WorldWideScience

Sample records for claim database cost

  1. Comparison of Complications, Trends, and Costs in Endoscopic vs Microscopic Pituitary Surgery: Analysis From a US Health Claims Database.

    Science.gov (United States)

    Asemota, Anthony O; Ishii, Masaru; Brem, Henry; Gallia, Gary L

    2017-09-01

    Microsurgical and endoscopic techniques are commonly utilized surgical approaches to pituitary pathologies. There are limited data comparing these 2 procedures. To evaluate postoperative complications, associated costs, and national and regional trends of microscopic and endoscopic techniques in the United States employing a nationwide database. The Truven MarketScan database 2010 to 2014 was queried and Current Procedural Terminology codes identified patients that underwent microscopic and/or endoscopic transsphenoidal pituitary surgery. International Classification of Diseases codes identified postoperative complications. Adjusted logistic regression and matched propensity analysis evaluated independent odds for complications. Among 5886 cases studied, 54.49% were microscopic and 45.51% endoscopic. The commonest surgical indications were benign pituitary tumors. Annual trends showed increasing utilization of endoscopic techniques vs microscopic procedures. Postoperative complications occurred in 40.04% of cases, including diabetes insipidus (DI; 16.90%), syndrome of inappropriate antidiuretic hormone (SIADH; 2.02%), iatrogenic hypopituitarism (1.36%), fluid/electrolyte abnormalities (hypoosmolality/hyponatraemia [5.03%] and hyperosmolality/hypernatraemia [2.48%]), and cerebrospinal fluid (CSF) leaks (CSF rhinorrhoea [4.42%] and other CSF leak [6.52%]). In our propensity-based model, patients that underwent endoscopic surgery were more likely to develop DI (odds ratio [OR] = 1.48; 95% confidence interval [CI] = 1.28-1.72), SIADH (OR = 1.53; 95% CI = 1.04-2.24), hypoosmolality/hyponatraemia (OR = 1.17; 95% CI = 1.01-1.34), CSF rhinorrhoea (OR = 2.48; 95% CI = 1.88-3.28), other CSF leak (OR = 1.59; 95% CI = 1.28-1.98), altered mental status (OR = 1.46; 95% CI = 1.01-2.60), and postoperative fever (OR = 4.31; 95% CI = 1.14-16.23). There were no differences in hemorrhagic complications, ophthalmological complications, or bacterial meningitis. Postoperative

  2. Analyzing claims by game theory and claim cost

    Institute of Scientific and Technical Information of China (English)

    LI Cong-wei; TANG Yao-gang; LIU Zhan-hong

    2006-01-01

    In managing an international project, claims are very important. In this paper, a complete information dynamic game model is designed; with the Nash equilibrium values, the huge influence of claim cost on claim strategy is testified and the importance of claims to both sides of a contract especially the contractor is elucidated. Claim chances are also discussed with game theory. At last, from the angle of a repeated game and by comparison with Pareto optimization and Nash equilibrium values, it is concluded that the best payoff can be obtained with a honest attitude and through cooperation between companies.

  3. One-year risk of psychiatric hospitalization and associated treatment costs in bipolar disorder treated with atypical antipsychotics: a retrospective claims database analysis

    Directory of Open Access Journals (Sweden)

    Pikalov Andrei

    2011-01-01

    Full Text Available Abstract Background This study compared 1-year risk of psychiatric hospitalization and treatment costs in commercially insured patients with bipolar disorder, treated with aripiprazole, ziprasidone, olanzapine, quetiapine or risperidone. Methods This was a retrospective propensity score-matched cohort study using the Ingenix Lab/Rx integrated insurance claims dataset. Patients with bipolar disorder and 180 days of pre-index enrollment without antipsychotic exposure who received atypical antipsychotic agents were followed for up to 12 months following the initial antipsychotic prescription. The primary analysis used Cox proportional hazards regression to evaluate time-dependent risk of hospitalization, adjusting for age, sex and pre-index hospitalization. Generalized gamma regression compared post-index costs between treatment groups. Results Compared to aripiprazole, ziprasidone, olanzapine and quetiapine had higher risks for hospitalization (hazard ratio 1.96, 1.55 and 1.56, respectively; p Conclusions In commercially insured adults with bipolar disorder followed for 1 year after initiation of atypical antipsychotics, treatment with aripiprazole was associated with a lower risk of psychiatric hospitalization than ziprasidone, quetiapine, olanzapine and risperidone, although this did not reach significance with the latter. Aripiprazole was also associated with significantly lower total healthcare costs than quetiapine, but not the other comparators.

  4. Treatment patterns, healthcare resource utilization, and costs following first-line antidepressant treatment in major depressive disorder: a retrospective US claims database analysis.

    Science.gov (United States)

    Gauthier, Geneviève; Guérin, Annie; Zhdanava, Maryia; Jacobson, William; Nomikos, George; Merikle, Elizabeth; François, Clément; Perez, Vanessa

    2017-06-19

    Although the symptoms of major depressive disorder (MDD) are often manageable with pharmacotherapy, response to first-line antidepressant treatment is often less than optimal. This study describes long-term treatment patterns in MDD patients in the United States and quantifies the economic burden associated with different treatment patterns following first-line antidepressant therapy. MDD patients starting first-line antidepressant monotherapy and having continuous enrollment ≥12 months before and ≥24 months following the index date (i.e., the first documented prescription fill) were selected from the Truven Health Analytics MarketScan (2003-2014) database. Based on the type of first treatment change following initiation, six treatment cohorts were defined a priori ("persistence"; "discontinuation"; "switch"; "dose escalation"; "augmentation"; and "combination"). Treatment patterns through the fourth line of therapy within each cohort, healthcare resource utilization (HCRU), and cost analyses were restricted to patients with adequate treatment duration (defined as ≥42 days) in each line (analysis sub-sample, N = 21,088). HCRU and costs were described at the cohort and pattern levels. Treatment cohorts representing patterns. Median time to discontinuation was 23 weeks. The switch cohort exhibited the highest HCRU (18.9 days with medical visits per-patient-per-year) and greatest healthcare costs ($11,107 per-patient-per-year) following the index date. Treatment patterns representing a cycling on and off treatment in the switch cohort were associated with the greatest healthcare costs overall. A high proportion of patients discontinue first-line antidepressant shortly after initiation. Patterns representing a cycling on and off treatment in the switch cohort were associated with the highest healthcare costs. These findings underscore challenges in effectively treating patients with MDD and a need for personalized patient management.

  5. The burden of multiple myeloma: assessment on occurrence, outcomes and cost using a retrospective longitudinal study based on administrative claims database

    Directory of Open Access Journals (Sweden)

    Simona De Portu

    2011-12-01

    Full Text Available

    Objective: Multiple myeloma (MM is a malignancy of plasma cells that results in an overproduction of light and heavy chain monoclonal immunoglobulins. Multiple myeloma imposes a significant economic and humanistic burden on patients and society. The present study is aimed at assessing the burden of multiple myeloma in both epidemiologic and economic terms.

    Methods: A retrospective, naturalistic longitudinal study on the occurrence, outcome and cost of multiple myeloma using an administrative database, was performed. We selected residents of a North-eastern Region of Italy, who had their first hospital admission for multiple myeloma during the period 2001-2005. This group was followed up until 31-12-2006, death or transfers to other regional health services. Direct medical costs were quantified within the perspective of the Regional Health Service.

    Results: During the period 2001-2005, out of a population if 1.2 million inhabitants, we observed 517 incidents of patients diagnosed with MM (52% female. During the period of observation, 364 (70.4% subjects died. Total health care costs per patient over the maximum of follow-up were estimated to be 76,630 Euro for subjects younger than 70 years old and 22,892 Euro in the older group.

    Conclusions: Multiple myeloma imposes a significant epidemiological and economic burden on the healthcare system.

  6. The prevalence and ingredient cost of chronic comorbidity in the Irish elderly population with medication treated type 2 diabetes: A retrospective cross-sectional study using a national pharmacy claims database

    Directory of Open Access Journals (Sweden)

    O’Shea Miriam

    2013-01-01

    Full Text Available Abstract Background Comorbidity in patients with diabetes is associated with poorer health and increased cost. The aim of this study was to investigate the prevalence and ingredient cost of comorbidity in patients ≥ 65 years with and without medication treated type 2 diabetes using a national pharmacy claims database. Methods The Irish Health Service Executive Primary Care Reimbursement Service pharmacy claims database, which includes all prescribing to individuals covered by the General Medical Services scheme, was used to identify the study population (≥ 65 years. Patients with medication treated type 2 diabetes (T2DM were identified using the prescription of oral anti-hyperglycaemic agents alone or in combination with insulin as a proxy for disease diagnosis. The prevalence and ingredient prescribing cost of treated chronic comorbidity in the study population with and without medication treated T2DM were ascertained using a modified version of the RxRiskV index, a prescription based comorbidity index. The association between T2DM and comorbid conditions was assessed using logistic regression adjusting for age and sex. Bootstrapping was used to ascertain the mean annual ingredient cost of treated comorbidity. Statistical significance at p  Results In 2010, 43165 of 445180 GMS eligible individuals (9.7% were identified as having received medication for T2DM. The median number of comorbid conditions was significantly higher in those with T2DM compared to without (median 5 vs. 3 respectively; p  Conclusions Individuals with T2DM were more likely to have a higher number of treated comorbid conditions than those without and this was associated with higher ingredient costs. This has important policy and economic consequences for the planning and provision of future health services in Ireland, given the expected increase in T2DM and other chronic conditions.

  7. Estimated Prevalence of Glaucoma in South Korea Using the National Claims Database

    Directory of Open Access Journals (Sweden)

    Sang Jin Seo

    2016-01-01

    Full Text Available Purpose. To estimate the prevalence of glaucoma and costs associated with glaucoma care in South Korea between 2008 and 2013 using the Korean national claims database. Design. Retrospective cross-sectional study from a national claims database. Methods. Patients who were diagnosed with glaucoma between 2008 and 2013 were retrospectively identified in the national claims database using glaucoma diagnostic codes. For each year, the prevalence of glaucoma and direct medical costs associated with glaucoma care were estimated. Result. The prevalence of glaucoma in patients ≥40 years of age increased from 0.79% in 2008 to 1.05% in 2013. The number of patients with glaucoma increased by 54% between 2008 and 2013 (9% average annual increase. The prevalence of glaucoma increased with age and was higher in males than in females. The cost to care for glaucoma patients increased from $16.5 million in 2008 to $29.2 million in 2013, which translated into an 81% increase over the 6 years examined (12.7% average annual increase. Conclusion. The estimated prevalence and socioeconomic burden of glaucoma have steadily increased each year in South Korea. Nevertheless, many glaucoma patients remain undiagnosed in the present study using national claims database.

  8. Signal detection of methylphenidate by comparing a spontaneous reporting database with a claims database.

    Science.gov (United States)

    Kim, JaYoung; Kim, Munsin; Ha, Ji-Hye; Jang, Junghoon; Hwang, Myungsil; Lee, Byung Koo; Chung, Myeon Woo; Yoo, Tae Moo; Kim, Myung Jung

    2011-11-01

    Data mining is critical for signal detection in pharmacovigilance systems. In this study, we compared signals between spontaneous reporting data and health insurance claims data for a socially issued drug, methylphenidate. We implemented data-mining tools for signal detection in both databases: Reporting Odds Ratios (ROR), Proportional Reporting Ratios (PRR), Chi-squared test, and Information Component (IC), in addition to a Relative Risk (RR) tool in the claims database. The claims database generated 15, 15, 36, 1, and 1 adverse drug reactions (ADRs) by ROR, PRR, chi-square, IC, and RR, respectively. The World Health Organization (WHO) spontaneous database generated 91, 91, 137, and 96 ADRs by ROR, PRR, chi-square, and IC, respectively. We found seven potential matching associations from the claims and WHO databases, but only one of them was present in the Korean spontaneous reporting database. In Korea, spontaneous reporting is still underreported and there is a small amount of data for Koreans. Signal comparison between the claims and WHO databases can provide additional regulatory insight.

  9. Repeat workers' compensation claims: risk factors, costs and work disability

    Directory of Open Access Journals (Sweden)

    Collie Alex

    2011-06-01

    Full Text Available Abstract Background The objective of our study was to describe factors associated with repeat workers' compensation claims and to compare the work disability arising in workers with single and multiple compensation claims. Methods All initial injury claims lodged by persons of working age during a five year period (1996 to 2000 and any repeat claims were extracted from workers' compensation administrative data in the state of Victoria, Australia. Groups of workers with single and multiple claims were identified. Descriptive analysis of claims by affliction, bodily location, industry segment, occupation, employer and workplace was undertaken. Survival analysis determined the impact of these variables on the time between the claims. The economic impact and duration of work incapacity associated with initial and repeat claims was compared between groups. Results 37% of persons with an initial claim lodged a second claim. This group contained a significantly greater proportion of males, were younger and more likely to be employed in manual occupations and high-risk industries than those with single claims. 78% of repeat claims were for a second injury. Duration between the claims was shortest when the working conditions had not changed. The initial claims of repeat claimants resulted in significantly (p lower costs and work disability than the repeat claims. Conclusions A substantial proportion of injured workers experience a second occupational injury or disease. These workers pose a greater economic burden than those with single claims, and also experience a substantially greater cumulative period of work disability. There is potential to reduce the social, health and economic burden of workplace injury by enacting prevention programs targeted at these workers.

  10. Costs of workers' compensation claims for hearing loss.

    Science.gov (United States)

    Alleyne, B C; Dufresne, R M; Kanji, N; Reesal, M R

    1989-02-01

    Much has been written about the merits, needs, adequacy, and effectiveness of hearing conservation programs but very little about the cost of noise-induced hearing loss. Using claims for hearing loss submitted to a Canadian compensation board for a 5-years period (1979 to 1983), we estimated the current cost per claim to be $14,106. We observed an annual increase of 20.4% for noise-induced hearing loss claims and project that if 80% of the 450 claims submitted in 1987 are accepted, it will commit the Workers' Compensation Board in Alberta to a cost of $5,373,360--a considerable commitment for a disease that makes up only 0.3% of all claims. As a measure of morbidity we determined the years of potential hearing loss. The 207 workers between the ages of 18 and 70 years who were pensioned had a potential hearing loss value of 2529 years. Some authors have expressed the view that hearing loss is currently inadequately compensated and our review of the literature suggests that a fertile climate is emerging for increasing litigation. This tendency is likely to lead to further escalation of costs if prevention is not taken more seriously.

  11. 10 CFR 950.23 - Claims process for payment of covered costs.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Claims process for payment of covered costs. 950.23 Section 950.23 Energy DEPARTMENT OF ENERGY STANDBY SUPPORT FOR CERTAIN NUCLEAR PLANT DELAYS Claims Administration Process § 950.23 Claims process for payment of covered costs. (a) General. No more than 120...

  12. Development of an algorithm for identifying rheumatoid arthritis in the Korean National Health Insurance claims database.

    Science.gov (United States)

    Cho, Soo-Kyung; Sung, Yoon-Kyoung; Choi, Chan-Bum; Kwon, Jeong-Mi; Lee, Eui-Kyung; Bae, Sang-Cheol

    2013-12-01

    This study aimed to develop an identification algorithm for validating the International Classification of Diseases-Tenth diagnostic codes for rheumatoid arthritis (RA) in the Korean National Health Insurance (NHI) claims database. An individual copayment beneficiaries program for rare and intractable diseases, including seropositive RA (M05), began in South Korea in July 2009. Patients registered in this system pay only 10 % of their total medical costs, but registration requires an official report from a doctor documenting that the patient fulfills the 1987 ACR criteria. We regarded patients registered in this system as gold standard RA and examined the validity of several algorithms to define RA diagnosis using diagnostic codes and prescription data. We constructed nine algorithms using two highly specific prescriptions (positive predictive value >90 % and specificity >90 %) and one prescription with high sensitivity (>80 %) and accuracy (>75 %). A total of 59,823 RA patients were included in this validation study. Among them, 50,082 (83.7 %) were registered in the individual copayment beneficiaries program and considered true RA. We tested nine algorithms that incorporated two specific regimens [biologics and leflunomide alone, methotrexate plus leflunomide, or more than 3 disease-modifying anti-rheumatic drugs (DMARDs)] and one sensitive drug (any non-steroidal anti-inflammatory drug (NSAID), any DMARD, or any NSAID plus any DMARD). The algorithm that included biologics, more than 3 DMARDs, and any DMARD yielded the highest accuracy (91.4 %). Patients with RA diagnostic codes with prescription of biologics or any DMARD can be considered as accurate cases of RA in Korean NHI claims database.

  13. Estimation of National Colorectal-Cancer Incidence Using Claims Databases

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    C. Quantin

    2012-01-01

    Full Text Available Background. The aim of the study was to assess the accuracy of the colorectal-cancer incidence estimated from administrative data. Methods. We selected potential incident colorectal-cancer cases in 2004-2005 French administrative data, using two alternative algorithms. The first was based only on diagnostic and procedure codes, whereas the second considered the past history of the patient. Results of both methods were assessed against two corresponding local cancer registries, acting as “gold standards.” We then constructed a multivariable regression model to estimate the corrected total number of incident colorectal-cancer cases from the whole national administrative database. Results. The first algorithm provided an estimated local incidence very close to that given by the regional registries (646 versus 645 incident cases and had good sensitivity and positive predictive values (about 75% for both. The second algorithm overestimated the incidence by about 50% and had a poor positive predictive value of about 60%. The estimation of national incidence obtained by the first algorithm differed from that observed in 14 registries by only 2.34%. Conclusion. This study shows the usefulness of administrative databases for countries with no national cancer registry and suggests a method for correcting the estimates provided by these data.

