Publications by authors named "David R Arday"

Background And Purpose: As childhood obesity is a concern in many communities, this study investigated outpatient evaluation and initial management of overweight and obese pediatric patients in U.S. military medical treatment facilities (MTFs).

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Despite the documented benefits of quitting smoking, studies have found that smokers who quit may have higher lifetime medical costs, in part because of increased risk for medical conditions, such as type 2 diabetes, brought on by associated weight gain. Using a simulation model and data on 612,332 adult smokers in the US Department of Defense's TRICARE Prime health plan in 2008, we estimated that cessation accompanied by weight gain would increase average life expectancy by 3.7 years, and that the average lifetime reduction in medical expenditures from improved health ($5,600) would be offset by additional expenditures resulting from prolonged life ($7,300).

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Introduction: The Disease Management Association of America identifies diabetes as one of the chronic conditions with the greatest potential for management. TRICARE Management Activity, which administers health care benefits for US military service personnel, retirees, and their dependents, created a disease management program for beneficiaries with diabetes. The objective of this study was to determine whether participation intensity and prior indication of uncontrolled diabetes were associated with health care use and costs for participants enrolled in TRICARE's diabetes management program.

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Background: TRICARE's Prime (managed care) plan spends more than $1 billion annually in medical expenditures attributed to overweight and obesity.

Purpose: This study estimates change in lifetime disease prevalence and medical expenditures associated with weight loss for beneficiaries in TRICARE's Prime plan.

Methods: This 2010 analysis uses Markov Chain Monte Carlo simulation with demographics, biometrics, health behavior, and disease presence for 857,200 overweight and 521,800 obese beneficiaries aged 18-64 years in 2008 to model future onset of diseases linked to excess weight.

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Objective: To assess the effect of TRICARE's asthma, congestive heart failure, and diabetes disease management programs using a scorecard approach. EVALUATION MEASURES: Patient healthcare utilization, financial, clinical, and humanistic outcomes. Absolute measures were translated into effect size and incorporated into a scorecard.

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Objective: To share outcomes and lessons learned from an evaluation of disease management (DM) programs for asthma, congestive heart failure (CHF), and diabetes for TRICARE patients.

Study Design: Multiyear evaluation of participants in voluntary, opt-out DM programs. Patient-centered programs, administered by 3 regional contractors, provide phone-based consultations with a care manager, educational materials, and newsletters.

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Background: Smoking is a major determinant of health status and outcomes. Current smoking has been associated with lower scores on the Short Form-36 Health Survey (SF-36). Whether this occurs among the elderly and disabled Medicare populations is not known.

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Objective: To examine state variability in diabetes care for Medicare beneficiaries and the impact of certain beneficiary characteristics on those variations.

Research Design And Methods: Medicare beneficiaries with diabetes, aged 18-75 years, were identified from 1997 to 1999 claims data. Claims data were used to construct rates for three quality of care measures (HbA(1c) tests, eye examinations, and lipid profiles).

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Objectives: To characterize smoking patterns in the older U.S. community-dwelling Medicare population at the national level and in states chosen to participate in the new Medicare Stop Smoking Program (MSSP) demonstration.

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