Objectives: To evaluate the associations between potentially avoidable diabetes-related emergency/urgent hospital admissions and different health insurance status (ie, Medicaid, Medicare, uninsured, private), along with other characteristics including sociodemographic status (age, race/ethnicity, gender, region), hospitalization status (previous hospitalizations, weekend admissions), and health status (complications, comorbidities), among patients with type 2 diabetes mellitus (T2DM).
Study Design: The 2011 data set of all inpatient discharge records with a primary diagnosis of T2DM from all hospitals in Pennsylvania were included in the analyses.
Methods: Multivariable logistic regression modeling with diabetes-related emergency/urgent hospitalizations as the dependent outcome variable and health insurance status as the main exposure independent variable, adjusting for age, race/ethnicity, gender, region, previous hospitalizations, weekend admissions, complications, and comorbidity.
Am J Manag Care
September 2014
Objectives: To evaluate the characteristics driving higher diabetes-related hospitalization charges.
Methods: Hospital discharge data on 216,858 hospitalizations from 2001 to 2011 with primary discharge diagnosis of diabetes were linked to the Pennsylvania death registry. Multiple linear regression analysis was used to evaluate the association between inpatient hospitalization charges and complications, sociodemographic status, comorbidities, readmission, length of stay, admission type, region, procedures, payer type, and hospitalization misadventures.
Although studies indicate school-based HIV/AIDS education programs effectively reduce risky behaviors, only 33 states and the District of Columbia in US mandate HIV/AIDS education. Ideally, school-based HIV/AIDS education should begin before puberty, or at the latest before first sexual intercourse. In 2011, 20% US states had fewer schools teaching HIV/AIDS prevention than during 2008; this is worrisome, especially for more vulnerable minorities.
View Article and Find Full Text PDFJ Prim Care Community Health
April 2014
Background: Multiple chronic conditions (MCCs) are significant public health problems receiving much attention, and rightly so, because of the substantial morbidity, mortality, and cost burden.
Objectives: To report the prevalence of selected frequent MCCs with shared risk factors that are leading causes of death; and to quantify the association between diabetes and its comorbidity and shared risk factors.
Methods: This is a cross-sectional study of 9172 participants in Pennsylvania's 2009 Behavioral Risk Factor Surveillance System (BRFSS).
Introduction: Philadelphia enacted its Clean Indoor Air Act (CIAA) nearly 2 years before the statewide CIAA. In this study, we assessed the economic impact of CIAAs on 4 types of food services and drinking places and addressed the predominant limitation of previous pre-post ban studies, namely the lack of control for confounders and changes in secular trends over time.
Methods: We analyzed data from Pennsylvania Department of Revenue Quarterly 1998-2011 taxable county-level revenue sales and number of food services and drinking places.
Introduction: Scientific evidence shows that cigarette price increases can significantly reduce smoking prevalence and smoking initiation among adolescents and young adults. However, data are lacking regarding the effectiveness of increasing Pennsylvania's cigarette tax to reduce smoking and/or adverse health effects of smoking. The objective of our study was to assess the impact of cigarette tax increases and resulting price increases on smoking prevalence, acute myocardial infarction (AMI) and asthma hospitalization rates, and sudden cardiac death (SCD) rates in Pennsylvania.
View Article and Find Full Text PDFCurr Opin Nephrol Hypertens
November 2010
Purpose Of Review: More than half a million Americans die each year from coronary heart disease (CHD), 26 million suffer from chronic kidney disease (CKD), and a large proportion have periodontal disease, a chronic infection of the tissues surrounding teeth. Chronic inflammation contributes to CHD and CKD occurrence and progression, and periodontal disease contributes to the cumulated chronic systemic inflammatory burden. This review examines recent evidence regarding the role of periodontal disease in CHD and CKD.
View Article and Find Full Text PDFPeriodontal disease is associated with diabetes, heart disease, and chronic kidney disease (CKD), relationships postulated to be due in part to vascular inflammation. A bidirectional relationship between CKD and periodontal disease is plausible, though this relationship has not been previously reported. In this study, we assessed the potential for connections between CKD and periodontal disease, and mediators of these relationships using structural equation models of data from 11,211 adults ≥ 18 years of age who participated in the Third National Health and Nutrition Examination Survey.
View Article and Find Full Text PDFPurpose/question: The authors attempted to study the gingival status of renal transplant patients receiving sirolimus immunosuppressive therapy by measuring the presence and severity of gingival overgrowth (GO) and by investigating the association between GO and sociodemographic, medical, and pharmacologic variables.