  14. Health risk factors as predictors of workers' compensation claim occurrence and cost

    Science.gov (United States)

    Schwatka, Natalie V; Atherly, Adam; Dally, Miranda J; Fang, Hai; vS Brockbank, Claire; Tenney, Liliana; Goetzel, Ron Z; Jinnett, Kimberly; Witter, Roxana; Reynolds, Stephen; McMillen, James; Newman, Lee S

    2017-01-01

    Objective The objective of this study was to examine the predictive relationships between employee health risk factors (HRFs) and workers' compensation (WC) claim occurrence and costs. Methods Logistic regression and generalised linear models were used to estimate the predictive association between HRFs and claim occurrence and cost among a cohort of 16 926 employees from 314 large, medium and small businesses across multiple industries. First, unadjusted (HRFs only) models were estimated, and second, adjusted (HRFs plus demographic and work organisation variables) were estimated. Results Unadjusted models demonstrated that several HRFs were predictive of WC claim occurrence and cost. After adjusting for demographic and work organisation differences between employees, many of the relationships previously established did not achieve statistical significance. Stress was the only HRF to display a consistent relationship with claim occurrence, though the type of stress mattered. Stress at work was marginally predictive of a higher odds of incurring a WC claim (pdemographics, organisational factors, HRFs and WC claims. PMID:27530688

  15. Technical evaluation of methods for identifying chemotherapy-induced febrile neutropenia in healthcare claims databases

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    Weycker Derek

    2013-02-01

    Full Text Available Abstract Background Healthcare claims databases have been used in several studies to characterize the risk and burden of chemotherapy-induced febrile neutropenia (FN and effectiveness of colony-stimulating factors against FN. The accuracy of methods previously used to identify FN in such databases has not been formally evaluated. Methods Data comprised linked electronic medical records from Geisinger Health System and healthcare claims data from Geisinger Health Plan. Subjects were classified into subgroups based on whether or not they were hospitalized for FN per the presumptive “gold standard” (ANC 9/L, and body temperature ≥38.3°C or receipt of antibiotics and claims-based definition (diagnosis codes for neutropenia, fever, and/or infection. Accuracy was evaluated principally based on positive predictive value (PPV and sensitivity. Results Among 357 study subjects, 82 (23% met the gold standard for hospitalized FN. For the claims-based definition including diagnosis codes for neutropenia plus fever in any position (n=28, PPV was 100% and sensitivity was 34% (95% CI: 24–45. For the definition including neutropenia in the primary position (n=54, PPV was 87% (78–95 and sensitivity was 57% (46–68. For the definition including neutropenia in any position (n=71, PPV was 77% (68–87 and sensitivity was 67% (56–77. Conclusions Patients hospitalized for chemotherapy-induced FN can be identified in healthcare claims databases--with an acceptable level of mis-classification--using diagnosis codes for neutropenia, or neutropenia plus fever.

  16. Quantification of missing prescriptions in commercial claims databases: results of a cohort study.

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    Cepeda, Maria Soledad; Fife, Daniel; Denarié, Michel; Bradford, Dan; Roy, Stephanie; Yuan, Yingli

    2017-04-01

    This study aims to quantify the magnitude of missed dispensings in commercial claims databases. A retrospective cohort study has been used linking PharMetrics, a commercial claims database, to a prescription database (LRx) that captures pharmacy dispensings independently of payment method, including cash transactions. We included adults with dispensings for opioids, diuretics, antiplatelet medications, or anticoagulants. To determine the degree of capture of dispensings, we calculated the number of subjects with the following: (1) same number of dispensings in both databases; (2) at least one dispensing, but not all dispensings, missed in PharMetrics; and (3) all dispensings missing in PharMetrics. Similar analyses were conducted using dispensings as the unit of analysis. To assess whether a dispensing in LRx was in PharMetrics, the dispensing in PharMetrics had to be for the same medication class and within ±7 days in LRx. A total of 1 426 498 subjects were included. Overall, 68% of subjects had the same number of dispensings in both databases. In 13% of subjects, PharMetrics identified ≥1 dispensing but also missed ≥1 dispensing. In 19% of the subjects, PharMetrics missed all the dispensings. Taking dispensings as the unit of analysis, 25% of the dispensings present in LRx were not captured in PharMetrics. These patterns were similar across all four classes of medications. Of the dispensings missing in PharMetrics, 48% involved a subject who had >1 health insurance plan. Commercial claims databases provide an incomplete picture of all prescriptions dispensed to patients. The lack of capture goes beyond cash transactions and potentially introduces substantial misclassification bias. © 2017 The Authors. Pharmacoepidemiology & Drug Safety Published by John Wiley & Sons Ltd. © 2017 The Authors. Pharmacoepidemiology & Drug Safety Published by John Wiley & Sons Ltd.

  17. Reducing medical claims cost to Ghana's National Health Insurance scheme: a cross-sectional comparative assessment of the paper- and electronic-based claims reviews.

    Science.gov (United States)

    Nsiah-Boateng, Eric; Asenso-Boadi, Francis; Dsane-Selby, Lydia; Andoh-Adjei, Francis-Xavier; Otoo, Nathaniel; Akweongo, Patricia; Aikins, Moses

    2017-02-06

    A robust medical claims review system is crucial for addressing fraud and abuse and ensuring financial viability of health insurance organisations. This paper assesses claims adjustment rate of the paper- and electronic-based claims reviews of the National Health Insurance Scheme (NHIS) in Ghana. The study was a cross-sectional comparative assessment of paper- and electronic-based claims reviews of the NHIS. Medical claims of subscribers for the year, 2014 were requested from the claims directorate and analysed. Proportions of claims adjusted by the paper- and electronic-based claims reviews were determined for each type of healthcare facility. Bivariate analyses were also conducted to test for differences in claims adjustments between healthcare facility types, and between the two claims reviews. The electronic-based review made overall adjustment of 17.0% from GHS10.09 million (USD2.64 m) claims cost whilst the paper-based review adjusted 4.9% from a total of GHS57.50 million (USD15.09 m) claims cost received, and the difference was significant (p < 0.001). However, there were no significant differences in claims cost adjustment rate between healthcare facility types by the electronic-based (p = 0.0656) and by the paper-based reviews (p = 0.6484). The electronic-based review adjusted significantly higher claims cost than the paper-based claims review. Scaling up the electronic-based review to cover claims from all accredited care providers could reduce spurious claims cost to the scheme and ensure long term financial sustainability.

  18. Medical Care Cost Recovery National Database (MCCR NDB)

    Data.gov (United States)

    Department of Veterans Affairs — The Medical Care Cost Recovery National Database (MCCR NDB) provides a repository of summary Medical Care Collections Fund (MCCF) billing and collection information...

  19. Arbitrage-free interval of American contingent claims under proportional transaction cost

    Institute of Scientific and Technical Information of China (English)

    Qingxin MENG; Bo WANG

    2006-01-01

    In a general continuous-time market model with proportional transaction costs, we derive the range of arbitrage-free prices of American contingent claims. Using a martingale approach, we obtain the upper and the lower hedging price of American contingent claims.

  20. Analysis of a claims database for the identification of patients with carcinoma of the breast.

    Science.gov (United States)

    Solin, L J; Legorreta, A; Schultz, D J; Levin, H A; Zatz, S; Goodman, R L

    1994-02-01

    To develop and optimize algorithms for the identification of newly diagnosed and treated cases of women with carcinoma of the breast, an analysis was performed of cases identified from the claims database of a large health maintenance organization (U.S. Healthcare). An initial algorithm was developed from the patterns of claims which suggested common clinical presentations of carcinoma of the breast, and the positive predictive value was 88% (411/469). To attempt to improve upon the positive predictive value, multiple modifications of the initial algorithm were performed. The best identified modification of the initial algorithm yielded a positive predictive value of 93% (400/432) with a loss of only 3% (11/411) of the true positive cases. These results demonstrate that logic-based algorithms can be used as a valid and efficient method of identifying large numbers of cases from claims data with specific clinical characteristics. The best algorithm identified provides a powerful and accurate tool to perform health care analysis and research on large populations of women with newly diagnosed and treated carcinoma of the breast.

  1. 45 CFR 95.631 - Cost identification for purpose of FFP claims.

    Science.gov (United States)

    2010-10-01

    ... INSURANCE PROGRAMS) Automatic Data Processing Equipment and Services-Conditions for Federal Financial... approved cost allocation plan. State agencies shall assign and claim the costs incurred under an approved... allocation plan required by Subpart E of this part to include the approved APD methodology for...

  2. Treatment patterns and health care resource utilization associated with dalfampridine extended release in multiple sclerosis: a retrospective claims database analysis

    Directory of Open Access Journals (Sweden)

    Guo A

    2016-05-01

    Full Text Available Amy Guo,1 Michael Grabner,2 Swetha Rao Palli,2 Jessica Elder,1 Matthew Sidovar,1 Peter Aupperle,1 Stephen Krieger3 1Acorda Therapeutics Inc., Ardsley, New York, NY, USA; 2HealthCore Inc., Wilmington, DE, USA; 3Corinne Goldsmith Dickinson Center for MS, Icahn School of Medicine at Mount Sinai, New York, NY, USA Background: Although previous studies have demonstrated the clinical benefits of dalfampridine extended release (D-ER tablets in patients with multiple sclerosis (MS, there are limited real-world data on D-ER utilization and associated outcomes in patients with MS. Purpose: The objective of this study was to evaluate treatment patterns, budget impact, and health care resource utilization (HRU associated with D-ER use in a real-world setting. Methods: A retrospective claims database analysis was conducted using the HealthCore Integrated Research DatabaseSM. Adherence (measured by medication possession ratio, or [MPR] and persistence (measured by days between initial D-ER claim and discontinuation or end of follow-up were evaluated over 1-year follow-up. Budget impact was calculated as cost per member per month (PMPM over the available follow-up period. D-ER and control cohorts were propensity-score matched on baseline demographics, comorbidities, and MS-related resource utilization to compare walking-impairment-related HRU over follow-up. Results: Of the 2,138 MS patients identified, 1,200 were not treated with D-ER (control and 938 were treated with D-ER. Patients were aged 51 years on average and 74% female. Approximately 82.6% of D-ER patients were adherent (MPR >80%. The estimated budget impact range of D-ER was $0.014–$0.026 PMPM. Propensity-score-matched D-ER and controls yielded 479 patients in each cohort. Postmatching comparison showed that the D-ER cohort was associated with fewer physician (21.5% vs 62.4%, P<0.0001 and other outpatient visits (22.8% vs 51.4%, P<0.0001 over the 12-month follow-up. Changes in HRU from follow

  3. The Problem with the Delta Cost Project Database

    Science.gov (United States)

    Jaquette, Ozan; Parra, Edna

    2016-01-01

    The Integrated Postsecondary Education System (IPEDS) collects data on Title IV institutions. The Delta Cost Project (DCP) integrated data from multiple IPEDS survey components into a public-use longitudinal dataset. The DCP Database was the basis for dozens of journal articles and a series of influential policy reports. Unfortunately, a flaw in…

  4. Use of a claims database to characterize and estimate the incidence rate for Castleman disease.

    Science.gov (United States)

    Munshi, Nikhil; Mehra, Maneesha; van de Velde, Helgi; Desai, Avinash; Potluri, Ravi; Vermeulen, Jessica

    2015-05-01

    Castleman disease (CD) is a rare lymphoproliferative disorder affecting single (unicentric; UCD) or multiple (multicentric; MCD) lymph nodes. The incidence of this difficult to diagnose disease is poorly understood, as no International Classification of Diseases, Ninth Revision (ICD-9) code is available. This study utilized a unique strategy to estimate its incidence using two commercial claims databases, IMS LifeLink™ and Truven Health Analytics MarketScan(®). Patients with an index diagnosis of lymphadenopathy (ICD-9 code 785.6) were followed longitudinally for 1 year prior to and 2 years post-index diagnosis date. An algorithm that identifies potential patients with CD was developed to determine the incidence rate in person-years. The incidence rate for CD was calculated as 21 (IMS LifeLink™) and 25 (MarketScan(®)) per million person-years. Additionally, 23% of patients with CD were identified as potentially suffering from MCD. These results are consistent with the definition of an orphan disease, and the low incidence of the disease estimated in the literature.

  5. Treatment patterns, complications, and direct medical costs associated with ankylosing spondylitis in Chinese urban patients: a retrospective claims dataset analysis.

    Science.gov (United States)

    Li, Jinghu; Liu, Qingjing; Chen, Yi; Gao, Shuangqing; Zhang, Jie; Yang, Yicheng; Chen, Wendong

    2017-01-01

    To describe treatment pattern, complications, and direct medical costs associated with ankylosing spondylitis (AS) in Chinese urban patients. The 2013 China Health Insurance Research Association (CHIRA) urban insurance claims database was used to identify patients with AS. The identified patients were stratified by AS treatments for the comparisons of well established AS-related complications and direct medical costs. Conventional regression analyses adjusted the collected patient baseline characteristics to confirm the impact of treatments on complications and direct medical costs. Of the identified 1299 patients with AS, 18.0% received non-steroidal anti-inflammatory drugs (NSAID), 11.2% received immunosuppressant, 48.2% received NSAID plus immunosuppressant, 4.6% received biologic agents, and 17.9% received medications without indication for AS. Biologic group was associated with the lowest proportion of AS-related complications (8.3%) that was confirmed by multiple logistic regression analysis (odds ratio = 0.200, p = .017). The biologic group was also associated with highest direct medical costs (median: RMB = 14,539) that were confirmed by the multiple generalized linear model (coefficient = 1.644, p < .001). Biologics were not commonly used for AS in Chinese patients likely due to their high cost. Future studies are needed to confirm the potential long-term clinical benefits associated biologic treatment for AS.

  6. Erectile Dysfunction Treatment Following Radical Cystoprostatectomy: Analysis of a Nationwide Insurance Claims Database.

    Science.gov (United States)

    Chappidi, Meera R; Kates, Max; Sopko, Nikolai A; Joice, Gregory A; Tosoian, Jeffrey J; Pierorazio, Phillip M; Bivalacqua, Trinity J

    2017-06-01

    or education about potential ED therapies may not be commonly discussed with patients following RCP. Urologists should consider discussing sexual function more frequently with their RCP patients. Strengths include the use of a national claims database, which allows for longitudinal follow-up and detailed information on prescription medications and devices. Limitations include the lack of pathologic and oncologic outcomes data. ED treatment use after RCP is quite low. The strongest predictor of ED treatment use after RCP was baseline treatment use. These findings suggest ED treatment is a low priority for patients with RCP or education about potential ED therapies might not be commonly discussed with patients after RCP. Urologists should consider discussing sexual function more frequently with their patients undergoing RCP. Chappadi MR, Kates M, Sopko NA, et al. Erectile Dysfunction Treatment Following Radical Cystoprostatectomy: Analysis of a Nationwide Insurance Claims Database. J Sex Med 2017;14:810-817. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  7. Expanding the use of administrative claims databases in conducting clinical real-world evidence studies in multiple sclerosis.

    Science.gov (United States)

    Capkun, Gorana; Lahoz, Raquel; Verdun, Elisabetta; Song, Xue; Chen, Weston; Korn, Jonathan R; Dahlke, Frank; Freitas, Rita; Fraeman, Kathy; Simeone, Jason; Johnson, Barbara H; Nordstrom, Beth

    2015-05-01

    Administrative claims databases provide a wealth of data for assessing the effect of treatments in clinical practice. Our aim was to propose methodology for real-world studies in multiple sclerosis (MS) using these databases. In three large US administrative claims databases: MarketScan, PharMetrics Plus and Department of Defense (DoD), patients with MS were selected using an algorithm identified in the published literature and refined for accuracy. Algorithms for detecting newly diagnosed ('incident') MS cases were also refined and tested. Methodology based on resource and treatment use was developed to differentiate between relapses with and without hospitalization. When various patient selection criteria were applied to the MarketScan database, an algorithm requiring two MS diagnoses at least 30 days apart was identified as the preferred method of selecting patient cohorts. Attempts to detect incident MS cases were confounded by the limited continuous enrollment of patients in these databases. Relapse detection algorithms identified similar proportions of patients in the MarketScan and PharMetrics Plus databases experiencing relapses with (2% in both databases) and without (15-20%) hospitalization in the 1 year follow-up period, providing findings in the range of those in the published literature. Additional validation of the algorithms proposed here would increase their credibility. The methods suggested in this study offer a good foundation for performing real-world research in MS using administrative claims databases, potentially allowing evidence from different studies to be compared and combined more systematically than in current research practice.

  8. Development of a refill pattern method to measure polypharmacy in administrative claims databases.

    Science.gov (United States)

    Liu, Xinyue; Kubilis, Paul; Bussing, Regina; Winterstein, Almut G

    2016-12-01

    The purposes of the study were to develop a refill pattern method to identify polypharmacy in pharmacy billing records and to compare the method with traditional days' supply overlap algorithms. This method is characterized by the assessment of prescription refill pattern. Concomitant therapy is assumed when two drugs are dispensed repeatedly during the active days' supply of each other. We tested the refill pattern method in a simplified scenario in which two drugs (methylphenidate/dexmethylphenidate and atomoxetine) for attention deficit/hyperactivity disorder (ADHD) were considered. Children who had at least one prescription of methylphenidate/dexmethylphenidate or atomoxetine in 2008 were included for the calculation of 2-year prevalence of ADHD treatment polypharmacy. Results were compared with traditional method that requires a minimum overlap of 30, 60 or 90 days of filled prescriptions. We compared polypharmacy prevalence estimated by the two methods and explored reasons for disagreement. Among 131 385 children who had at least one prescription of methylphenidate/dexmethylphenidate or atomoxetine, the refill pattern method identified 4021 patients who had ADHD treatment polypharmacy (2-year prevalence = 3.1%). This prevalence estimate fell between those from a 30- to 60-day overlap method. The Cohen's kappa regarding determination of polypharmacy was 0.83, 0.92 and 0.80 considering 90-, 60- and 30-day overlap method, respectively. The refill pattern method can be used as another way to measure polypharmacy in administrative claims databases and can be adapted to a wide variety of research questions, diseases and study populations. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  9. Comparison of Cloud backup performance and costs in Oracle database

    Directory of Open Access Journals (Sweden)

    Aljaž Zrnec

    2011-06-01

    Full Text Available Normal 0 21 false false false SL X-NONE X-NONE Current practice of backing up data is based on using backup tapes and remote locations for storing data. Nowadays, with the advent of cloud computing a new concept of database backup emerges. The paper presents the possibility of making backup copies of data in the cloud. We are mainly focused on performance and economic issues of making backups in the cloud in comparison to traditional backups. We tested the performance and overall costs of making backup copies of data in Oracle database using Amazon S3 and EC2 cloud services. The costs estimation was performed on the basis of the prices published on Amazon S3 and Amazon EC2 sites.

