Practice Trends and Characteristics of US Hospitalists From 2012 to 2018.
Ontology highlight
ABSTRACT:
SUBMITTER: Ryskina KL
PROVIDER: S-EPMC8796912 | biostudies-literature | 2021 Nov
REPOSITORIES: biostudies-literature
Publications
Practice Trends and Characteristics of US Hospitalists From 2012 to 2018.
Ryskina Kira L KL Shultz Kaitlyn K Unruh Mark Aaron MA Jung Hye-Young HY
JAMA health forum 20211105 11
This cohort study uses Medicare data to assess trends and characteristics among hospitalists who shift practice to settings outside of the hospital. ...[more]
Similar Datasets
Project description:PurposePrior studies have been inconclusive in documenting whether the prevalence of adolescent anxiety is increasing, given sampling and measurement limitations. This study adds new information on recent time trends in anxiety prevalence, specifically investigating trends among previously unexamined sociodemographic subgroups.MethodsWeighted data of 37,360 youth respondents (51.1% female, 71.8% White, 91.3% heterosexual, 99.2% cisgender) from the 2012-2018 Dane County Youth Assessment, a county-wide survey administered to youth in participating school districts, were analyzed to estimate time trends in anxiety prevalence among the whole sample and by sociodemographic subgroups.ResultsThe prevalence of youth meeting anxiety-screening criteria increased from 34.1% (95% CI 33.4-34.9) in 2012 to 44% (95% CI 43.2-44.7) in 2018 (OR for trend = 1.07, P for trend < 0.001). The trend remained significant after adjusting for known confounds (AOR for trend = 1.07, P for trend < 0.001). Anxiety increased significantly for several subgroups and widening disparities were documented among females relative to males (P < 0.001), and sexual minority youth relative to heterosexual youth (P = 0.003). In addition, Black youth did not increase at the same swift rate as White youth over the study period (P < 0.001).ConclusionThis study reports recent data on anxiety time trends and finds that among a geographically representative sample of adolescents, anxiety prevalence is rising. Findings provide new evidence documenting increased anxiety prevalence among sexual minority youth relative to their peers. Results highlight the need to bolster public health interventions focused on adolescent mental health, with tailored interventions for vulnerable groups.
| S-EPMC8183580 | biostudies-literature
Project description:INTRODUCTION:Large chain restaurants reduced calories in their newly-introduced menu items from 2012 to 2015. The objective of this study was to provide updated calorie trends through 2018 and examine trends in the macronutrient composition of menu items across this time period. METHODS AND FINDINGS:Data were obtained from the MenuStat project and include 66 of the 100 largest revenue generating U.S. chain restaurants (N = 28,238 items) that had data available in all years from 2012 to 2018. Generalized linear models were used to examine per-item calorie and nutrient changes (saturated fat, trans fat, unsaturated fat, sugar, non-sugar carbohydrates, protein, sodium) among (1) items on the menu in all years (common items) and (2) newly introduced items (2013-2018). Overall, there were no significant changes in calories or nutrients among common items from 2012 to 2018. Among all newly introduced items, calories (-120 kcals, -25%, p = 0.01; p-for-trend = 0.02), saturated fat (-3.4g, -41%, p<0.01, p-for-trend = 0.06), unsaturated fat (-4.5g, -37%, p = 0.02; p-for-trend = 0.04), non-sugar carbohydrates (-10.3g, -40%, p = 0.02, p-for-trend = 0.69), and protein (-4.3g, -25%, p = 0.04, p-for-trend = 0.02) declined. CONCLUSION:Newly introduced menu items in large chain restaurants have continued to decline in calories through 2018, which may help to reduce calorie intake. Other changes in macronutrient content were sporadic and not clearly toward improved dietary quality.
