impact and Utilization of Imaging Studies for Pediatric Urolithiasis Across the United States Increasing?

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Is the Economic Impact and Utilization of Imaging Studies for Pediatric Urolithiasis Across the United States Increasing?

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