  10. Assessment of statin-associated muscle toxicity in Japan: a cohort study conducted using claims database and laboratory information

    OpenAIRE

    Chang, Chia-Hsien; Kusama, Makiko; Ono, Shunsuke; Sugiyama, Yuichi; Orii, Takao; Akazawa, Manabu

    2013-01-01

    Objective To estimate the incidence of muscle toxicity in patients receiving statin therapy by examining study populations, drug exposure status and outcome definitions. Design A retrospective cohort study. Setting 16 medical facilities in Japan providing information on laboratory tests performed in and claims received by their facilities between 1 April 2004 and 31 December 2010. Participants A database representing a cohort of 35 903 adult statin (atorvastatin, fluvastatin, pitavastatin, pr...

  11. Predicting Occurrence of Spine Surgery Complications Using "Big Data" Modeling of an Administrative Claims Database.

    Science.gov (United States)

    Ratliff, John K; Balise, Ray; Veeravagu, Anand; Cole, Tyler S; Cheng, Ivan; Olshen, Richard A; Tian, Lu

    2016-05-18

    Postoperative metrics are increasingly important in determining standards of quality for physicians and hospitals. Although complications following spinal surgery have been described, procedural and patient variables have yet to be incorporated into a predictive model of adverse-event occurrence. We sought to develop a predictive model of complication occurrence after spine surgery. We used longitudinal prospective data from a national claims database and developed a predictive model incorporating complication type and frequency of occurrence following spine surgery procedures. We structured our model to assess the impact of features such as preoperative diagnosis, patient comorbidities, location in the spine, anterior versus posterior approach, whether fusion had been performed, whether instrumentation had been used, number of levels, and use of bone morphogenetic protein (BMP). We assessed a variety of adverse events. Prediction models were built using logistic regression with additive main effects and logistic regression with main effects as well as all 2 and 3-factor interactions. Least absolute shrinkage and selection operator (LASSO) regularization was used to select features. Competing approaches included boosted additive trees and the classification and regression trees (CART) algorithm. The final prediction performance was evaluated by estimating the area under a receiver operating characteristic curve (AUC) as predictions were applied to independent validation data and compared with the Charlson comorbidity score. The model was developed from 279,135 records of patients with a minimum duration of follow-up of 30 days. Preliminary assessment showed an adverse-event rate of 13.95%, well within norms reported in the literature. We used the first 80% of the records for training (to predict adverse events) and the remaining 20% of the records for validation. There was remarkable similarity among methods, with an AUC of 0.70 for predicting the occurrence of

  12. PS2-15: Coding for Obesity in a Health Plan Claims Database

    OpenAIRE

    Shainline, Michael; Carter, Shelley; Von Worley, Ann; Gunter, Margaret

    2010-01-01

    Background and Aims: The Centers for Disease Control estimated the obesity rate in New Mexico for 2008 to be 25.2%. Sources estimate the following associations between obesity and type 2 diabetes (80%); cardiovascular disease (70%); hypertension (26 %). Yet obesity is infrequently coded as a secondary diagnosis among providers submitting claims. This study examines the frequency with which obesity is documented on claims forms, the relationship between age, gender, and obesity coding, and the...

  13. Dental injury associated with anaesthesia: an 8-year database analysis of 592 claims from a major French insurance company.

    Science.gov (United States)

    Antoine, Giraudon; Maurice, Guillaume de Saint; Biais, Matthieu; Benhamou, Dan; Nouette-Gaulain, Karine

    2017-08-21

    Introduction Dental injury is the most common incident associated with anaesthesia. Regarding recent recommendations on informed consent and changes in airway management practices, a large series of claims related to dental injury has not been recently described. The aim of this study was to analyse a recent database in order to describe the characteristics of dental injury in France. Methods A database that prospectively collected claims reported to Le Sou Médical-MACSF between January 2003 and December 2010, was analysed. 592 cases were reported. The following characteristics were analysed: number and type of teeth injured, mechanism of injury, anaesthetic procedure, risk factors and dental outcome after injury. Results Amongst the 1514 claims related to anaesthesia, 592 (39.2%) were classified as dental damage. Preoperative informed consent concerning possible perioperative dental injury was documented in only 34.8% of patients. Only one tooth was affected in 65.2% of patients, dental bridge injury in 12.8% of cases and damage to two or more teeth in 14% of patients. Incisors were involved in 50% of cases. Fracture was the most common type of injury (64.2%). Poor dentition was the most common risk factor (23.1%) followed by difficult intubation (15.4%). Both risks were combined in only 7.6% of cases. Tracheal intubation was the highest risk procedure (41.6%). Conclusion Dental injury remains the most common anaesthesia-related claim. Dental examination and documentation in patient medical files requires improvement and better informed consent on dental injury risk needs to be provided to patients. Copyright © 2017. Published by Elsevier Masson SAS.

  14. Occupational management in the workplace and impact on injury claims, duration, and cost: a prospective longitudinal cohort

    Directory of Open Access Journals (Sweden)

    Lemstra ME

    2016-07-01

    Full Text Available Mark E Lemstra Alliance Health Medical Clinic, Moose Jaw, SK, Canada Abstract: Few workplaces have prospectively reviewed workplace and worker issues simultaneously and assessed their impact on Workers’ Compensation Board (WCB claims. In January of 2014, each worker in a large workplace in Saskatchewan, Canada, was prospectively followed for 1 year to determine factors that impact injury claim incidence, recovery, and costs. In total, 207 out of 245 workers agreed to complete the baseline survey (84.5%. In 2014, 82.5% of workers had self-reported pain, but only 35.5% submitted a WCB claim. Binary logistic regression was used to compare those with pain who did not submit a WCB injury claim to those with pain who did initiate a WCB claim. Independent risk factors associated with WCB claim incidence included depressed mood (odds ratio [OR] =2.75, 95% confidence interval [CI] 1.44–9.78 and lower job satisfaction (OR =1.70, 95% CI 1.08–10.68. Higher disability duration was independently associated with higher depressed mood (OR =1.60, 95% CI 1.05–4.11 and poor recovery expectation (OR =1.31, 95% CI 1.01–5.78. Higher cost disability claims were independently associated with higher depressed mood (OR =1.51, 95% CI 1.07–6.87 and pain catastrophizing (OR =1.11, 95% CI 1.02–8.11. Self-reported pain, physically assessed injury severity, and measured ergonomic risk of workstation did not significantly predict injury claim incidence, duration, or costs. In January 2015, the workplace implemented a new occupational prevention and management program. The injury incidence rate ratio reduced by 58% from 2014 to 2015 (IRR =1.58, 95% CI =1.28–1.94. The ratio for disability duration reduced by 139% from 2014 to 2015 (RR =2.39, 95% CI =2.16–2.63. Costs reduced from $114,149.07 to $56,528.14 per year. In summary, WCB claims are complex. Recognizing that nonphysical factors, such as depressed mood, influence injury claim incidence, recovery, and

  15. Occupational management in the workplace and impact on Workers' Compensation Board claims, duration, and cost: a prospective longitudinal cohort.

    Science.gov (United States)

    Lemstra, Mark E

    2016-01-01

    Few workplaces have prospectively reviewed workplace and worker issues simultaneously and assessed their impact on Workers' Compensation Board (WCB) claims. In January of 2014, each worker in a large workplace in Saskatchewan, Canada, was prospectively followed for 1 year to determine factors that impact injury claim incidence, recovery, and costs. In total, 207 out of 245 workers agreed to complete the baseline survey (84.5%). In 2014, 82.5% of workers had self-reported pain, but only 35.5% submitted a WCB claim. Binary logistic regression was used to compare those with pain who did not submit a WCB injury claim to those with pain who did initiate a WCB claim. Independent risk factors associated with WCB claim incidence included depressed mood (odds ratio [OR] =2.75, 95% confidence interval [CI] 1.44-9.78) and lower job satisfaction (OR =1.70, 95% CI 1.08-10.68). Higher disability duration was independently associated with higher depressed mood (OR =1.60, 95% CI 1.05-4.11) and poor recovery expectation (OR =1.31, 95% CI 1.01-5.78). Higher cost disability claims were independently associated with higher depressed mood (OR =1.51, 95% CI 1.07-6.87) and pain catastrophizing (OR =1.11, 95% CI 1.02-8.11). Self-reported pain, physically assessed injury severity, and measured ergonomic risk of workstation did not significantly predict injury claim incidence, duration, or costs. In January 2015, the workplace implemented a new occupational prevention and management program. The injury incidence rate ratio reduced by 58% from 2014 to 2015 (IRR =1.58, 95% CI =1.28-1.94). The ratio for disability duration reduced by 139% from 2014 to 2015 (RR =2.39, 95% CI =2.16-2.63). Costs reduced from $114,149.07 to $56,528.14 per year. In summary, WCB claims are complex. Recognizing that nonphysical factors, such as depressed mood, influence injury claim incidence, recovery, and costs, can be helpful to claims management.

  16. Rugby league injuries in New Zealand: a review of 8 years of Accident Compensation Corporation injury entitlement claims and costs.

    Science.gov (United States)

    King, D A; Hume, P A; Milburn, P; Gianotti, S

    2009-08-01

    This paper provides an overview of the epidemiology of rugby league injuries and associated costs in New Zealand requiring medical treatment. New Zealand national Accident Compensation Corporation injury data for the period 1999 to 2007 were searched for rugby league injury cases. Data were analysed by demographics, body region, nature/severity of injury, and medical procedure and costs. A total of 5941 injury entitlement claims were recorded over the study period with a significant decrease observed in the injury rate between the 1999-2000 and 2002-2003 reporting years. The total cost of the injuries for the study period was $42,822,048 (equivalent to pound15,916,072). The mean (SD) number of injury entitlement claims per year was 743 (271) and yearly cost was $5,352,760 (pound1,989,880) ($2,485,535 (pound923,994)). The knee was the most commonly reported injury site (225 per 1000 entitlement claims; $8,750,147 (pound3,252,020)) and soft tissue injuries were the most common injury types (474 per 1000 entitlement claims; $17,324,214 (pound6,438,599)). Accounting for only 1.8% of total injury entitlement claims, concussion/brain injuries accounted for 6.3% of injury entitlement costs and had the highest mean cost per claim ($25 347 (pound9420)). The upper and lower arm recorded the highest mean injury site claim cost of $43,096 (pound16,016) per claim. The 25-29 age group recorded 27.7% of total injury entitlement claims and 29.6% of total injury entitlement costs, which was slightly more than the 20-24 age group (27.3% claims; 24.7% costs). Nearly 15% of total moderate to serious injury entitlement claims and 20% of total costs were recorded from participants 35 years or older. This study identified that the knee was the most common injury site and soft tissue injuries were the most common injury type requiring medical treatment, which is consistent with other international studies on rugby league epidemiology. This study also highlights that the rate of injury and

  17. Pharmacotherapy of dementia in Germany: Results from a nationwide claims database.

    Science.gov (United States)

    Bohlken, Jens; Schulz, Mandy; Rapp, Michael A; Bätzing-Feigenbaum, Jörg

    2015-12-01

    In 2011, about 1.1-1.4 million patients with dementia were living in Germany, a number expected to rise to three million by 2050. Dementia poses a major challenge to the healthcare system and neuropharmacological service provision. The aim of this study was to determine prescription rates for anti-dementia drugs as well as for neuroleptics, sedative-hypnotics and antidepressants in dementia using the complete nationwide outpatient claims data pertaining to the services of statutory health insurance. We controlled for gender, age, dementia diagnosis, physician specialty (general practitioner GP versus neuropsychiatry specialist physician NPSP), and rural and urban living area. In about one million prevalent dementia patients (N=1,014,710) in 2011, the prescription prevalence rate of anti-dementia drugs was 24.6%; it varied with gender, age, and diagnosis (highest in Alzheimer's disease; 42%), and was higher in patients treated by NPSPs (48% vs. 25% in GPs). At the same time, we found an alarmingly high rate of treatment with neuroleptics in dementia patients (35%), with an only slightly decreased risk in patients treated exclusively by NPSPs (OR=0.86). We found marginal differences between rural and urban areas. Our results show that the majority of anti-dementia drug prescriptions appear guideline-oriented, yet prescription rates are overall comparatively low. On the other hand, neuroleptic drugs, which are associated with excess morbidity and mortality in dementia, were prescribed very frequently, suggesting excess use given current guidelines. We therefore suggest that guideline implementation measures and increasing quality control procedures are needed with respect to the pharmacotherapy of this vulnerable population.

  18. Data-driven identification of co-morbidities associated with rheumatoid arthritis in a large US health plan claims database

    Directory of Open Access Journals (Sweden)

    Robinson Noah

    2010-10-01

    Full Text Available Abstract Background In drug development, it is important to have an understanding of the full spectrum of co-morbidities to be expected in the group of patients with the disease of interest. It is usually a challenge to identify the less common events associated with the target disease, even if these events are severe. The purpose of this study is to identify co-morbidities associated with rheumatoid arthritis (RA as compared with a control group, using a large health care database. Methods Marketscan US claims database was used for this retrospective cohort study. Selected were records of persons aged at least 16 Y with at least two claims for RA, and with active insurance status on June 30,2007. The control group had at least two claims for eczema/dermatitis. Controls were matched by age, gender and insurance status (Medicare or not. All co-morbidities with an ICD9 diagnostic code were identified in the RA and control groups, during a one-year window. Relative risks (RRs were calculated. Diagnoses were rank-ordered by magnitude of RR. Codes covering RA and arthropathy were excluded. In order to get stable estimates, rank-ordering was performed for diagnoses occurring in at least 20 persons in the control group. Results Records were selected of 62,681 persons with RA (mean age was 59.0 Y, with 73.8% female, Medicare-covered 35%. A total of 6897 different ICD9 diagnostic codes were recorded, with 2220 codes in at least 20 persons of the control group [listed with Relative Risk]. Apart from joint/bone related conditions, strong associations with RA (RR > 3 were found for Adverse effect medicinal and biological substance not elsewhere classified, Unspecified adverse effect drug properly administered, Idiopathic fibrosing alveolitis, Osteomyelitis, Immune deficiency, Elevated sedimentation rate, Tuberculin test reaction abnormal or positive, Anemia and Cushing syndrome. Conclusions Data on a large number (> 60,000 of patients with a diagnosis of RA

  19. Continuation and discontinuation of benzodiazepine prescriptions: A cohort study based on a large claims database in Japan.

    Science.gov (United States)

    Takeshima, Nozomi; Ogawa, Yusuke; Hayasaka, Yu; Furukawa, Toshi A

    2016-03-30

    Although benzodiazepines (BZDs) are often prescribed to treat a wide range of psychiatric and neurological conditions, they are also associated with various harms and risks including dependence. However the frequency of its continued use in the real world has not been well studied, especially at longer follow-ups. The aim of this study was to clarify the frequency of long-term BZD use among new BZD users over longer follow-ups and to identify its predictors. We conducted a cohort study to examine how frequently new BZD users became chronic users, based on a large claims database in Japan from January 2005 to June 2014. We used Cox proportional hazards models to identify potential predictors. A total 84,412 patients with new BZD prescriptions were included in our cohort. Among them, 35.8% continued to use BZD for three months, 15.2% for one year and 4.9% for eight years without ever attaining three months of no BZD prescription. The confirmed predictors for long-term BZD use were older age, psychiatrist-prescriber, regular use, high dose of BZD, and concomitant prescription of psychotropic drugs. When we consider BZD use, we have to keep in mind these figures and avoid these predictors as much as possible.

  20. Abel model: Evaluates claims of inability to afford penalties and compliance costs, version 2.6 (for microcomputers). Software

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-12-01

    The easy-to-use ABEL software evaluates for-profit company claims of inabiltiy to afford penalties, clean-up costs, or compliance costs. Violators raise the issue of inability to pay in most of EPA`s enforcement actions regardless of whether there is any hard evidence pay in most of EPA`s enforcement actions regardless of whether there is any hard evidence supporting those claims. The program enables Federal, State and local enforcement professionals to quickly determine if there was any validity to those claims. ABEL is a tool that promotes quick settlements by performing screening analyses of defendants and potentially responsible parties (PRP`s) to determine their financial capacity. If ABEL indicates the firm can afford the full penalty, compliance of clean-up cost, then EPA makes no adjustments for inability to pay. If it indicates that the firm cannot afford the full amount, it directs the enforcement personnel to review other financial reports before making any adjustments. After analyzing some basic financial ratios that reflect a company`s solvency, ABEL assesses the firm`s ability to pay by focusing on projected cash flows. The model explicitly calculates the value of projected, internally generated cash flows from historical tax information, and compares these cash flows to the prosposed environmental expenditure(s). The sofware is extremely easy to use. Users are taken through a series of prompts to enter specified data. On screen `help` information is available at any time.