| S-EPMC7010289 | biostudies-literature
Project description:ObjectiveDescribe trends and patterns in long-term opioid prescriptions among adults with musculoskeletal conditions (MSK).DesignInterrupted time-series analysis based on an open cohort study.SettingA representative sample of 402 Australian general practices contributing data to the MedicineInsight database.Participants811 174 patients aged 18+ years with an MSK diagnosis and three or more consultations in any two consecutive years between 2012 and 2018. Males represented 44.5% of the sample, 28.4% were 65+ years and 1.9% were Aboriginal or Torres Strait Islanders.Primary and secondary outcome measuresAnnual prevalence and cumulative incidence (%) of long-term opioid prescribing (3+ prescriptions in 90 days) among patients with an MSK. Average duration of these episodes in each year between 2012 and 2018.ResultsThe prevalence of long-term opioid prescribing increased from 5.5% (95% CI 5.2 to 5.8) in 2012 to 9.1% (95% CI 8.8 to 9.7) in 2018 (annual change OR 1.09, 95% CI 1.08 to 1.09), but a slightly lower incidence was observed in 2018 (3.0% vs 3.6%-3.8% in other years; annual change OR 0.99, 95% CI 0.98 to 0.99). The incidence was between 37% and 52% higher among practices located in rural Australia or lower socioeconomic areas. Individual risk factors included increasing age (3.4 times higher among those aged 80+ years than the 18-34 years group in 2012, increasing to 4.8 times higher in 2018), identifying as Aboriginal or Torres Strait Islander (1.7-1.9 higher incidence than their peers), or living in disadvantaged areas (36%-57% more likely than among those living in wealthiest areas). Long-term opioid prescriptions lasted in average 287-301 days between 2012 and 2016, reducing to 229 days in 2017 and 140 days in 2018. A longer duration was observed in practices from more disadvantaged areas and females in all years, except in 2018.ConclusionsThe continued rise in the prevalence of long-term opioid prescribing is of concern, despite a recent reduction in the incidence and duration of opioid management.
| S-EPMC8031026 | biostudies-literature
Project description:BackgroundPostoperative complications continue to constitute a major issue for both the healthcare system and the individual patient and are associated with inferior outcomes and higher healthcare costs. The objective of this study was to evaluate the trends of postoperative complication rates over a 7-year period.MethodsThe NSQIP datasets from 2012 to 2018 were used to assess 30-day complication incidence rates including mortality rate following surgical procedures within ten surgical subspecialties. Multivariable logistic regression was used to associate complication rates with dataset year, while adjusting for relevant confounders.ResultsA total of 5,880,829 patients undergoing major surgery were included. Particularly the incidence rates of four complications were found to be decreasing: superficial SSI (1.9 to 1.3%), deep SSI (0.6 to 0.4%), urinary tract infection (1.6 to 1.2%) and patient unplanned return to the operating room (3.1 to 2.7%). Incidence rate for organ/space SSI exhibited an increase (1.1 to 1.5%). When adjusted, regression analyses indicated decreased odds ratios (OR) through the study period years for particularly deep SSI OR 0.92 [0.92-0.93], superficial SSI OR 0.94 [0.94-0.94] and acute renal failure OR 0.96 [0.95-0.96] as the predictor variable (study year) increased (p < 0.01). However, OR's for organ/space SSI 1.05 [1.05-1.06], myocardial infarction 1.01 [1.01-1.02] and sepsis 1.01 [1.01-1.02] increased slightly over time (all p < 0.01).ConclusionsIncidence rates for the complications exhibited a stable trend over the study period, with minor in or decreases observed.
| S-EPMC8571843 | biostudies-literature
Project description:ImportanceAdvanced practice professionals (APPs) such as nurse practitioners and physician assistants independently perform a large number and variety of dermatologic procedures, but little is known about how the number and scope of these procedures have changed over time.ObjectiveTo examine the trends in scope and volume of dermatology procedures billed by APPs over time.Design, setting, and participantsA longitudinal study was conducted using the Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File from 2012 through 2015. The data encompass nearly all outpatient procedures paid by Medicare Part B in the United States and include the type of clinician under which procedures were billed.Main outcomes and measuresFor each type of dermatology procedure, the total number performed by APPs and the total number performed by dermatologists each year.ResultsThe total number (and percentage) of all dermatologic procedures performed by APPs increased from 2.69 million of 30.7 million (8.8%) in 2012 to 4.54 million of 33.9 million (13.4%) in 2015. The most common procedures performed by APPs in 2015 were destructions of benign neoplasms (3.6 million), biopsies (788?834), and destructions of malignant neoplasms (48?982). The numbers of patch tests, removals of benign and malignant neoplasms, intermediate and complex repairs, flaps, and surgical pathologic specimen examinations by APPs also increased each year from 2012 through 2015.Conclusions and relevanceThe number and scope of dermatologic procedures performed by APPs appear to be increasing over time. These procedures can be difficult and invasive. This study suggests that further studies are needed to determine what association these procedures have with patient outcomes and the potential need for more formal training.
