Patient Outcomes, Health Care Resource Use, and Costs Associated with High Versus Low HEDIS Asthma Medication Ratio.

Background: The Healthcare Effectiveness Data and Information Set (HEDIS) quality measures for asthma include the asthma medication ratio (AMR) as a marker of quality of care for patients with asthma. Few data are available to describe the association between health care use and costs in patients with high versus low AMR.

Objective: To characterize health care use and costs associated with high versus low AMR in patients participating in commercial health plans.

Baseline asthma burden, comorbidities, and biomarkers in omalizumab-treated patients in PROSPERO.

Background: Patients included in clinical trials do not necessarily reflect the real-world population.

Objective: To understand the characteristics, including disease and comorbidity burden, of patients with asthma receiving omalizumab in a real-world setting.

Methods: The Prospective Observational Study to Evaluate Predictors of Clinical Effectiveness in Response to Omalizumab (PROSPERO) was a US-based, multicenter, single-arm, and prospective study.

Corticosteroid-related toxicity in patients with chronic idiopathic urticariachronic spontaneous urticaria.

Background: Treatments for patients with chronic idiopathic urticaria (CIU)chronic spontaneous urticaria (CSU) who were unresponsive to antihistamines include oral corticosteroids (OCS). Risks of OCS-related side effects in these patients have not been described quantitatively.

Objective: To investigate the relationship between OCS use and the risk of developing side effects possibly attributable to OCS and associated health care costs in privately insured patients with CIU/CSU.

Health care resource use and costs associated with possible side effects of high oral corticosteroid use in asthma: a claims-based analysis.

Background: The objective of this study was to estimate the prevalence of possible oral corticosteroid (OCS)-related side effects and health care resource use and costs in patients with asthma.

Methods: This was a cross-sectional, matched-cohort, retrospective study using a commercial claims database. Adults with asthma diagnosis codes and evidence of asthma medication use were studied.

Improvement of sleep in patients with chronic idiopathic/spontaneous urticaria treated with omalizumab: results of three randomized, double-blind, placebo-controlled studies.

Background: Patients with chronic idiopathic/spontaneous urticaria (CIU/CSU) report difficulty with sleep.

Methods: We examined the effect of omalizumab on sleep-related outcomes during 3-6 months omalizumab or placebo treatment and a 16-week follow-up period within three Phase III double-blind randomized placebo-controlled pivotal trials in CIU/CSU: ASTERIA I, ASTERIA II, and GLACIAL. Sleep quality was assessed in all three studies using sleep-related questions included in an electronic diary, the Chronic Urticaria Quality of Life Questionnaire, and the Medical Outcomes Study Sleep Scale.

Angioedema in the omalizumab chronic idiopathic/spontaneous urticaria pivotal studies.

Background: Angioedema, present in some patients with chronic idiopathic/spontaneous urticaria (CIU/CSU), may have a negative effect on patient quality of life.

Objective: To describe patient-reported angioedema and its management in the pivotal omalizumab studies (ASTERIA I, ASTERIA II, GLACIAL).

Methods: Enrolled patients with CIU/CSU remained symptomatic despite treatment with histamine (H)-antihistamines at licensed doses (ASTERIA I, ASTERIA II) or H-antihistamines at up to 4 times the approved dose plus H-antihistamines and/or a leukotriene receptor antagonist (GLACIAL).

Timing and duration of omalizumab response in patients with chronic idiopathic/spontaneous urticaria.

Background: Few data are available that describe response patterns in patients with chronic idiopathic urticaria (CIU)/chronic spontaneous urticaria (CSU) treated with omalizumab.

Objective: We sought to describe response patterns by using data from the 3 pivotal omalizumab CIU/CSU trials.

Methods: Every 4 weeks, randomized patients received dosing with placebo or 75, 150, or 300 mg of omalizumab (ASTERIA I: n = 318, 24 weeks; ASTERIA II: n = 322, 12 weeks) or placebo or 300 mg of omalizumab (GLACIAL: n = 335, 24 weeks).

Resource use and costs in an insured population of patients with chronic idiopathic/spontaneous urticaria.

Background: Chronic idiopathic or spontaneous urticaria (CIU/CSU) impairs patients' quality of life, and updated information on disease prevalence, treatment patterns, and disease burden is lacking.

Objectives: We aimed to estimate these figures in a large US real-world claims database via a validated algorithm.

Methods: In this retrospective cross-sectional cohort study, we identified patients with CIU/CSU, estimated disease prevalence, comorbidities, and healthcare use (medications, office visits, emergency department visits, and hospitalizations) and costs (urticaria related and all cause).

Can bundled payment improve quality and efficiency of care for patients with hip fractures?

The current Medicare reimbursement for hip fractures lacks accountability and promotes cost cutting. A bundled payment system-analogous to the Medicare Acute Care Episodes Demonstration for Orthopedic and Cardiovascular Surgery-may help curtail costs, foster communication among health care providers, and improve their accountability for patient outcomes. In hip fracture care, bundled payment may spur development of multidisciplinary best practice guidelines, quality assessment, and reporting, and result in benchmarking and best practices sharing.

Seasonal influenza vaccination trends from 2007-2011 in privately insured children and adults in the United States.

Background: To ensure adequate protection from seasonal influenza in the US, the Advisory Committee on Immunization Practices recommends vaccination of all persons aged 6 months or older, with rare exceptions. It also advises starting vaccination as soon as available and continuing throughout the influenza season. This study examined US seasonal vaccination trends during five consecutive influenza seasons in privately-insured children and adults.

Tibia shaft fractures: costly burden of nonunions.

Background: Tibia shaft fractures (TSF) are common for men and women and cause substantial morbidity, healthcare use, and costs. The impact of nonunions on healthcare use and costs is poorly described. Our goal was to investigate patient characteristics and healthcare use and costs associated with TSF in patients with and without nonunion.

Burden of paediatric influenza in Western Europe: a systematic review.

Background: Influenza illness in children causes significant clinical and economic burden. Although some European countries have adopted influenza immunisation policies for healthy children, the debate about paediatric influenza vaccination in most countries of the European Union is ongoing. Our aim was to summarise influenza burden (in terms of health outcomes and economic burden) in children in Western Europe via a systematic literature review.

Older people presenting to the emergency department after a fall: a population with substantial recurrent healthcare use.

Objectives: To document patient characteristics, care pathways, healthcare use and costs of fall-related emergency department (ED) presentations by older adults.

Participants And Methods: All fallers aged ≥70 years, presenting to the ED of a 450-bed metropolitan university hospital in Sydney, Australia (1 April 2007 through 31 March 2009) were studied. Data were collected from the ED electronic information system, ED clinical records and the hospital electronic information system database.

Scope and severity index: a metric for quantifying nursing home survey deficiency number, scope, and severity adjusted for the state-related measurement bias.

Objectives: To develop a metric (scope and severity index [SSI]) to measure nursing home deficiency number, scope, and severity adjusted for the state-related bias and to test its convergent and predictive validity.

Design: We assigned scope and severity weights to each level of scope and severity (A-L). SSI was calculated as a sum of all weights per survey which was further corrected for the state-level bias by dividing by the state average number of health deficiencies and multiplying by the national average number of health deficiencies.