  1. Relapse rates in patients with multiple sclerosis switching from interferon to fingolimod or glatiramer acetate: a US claims database study.

    Directory of Open Access Journals (Sweden)

    Niklas Bergvall

    Full Text Available BACKGROUND: Approximately one-third of patients with multiple sclerosis (MS are unresponsive to, or intolerant of, interferon (IFN therapy, prompting a switch to other disease-modifying therapies. Clinical outcomes of switching therapy are unknown. This retrospective study assessed differences in relapse rates among patients with MS switching from IFN to fingolimod or glatiramer acetate (GA in a real-world setting. METHODS: US administrative claims data from the PharMetrics Plus™ database were used to identify patients with MS who switched from IFN to fingolimod or GA between October 1, 2010 and March 31, 2012. Patients were matched 1∶1 using propensity scores within strata (number of pre-index relapses on demographic (e.g. age and gender and disease (e.g. timing of pre-index relapse, comorbidities and symptoms characteristics. A claims-based algorithm was used to identify relapses while patients were persistent with therapy over 360 days post-switch. Differences in both the probability of experiencing a relapse and the annualized relapse rate (ARR while persistent with therapy were assessed. RESULTS: The matched sample population contained 264 patients (n = 132 in each cohort. Before switching, 33.3% of patients in both cohorts had experienced at least one relapse. During the post-index persistence period, the proportion of patients with at least one relapse was lower in the fingolimod cohort (12.9% than in the GA cohort (25.0%, and ARRs were lower with fingolimod (0.19 than with GA (0.51. Patients treated with fingolimod had a 59% lower probability of relapse (odds ratio, 0.41; 95% confidence interval [CI], 0.21-0.80; p = 0.0091 and 62% fewer relapses per year (rate ratio, 0.38; 95% CI, 0.21-0.68; p = 0.0013 compared with those treated with GA. CONCLUSIONS: In a real-world setting, patients with MS who switched from IFNs to fingolimod were significantly less likely to experience relapses than those who switched to GA.

  2. Assessment of statin-associated muscle toxicity in Japan: a cohort study conducted using claims database and laboratory information

    Science.gov (United States)

    Chang, Chia-Hsien; Kusama, Makiko; Ono, Shunsuke; Sugiyama, Yuichi; Orii, Takao; Akazawa, Manabu

    2013-01-01

    Objective To estimate the incidence of muscle toxicity in patients receiving statin therapy by examining study populations, drug exposure status and outcome definitions. Design A retrospective cohort study. Setting 16 medical facilities in Japan providing information on laboratory tests performed in and claims received by their facilities between 1 April 2004 and 31 December 2010. Participants A database representing a cohort of 35 903 adult statin (atorvastatin, fluvastatin, pitavastatin, pravastatin, rosuvastatin and simvastatin) users was studied. Use of interacting drugs (fibrates, triazoles, macrolides, amiodarone and ciclosporin) by these patients was determined. Main outcome measure Statin-associated muscle toxicity (the ‘event’) was identified based on a diagnosis of muscle-related disorders (myopathy or rhabdomyolysis) and/or abnormal elevation of creatine kinase (CK) concentrations. Events were excluded if the patients had CK elevation-related conditions other than muscle toxicity. Incidence rates for muscle toxicity were determined per 1000 person-years, with 95% CI determined by Poisson regression. Results A total of 18 036 patients accounted for 42 193 person-years of statin therapy, and 43 events were identified. The incidence of muscle toxicity in the patients treated with statins was 1.02 (95% CI 0.76 to 1.37)/1000 person-years. The estimates varied when outcome definitions were modified from 0.09/1000 person-years, which met both diagnosis and CK 10× greater than the upper limit of normal range (ULN) criteria, to 2.06/1000 person-years, which met diagnosis or CK 5× ULN criterion. The incidence of muscle toxicity was also influenced by the statin therapies selected, but no significant differences were observed. Among 2430 patients (13.5%) received interacting drugs with statins, only three muscle toxicity cases were observed (incidence: 1.69/1000 person-years). Conclusions This database study suggested that statin use is generally well

  3. Validation of algorithms to identify stroke risk factors in patients with acute ischemic stroke, transient ischemic attack, or intracerebral hemorrhage in an administrative claims database.

    Science.gov (United States)

    Sung, Sheng-Feng; Hsieh, Cheng-Yang; Lin, Huey-Juan; Chen, Yu-Wei; Yang, Yea-Huei Kao; Li, Chung-Yi

    2016-07-15

    Stroke patients have a high risk for recurrence, which is positively correlated with the number of risk factors. The assessment of risk factors is essential in both stroke outcomes research and the surveillance of stroke burden. However, methods for assessment of risk factors using claims data are not well developed. We enrolled 6469 patients with acute ischemic stroke, transient ischemic attack, or intracerebral hemorrhage from hospital-based stroke registries, which were linked with Taiwan's National Health Insurance (NHI) claims database. We developed algorithms using diagnosis codes and prescription data to identify stroke risk factors including hypertension, diabetes, hyperlipidemia, atrial fibrillation (AF), and coronary artery disease (CAD) in the claims database using registry data as reference standard. We estimated the kappa statistics to quantify the agreement of information on the risk factors between claims and registry data. The prevalence of risk factors in the registries was hypertension 77.0%, diabetes 39.1%, hyperlipidemia 55.6%, AF 10.1%, and CAD 10.9%. The highest kappa statistics were 0.552 (95% confidence interval 0.528-0.577) for hypertension, 0.861 (0.836-0.885) for diabetes, 0.572 (0.549-0.596) for hyperlipidemia, 0.687 (0.663-0.712) for AF, and 0.480 (0.455-0.504) for CAD. Algorithms based on diagnosis codes alone could achieve moderate to high agreement in identifying the selected risk factors, whereas prescription data helped improve identification of hyperlipidemia. We tested various claims-based algorithms to ascertain important risk factors in stroke patients. These validated algorithms are useful for assessing stroke risk factors in future studies using Taiwan's NHI claims data. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. Utilization of evidence-based treatment in elderly patients with chronic heart failure: using Korean Health Insurance claims database

    Directory of Open Access Journals (Sweden)

    Kim Ju-Young

    2012-07-01

    Full Text Available Abstract Background Chronic heart failure accounts for a great deal of the morbidity and mortality in the aging population. Evidence-based treatments include angiotensin-2 receptor blockers (ARBs, angiotensin-converting enzyme inhibitors (ACE-I, beta-blockers, and aldosterone antagonists. Underutilization of these treatments in heart failure patients were frequently reported, which could lead to increase morbidity and mortality. The aim of this study was to evaluate the utilization of evidence-based treatments and their related factors for elderly patients with chronic heart failure. Methods This is retrospective observational study using the Korean National Health Insurance claims database. We identified prescription of evidence based treatment to elderly patients who had been hospitalized for chronic heart failure between January 1, 2005, and June 30, 2006. Results Among the 28,922 elderly patients with chronic heart failure, beta-blockers were prescribed to 31.5%, and ACE-I or ARBs were prescribed to 54.7% of the total population. Multivariable logistic regression analyses revealed that the prescription from outpatient clinic (prevalent ratio, 4.02, 95% CI 3.31–4.72, specialty of the healthcare providers (prevalent ratio, 1.26, 95% CI, 1.12–1.54, residence in urban (prevalent ratio, 1.37, 95% CI, 1.23–1.52 and admission to tertiary hospital (prevalent ratio, 2.07, 95% CI, 1.85–2.31 were important factors associated with treatment underutilization. Patients not given evidence-based treatment were more likely to experience dementia, reside in rural areas, and have less-specialized healthcare providers and were less likely to have coexisting cardiovascular diseases or concomitant medications than patients in the evidence-based treatment group. Conclusions Healthcare system factors, such as hospital type, healthcare provider factors, such as specialty, and patient factors, such as comorbid cardiovascular disease, systemic disease with

  5. The least costly remedy: Claiming delayed understanding in the context of disaffiliation

    DEFF Research Database (Denmark)

    Emmertsen, Sofie; Heinemann, Trine

    2008-01-01

    ’s recollection, recognition or understanding of relevant matters, the realization token functions as a claim that 1) there were problems in the speaker’s prior turns due to her lack of understanding and 2) that these problems are now solved due to a change in the speaker’s epistemic access. The realization token...... can therefore be used to remedy prior turns that are potentially or actually disaffiliative in a way that minimally involves questions of character or relationship. ...

  6. Development of an Expanded, High Reliability Cost and Performance Database for In Situ Remediation Technologies

    Science.gov (United States)

    2016-03-01

    large investment in groundwater remediation technologies more effective, end-users need quantitative, accurate, and reliable performance and cost ... technologies . The overall objective of this work was to develop a comprehensive remediation performance and cost database. N/A U U U UU 42 Travis...end-users need quantitative, accurate, and reliable performance and cost data for commonly used remediation technologies . While the data from an

  7. 44 CFR 208.66 - Reopening of claims for retrospective or retroactive adjustment of costs.

    Science.gov (United States)

    2010-10-01

    ... adoption of a generally applicable State or local law, ordinance or wage order or a cost-of-living... submitted its request for reimbursement, if: (1) The salary or wage rate applicable to the period of an...

  8. Assessment of malignancy risk in patients with multiple sclerosis treated with intramuscular interferon beta-1a: retrospective evaluation using a health insurance claims database and postmarketing surveillance data

    Directory of Open Access Journals (Sweden)

    Bloomgren G

    2012-06-01

    Full Text Available Gary Bloomgren, Bjørn Sperling, Kimberly Cushing, Madé WentenBiogen Idec Inc., Weston, MA, USABackground: Intramuscular interferon beta-1a (IFNβ-1a, a multiple sclerosis (MS therapy that has been commercially available for over a decade, provides a unique opportunity to retrospectively assess postmarketing data for evidence of malignancy risk, compared with relatively limited data available for more recently approved therapies. Postmarketing and claims data were analyzed to determine the risk of malignancy in MS patients treated with intramuscular IFNβ-1a.Materials and methods: The cumulative reporting rates of suspected adverse drug reactions coded to malignancy in the intramuscular IFNβ-1a global safety database were compared with malignancy incidence rates in the World Health Organization GLOBOCAN database. In addition, using data from a large US claims database, the cumulative prevalence of malignancy in MS patients treated with intramuscular IFNβ-1a was compared with non-MS population controls, MS patients without intramuscular IFNβ-1a use, and untreated MS patients. Mean follow-up was approximately 3 years for all groups, ie, 3.1 years for the intramuscular IFNβ-1a group (range 0.02–6.0 years, 2.6 years for non-MS population controls (range 0–6.0 years, 2.6 years for the intramuscular IFNβ-1a nonuse group (range 0.01–6.0 years, and 2.4 years for the untreated MS group (range 0.01–6.0 years.Results: An estimated 402,250 patients received intramuscular IFNβ-1a during the postmarketing period. Cumulative reporting rates of malignancy in this population were consistent with GLOBOCAN incidence rates observed within the general population. The claims database included 12,894 MS patients who received intramuscular IFNβ-1a. No significant difference in malignancy prevalence was observed in intramuscular IFNβ-1a users compared with other groups.Conclusion: Results from this evaluation provide no evidence of an increased risk of

  9. Health Care Utilization and Direct Costs in Mild, Moderate, and Severe Adult Asthma: A Descriptive Study Using the 2014 South Korean Health Insurance Database.

    Science.gov (United States)

    Lee, Yoo Ju; Kwon, Sun-Hong; Hong, Sung-Hyun; Nam, Jin Hyun; Song, Hyun Jin; Lee, Jong Seop; Lee, Eui-Kyung; Shin, Ju-Young

    2017-03-01

    Although asthma exacerbation comprises a large burden of the total asthma-related costs, few studies have examined the frequency and cost of acute exacerbation according to asthma severity. This study investigated asthma-related health care utilization and costs according to the severity of asthma. We conducted a descriptive study using the national health insurance claims database between January 1 and December 31, 2014. We included adult patients with asthma (18 years of age and older) who had ≥2 claims with for an asthma diagnosis and were prescribed ≥1 asthma medications. They were classified into 3 asthma severity levels (level 1 = mild, level 2 = moderate, and level 3 = severe), based on individual medication prescriptions. Acute exacerbation was defined as having a corticosteroid burst, an emergency department visit, or hospitalization. Health care utilization, acute exacerbation, and direct costs associated with asthma were compared according to asthma severity levels. Of the 36,687 adult asthma patients, level 1 had the largest proportion of patients (81.2%), followed by level 2 (18.2%), and level 3 (0.6%). The average number of asthma-related outpatient visits was 4.5 for level 1, 7.2 for level 2, and 11.9 for level 3 (P cost per patient was $174 for level 1, $634 for level 2, and $1635 for level 3 (P costs associated with asthma exacerbation dramatically increased and accounted for 15.1% of the total cost in level 1 patients, 19.5% in level 2 patients, and 40.8% in level 3 patients (P costs of acute exacerbation increased as asthma severity increased. In patients with severe asthma, acute exacerbation and the relative cost ratio in South Korea were higher than those in other countries. Proper management is required to avoid acute exacerbations and to reduce the burden of asthma, particularly in patients with severe asthma. Copyright © 2017 Elsevier HS Journals, Inc. All rights reserved.

  10. Databases

    Data.gov (United States)

    National Aeronautics and Space Administration — The databases of computational and experimental data from the first Aeroelastic Prediction Workshop are located here. The databases file names tell their contents by...

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

    Directory of Open Access Journals (Sweden)

    Luskin AT

    2016-10-01

    Full Text Available Allan T Luskin,1 Evgeniya N Antonova,2 Michael S Broder,3 Eunice Y Chang,3 Theodore A Omachi,2 Dennis K Ledford4 1HealthyAirways, Madison, WI, 2Genentech, Inc., South San Francisco, 3Partnership for Health Analytic Research, LLC, Beverly Hills, CA, 4Division of Allergy and Immunology, Department of Medicine, James A. Haley Veterans’ Hospital, Morsani College of Medicine, University of South Florida, Tampa, FL, USA 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. Patients with high OCS use (≥30 days of OCS annually were divided into those who did versus those who did not experience OCS-related possible side effects. Their health care resource use and costs were compared using linear regression or negative binomial regression models, adjusting for age, sex, geographic region, Charlson Comorbidity Index score, and chronic obstructive pulmonary disease status.Results: After adjustment, high OCS users with possible side effects were more likely to have office visits (23.0 vs 19.6; P<0.001 and hospitalizations (0.44 vs 0.22; P<0.001 than those without possible side effects. Emergency department visits were similar between the groups. High OCS users with possible side effects had higher adjusted total annual mean health care costs ($25,168 than those without such side effects ($21,882; P=0.009.Conclusion: Among high OCS users, patients with possible OCS-related side effects are more likely to use health care services than those without such side effects. Although OCS may help control asthma and manage exacerbations, OCS side effects may result in additional health care resource use and costs, highlighting the need

  12. Utilization and Expenditure of Hospital Admission in Patients with Autism Spectrum Disorder: National Health Insurance Claims Database Analysis

    Science.gov (United States)

    Lin, Jin-Ding; Hung, Wen-Jiu; Lin, Lan-Ping; Lai, Chia-Im

    2011-01-01

    There were not many studies to provide information on health access and health utilization of people with autism spectrum disorders (ASD). The present study describes a general profile of hospital admission and the medical cost among people with ASD, and to analyze the determinants of medical cost. A retrospective study was employed to analyze…

  13. Databases

    Directory of Open Access Journals (Sweden)

    Nick Ryan

    2004-01-01

    Full Text Available Databases are deeply embedded in archaeology, underpinning and supporting many aspects of the subject. However, as well as providing a means for storing, retrieving and modifying data, databases themselves must be a result of a detailed analysis and design process. This article looks at this process, and shows how the characteristics of data models affect the process of database design and implementation. The impact of the Internet on the development of databases is examined, and the article concludes with a discussion of a range of issues associated with the recording and management of archaeological data.

  14. Gluten-free food database: the nutritional quality and cost of packaged gluten-free foods

    OpenAIRE

    Benjamin Missbach; Lukas Schwingshackl; Alina Billmann; Aleksandra Mystek; Melanie Hickelsberger; Gregor Bauer; Jürgen König

    2015-01-01

    Notwithstanding a growth in popularity and consumption of gluten-free (GF) food products, there is a lack of substantiated analysis of the nutritional quality compared with their gluten-containing counterparts. To put GF foods into proper perspective both for those who need it (patients with celiac disease) and for those who do not, we provide contemporary data about cost and nutritional quality of GF food products. The objective of this study is to develop a food composition database for sev...

  15. Treatment Patterns, Direct Cost of Biologics, and Direct Medical Costs for Rheumatoid Arthritis Patients: A Real-world Analysis of Nationwide Japanese Claims Data.