| S-EPMC6143033 | biostudies-literature
Project description:OBJECTIVES:The aim was to provide figures for drug shortages in France and describe their characteristics, causes and trends between 2012 and 2018. METHODS:Data from the national reporting system from the Agency of Medicine and Health Product Safety (ANSM) was analysed. This database contains information regarding effective and predicted shortages of major therapeutic of interest drugs (ie, drugs whose shortage would be life-threatening or representing a loss of treatment opportunity for patients with a severe disease) which are mandatory reported by marketing authorisation holders to the ANSM. Data are presented as numbers or percentages of pharmaceutical products (ie, the product name and its formulation) reported on shortage between 2012 and 2018. RESULTS:There were 3530 pharmaceutical products reported on shortage during the period, including 1833 different active substances. Drugs on shortage were mostly old products (63.4%) with national marketing authorisation procedures (62.8%), as well as injectable and oral forms (47.5% and 43.3%, respectively). Anti-infectives for systemic use ranked first (18%), followed by nervous and cardiovascular system drugs and by antineoplastic and immunomodulating agents (17.4%, 12.5% and 10.4%, respectively). The number of reported shortages presented a fourfold increase between 2012 and 2018 and a sharp rise in 2017 and 2018, along with a rise in the number of active substances on shortage. The therapeutic classes concerned remained similar over time. Manufacturing and material supply issues were the main reported reasons for the shortage each year (30%) and there was an overall rise of pharmaceutical market reasons. CONCLUSION:Drug shortages were increasingly reported in France. Preventive measures should specifically target the products most on shortage, in particular old drugs, injectable, anti-infective, nervous system and cardiovascular system drugs as well as antineoplastic and immunomodulating agents.
| S-EPMC7059530 | biostudies-literature
Project description:Long-term US trends in alcoholic beverage calorie intakes remain unexamined, particularly with respect to changes in population subgroup-specific patterns over time.This study examined shifts in the consumption of alcoholic beverages, in total and by beverage type, on any given day among US adults in relation to sociodemographic characteristics.This study was a repeated cross-sectional analysis of data from the 1989-1991 and 1994-1996 Continuing Survey of Food Intakes by Individuals and the 2003-2006 and 2009-2012 National Health and Nutrition Examination Surveys.Adults aged ?19 years (N=39,298) were targeted. A subset of alcoholic beverage consumers (n=7,081) were studied.Survey weighted mean per capita per day intakes (among all participants, both consumers of alcoholic beverages and nonconsumers) and contributions of beer, wine, and liquor/mixed drinks to total alcoholic beverage energy were determined. Multivariable regression models were used to examine trends in the proportion of alcoholic beverage consumers and the per consumer intakes (among consumers of alcoholic beverages only).Per capita intakes from alcoholic beverages increased from 49 kcal/capita/day in 1989-1991 to 109 kcal/capita/day in 2003-2006 (P<0.001). The proportion consuming alcoholic beverages on any given day increased significantly from 1989-1991 to 2009-2012 (P for overall increasing trend <0.0001) for most sociodemographic subgroups. Per consumer, alcoholic beverage calories increased between 1989-1991 and 1994-1996 (P<0.05) for many subpopulations. Adults with less than high school education were less likely to consume alcohol, yet had higher per consumer calorie intakes compared with adults with a college degree. Women and adults aged ?60 years experienced a shift away from liquor/mixed drinks toward wine between 2003-2006 and 2009-2012. Beer contributed roughly 70% to total alcoholic beverage intake for less educated consumers across time.These results indicate there has been an increase in the proportion of US adults who drink on any given day and an increase in calories consumed from alcoholic beverages when drinking occurs.
