The State of US Health, 1990-2016

Mokdad, Ali H.; Ballestros, Katherine; Echko, Michelle; Glenn, Scott; Olsen, Helen Elizabeth; Mullany, Erin C; Lee, Alex; Khan, Abdur Rahman; Ahmadi, Alireza; Ferrari, Alize J.; Kasaeian, Amir; Werdecker, Andrea; Carter, Austin; Zipkin, Ben; Sartorius, Benn; Serdar, Berrin; Sykes, Bryan L.; Troeger, Chris; Fitzmaurice, Christina; Rehm, Jürgen; Santomauro, Damian; Kim, Daniel; Colombara, Danny V.; Schwebel, David C.; Tsoi, Derrick; Kolte, Dhaval; Nsoesie, Elaine O.; Nichols, Emma; Oren, Eyal; Charlson, Fiona J; Patton, George C.; Roth, Gregory A.; Hosgood, H. Dean; Whiteford, Harvey; Kyu, Hmwe Hmwe; Erskine, Holly E.; Huang, Hsiang; Martopullo, Ira; Singh, Jasvinder A; Nachega, Jean B.; Sanabria, Juan; Abbas, Kaja; Ong, Kanyin; Tabb, Karen M.; Krohn, Kristopher J.; Cornaby, Leslie; Degenhardt, Louisa; Moses, Mark; Farvid, Maryam S.; Griswold, Max; Criqui, Michael H.; Bell, Michelle L.; Nguyen, Minh Hao; Wallin, M. T.; Mirarefin, Mojde; Qorbani, Mostafa; Younis, Mustafa Z; Fullman, Nancy; Liu, Patrick; Briant, Paul Svitil; Gona, Philimon; Havmöller, Rasmus; Leung, Janni; Kimokoti, Ruth W; Bazargan‐Hejazi, Shahrzad; Hay, Simon I.; Yadgir, Simon; Biryukov, Stan; Vollset, Stein Emil; Alam, Tahiya; Frank, Tahvi; Farid, Talha; Miller, Ted R.; Vos, Theo; Bärnighausen, Till; Gebrehiwot, Tsegaye Telwelde; Yano, Yuichiro; Al‐Aly, Ziyad; Mehari, Alem; Handal, Alexis J.; Kandel, Amit; Anderson, Ben; Biroscak, Brian J.; Mozaffarian, Dariush; Dorsey, E. Ray; Ding, Eric L.; Park, Eun-Kee; Wagner, Gregory R.; Hu, Guoqing; Chen, Honglei; Sunshine, Jacob; Khubchandani, Jagdish; Leasher, Janet; Leung, Janni; Salomon, Joshua A.; Unützer, Jürgen; Cahill, Leah E.; Cooper, Leslie T.; Horino, Masako; Bräuer, Michael; Breitborde, Nicholas J. K.; Hotez, Peter J.; Topór-Mądry, Roman; Soneji, Samir; Stranges, Saverio; James, Spencer L.; Amrock, Stephen M.; Jayaraman, Sudha; Patel, Tejas; Akinyemiju, Tomi; Skirbekk, Vegard; Kinfu, Yohannes; Bhutta, Zulfiqar A; Jonas, Jost B.; Murray, Christopher J L

doi:10.1001/jama.2018.0158

Cited by 1,093 publications

(232 citation statements)

References 54 publications

Supporting

Mentioning

219

Contrasting

Order By: Relevance

“…The finding on multicomorbidity and hospitalization may reflect a clustering pattern of risk factors among some patients as well as the issue of “opportunity to be diagnosed” given the presence of one or more chronic disease. For example, substance use, high body mass index, high fasting plasma glucose, high systolic blood pressure, and impaired kidney function are all leading risk factors for mortality that are linked with chronic diseases (Brick, 2012; U.S. Burden of Disease Collaborators, 2018).…”

Section: Discussionmentioning

confidence: 99%

Multicomorbidity of chronic diseases and substance use disorders and their association with hospitalization: Results from electronic health records data

Zhu

Ghitza

2018

Drug and Alcohol Dependence

111

View full text Add to dashboard Cite

Background: Chronic diseases are prevalent and the leading causes of mortality. Comorbidity of substance use disorders (SUDs) and chronic diseases is understudied to inform behavioral healthcare integration. Objectives: This study leveraged electronic health record (EHR) data of 211,880 adults from a large health system to examine prevalence and correlates of comorbidity of SUDs and nine chronic disease groups and to determine their association with hospitalization. Methods: Logistic regression analyses were conducted to estimate associations between chronic diseases and SUDs. To control for severity of diagnosis, analyses of associations between SUD and hospitalization were stratified by the number of chronic conditions. Results: In the sample, 48.3% had ≥1 chronic condition (hypertension 33.7%, arthritis 16.2%, diabetes 13.7%, chronic kidney disease 9.9%, asthma 9.1%, chronic obstructive pulmonary disease 8.9%, ischemic heart disease 8.3%, cancer 4.6%, and hepatitis 1.3%). Prevalence of SUD (overall 13.3%) among patients increased with multiple chronic conditions (14.3% having SUD among patients with one condition; 21.2% having SUD among patients with two to three conditions; and 32.5% having SUD among patients with 4–9 conditions). Chronic conditions were associated with increased odds of SUDs. For all SUD groups, hospitalization was more prevalent among patients with SUD than those without it; prevalence of hospitalization increased with the number of comorbid chronic conditions. Conclusions: Findings reveal a striking pattern of multicomorbidity of SUD and chronic diseases and its positive association with hospitalization. Behavioral healthcare integration should consider efforts to assess and treat comorbid SUD and chronic diseases, especially among adults with multiple chronic conditions.