    Science.gov (United States)

    Sugiyama, Naonobu; Kawahito, Yutaka; Fujii, Takao; Atsumi, Tatsuya; Murata, Tatsunori; Morishima, Yosuke; Fukuma, Yuri

    2016-06-01

    The aims of this article were to characterize the patterns of treating rheumatoid arthritis with biologics and to evaluate costs using claims data from the Japan Medical Data Center Co, Ltd. Patients aged 16 to <75 years who were diagnosed with rheumatoid arthritis and prescribed adalimumab (ADA), etanercept (ETN), infliximab (IFX), tocilizumab (TCZ), abatacept, certolizumab, or golimumab between January 2005 and August 2014 were included. For the cross-sectional analysis, the annual costs of ETN, IFX, ADA, and TCZ from 2009 to 2013 were assessed. For the longitudinal analysis, patients prescribed these biologics as the first line of biologics, from January 2005 to August 2014, were included. The cost of biologic treatment over 1, 2, and 3 years (including prescription of subsequent biologics) and direct medical costs (including treatment of comorbidities) were compared between groups. Discontinuation and switching rates in each group were estimated, and multivariate analyses were conducted to estimate an adjusted hazard ratio of discontinuation and switching rates among each group. The dose of each first-line biologic treatment until discontinuation was analyzed to calculate relative dose intensity. The cross-sectional annual biologic costs of ETN, IFX, ADA, and TCZ were ~$8000 (2009 and 2013), $13,000 (2009) and $15,000 (2013), $10,000 (2009) and $11,000 (2013), and $9000 (2009) and $8000 (2013), respectively. In longitudinal analyses (n = 764), 276 (36%) initiated ETN; 242 (32%), IFX; 147 (19%), ADA; and 99 (13%), TCZ. The 1-year cumulative annual biologic costs per patient from the initial prescription of ETN, IFX, ADA, and TCZ as the first-line biologic treatment were ~$11,000, $19,000, $16,000, and $12,000. The corresponding direct medical costs over 1 year from the initial prescription were ~$17,000, $26,000, $22,000, and $22,000. Costs remained greatest in the IFX-initiation group at year 3. The discontinuation rates at 36 months with ETN, IFX, ADA, and TCZ

  16. The risk of malignancy among biologic-naïve pediatric psoriasis patients: A retrospective cohort study in a US claims database.

    Science.gov (United States)

    Gu, Yun; Nordstrom, Beth L

    2017-08-01

    Little published literature exists regarding malignancy risk in pediatric psoriasis patients. To compare malignancy risk in biologic-naïve pediatric psoriasis patients with a matched pediatric population without psoriasis. This retrospective cohort study used IMS LifeLink Health Plan Claims data covering 1998-2008. Cancer incidence was compared with the US Surveillance, Epidemiology, and End Results (SEER) data using standardized incidence ratios (SIR), and between cohorts using Cox models. Among 9045 pediatric psoriasis patients and 77,206 comparators, 18 probable or highly probable cancers were identified. Pediatric psoriasis patients had a nonsignificantly lower incidence than comparators (hazard ratio [HR] 0.43, 95% confidence interval [CI] 0.05-3.54). The HR increased to 1.67 (95% CI 0.54-5.18) when cancer diagnosed during the first 90 days of follow-up was included. The pediatric psoriasis cohort had a significantly increased lymphoma rate compared with SEER (SIR 5.42, 95% CI 1.62-12.94), but no significant increase relative to the comparator cohort. Misclassification of disease and outcome might have occurred with patients in the claims database. Patients with pediatric psoriasis showed no significant increase in overall cancer risk compared with those without psoriasis. A potential increased risk for lymphoma was observed when compared with the general population. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  17. Sex Differences in the Treatment and Outcome of Korean Patients With Acute Myocardial Infarction Using the Korean National Health Insurance Claims Database

    Science.gov (United States)

    Hong, Jae-Seok; Kang, Hee-Chung

    2015-01-01

    Abstract Evidence showing higher acute myocardial infarction (AMI) mortality rates among female compared with male inpatients has stimulated interest in whether this disparity is the result of biological factors or differences in the provision of healthcare services. We investigated the impact of sex on in-hospital mortality rates due to AMI, and evaluated the contribution of differences in the delivery of optimal medical services for AMI. We retrospectively constructed a dataset of 85,329 new patients admitted to Korean hospitals with AMI between 2003 and 2007 from the Korea National Health Insurance Claims Database. We used the claims database to provide information about treatment after admission or death for each patient. Proportionally more female than male patients aged 65 years or older had complications; however, proportionally fewer female patients underwent invasive procedures. Female patients had a higher in-hospital mortality rate than males (21.2% vs 14.6%, odds ratio [OR] 1.58, 95% confidence interval [CI] 1.52–1.64). The probability of death within 30 days after admission remained higher for females than males after adjusting for demographic characteristics and severity (OR 1.08, 95% CI 1.04–1.13). After additionally adjusting for invasive and medical management, the probability of death within 30 days did not differ between males and females (OR 1.04, 95% CI 0.99–1.08). A similar trend was revealed by an additional analysis of patients according to younger (<65 years) and older (≥65 years) age groups. The higher in-hospital mortality rates after AMI in Korean female patients was associated with a lower procedure rate. Evidence indicating that AMI symptoms differ according to sex highlights the need for health policies and public education programs that raise awareness of sex-related differences in early AMI symptoms to increase the incidence of appropriate early treatment in females. PMID:26334894

  18. Comparison of literature searches on quality and costs for health technology assessment using the MEDLINE and EMBASE databases.

    Science.gov (United States)

    Topfer, L A; Parada, A; Menon, D; Noorani, H; Perras, C; Serra-Prat, M

    1999-01-01

    Biomedical databases are an important source of information for health technology assessment. However, there is considerable variation in the costs of accessing commercial databases. We sought to measure the quality, amount of overlap, and costs of information retrieved from two of the main database sources--MEDLINE and EMBASE. Librarians at two health technology assessment agencies ran a total of eight literature searches on various medical technologies, using both databases. All search results were independently reviewed by two researchers. The researchers were asked to identify relevant references and to rank each of these according to a level of evidence scale. The results were tabulated to show the number of references identified by each database, the number of relevant references ranked by level of evidence, and the number of these references that were unique to one or the other database. The cost of retrieving references from each source was also calculated. Each database contained relevant references not available in the other. Because of the longer time lag for indexing in MEDLINE, many of the references that originally appeared to be unique to EMBASE were subsequently available in MEDLINE as well. Since our study was conducted, MEDLINE has been made available worldwide, free of charge, via the Internet. Hence, the cost difference between the databases is now even greater. However, notwithstanding the costs, it appears that literature searches that rely on only one or the other database will inevitably miss pertinent information.

  19. Gluten-free food database: the nutritional quality and cost of packaged gluten-free foods.

    Science.gov (United States)

    Missbach, Benjamin; Schwingshackl, Lukas; Billmann, Alina; Mystek, Aleksandra; Hickelsberger, Melanie; Bauer, Gregor; König, Jürgen

    2015-01-01

    Notwithstanding a growth in popularity and consumption of gluten-free (GF) food products, there is a lack of substantiated analysis of the nutritional quality compared with their gluten-containing counterparts. To put GF foods into proper perspective both for those who need it (patients with celiac disease) and for those who do not, we provide contemporary data about cost and nutritional quality of GF food products. The objective of this study is to develop a food composition database for seven discretionary food categories of packaged GF products. Nutrient composition, nutritional information and cost of foods from 63 GF and 126 gluten-containing counterparts were systematically obtained from 12 different Austrian supermarkets. The nutrition composition (macro and micronutrients) was analyzed by using two nutrient composition databases in a stepwise approximation process. A total of 63 packaged GF foods were included in the analysis representing a broad spectrum of different GF categories (flour/bake mix, bread and bakery products, pasta and cereal-based food, cereals, cookies and cakes, snacks and convenience food). Our results show that the protein content of GF products is >2 fold lower across 57% of all food categories. In 65% of all GF foods, low sodium content was observed (defined as 6g/100 g). On average, GF foods were substantially higher in cost, ranging from +205% (cereals) to +267% (bread and bakery products) compared to similar gluten-containing products. In conclusion, our results indicate that for GF foods no predominant health benefits are indicated; in fact, some critical nutrients must be considered when being on a GF diet. For individuals with celiac disease, the GF database provides a helpful tool to identify the food composition of their medical diet. For healthy consumers, replacing gluten-containing products with GF foods is aligned with substantial cost differences but GF foods do not provide additional health benefits from a nutritional

  20. Gluten-free food database: the nutritional quality and cost of packaged gluten-free foods

    Directory of Open Access Journals (Sweden)

    Benjamin Missbach

    2015-10-01

    Full Text Available Notwithstanding a growth in popularity and consumption of gluten-free (GF food products, there is a lack of substantiated analysis of the nutritional quality compared with their gluten-containing counterparts. To put GF foods into proper perspective both for those who need it (patients with celiac disease and for those who do not, we provide contemporary data about cost and nutritional quality of GF food products. The objective of this study is to develop a food composition database for seven discretionary food categories of packaged GF products. Nutrient composition, nutritional information and cost of foods from 63 GF and 126 gluten-containing counterparts were systematically obtained from 12 different Austrian supermarkets. The nutrition composition (macro and micronutrients was analyzed by using two nutrient composition databases in a stepwise approximation process. A total of 63 packaged GF foods were included in the analysis representing a broad spectrum of different GF categories (flour/bake mix, bread and bakery products, pasta and cereal-based food, cereals, cookies and cakes, snacks and convenience food. Our results show that the protein content of GF products is >2 fold lower across 57% of all food categories. In 65% of all GF foods, low sodium content was observed (defined as 6g/100 g. On average, GF foods were substantially higher in cost, ranging from +205% (cereals to +267% (bread and bakery products compared to similar gluten-containing products. In conclusion, our results indicate that for GF foods no predominant health benefits are indicated; in fact, some critical nutrients must be considered when being on a GF diet. For individuals with celiac disease, the GF database provides a helpful tool to identify the food composition of their medical diet. For healthy consumers, replacing gluten-containing products with GF foods is aligned with substantial cost differences but GF foods do not provide additional health benefits from a

  1. Professional liability claims against dentists

    National Research Council Canada - National Science Library

    Moscoso Matus, Karla; Smok Vásquez, Pía

    2015-01-01

    .... To determine the magnitude and frequency of professional liability claims against dentists. A retrospective analysis of the Medical Liability Unit of the Legal Medical Service of Chile database...

  2. Neck back and spine injuries in amateur rugby league: a review of nine years of Accident Compensation Corporation injury entitlement claims and costs.

    Science.gov (United States)

    King, Doug A; Hume, Patria A; Gianotti, Simon; Clark, Trevor

    2011-03-01

    Rugby league is a popular participation sport, but there have been concerns raised regarding the possible high number of severe neck, back and spine injuries. Therefore an epidemiological overview of rugby league neck, back and spine injuries and associated costs of these injuries was undertaken in one country over nine years. The New Zealand national Accident Compensation Corporation data for moderate to serious injury entitlement claims (MSC) over nine years were analysed for the number, type and cost of neck, back and spine rugby league injuries resulting in medical treatment. There were 206 (3%) neck, back and spine MSC claims totalling NZD$1,585,927 (4%) of the total injury entitlement costs for rugby league over the nine-year period. The rate of MSC neck, back and spine rugby league injuries was 26 per 1000 total rugby league claims. Although the rate of neck, back and spine injuries varied over the nine years from 22 to 40 per 1000 injury claims, there was a significant increase over the duration of the study in the number of neck, back and spine MSC claims (χ2=849, df=8, prugby league is an issue that needs to be addressed. Unfortunately the ACC data base does not provide information on how or why the injuries occurred. A prospective injury epidemiology study needs to be conducted that will allow collection of information surrounding the mechanisms of injury and possible causative risk factors such as tackling technique. In the meantime it is suggested that coaches should ensure tackling technique is correctly taught to all rugby league players to reduce the risk of neck, back and spine injury. Team medical personnel should be trained in dealing with neck and spine injuries as well as head related injuries, and emergency procedures in dealing with players with a suspected neck or back injury should be practiced at clubs. Copyright © 2010 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  3. Good agreement between questionnaire and administrative databases for health care use and costs in patients with osteoarthritis

    Directory of Open Access Journals (Sweden)

    Robertson M Clare

    2011-04-01

    Full Text Available Abstract Background Estimating costs is essential to the economic analysis of health care programs. Health care costs are often captured from administrative databases or by patient report. Administrative records only provide a partial representation of health care costs and have additional limitations. Patient-completed questionnaires may allow a broader representation of health care costs; however the validity and feasibility of such methods have not been firmly established. This study was conducted to assess the validity and feasibility of using a patient-completed questionnaire to capture health care use and costs for patients with osteoarthritis, and to compare the research costs of the data-capture methods. Methods We designed a patient questionnaire and applied it in a clinical trial. We captured equivalent data from four administrative databases. We evaluated aspects of the questionnaire's validity using sensitivity and specificity, Lin's concordance correlation coefficient (ρc, and Bland-Altman comparisons. Results The questionnaire's response rate was 89%. Acceptable sensitivity and specificity levels were found for all types of health care use. The numbers of visits and the majority of medications reported by patients were in agreement with the database-derived estimates (ρc > 0.40. Total cost estimates from the questionnaire agreed with those from the databases. Patient-reported co-payments agreed with administrative records with respect to GP office transactions, but not pharmaceutical co-payments. Research costs for the questionnaire-based method were less than one-third of the costs for the databases method. Conclusion A patient-completed questionnaire is feasible for capturing health care use and costs for patients with osteoarthritis, and data collected using it mostly agree with administrative databases. Caution should be exercised when applying unit costs and collecting co-payment data.

  4. ABEL model: Evaluates claims of inability to afford penalities and compliance costs (version 2.8) (for microcomputers). Model-Simulation

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-09-01

    The easy-to-use ABEL software evaluates for-profit company claims of inability to afford penalties, clean-up costs, or compliance costs. Violators raise the issue of inability to pay in most of EPA`s enforcement actions regardless of whether there is any hard evidence supporting those claims. The program enables Federal, State and local enforcement professionals to quickly determine if there was any validity to those claims. ABEL is a tool that promotes quick settlements by performing screening analyses of defendants and potentially responsible parties (PRP`s) to determine their financial capacity. If ABEL indicates the firm can afford the full penalty, compliance or clean-up costs, then EPA makes no adjustments for inability to pay. If it indicates that the firm cannot afford the full amount, it directs the enforcement personnel to review other financial reports before making any adjustments. After analyzing some basic financial ratios that reflect a company`s solvency, ABEL assesses the firm`s ability to pay by focusing on projected cash flows. The model explicitly calculates the value of projected, internally generated cash flows from historical tax information, and compares these cash flows to the proposed environmental expenditure(s). The software is extremely easy to use. Users are taken through a series of prompts to enter specified data. On screen `help` information is available at any time.

  5. 76 FR 60031 - Notice of Order: Revisions to Enterprise Public Use Database Incorporating High-Cost Single...

    Science.gov (United States)

    2011-09-28

    ... AGENCY Notice of Order: Revisions to Enterprise Public Use Database Incorporating High-Cost Single-Family... contains Enterprise single-family and multifamily mortgage loan-level data reported to FHFA by the... data characteristics of single-family high-cost loans purchased and securitized by the Enterprises...

  6. 76 FR 77533 - Notice of Order: Revisions to Enterprise Public Use Database Incorporating High-Cost Single...

    Science.gov (United States)

    2011-12-13

    ... AGENCY Notice of Order: Revisions to Enterprise Public Use Database Incorporating High-Cost Single-Family... matrices to include certain data fields for high-cost single-family loans purchased and securitized by the... rate spread field has been corrected in the Single Family Census Tract Data Set. Both files...

  7. The Impact of Patient Profiles and Procedures on Hospitalization Costs through Length of Stay in Community-Acquired Pneumonia Patients Based on a Japanese Administrative Database.

    Directory of Open Access Journals (Sweden)

    Hironori Uematsu

    Full Text Available Community-acquired pneumonia is a common cause of patient hospitalization, and its burden on health care systems is increasing in aging societies. In this study, we aimed to investigate the factors that affect hospitalization costs in community-acquired pneumonia patients while considering the intermediate influence of patient length of stay.Using a multi-institutional administrative claims database, we analyzed 30,041 patients hospitalized for community-acquired pneumonia who had been discharged between April 1, 2012 and September 30, 2013 from 289 acute care hospitals in Japan. Possible factors associated with hospitalization costs were investigated using structural equation modeling with length of stay as an intermediate variable. We calculated the direct, indirect (through length of stay, and total effects of the candidate factors on hospitalization costs in the model. Lastly, we calculated the ratio of indirect effects to direct effects for each factor.The structural equation model showed that higher disease severities (using A-DROP, Barthel Index, and Charlson Comorbidity Index scores, use of mechanical ventilation, and tube feeding were associated with higher hospitalization costs, regardless of the intermediate influence of length of stay. The severity factors were also associated with longer length of stay durations. The ratio of indirect effects to direct effects on total hospitalization costs showed that the former was greater than the latter in the factors, except in the use of mechanical ventilation.Our structural equation modeling analysis indicated that patient profiles and procedures impacted on hospitalization costs both directly and indirectly. Furthermore, the profiles were generally shown to have greater indirect effects (through length of stay on hospitalization costs than direct effects. These findings may be useful in supporting the more appropriate distribution of health care resources.

  8. ABEL model: Evaluates corporations` claims of inability to afford penalties and compliance costs (version 3.0.16). Model-simulation

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-11-01

    The easy-to-use ABEL software evaluates for-profit company claims of inability to afford penalties, clean-up costs, or compliance costs. Violators raise the issue of inability to pay in most of EPA`s enforcement actions regardless of whether there is any hard evidence supporting those claims. The program enables Federal, State and local enforcement professionals to quickly determine if there was any validity to those claims. ABEL is a tool that promotes quick settlements by performing screening analyses of defendants and potentially responsible parties (PRP`s) to determine their financial capacity. After analyzing some basic financial ratios that reflect a company`s solvency, ABEL assesses the firm`s ability to pay by focusing on projected cash flows. The model explicitly calculates the value of projected, internally generated cash flows from historical tax information, and compares these cash flows to the proposed environmental expenditure(s). The software is extremely easy to use. Version 3.0.16 updates the standard values for inflation and discount rate.