| S-EPMC4921270 | biostudies-other
Project description:The objective was to examine levels of, correlates of and changes in the use of individual and grouped methods of contraception among US females aged 15-44 from 2008 to 2014.Using three rounds of the National Survey of Family Growth, we analyzed samples of 12,279 (2008), 5601 (2012) and 5699 (2014) females. We conducted simple and multivariable logistic regression analyses to identify associations between demographic characteristics and contraceptive use, as well as between characteristics and changes in use patterns.In terms of overall trends in contraceptive use between 2008 and 2014, there was no significant change in the proportion of women who used a method among either all women (60%) or those at risk of unintended pregnancy (90%). Significant changes in use occurred among six methods. The largest increase in use was among users of long-acting reversible contraceptive (LARC) methods, including the intrauterine device and implant - from 6% to 14% - across almost all population groups of female contraceptive users, while the largest decrease occurred among users of sterilization - from 37% to 28% - with lower-income women driving the decline in female sterilization and higher-income women driving the decline in a partner's sterilization as a primary method. Moderate increases were seen in the use of withdrawal and natural family planning.Most shifts in recent contraceptive use have occurred among the most effective methods - sterilization and LARCs. Differences in method-specific user characteristics underscore the importance of ensuring full access to the broad range of methods available.The lack of change in the overall use of contraceptives among women at risk for unintended pregnancy may have implications for the extent to which further declines in national rates of unintended pregnancy can be expected.
| S-EPMC5959010 | biostudies-literature
Project description:BackgroundPrevalence of self-reported methamphetamine use has remained relatively stable over the past decade; however, deaths and seizures involving methamphetamine have been increasing. Research is needed to determine if select subgroups in the US are at increased risk for use.MethodsWe examined data from individuals ages ≥12 from the 2015-2018 National Survey on Drug Use and Health (n = 226,632), an annual nationally representative cross-sectional survey of non-institutionalized individuals in the US. Log-linear trends in past-year methamphetamine use were examined, stratified by demographic and drug use characteristics.ResultsMethamphetamine use increased in the US from 2015 to 2018, including among those reporting past-year use of ecstasy/MDMA (6.1 % to 10.8 % [p = .018], a 78.2 % increase), cocaine (8.4 % to 11.8 % [p = .013], a 40.1 % increase), and among those reporting past-year prescription opioid misuse (5.4 % to 8.0 % [p = .019], a 49.2 % increase). Increases were particularly pronounced among those reporting past-year use of heroin (22.5 % to 37.4 % [p = .032], a 66.2 % increase) and LSD (5.1 %-= to 10.3 % [p = .002], a 100.4 % increase). Small increases were also detected among heterosexuals (0.6 % to 0.7 % [p = .044], a 16.2 % increase), those with a high school diploma or less (1.0 % to 1.2 % [p = .020], a 22.0 % increase), and among those receiving government assistance (1.4 % to 1.8 % [p = .046], a 26.2 % increase).ConclusionsMethamphetamine use is increasing among people who use other drugs with sharp increases among people who use heroin or LSD in particular, and this could have serious public health consequences. Results may signal that methamphetamine use may continue to increase in the general population.
| S-EPMC7371537 | biostudies-literature
Project description:Background The trends in outcomes in patients who undergo transcatheter aortic valve replacement are well described in the literature. Some of these trends are driven by the decreasing risk profile of patients because of changing indications for transcatheter aortic valve replacement. We aimed to evaluate these trends in different age groups and quantify how much of these trends are driven by changes in procedural characteristics. Methods and Results Using the National Inpatient Sample from 2012 to 2018, we identified 204 230 adult patients who underwent transfemoral aortic valve replacement. The study's primary objective was to evaluate the changes in age-based trends in in-hospital mortality driven by changes in procedural characteristics over time. The secondary objectives were to evaluate similar trends in cardiac and noncardiac complications and resource use. Univariate and multivariate linear and logistic regression were used to obtain effect sizes. From 2012 to 2018, in-hospital mortality decreased from 1.8% to 0.79% in the age group 18 to 64 years, from 3.8% to 1.6% in the age group 65 to 80 years, and from 5.3% to 1.5% in the age group >80 years (P trend<0.01 for all age groups); these trends remained statistically significant on adjusted analysis except in patients aged 18 to 64 years. The other outcomes also showed variable trends over time. Length of stay, cost, and early discharge rates improved even after adjusting for comorbidities, which is likely attributable to improvement in procedural characteristics. Conclusions The changes in outcomes related to transcatheter aortic valve replacement are partly driven by changing patient risk profiles over time, but procedural characteristics have likely contributed to these trends in all age groups.
| S-EPMC9750063 | biostudies-literature