Source Of Funding: Grants from the Coordination of Improvement of Upper Level Personnel (CAPES), Brasilia, DF, Brazil, and the Foundation for Support of Research in Minas Gerais (FAPEMIG/#13016).
Type Of Study/design: Cross-sectional
Level Of Evidence: Level 3: Other evidence.
Am J Orthod Dentofacial Orthop
February 2010
Introduction: Pretreatment characteristics can assist orthodontists in accurately estimating treatment duration.
Methods: This case-control study identified 400 patients, 9 to 18 years of age. Short treatment duration was 20 months or less, and long treatment duration was 30 months or longer.
As dental schools incorporate training in evidence-based dentistry (EBD) into their curricula, students must learn how to critically evaluate systematic reviews and meta-analyses. It is important that dental education in the United States support the American Dental Association's position statement on EBD, which defines "best evidence" as data obtained from all study designs. Given that much evidence is missing when EBD is derived from Cochrane Systematic Reviews' randomized clinical trials, we propose the creation of a dental practice network of U.
View Article and Find Full Text PDFBackground: In a population-based study of Medicaid-eligible children, the authors described and compared sociodemographic attributes, medical and dental health care utilization, and health status between Medicaid-insured and uninsured Medicaid-eligible children.
Methods: The authors analyzed data from 2,491 poor Medicaid-eligible children 2 to 16 years of age who participated in the 1999-2004 National Health and Nutrition Examination Survey. They quantified the association of medical and dental health care utilization, health status and treatment needs with Medicaid insurance status by using multivariable logistic regression modeling, taking into account the complex survey design and sample weights.
J Periodontol
January 2009
Background: An estimated 75% of the seven million Americans with moderate-to-severe chronic kidney disease are undiagnosed. Improved prediction models to identify high-risk subgroups for chronic kidney disease enhance the ability of health care providers to prevent or delay serious sequelae, including kidney failure, cardiovascular disease, and premature death.
Methods: We identified 11,955 adults > or =18 years of age in the Third National Health and Nutrition Examination Survey.
Background: Chronic kidney disease and its concomitant sequelae represent a major public health problem. Recent data suggest periodontal infection contributes to chronic kidney disease.
Methods: This United States population-based study of 4,053 adults > or =40 years of age investigated the association between chronic kidney disease and clinical measures and serologic markers of periodontal infection.
J Health Care Poor Underserved
February 2008
Smoking is a major risk factor for many chronic diseases. Nearly all studies collecting smoking data use self-reports, which are very rarely validated. We identified 15,182 adults 18 years or older in the Third National Health and Nutrition Examination Survey.
View Article and Find Full Text PDFBackground: Chronic kidney disease, undiagnosed in a significant number of adults, is a public health problem. Given the systemic inflammatory response to periodontal disease, we hypothesized that periodontal disease could be associated with chronic kidney disease.
Study Design: Cross-sectional.
The goal of this paper was to report the prevalence of dental care--a Healthy People 2010 objective--for nursing home residents 65 years and older, and to assess the association between receipt of dental care with other oral status and workforce measures. Data from 7,363 residents aged 65 years and older with information in the 1997 National Nursing Home Survey (NNHS) were used. Overall, 18.
View Article and Find Full Text PDFBackground: This study assessed predictive values of self-reported periodontal need to identify periodontal conditions using clinical examinations as the gold standard.
Methods: We identified 12,370 adults > or = 18 years of age in the third National Health and Nutrition Examination Survey. Self-reported periodontal need was based on participants responding that gum treatment and/or cleaning was needed when asked: "What type of dental care do you need now?" Two periodontal conditions were at least two sites with pockets (pockets > or = 3 mm or pockets > or = 4 mm) and at least two sites with calculus.
Community Dent Oral Epidemiol
August 2007
Background: Data are lacking to support the contention that Medicaid services improve utilization of healthcare services and result in better health.
Objective: To compare sociodemographic, utilization of healthcare services and health status characteristics among Medicaid-eligible children.
Methods: The third National Health and Nutrition Examination Survey included 2821 children 2-16 years of age eligible for Medicaid.
Background: Nearly all studies reporting smoking status collect self-reported data. The objective of this study was to assess sociodemographic characteristics and selected, common smoking-related diseases as predictors of invalid reporting of non-smoking. Valid self-reported smoking may be related to the degree to which smoking is a behavior that is not tolerated by the smoker's social group.
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