  9. Cost of Hospitalization and Length of Stay in People with Down Syndrome: Evidence from a National Hospital Discharge Claims Database

    Science.gov (United States)

    Hung, Wen-Jiu; Lin, Lan-Ping; Wu, Chia-Ling; Lin, Jin-Ding

    2011-01-01

    The present paper aims to describe the hospitalization profiles which include medical expenses and length of stays, and to determine their possible influencing factors of hospital admission on persons with Down syndrome in Taiwan. We employed a population-based, retrospective analyses used national health insurance hospital discharge data of the…

  10. Cost of Hospitalization and Length of Stay in People with Down Syndrome: Evidence from a National Hospital Discharge Claims Database

    Science.gov (United States)

    Hung, Wen-Jiu; Lin, Lan-Ping; Wu, Chia-Ling; Lin, Jin-Ding

    2011-01-01

    The present paper aims to describe the hospitalization profiles which include medical expenses and length of stays, and to determine their possible influencing factors of hospital admission on persons with Down syndrome in Taiwan. We employed a population-based, retrospective analyses used national health insurance hospital discharge data of the…

  11. Resource consumption and healthcare costs of acute coronary syndrome: a retrospective observational administrative database analysis.

    Science.gov (United States)

    Roggeri, Alessandro; Gnavi, Roberto; Dalmasso, Marco; Rusciani, Raffaella; Giammaria, Massimo; Anselmino, Monica; Roggeri, Daniela Paola

    2013-12-01

    The objective of this study was to estimate resource consumption and direct healthcare costs of patients with a first hospitalization for acute coronary syndrome (ACS) in 2008 in the Piedmont Region, Italy. Subjects hospitalized with a first episode of ACS in 2008 were selected from the regional hospital discharge database. All hospitalizations, drug prescriptions, and outpatient episodes of care in the 12 months following discharge were considered to estimate resource consumption and direct healthcare costs from the Piedmont Regional Health Service perspective. The analysis was carried out separately for ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), and unstable angina (UA) populations. In the accrual period, 7765 subjects (1.75‰ of the total population) were hospitalized for ACS (64.2% men). The average age was 66.5 for men and 75.4 for women. The average in-hospital mortality was 6.5% (n = 508). The total ACS population was classified as: STEMI 45.2%, NSTEMI 29.4%, and UA 25.4%. The average yearly costs per patient alive at the end of follow-up (n = 6851) were 14,160.8&OV0556; (18,678.7 USD): 83.9% for inpatient admissions [11,881.2&OV0556; (15,671.8 USD)], 9.3% for drugs [1311.6&OV0556; (1730.1 USD)], 5.0% for diagnostic and therapeutic procedures and outpatient visits [708.2&OV0556; (934.1 USD)], and 1.8% for 1-day hospital stays [259.8&OV0556; (342.7 USD)]. The average yearly direct healthcare costs by ACS event were 14,984.5&OV0556; (19,765.2 USD) for STEMI, 14,554.1&OV0556; (19,197.4 USD) for NSTEMI, and 12,481.5&OV0556; (16,463.6 USD) for UA. In each subpopulation, costs were significantly higher for men than for women. ACS imposes a significant burden in terms of morbidity and mortality and generates major public health service costs.

  12. Medication adherence in patients with diabetes mellitus: does physician drug dispensing enhance quality of care? Evidence from a large health claims database in Switzerland

    Science.gov (United States)

    Huber, Carola A; Reich, Oliver

    2016-01-01

    Background The drug-dispensing channel is a scarcely explored determinant of medication adherence, which is considered as a key indicator for the quality of care among patients with diabetes mellitus. In this study, we investigated the difference in adherence between diabetes patients who obtained their medication directly from a prescribing physician (physician dispensing [PD]) or via a pharmacy. Methods A retrospective cohort study was conducted using a large health care claims database from 2011 to 2014. Patients with diabetes of all ages and receiving at least one oral antidiabetic drug (OAD) prescription were included. We calculated patients’ individual adherence to OADs defined as the proportion of days covered (PDC), which was measured over 1 year after patient identification. Good adherence was defined as PDC ≥80%. Multivariate logistic regression analysis was performed to assess the relationship between the PDC and the dispensing channel (PD, pharmacy). Results We identified a total of 10,430 patients prescribed drugs by a dispensing physician and 16,292 patients receiving drugs from a pharmacy. Medication adherence was poor in both patient groups: ~40% of the study population attained good adherence to OADs. We found no significant impact of PD on the adherence level in diabetes patients. Covariates associated significantly with good adherence were older age groups, male sex, occurrence of comorbidity and combined diabetes drug therapy. Conclusion In conclusion, adherence to antihyperglycemic medication is suboptimal among patients with diabetes. The results of this study provide evidence that the dispensing channel does not have an impact on adherence in Switzerland. Certainly, medication adherence needs to be improved in both supply settings. Physicians as well as pharmacists are encouraged to develop and implement useful tools to increase patients’ adherence behavior. PMID:27695299

  13. Linked Patient-Reported Outcomes Data From Patients With Multiple Sclerosis Recruited on an Open Internet Platform to Health Care Claims Databases Identifies a Representative Population for Real-Life Data Analysis in Multiple Sclerosis.

    Science.gov (United States)

    Risson, Valery; Ghodge, Bhaskar; Bonzani, Ian C; Korn, Jonathan R; Medin, Jennie; Saraykar, Tanmay; Sengupta, Souvik; Saini, Deepanshu; Olson, Melvin

    2016-09-22

    An enormous amount of information relevant to public health is being generated directly by online communities. To explore the feasibility of creating a dataset that links patient-reported outcomes data, from a Web-based survey of US patients with multiple sclerosis (MS) recruited on open Internet platforms, to health care utilization information from health care claims databases. The dataset was generated by linkage analysis to a broader MS population in the United States using both pharmacy and medical claims data sources. US Facebook users with an interest in MS were alerted to a patient-reported survey by targeted advertisements. Eligibility criteria were diagnosis of MS by a specialist (primary progressive, relapsing-remitting, or secondary progressive), ≥12-month history of disease, age 18-65 years, and commercial health insurance. Participants completed a questionnaire including data on demographic and disease characteristics, current and earlier therapies, relapses, disability, health-related quality of life, and employment status and productivity. A unique anonymous profile was generated for each survey respondent. Each anonymous profile was linked to a number of medical and pharmacy claims datasets in the United States. Linkage rates were assessed and survey respondents' representativeness was evaluated based on differences in the distribution of characteristics between the linked survey population and the general MS population in the claims databases. The advertisement was placed on 1,063,973 Facebook users' pages generating 68,674 clicks, 3719 survey attempts, and 651 successfully completed surveys, of which 440 could be linked to any of the claims databases for 2014 or 2015 (67.6% linkage rate). Overall, no significant differences were found between patients who were linked and not linked for educational status, ethnicity, current or prior disease-modifying therapy (DMT) treatment, or presence of a relapse in the last 12 months. The frequencies of the

  14. Linked Patient-Reported Outcomes Data From Patients With Multiple Sclerosis Recruited on an Open Internet Platform to Health Care Claims Databases Identifies a Representative Population for Real-Life Data Analysis in Multiple Sclerosis

    Science.gov (United States)

    Ghodge, Bhaskar; Bonzani, Ian C; Korn, Jonathan R; Medin, Jennie; Saraykar, Tanmay; Sengupta, Souvik; Saini, Deepanshu; Olson, Melvin

    2016-01-01

    Background An enormous amount of information relevant to public health is being generated directly by online communities. Objective To explore the feasibility of creating a dataset that links patient-reported outcomes data, from a Web-based survey of US patients with multiple sclerosis (MS) recruited on open Internet platforms, to health care utilization information from health care claims databases. The dataset was generated by linkage analysis to a broader MS population in the United States using both pharmacy and medical claims data sources. Methods US Facebook users with an interest in MS were alerted to a patient-reported survey by targeted advertisements. Eligibility criteria were diagnosis of MS by a specialist (primary progressive, relapsing-remitting, or secondary progressive), ≥12-month history of disease, age 18-65 years, and commercial health insurance. Participants completed a questionnaire including data on demographic and disease characteristics, current and earlier therapies, relapses, disability, health-related quality of life, and employment status and productivity. A unique anonymous profile was generated for each survey respondent. Each anonymous profile was linked to a number of medical and pharmacy claims datasets in the United States. Linkage rates were assessed and survey respondents’ representativeness was evaluated based on differences in the distribution of characteristics between the linked survey population and the general MS population in the claims databases. Results The advertisement was placed on 1,063,973 Facebook users’ pages generating 68,674 clicks, 3719 survey attempts, and 651 successfully completed surveys, of which 440 could be linked to any of the claims databases for 2014 or 2015 (67.6% linkage rate). Overall, no significant differences were found between patients who were linked and not linked for educational status, ethnicity, current or prior disease-modifying therapy (DMT) treatment, or presence of a relapse in

  15. Current and Future Incidence and Costs of Osteoporosis-Related Fractures in the Netherlands : Combining Claims Data with BMD Measurements

    NARCIS (Netherlands)

    F.J.B. Lötters (Freek); J.P.W. van den Bergh (Joop); F. de Vries (Frank); M.P.M.H. Rutten-van Mölken (Maureen)

    2016-01-01

    markdownabstractThis study aims to estimate the incidence and costs of osteoporosis-related fractures in The Netherlands in 2010 and project them to 2030. The incidence and costs of five different types of fractures (spine, hip, upper extremity, lower extremity, wrist/distal forearm, other) were der

  16. Current and Future Incidence and Costs of Osteoporosis-Related Fractures in the Netherlands : Combining Claims Data with BMD Measurements

    NARCIS (Netherlands)

    F.J.B. Lötters (Freek); J.P.W. van den Bergh (Joop); F. de Vries (Frank); M.P.M.H. Rutten-van Mölken (Maureen)

    2016-01-01

    markdownabstractThis study aims to estimate the incidence and costs of osteoporosis-related fractures in The Netherlands in 2010 and project them to 2030. The incidence and costs of five different types of fractures (spine, hip, upper extremity, lower extremity, wrist/distal forearm, other) were

  17. Current and Future Incidence and Costs of Osteoporosis-Related Fractures in The Netherlands: Combining Claims Data with BMD Measurements

    NARCIS (Netherlands)

    F.J.B. Lötters (Freek); J.P.W. van den Bergh (Joop); F. de Vries (Frank); M.P.M.H. Rutten-van Mölken (Maureen)

    2016-01-01

    textabstractThis study aims to estimate the incidence and costs of osteoporosis-related fractures in The Netherlands in 2010 and project them to 2030. The incidence and costs of five different types of fractures (spine, hip, upper extremity, lower extremity, wrist/distal forearm, other) were derived

  18. Administrative databases as a tool for identifying healthcare demand and costs in an over-one million population

    Directory of Open Access Journals (Sweden)

    Fabiana Madotto

    2013-06-01

    Full Text Available Background: the aim of this study was to assess healthcare demand of specific groups of population and their costs borne by Italian Health System, using healthcare administrative databases.Methods: demographic, clinical and economic data were obtained from datasets available at the Regional Health System, combined into a data warehouse (DENALI, using a probabilistic record linkage to optimize the data matching process. The study population consisted of more than 1 million people registered in 2005 at one Local Healthcare Unit of Lombardy. Eight different segments were identified. Costs occurring in 2005 for hospital admissions, drug prescriptions, outpatient medical specialist visits were quantified in each segment.Results: healthy people accounted for 53% of the population and cost € 180 per-capita. Subjects with only one chronic disease made up 16% of the population and cost € 916 per-capita, those affected by several chronic diseases accounted for 13% and cost € 3 457 per-capita. Hospitalizations were the cost driver in five segments, ranging from 42% to 89% of total expenditures. Outpatient visits were the cost driver among healthy subjects (54% and those with a possible chronic disease (42%, while drug costs ranged between 4% (“acute event” and 32% (“one chronic disease”. Overall, healthcare cost was € 809 per-capita.Conclusions: healthcare costs were mainly determined by people affected by chronic conditions, even if “healthy people” ranked third for total expenditure. These costs need an appropriate identification of healthcare demand, that could be efficiently monitored through the use of administrative databases.

  19. Healthcare Costs for Chronic Hepatitis C in South Korea from 2009 to 2013: An Analysis of the National Health Insurance Claims' Data.

    Science.gov (United States)

    Ki, Moran; Choi, Hwa Young; Kim, Kyung-Ah; Jang, Eun Sun; Jeong, Sook-Hyang

    2017-08-14

    The introduction of direct-acting antivirals (DAA) in 2013 revolutionized hepatitis C virus (HCV) treatment, offering a cure rate >90%. However, this therapy is expensive, and estimations of the number of chronic HCV-infected (CHC) patients and their treatment costs pre-2013 are therefore essential for creating policies and expanding drug access. Herein, we aimed to investigate the number of HCV-related liver disease patients, their healthcare utilization, their annual direct medical costs, and the interferon-based antiviral treatment rates and costs from 2009 to 2013 in South Korea. The National Health Insurance database was reviewed, and patients diagnosed with CHC from 2009 to 2013 were extracted. Data regarding detailed healthcare utilization, prescribed drugs, and direct medical costs were obtained. For annual direct healthcare cost calculations, a prevalence-based approach was used. Overall, 181,768 CHC patients were identified. In 2013, the annual per-patient costs for chronic hepatitis, liver cirrhosis, hepatocellular carcinoma, and the first year post-liver transplant were 895, 1,873, 6,945, and 67,359 USD, respectively. Interferon-based antiviral therapeutics were prescribed to 25,223 patients (13.9%). Healthcare costs have increased remarkably with increasing liver disease severity. Thus, efforts to stop disease progression are needed. Moreover, the low rate of interferon-based therapy indicates an unmet need for DAA.

  20. Cost of opioid intravenous patient-controlled analgesia: results from a hospital database analysis and literature assessment

    Directory of Open Access Journals (Sweden)

    Palmer P

    2014-06-01

    Full Text Available Pamela Palmer,1 Xiang Ji,2 Jennifer Stephens21AcelRx Pharmaceuticals, Inc., Redwood City, CA, 2Pharmerit International, Bethesda, MD, USABackground: Intravenous patient-controlled analgesia (PCA equipment and opioid cost analyses on specific procedures are lacking. This study estimates the intravenous PCA hospital cost for the first 48 postoperative hours for three inpatient surgeries.Methods: Descriptive analyses using the Premier database (2010–2012 of more than 500 US hospitals were conducted on cost (direct acquisition and indirect cost for the hospital, such as overhead, labor, pharmacy services of intravenous PCA after total knee/hip arthroplasty (TKA/THA or open abdominal surgery. Weighted average cost of equipment and opioid drug and the literature-based cost of adverse events and complications were aggregated for total costs.Results: Of 11,805,513 patients, 272,443 (2.3%, 139,275 (1.2%, and 195,062 (1.7% had TKA, THA, and abdominal surgery, respectively, with approximately 20% of orthopedic and 29% of abdominal patients having specific intravenous PCA database cost entries. Morphine (57% and hydromorphone (44% were the most frequently used PCA drugs, with a mean cost per 30 cc syringe of $16 (30 mg and $21 (6 mg, respectively. The mean number of syringes used for morphine and hydromorphone in the first 48 hours were 1.9 and 3.2 (TKA, 2.0 and 4.2 (THA, and 2.5 and 3.9 (abdominal surgery, respectively. Average costs of PCA pump, intravenous tubing set, and drug ranged from $46 to $48, from $20 to $22, and from $33 to $46, respectively. Pump, tubing, and saline required to maintain patency of the intravenous PCA catheter over 48 hours ranged from $9 to $13, from $8 to $9, and from $20 to $22, respectively. Supplemental non-PCA opioid use ranged from $56 for THA to $87 for abdominal surgery. Aggregated mean intravenous PCA equipment and opioid cost per patient were $196 (THA, $204 (TKA, and $243 (abdominal surgery. Total costs, including

  1. Evaluation of gender-based disparities in time from initial haematuria presentation to upper tract urothelial carcinoma diagnosis: analysis of a nationwide insurance claims database.