show abstract

Section: Discussionmentioning

confidence: 99%

Multicomorbidity of chronic diseases and substance use disorders and their association with hospitalization: Results from electronic health records data

Zhu

Ghitza

2018

Drug and Alcohol Dependence

111

View full text Add to dashboard Cite

show abstract

“…Health burden associated with ACEs during 2013: We also tabulated the estimated health burden in California during 2013 that was associated with ACEs, with burden measured in DALYs. The 2016 Global Burden of Disease (GBD) study [25,29] provided prevalence-based DALYs estimates by disease for the US. It defined DALYs as the sum of the years of healthy life lost to the disease during the year plus the years of life lost to deaths from the disease that occurred during the year.…”

Section: Estimating Excess Disease Risk Associated With Acesmentioning

confidence: 99%

Adult health burden and costs in California during 2013 associated with prior adverse childhood experiences

Miller

Waehrer

et al. 2020

PLoS ONE

View full text Add to dashboard Cite

ObjectivesTo estimate the adult health burden and costs in California during 2013 associated with adults' prior Adverse Childhood Experiences (ACEs). MethodsWe analyzed five ACEs-linked conditions (asthma, arthritis, COPD, depression, and cardiovascular disease) and three health risk factors (lifetime smoking, heavy drinking, and obesity). We estimated ACEs-associated fractions of disease risk for people aged 18+ for these conditions by ACEs exposure using inputs from a companion study of California Behavioral Risk Factor Surveillance System data for 2008-2009, 2011, and 2013. We combined these estimates with published estimates of personal healthcare spending and Disability-Adjusted-Life-Years (DALYs) in the United States by condition during 2013. DALYs captured both the years of healthy life lost to disability and the years of life lost to deaths during 2013. We applied a published estimate of cost per DALY.Estimates of the costs of childhood adversity are far greater than previously understood and provide a fiscal rationale for prevention efforts. PLOS ONE | https://doi.org/10.1371/journal.pone.

show abstract

“…1 In the USA in 2016, COPD was ranked as the third leading cause of disability after ischemic heart disease and lung cancer. 3 Moreover, COPD is associated with a substantial economic burden and, by 2020, the national medical costs attributable to COPD in the USA are projected to increase to $49.0 billion (from $32.1 billion in 2010). 4 The treatment of COPD aims to reduce symptoms and the risk of exacerbations, and improve overall health status.…”

Section: Introductionmentioning

confidence: 99%

<p>Patient Characteristics and Healthcare Resource Utilization Among Patients with COPD New to LAMA/LABA Fixed-Dose Combination Treatment in US-Based Real-World Practice</p>

Ding

Kallenbach

Slipski

et al. 2020

COPD

View full text Add to dashboard Cite

Introduction: This retrospective, observational cohort study utilized an integrated dataset from an electronic health records system and a claims database to describe demographic and clinical characteristics, healthcare resource utilization (HCRU), and treatment patterns in COPD patients initiating long-acting muscarinic antagonist (LAMA)/long-acting β 2 -agonist (LABA) fixed-dose combination (FDC) treatment in the USA. Methods: Patients were aged ≥40 years and had a COPD diagnosis (Practice Fusion system) and ≥1 prescription of LAMA/LABA FDC therapy, with an index date (first prescription) 1 May 2014-31 December 2017. For the HCRU analysis, patients had ≥2 claims from the Symphony Health database within 12 months before index. All analyses of outcomes relating to demographic and clinical characteristics, HCRU, and treatment patterns were descriptive. Results: Patients initiating LAMA/LABA FDCs (n=8224) had a mean age of 67.9 years, 52.8% were female, and mean BMI was 29.2 kg/m 2 . The most common comorbidities were cardiovascular disease (74.3%), hypertension (64.0%), and hyperlipidemia (45.6%). In the 12 months prior to index, 53.1% of patients had used inhaled therapy: 23.4% short-acting therapy only, 16.7% short-acting and maintenance therapy, and 13.1% maintenance therapy only. Amongst users of inhaled therapies, the pMDI was the most frequently used device (64.3%, n=2812/4370). Of 7050 patients included in the HCRU analysis, 79.8% had COPDrelated costs; mean cost/patient was $4174. Mean COPD-related costs per patient for moderate and severe exacerbations were $910 and $23,208, respectively. Per-patient costs included $23,032 for inpatient visits, $2358 for emergency visits, $4432 for outpatient visits, and $1989 for pharmacy claims. Conclusion: This observational study is the first to describe the real-world demographic and clinical characteristics and HCRU of patients initiating LAMA/LABA FDC treatment in the USA. Patients were generally elderly and overweight, with comorbidities of CVD, hypertension, and hyperlipidemia. Inpatient visits were the largest contributor to COPD-related costs per patient in the year prior to initiation of LAMA/LABA FDCs.

show abstract

The State of US Health, 1990-2016

Cited by 1,093 publications

References 54 publications

Multicomorbidity of chronic diseases and substance use disorders and their association with hospitalization: Results from electronic health records data

Multicomorbidity of chronic diseases and substance use disorders and their association with hospitalization: Results from electronic health records data

Adult health burden and costs in California during 2013 associated with prior adverse childhood experiences

<p>Patient Characteristics and Healthcare Resource Utilization Among Patients with COPD New to LAMA/LABA Fixed-Dose Combination Treatment in US-Based Real-World Practice</p>

Contact Info

Product

Resources

About