Physical activity, health status and risk of hospitalization in patients with severe chronic obstructive pulmonary disease.

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of death and 70% of the cost of COPD is due to hospitalizations. Self-reported daily physical activity and health status have been reported as predictors of a hospitalization in COPD but are not routinely assessed.

Objectives: We tested the hypothesis that self-reported daily physical activity and health status assessed by a simple question were predictors of a hospitalization in a well-characterized cohort of patients with severe emphysema.

Is survival better at hospitals with higher "end-of-life" treatment intensity?

Background: Concern regarding wide variations in spending and intensive care unit use for patients at the end of life hinges on the assumption that such treatment offers little or no survival benefit.

Objective: To explore the relationship between hospital "end-of-life" (EOL) treatment intensity and postadmission survival.

Research Design: Retrospective cohort analysis of Pennsylvania Health Care Cost Containment Council discharge data April 2001 to March 2005 linked to vital statistics data through September 2005 using hospital-level correlation, admission-level marginal structural logistic regression, and pooled logistic regression to approximate a Cox survival model.

Development and validation of hospital "end-of-life" treatment intensity measures.

Background: Health care utilization among decedents is increasingly used as a measure of health care efficiency, but decedent-based measures may be biased estimates of care received by "dying" patients.

Objective: To develop and validate new measures of hospital "end-of-life" treatment intensity.

Research Design: Retrospective cohort study using Pennsylvania Health Care Cost Containment Council (PHC4) discharge data (April 2001-March 2005) and Centers for Medicare and Medicaid Services (CMS) data (January 1999-December 2003).

Integrating health status and survival data: the palliative effect of lung volume reduction surgery.

Rationale: In studies that address health-related quality of life (QoL) and survival, subjects who die are usually censored from QoL assessments. This practice tends to inflate the apparent benefits of interventions with a high risk of mortality. Assessing a composite QoL-death outcome is a potential solution to this problem.

Organizational determinants of hospital end-of-life treatment intensity.

Background: There is substantial hospital-level variation in end-of-life (EOL) treatment intensity.

Objective: To explore the association between organizational factors and EOL treatment intensity in Pennsylvania (PA) hospitals.

Research Design: Cross-sectional mixed-mode survey of Chief Nursing Officers of PA hospitals linked to hospital-level measures of EOL treatment intensity calculated from PA Health Care Cost Containment Council (PHC4) hospital discharge data.

Factors associated with alcohol use, depression, and their co-occurrence during pregnancy.

Background: Alcohol use and depression each adversely affect birth outcomes, but the impact of their co-occurrence among pregnant women is not well understood. In this study, we examined factors associated with alcohol use, depression, and their co-occurrence during pregnancy.

Methods: We analyzed datasets from 2 longitudinal studies conducted nearly 20 years apart in the same outpatient prenatal clinic of an urban women's hospital.

Prevalence of urinary tract infection in childhood: a meta-analysis.

Background: Knowledge of baseline risk of urinary tract infection can help clinicians make informed diagnostic and therapeutic decisions. We conducted a meta-analysis to determine the pooled prevalence of urinary tract infection (UTI) in children by age, gender, race, and circumcision status.

Methods: MEDLINE and EMBASE databases were searched for articles about pediatric urinary tract infection.

Mapping FACT-P and EORTC QLQ-C30 to patient health status measured by EQ-5D in metastatic hormone-refractory prostate cancer patients.

Objectives: To construct and validate a prediction model of preference-adjusted health status (EQ-5D) for metastatic hormone-refractory prostate cancer (HRPCA) patients using cancer-specific health-related quality of life (HRQoL) measures.

Methods: Data were obtained from a multicenter, multinational observational study of metastatic HRPCA patients conducted during 2002 to 2004. In addition to clinical and resource utilization, preference-adjusted health status (EQ-5D) and HRQoL (Functional Assessment of Cancer Therapy-Prostate [FACT-P] and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire [EORTC QLQ-C30]) data were collected.

Annual costs associated with diagnosis of uterine leiomyomata.

Objective: To describe the annual care, direct health care, and indirect work loss costs for women with a diagnosis of uterine leiomyomata.

Methods: We examined data from an employer claims database of 1.2 million beneficiaries (1999 to 2003).