    Science.gov (United States)

    Chappidi, Meera R; Kates, Max; Tosoian, Jeffrey J; Johnson, Michael H; Hahn, Noah M; Bivalacqua, Trinity J; Pierorazio, Phillip M

    2017-09-01

    To investigate the length of time from initial haematuria presentation to upper tract urothelial carcinoma (UTUC) diagnosis and the effect of gender on this duration. Patients with haematuria claims in the year prior to UTUC diagnosis were identified from the MarketScan database (2010-2014). Delayed diagnosis was defined as >90 days from haematuria presentation to UTUC diagnosis. Multivariable Poisson regression models were used to determine factors associated with delayed UTUC diagnosis. Among 1 326 patients with UTUC, 469 (35.4%) experienced delayed diagnosis. Men (n = 866) had a longer median interval from haematuria to diagnosis than women (60 vs 49 days; P = 0.04). In the multivariable model, male gender (relative risk [RR] 1.13, 95% confidence interval [CI] 0.95-1.34) was not associated with delayed diagnosis, while urinary tract infection (UTI; RR 1.52, 95% CI 1.32-1.76), nephrolithiasis (RR 1.23, 95% CI 1.06-1.44), new (RR 1.37, 95% CI 1.12-1.66) and recurrent prostate-related diagnoses (RR 1.61, 95% CI 1.23-2.10) were. For men presenting to non-urologists, UTI (RR 1.44, 95% CI 1.22-1.71), nephrolithiasis (RR 1.25 95% CI 1.05-1.49), new (RR 1.41, 95% CI 1.12-1.78) and recurrent prostate-related diagnoses (RR 1.94, 95% CI 1.45-2.58) were associated with delayed diagnosis; however, for men presenting to urologists, nephrolithiasis (RR 1.08 95% CI 0.78-1.49), new (RR 1.15, 95% CI 0.79-1.68) and recurrent prostate-related diagnoses (RR 1.17, 95% CI 0.69-1.97) were not associated with delayed diagnosis, while UTI diagnosis (RR 1.74, 95% CI 1.31-2.31) was still associated with delayed diagnosis. A UTUC diagnosis was made >90 days after haematuria presentation in approximately one-third of patients. Men experienced a longer median interval from haematuria to UTUC diagnosis compared with women, but male gender was not an independent predictor of delayed diagnosis. Benign diagnoses during haematuria evaluation were strongly associated with delayed diagnosis

  2. Trend and geographic analysis for traumatic brain injury mortality and cost based on MarketScan database.

    Science.gov (United States)

    Hu, Jiahui; Ugiliweneza, Beatrice; Meyer, Kimberly; Lad, Shivanand P; Boakye, Maxwell

    2013-10-15

    The objective of the current research was to examine the current epidemiology of traumatic brain injury (TBI); to determine the effects of geographic region, co-morbidities, year of injury, injury severity, and demographics on hospital costs, length of stay (LOS), and mortality. All subjects were drawn from the Thomason Reuters MarketScan(®) database. Statistical methods used included descriptive analysis, bivariate analysis, logistic regression, and the Geographic Information System (GIS) software, ArcMap. We studied 76,313 patients with TBI from 2004 to 2009 (52,721 with commercial insurance and 23,592 with Medicare) from the MarketScan database. As age increased, mortality rate and median LOS increased. The median hospital costs for adults were the highest ($13,000 for ages 18-64) compared with children ($8000 for age 0-14) and elderly persons ($9000 for age ≥ 65). The mortality rate for the elderly population has decreased slightly (11.1% in 2004 to 9.9% in 2009 for men, and 7.0% to 6.9% for women); however, their hospital costs have increased significantly ($6899 in 2004 to $11,567 in 2009 for men; $6784 to $9782 for women). Concerning the impact of geography, the western United States (e.g., Washington and California) had lower mortality rates and higher median costs while the southeast United States had the highest mortality and mixed median costs. Both overall mortality and median LOS have remained relatively stable over the years. Hospital cost, however, has increased for the elderly population even after accounting for the inflation. There is significant geographic variation for both mortality and hospital costs.

  3. The cost and performance of utility commercial lighting programs. A report from the Database on Energy Efficiency Programs (DEEP) project

    Energy Technology Data Exchange (ETDEWEB)

    Eto, J.; Vine, E.; Shown, L.; Sonnenblick, R.; Payne, C. [Lawrence Berkeley Lab., CA (United States). Energy and Environment Div.

    1994-05-01

    The objective of the Database on Energy Efficiency Programs (DEEP) is to document the measured cost and performance of utility-sponsored, energy-efficiency, demand-side management (DSM) programs. Consistent documentation of DSM programs is a challenging goal because of problems with data consistency, evaluation methodologies, and data reporting formats that continue to limit the usefulness and comparability of individual program results. This first DEEP report investigates the results of 20 recent commercial lighting DSM programs. The report, unlike previous reports of its kind, compares the DSM definitions and methodologies that each utility uses to compute costs and energy savings and then makes adjustments to standardize reported program results. All 20 programs were judged cost-effective when compared to avoided costs in their local areas. At an average cost of 3.9{cents}/kWh, however, utility-sponsored energy efficiency programs are not ``too cheap to meter.`` While it is generally agreed upon that utilities must take active measures to minimize the costs and rate impacts of DSM programs, the authors believe that these activities will be facilitated by industry adoption of standard definitions and reporting formats, so that the best program designs can be readily identified and adopted.

  4. Development of a Cost-Effective Database Software for Psychiatric Research: A Study From Tertiary Care Teaching Hospital

    Directory of Open Access Journals (Sweden)

    Sabu Karakkamandapam

    2010-10-01

    Full Text Available Background: Technological progression made drastic changes in health care. Still there is a growing concern about proper utilization of health information within hospitals for various research activities. Huge volumes of such health information in majority of hospitals are redundant due to lack of appropriate and cost-effective technological tools for retrieving relevant health information for research purpose. Objective: To develop a cost-effective and user-friendly computerized medical record database for psychiatry using available technology with the department. Methodology: Study performed at a tertiary care teaching hospital in Udupi district of South India. Various datasets from psychiatry medical records were utilized for the design and creation of database. A computerized database called PsyCase was developed with the help of technology available within the department. A 4612 patient’s data were entered into the PsyCase and subjected to various analyses. Results: Applications of PsyCase in various epidemiological studies were explored through performing numerous analyses with actual data. PsyCase was found effective in supporting psychiatric research as well as routine clinical and administrative activities. Conclusion: This study emphasizes need of appropriate use of technology available within a healthcare system to facilitate medical research in psychiatry and role of health information professional in such initiatives. Healthcare organization must focus on collective utilization of resources within the system to improve the utilization of health information for medical research.

  5. Claims in civil engineering contracts

    CERN Document Server

    Speirs, N A

    1999-01-01

    This paper considers claims arising during civil engineering construction contracts. The meaning of the word 'claim' is considered and its possible implications for additional cost and time to completion. The conditions of the construction contract selected will influence the risk apportionment between contractor and client and the price offered by the contractor for the work. Competitive bidding constraints and profit margins in the construction industry, however, may also influence the price offered. This in turn can influence the likelihood of claims arising. The client from his point of view is concerned to complete the work within an agreed time and budget. The circumstances under which claims may arise are reviewed in relation to typical conditions of contract. These circumstances are then related to the CERN LHC civil works. Ways of avoiding claims, where this is possible, are considered. Finally, the means of evaluation of claims and their settlement are considered.

  6. What does the U.S. Medicare administrative claims database tell us about initial antiepileptic drug treatment for older adults with new-onset epilepsy?

    Science.gov (United States)

    Martin, Roy C; Faught, Edward; Szaflarski, Jerzy P; Richman, Joshua; Funkhouser, Ellen; Piper, Kendra; Juarez, Lucia; Dai, Chen; Pisu, Maria

    2017-04-01

    Disparities in epilepsy treatment are not uncommon; therefore, we examined population-based estimates of initial antiepileptic drugs (AEDs) in new-onset epilepsy among racial/ethnic minority groups of older US Medicare beneficiaries. We conducted retrospective analyses of 2008-2010 Medicare administrative claims for a 5% random sample of beneficiaries augmented for minority representation. New-onset epilepsy cases in 2009 had ≥1 International Classification of Diseases, Ninth Revision (ICD-9) 345.x or ≥2 ICD-9 780.3x, and ≥1 AED, AND no seizure/epilepsy claim codes or AEDs in preceding 365 days. We examined AED use and concordance with Quality Indicators of Epilepsy Treatment (QUIET) 6 (monotherapy as initial treatment = ≥30 day first prescription with no other concomitant AEDs), and prompt AED treatment (first AED within 30 days of diagnosis). Logistic regression examined likelihood of prompt treatment by demographic (race/ethnicity, gender, age), clinical (number of comorbid conditions, neurology care, index event occurring in the emergency room (ER)), and economic (Part D coverage phase, eligibility for Part D Low Income Subsidy [LIS], and ZIP code level poverty) factors. Over 1 year of follow-up, 79.6% of 3,706 new epilepsy cases had one AED only (77.89% of whites vs. 89% of American Indian/Alaska Native [AI/AN]). Levetiracetam was the most commonly prescribed AED (45.5%: from 24.6% AI/AN to 55.0% whites). The second most common was phenytoin (30.6%: from 18.8% Asians to 43.1% AI/AN). QUIET 6 concordance was 94.7% (93.9% for whites to 97.3% of AI/AN). Only 50% received prompt AED therapy (49.6% whites to 53.9% AI/AN). Race/ethnicity was not significantly associated with AED patterns, monotherapy use, or prompt treatment. Monotherapy is common across all racial/ethnic groups of older adults with new-onset epilepsy, older AEDs are commonly prescribed, and treatment is frequently delayed. Further studies on reasons for treatment delays are warranted

  7. Claiming Copernicus.

    Science.gov (United States)

    Fara, Patricia

    2005-12-01

    The reputations of scientific heroes shift constantly, modified by politicians as well as by historians. Now that the Scientific Revolution has been reappraised, Nicolas Copernicus is portrayed as a friend of the Catholic Church rather than a scientific martyr. As a German-speaking Pole he has been claimed as a figure of national historical importance by both Germany and Poland, and since the early 20th century has been an important symbol of Polish independence.

  8. Clinical outcomes in low risk coronary artery disease patients treated with different limus-based drug-eluting stents--a nationwide retrospective cohort study using insurance claims database.

    Directory of Open Access Journals (Sweden)

    Chao-Lun Lai

    Full Text Available The clinical outcomes of different limus-based drug-eluting stents (DES in a real-world setting have not been well defined. The aim of this study was to investigate the clinical outcomes of three different limus-based DES, namely sirolimus-eluting stent (SES, Endeavor zotarolimus-eluting stent (E-ZES and everolimus-eluting stent (EES, using a national insurance claims database. We identified all patients who received implantation of single SES, E-ZES or EES between January 1, 2007 and December 31, 2009 from the National Health Insurance claims database, Taiwan. Follow-up was through December 31, 2011 for all selected clinical outcomes. The primary end-point was all-cause mortality. Secondary end-points included acute coronary events, heart failure needing hospitalization, and cerebrovascular disease. Cox regression model adjusting for baseline characteristics was used to compare the relative risks of different outcomes among the three different limus-based DES. Totally, 6584 patients were evaluated (n=2142 for SES, n=3445 for E-ZES, and n=997 for EES. After adjusting for baseline characteristics, we found no statistically significant difference in the risk of all-cause mortality in three DES groups (adjusted hazard ratio [HR]: 1.14, 95% confidence interval [CI]: 0.94-1.38, p=0.20 in E-ZES group compared with SES group; adjusted HR: 0.77, 95% CI: 0.54-1.10, p=0.15 in EES group compared with SES group. Similarly, we found no difference in the three stent groups in risks of acute coronary events, heart failure needing hospitalization, and cerebrovascular disease. In conclusion, we observed no difference in all-cause mortality, acute coronary events, heart failure needing hospitalization, and cerebrovascular disease in patients treated with SES, E-ZES, and EES in a real-world population-based setting in Taiwan.

  9. Clinical outcomes in low risk coronary artery disease patients treated with different limus-based drug-eluting stents--a nationwide retrospective cohort study using insurance claims database.

    Science.gov (United States)

    Lai, Chao-Lun; Wu, Ching-Fen; Kuo, Raymond Nien-Chen; Yang, Yen-Yun; Chen, Ming-Fong; Chan, K Arnold; Lai, Mei-Shu

    2015-01-01

    The clinical outcomes of different limus-based drug-eluting stents (DES) in a real-world setting have not been well defined. The aim of this study was to investigate the clinical outcomes of three different limus-based DES, namely sirolimus-eluting stent (SES), Endeavor zotarolimus-eluting stent (E-ZES) and everolimus-eluting stent (EES), using a national insurance claims database. We identified all patients who received implantation of single SES, E-ZES or EES between January 1, 2007 and December 31, 2009 from the National Health Insurance claims database, Taiwan. Follow-up was through December 31, 2011 for all selected clinical outcomes. The primary end-point was all-cause mortality. Secondary end-points included acute coronary events, heart failure needing hospitalization, and cerebrovascular disease. Cox regression model adjusting for baseline characteristics was used to compare the relative risks of different outcomes among the three different limus-based DES. Totally, 6584 patients were evaluated (n=2142 for SES, n=3445 for E-ZES, and n=997 for EES). After adjusting for baseline characteristics, we found no statistically significant difference in the risk of all-cause mortality in three DES groups (adjusted hazard ratio [HR]: 1.14, 95% confidence interval [CI]: 0.94-1.38, p=0.20 in E-ZES group compared with SES group; adjusted HR: 0.77, 95% CI: 0.54-1.10, p=0.15 in EES group compared with SES group). Similarly, we found no difference in the three stent groups in risks of acute coronary events, heart failure needing hospitalization, and cerebrovascular disease. In conclusion, we observed no difference in all-cause mortality, acute coronary events, heart failure needing hospitalization, and cerebrovascular disease in patients treated with SES, E-ZES, and EES in a real-world population-based setting in Taiwan.

  10. Cost and resource utilization associated with fluconazole as first-line therapy for invasive candidiasis: a retrospective database analysis.

    Science.gov (United States)

    Craver, Christopher W; Tarallo, Miriam; Roberts, Craig S; Blanchette, Christopher M; Ernst, Frank R

    2010-12-01

    Fluconazole is a standard first-line therapy for candidemia/invasive candidiasis (C/IC), based on its efficacy, safety profile, and comparatively low acquisition cost. However, little is known about the total costs associated with fluconazole treatment for this indication, particularly in cases of clinical failure. The aim of this study was to examine overall costs, resource use, and treatment outcomes associated with fluconazole as first-line therapy for invasive Candida infections in the United States. A retrospective analysis of data from a US hospital-based (>500 hospitals), service-level database was performed. All patients aged >16 years with primary or secondary International Classification of Diseases, Ninth Revision, Clinical Modification codes for IC or septicemia, receiving intravenous fluconazole treatment, and discharged between October 1, 2004 and September 30, 2005 were selected. Costs and resource use were calculated from the start of antifungal therapy until discharge. Two groups were analyzed: patients who received fluconazole only and those who required a second-line antifungal. Separate analyses for the survivor subpopulations were also conducted. A total of 7170 patients met the inclusion criteria; 21.2% required an additional antifungal agent. Overall mortality was 27.1%, and total mean treatment cost for all patients was $44,482 (in 2005 US dollars). Patients treated with fluconazole alone incurred mean costs of $36,319. Mean hospital and intensive care unit stays in the fluconazole monotherapy group were 17.9 days and 7.1 days, respectively. Patients requiring additional therapy had a mortality rate of 34.5% and a mean treatment cost of $76,329; in this group, the mean hospital and intensive care unit stays were 31.7 days and 14.8 days, respectively. The overall resource use associated with fluconazole as first-line treatment for C/IC was high, especially in patients who required additional antifungal therapy. Future studies should examine

  11. Report: Costs Claimed by the Tribal Association on Solid Waste and Emergency Response Under EPA Assistance Agreement No. CR827181-01

    Science.gov (United States)

    Report #2003-4-00119, September 19, 2003. We questioned the total Federal share claimed of $2,357,376 as unsupported, because the Association did not comply with the Federal rules, regulations, and terms of the assistance agreement.

  12. Real-world costs and outcomes in metastatic renal cell carcinoma patients treated with targeted therapies: a cohort study from the French health insurance database.

    Science.gov (United States)

    Maroun, Rana; Fleury, Laetitia; Nachbaur, Gaelle; Maunoury, Franck; Vanhille, Jean-Louis; Durand-Zaleski, Isabelle

    2017-08-07

    The objective of this study was to describe treatment patterns, survival, healthcare use and costs in patients with metastatic renal cell carcinoma (mRCC) in a real-world setting. We used the National Health Insurance (NHI) claims database for the Ile-de-France region to perform a retrospective cohort analysis of patients with mRCC treated by a first-line targeted therapy. Treatment naïve patients were identified combining the 10th revision of the International Classification of Diseases (ICD-10) codes (C64 & C77-C79) and a first prescription of targeted therapies. Descriptive analyses were performed on treatment patterns and patients' characteristics. Progression free survival (PFS) and overall survival (OS) were determined using Kaplan-Meier actuarial survival analysis. All healthcare resource use and costs were estimated on a per patient per month (PPPM) basis (€2016). A total of 327 treatment naïve patients with mRCC were included. Median follow-up was 13.4 months. Sunitinib accounted for 73% of first-line treatments. The most frequently observed treatment sequence for the first two lines was sunitinib-everolimus (16%; n = 137) and for the first three lines sunitinib-everolimus-axitinib (20%; n = 49). First-line PFS for sunitinib, everolimus, pazopanib, sorafenib and other was 8.7, 6.2, 10.7, 5.7 and 11.2 months, respectively. Median OS for patients treated by first-line sunitinib, everolimus, pazopanib, sorafenib and other was respectively 14.7, 8.1, 21.1, 8.9 and 14.0 months. From the NHI's perspective, the mean PPPM was €5546. The average PPPM in pre-progression was €5597 compared to €5541 beyond progression of the disease. Oral targeted therapies accounted for 53% of the total PPPM. This descriptive study showed that the economic burden of mRCC is substantial with oral targeted therapies accounting for 53% of the PPPM. OS and PFS in real life are poorer than observed in clinical trials.

  13. Rate of bleeding-related episodes in adult patients with primary immune thrombocytopenia: a retrospective cohort study using a large administrative medical claims database in the US

    Directory of Open Access Journals (Sweden)

    Altomare I

    2016-06-01

    Full Text Available Ivy Altomare,1 Karynsa Cetin,2 Sally Wetten,3 Jeffrey S Wasser4 1Department of Medicine, Duke University School of Medicine, Durham, NC, 2Center for Observational Research, Amgen Inc., Cambridge, MA, USA; 3Centre for Observational Research, Amgen Ltd., Uxbridge, UK; 4Carole and Ray Neag Comprehensive Cancer Center, University of Connecticut School of Medicine, Farmington, CT, USA Background: Immune thrombocytopenia (ITP is a rare disorder characterized by low platelet counts and an increased tendency to bleed. The goal of ITP therapy is to treat or prevent bleeding. Actual rates of bleeding are unknown. Clinical trial data may not reflect real-world bleeding rates because of the inclusion of highly refractory patients and more frequent use of rescue therapy. Methods: We used administrative medical claims data in the US to examine the occurrence of bleeding-related episodes (BREs – a composite end point including bleeding and/or rescue therapy use – in adults diagnosed with primary ITP (2008–2012. BRE rates were calculated overall and by ITP phase and splenectomy status. Patients were followed from ITP diagnosis until death, disenrollment from the health plan, or June 30, 2013, whichever came first. Results: We identified 6,651 adults diagnosed with primary ITP over the study period (median age: 53 years; 59% female. During 13,064 patient-years of follow-up, 3,768 patients (57% experienced ≥1 BRE (1.08 BREs per patient-year; 95% confidence interval: 1.06–1.10. The majority (58% of BREs consisted of rescue therapy use only. Common bleeding types were gastrointestinal hemorrhage, hematuria, ecchymosis, and epistaxis. Intracranial hemorrhage was reported in 74 patients (1%. Just over 7% of patients underwent splenectomy. Newly diagnosed and splenectomized patients had elevated BRE rates. Conclusion: We provide current real-world estimates of BRE rates in adults with primary ITP. The majority of ITP patients experienced ≥1 BRE, and over

  14. Risk of Peripheral Artery Occlusive Disease in Patients with Vertigo, Tinnitus, or Sudden Deafness: A Secondary Case-Control Analysis of a Nationwide, Population-Based Health Claims Database.

    Science.gov (United States)

    Koo, Malcolm; Chen, Jin-Cherng; Hwang, Juen-Haur

    2016-01-01

    Cochleovestibular symptoms, such as vertigo, tinnitus, and sudden deafness, are common manifestations of microvascular diseases. However, it is unclear whether these symptoms occurred preceding the diagnosis of peripheral artery occlusive disease (PAOD). Therefore, the aim of this case-control study was to investigate the risk of PAOD among patients with vertigo, tinnitus, and sudden deafness using a nationwide, population-based health claim database in Taiwan. We identified 5,340 adult patients with PAOD diagnosed between January 1, 2006 and December 31, 2010 and 16,020 controls, frequency matched on age interval, sex, and year of index date, from the Taiwan National Health Insurance Research Database. Risks of PAOD in patients with vertigo, tinnitus, or sudden deafness were separately evaluated with multivariate logistic regression analyses. Of the 5,340 patients with PAOD, 12.7%, 6.7%, and 0.3% were diagnosed with vertigo, tinnitus, and sudden deafness, respectively. In the controls, 10.6%, 6.1%, and 0.3% were diagnosed with vertigo (P vertigo (adjusted odds ratio = 1.12, P = 0.027) but not in those with tinnitus or sudden deafness. A modest increase in the risk of PAOD was observed among Taiwanese patients with vertigo, after adjustment for comorbidities.

  15. Comparison of the prescribing pattern of bisphosphonate and raloxifene in Korean women with osteoporosis: from a national health insurance claims database.

    Directory of Open Access Journals (Sweden)

    Jungmee Kim

    Full Text Available This study aimed to evaluate the differences of prescribing pattern between bisphosphonate and raloxifene users among Korean women with osteoporosis, focusing on the underlying conditions, concurrent medications, nature of healthcare utilization, and regional disparity. We used the Health Insurance Review and Assessment Service National Patients Sample database of the year 2010. Study subjects were defined as female osteoporosis patients aged over 50 years with both the diagnosis of osteoporosis and prescriptions of bisphosphonate or raloxifene. The frequency and the proportion of bisphosphonate and raloxifene were compared using chi-square test and the trend of the proportion using the Cochran-Armitage test. Medications were quantified as defined daily doses per 1,000 patients per day. The prescription pattern was visualized by using the Quantum Geographic Information Systems program. Of the 1,367,367 people who utilized medical services in 2010, the final number of study subjects was 26,881--26,032 (96.8% bisphosphonate and 849 (3.2% raloxifene recipients. Raloxifene users were younger than bisphosphonate users and were more frequently patients with a lipid disorder (16.0% vs. 22.1%, p-value < 0.0001, rheumatic disease (4.0% vs. 6.1%, p-value = 0.0024, hot flash (1.8% vs. 6.1%, p <0.0001, and coronary artery disease (1.2% vs. 2.8%, p< 0.0001. The proportion of raloxifene users was higher in tertiary care institutions (21.6% vs. 44.7%, p-value < 0.0001. A regional distribution showed that raloxifene use was higher in the Seoul metropolitan area. These differences in demographic and clinical profiles of each recipient may influence prescription decisions.

  16. Claiming Community

    DEFF Research Database (Denmark)

    Jensen, Steffen Bo

    As its point of departure this working paper takes the multitude of different uses and meanings of the concept of community in local politics in Cape Town. Instead of attempting to define it in substantive terms, the paper takes a social constructivist approach to the study of community...... is termed community work. First, the paper explores how community has become a governmental strategy, employed by the apartheid regime as well, although in different ways, as post-apartheid local government. Secondly, the paper explores the ways in which community becomes the means in which local residents...... lay claim on the state, as well as how it enters into local power struggles between different political groups within the township. In the third part, the paper explores how the meanings of community and the struggles to realise it have changed as South Africa, nationally and locally, has become...

  17. Treatment patterns of postherpetic neuralgia patients before and after the launch of pregabalin and its effect on medical costs: Analysis of Japanese claims data provided by Japan Medical Data Center.

    Science.gov (United States)

    Honda, Mariko; Murata, Tatsunori; Ebata, Nozomi; Fujii, Koichi; Ogawa, Setsuro

    2017-03-03

    Except for neurotrophin, no drug had an indication for postherpetic neuralgia (PHN) in Japan prior to pregabalin approval. This approval might have changed PHN treatment patterns. This study aimed to compare PHN treatment patterns and medical costs between patients who started treatment before and after pregabalin approval. Japanese claims data were used to identify patients aged 18 years or more with PHN, postherpetic trigeminal neuralgia or postherpetic polyneuropathy who were initiated on their first PHN-associated prescription through May 2010 (before approval) or from June 2010 (after approval). From these claims, 6-month treatment patterns from first prescription were compared for the periods before and after approval. These patterns included pain-related medications and the frequency of pain-relief procedures. All-cause and pain-related medical costs were also compared for these periods. The number of PHN patients who were initiated on treatment before and after approval were 107 (mean age, 47.4 ± 13.0 years) and 505 (45.9 ± 13.0), respectively. Post-approval, significant reductions were observed for prescription of non-steroidal anti-inflammatory drugs, tricyclic antidepressants and neurotrophin relative to before approval. Excluding pregabalin acquisition costs, mean costs per patient for medications associated with PHN for 6 months from the first prescription were significantly lower after approval, ¥2882 vs ¥4185. Total medical costs were similar in both periods. Approval of pregabalin appeared to result in a treatment paradigm toward use of an approved therapy with demonstrated efficacy.

  18. The effect of pre-existing health conditions on the cost of recovery from road traffic injury: insights from data linkage of medicare and compensable injury claims in Victoria, Australia.

    Science.gov (United States)

    Hassani-Mahmooei, Behrooz; Berecki-Gisolf, Janneke; Hahn, Youjin; McClure, Roderick J

    2016-04-29

    Comorbidity is known to affect length of hospital stay and mortality after trauma but less is known about its impact on recovery beyond the immediate post-accident care period. The aim of this study was to investigate the role of pre-existing health conditions in the cost of recovery from road traffic injury using health service use records for 1 year before and after the injury. Individuals who claimed Transport Accident Commission (TAC) compensation for a non-catastrophic injury that occurred between 2010 and 2012 in Victoria, Australia and who provided consent for Pharmaceutical Benefits Scheme (PBS) and Medicare Benefits Schedule (MBS) linkage were included (n = 738) in the analysis. PBS and MBS records dating from 12 months prior to injury were provided by the Department of Human Services (Canberra, Australia). Pre-injury use of health service items and pharmaceuticals were considered to indicate pre-existing health condition. Bayesian Model Averaging techniques were used to identify the items that were most strongly correlated with recovery cost. Multivariate regression models were used to determine the impact of these items on the cost of injury recovery in terms of compensated ambulance, hospital, medical, and overall claim cost. Out of the 738 study participants, 688 used at least one medical item (total of 15,625 items) and 427 used at least one pharmaceutical item (total of 9846). The total health service cost of recovery was $10,115,714. The results show that while pre-existing conditions did not have any significant impact on the total cost of recovery, categorical costs were affected: e.g. on average, for every anaesthetic in the year before the accident, hospital cost of recovery increased by 24 % [95 % CI: 13, 36 %] and for each pathological test related to established diabetes, hospital cost increased by $10,407 [5466.78, 15346.28]. For medical costs, each anaesthetic led to $258 higher cost [174.16, 341.16] and every prescription of drugs

  19. Assessing comorbidity using claims data: an overview.

    Science.gov (United States)

    Klabunde, Carrie N; Warren, Joan L; Legler, Julie M

    2002-08-01

    Comorbidity, additional disease beyond the condition under study that increases a patient's total burden of illness, is one dimension of health status. For investigators working with observational data obtained from administrative databases, comorbidity assessment may be a useful and important means of accounting for differences in patients' underlying health status. There are multiple ways of measuring comorbidity. This paper provides an overview of current approaches to and issues in assessing comorbidity using claims data, with a particular focus on established indices and the SEER-Medicare database. In addition, efforts to improve measurement of comorbidity using claims data are described, including augmentation of claims data with medical record, patient self-report, or health services utilization data; incorporation of claims data from sources other than inpatient claims; and exploration of alternative conditions, indices, or ways of grouping conditions. Finally, caveats about claims data and areas for future research in claims-based comorbidity assessment are discussed. Although the use of claims databases such as SEER-Medicare for health services and outcomes research has become increasingly common, investigators must be cognizant of the limitations of comorbidity measures derived from these data sources in capturing and controlling for differences in patient health status. The assessment of comorbidity using claims data is a complex and evolving area of investigation.

  20. Analysis of NHSLA claims in orthopedic surgery.

    Science.gov (United States)

    Khan, Irfan H; Jamil, Wiqqas; Lynn, Sam Mathew; Khan, Osman H; Markland, Kate; Giddins, Grey

    2012-05-01

    National Health Service (NHS) statistics in the United Kingdom demonstrate an increase in clinical negligence claims over the past 30 years. Reasons for this include elements of a cultural shift in attitudes toward the medical profession and the growth of the legal services industry. This issue affects medical and surgical health providers worldwide.The authors analyzed 2117 NHS Litigation Authority (NHSLA) orthopedic surgery claims between 1995 and 2001 with respect to these clinical areas: emergency department, outpatient care, surgery (elective or trauma operations), and inpatient care. The authors focused on the costs of settling and defending claims, costs attributable to clinical areas, common causes of claims, and claims relating to elective or trauma surgery. Numbers of claims and legal costs increased most notably in surgery (elective and trauma) and in the emergency department. However, claims are being defended more robustly. The annual cost for a successful defense has remained relatively stable, showing a slight decline. The common causes of claims are postoperative complication; wrong, delayed, or failure of diagnosis; inadequate consent; and wrong-site surgery. Certain surgical specialties (eg, spine and lower-limb surgery) have the most claims made during elective surgery, whereas upper-limb surgery has the most claims made during trauma surgery.The authors recommend that individual trusts liaise with orthopedic surgeons to devise strategies to address areas highlighted in our study. Despite differences in health care systems worldwide, the underlying issues are common. With improved understanding, physicians can deliver the service they promise their patients.

  1. An Evaluation of Algorithms for Identifying Metastatic Breast, Lung, or Colorectal Cancer in Administrative Claims Data.

    Science.gov (United States)

    Whyte, Joanna L; Engel-Nitz, Nicole M; Teitelbaum, April; Gomez Rey, Gabriel; Kallich, Joel D

    2015-07-01

    Administrative health care claims data are used for epidemiologic, health services, and outcomes cancer research and thus play a significant role in policy. Cancer stage, which is often a major driver of cost and clinical outcomes, is not typically included in claims data. Evaluate algorithms used in a dataset of cancer patients to identify patients with metastatic breast (BC), lung (LC), or colorectal (CRC) cancer using claims data. Clinical data on BC, LC, or CRC patients (between January 1, 2007 and March 31, 2010) were linked to a health care claims database. Inclusion required health plan enrollment ≥3 months before initial cancer diagnosis date. Algorithms were used in the claims database to identify patients' disease status, which was compared with physician-reported metastases. Generic and tumor-specific algorithms were evaluated using ICD-9 codes, varying diagnosis time frames, and including/excluding other tumors. Positive and negative predictive values, sensitivity, and specificity were assessed. The linked databases included 14,480 patients; of whom, 32%, 17%, and 14.2% had metastatic BC, LC, and CRC, respectively, at diagnosis and met inclusion criteria. Nontumor-specific algorithms had lower specificity than tumor-specific algorithms. Tumor-specific algorithms' sensitivity and specificity were 53% and 99% for BC, 55% and 85% for LC, and 59% and 98% for CRC, respectively. Algorithms to distinguish metastatic BC, LC, and CRC from locally advanced disease should use tumor-specific primary cancer codes with 2 claims for the specific primary cancer >30-42 days apart to reduce misclassification. These performed best overall in specificity, positive predictive values, and overall accuracy to identify metastatic cancer in a health care claims database.

  2. Identification of groups with poor cost-effectiveness of peginterferon plus ribavirin for naïve hepatitis C patients with a real-world cohort and database.

    Science.gov (United States)

    Tsai, Pei-Chien; Liu, Ta-Wei; Tsai, Yi-Shan; Ko, Yu-Min; Chen, Kuan-Yu; Lin, Ching-Chih; Huang, Ching-I; Liang, Po-Cheng; Lin, Yi-Hung; Hsieh, Ming-Yen; Hou, Nai-Jen; Huang, Chung-Feng; Yeh, Ming-Lun; Lin, Zu-Yau; Chen, Shinn-Cherng; Dai, Chia-Yen; Chuang, Wan-Long; Huang, Jee-Fu; Yu, Ming-Lung

    2017-06-01

    For decades, peginterferon and ribavirin (PegIFN/RBV) have been the standard-of-care for chronic hepatitis C virus (CHC) infection. However, the actual cost-effectiveness of this therapy remains unclear. We purposed to explore the real-world cost effectiveness for subgroups of treatment-naïve CHC patients with PegIFN/RBV therapy in a large real-world cohort using a whole population database. A total of 1809 treatment-naïve chronic hepatitis C virus (HCV) patients (829 HCV genotype 1 [G1] and 980 HCV G2) treated with PegIFN/RBV therapies were linked to the National Health Insurance Research Database, covering the entire population of Taiwan from 1998 to 2013 to collect the total medical-care expenses of outpatient (antiviral agents, nonantiviral agents, laboratory, and consultation costs) and inpatient (medication, logistic, laboratory, and intervention costs) visits. The costs per treatment and the cost per sustained virological response (SVR) achieved were calculated. The average medical-care cost was USD $4823 (±$2984) per treatment and $6105 (±$3778) per SVR achieved. With SVR rates of 68.6% and 87.8%, the cost/SVR was significantly higher in G1 than those in G2 patients, respectively ($8285 vs $4663, P costs per SVR than their counterparts. The cost/SVR was extremely high among patients without RVR and in patients without cEVR. We investigated the real-world cost effectiveness data for different subgroups of treatment-naïve HCV patients with PegIFN/RBV therapies, which could provide useful, informative evidence for making decisions regarding future therapeutic strategies comprising costly direct-acting antivirals.

  3. Impact of a Comprehensive Workplace Hand Hygiene Program on Employer Health Care Insurance Claims and Costs, Absenteeism, and Employee Perceptions and Practices

    OpenAIRE

    Arbogast, James W.; Moore-Schiltz, Laura; Jarvis, William R.; Harpster-Hagen, Amanda; Hughes, Jillian; Parker, Albert

    2016-01-01

    Objective: The aim of this study was to determine the efficacy of a multimodal hand hygiene intervention program in reducing health care insurance claims for hygiene preventable infections (eg, cold and influenza), absenteeism, and subjective impact on employees. Methods: A 13.5-month prospective, randomized cluster controlled trial was executed with alcohol-based hand sanitizer in strategic workplace locations and personal use (intervention group) and brief hand hygiene education (both group...

  4. Cost containment interventions introduced on the community drugs schemes in Ireland-evaluation of expenditure trends using a national prescription claims database.

    LENUS (Irish Health Repository)

    Usher, Cara

    2012-03-01

    The majority of pharmaceutical expenditure in Ireland occurs in the community for services provided by general practitioners and pharmacists. In the current national and international economic climate, it is anticipated that demand on these services will continue to grow.

  5. Risk of new acute myocardial infarction hospitalization associated with use of oral and parenteral non-steroidal anti-inflammation drugs (NSAIDs: a case-crossover study of Taiwan's National Health Insurance claims database and review of current evidence

    Directory of Open Access Journals (Sweden)

    Shau Wen-Yi

    2012-02-01

    Full Text Available Abstract Background Previous studies have documented the increased cardiovascular risk associated with the use of some nonsteroidal anti-inflammatory drugs (NSAIDs. Despite this, many old NSAIDs are still prescribed worldwide. Most of the studies to date have been focused on specific oral drugs or limited by the number of cases examined. We studied the risk of new acute myocardial infarction (AMI hospitalization with current use of a variety of oral and parenteral NSAIDs in a nationwide population, and compared our results with existing evidence. Methods We conducted a case-crossover study using the Taiwan's National Health Insurance claim database, identifying patients with new AMI hospitalized in 2006. The 1-30 days and 91-120 days prior to the admission were defined as case and matched control period for each patient, respectively. Uses of NSAIDs during the respective periods were compared using conditional logistic regression and adjusted for use of co-medications. Results 8354 new AMI hospitalization patients fulfilled the study criteria. 14 oral and 3 parenteral NSAIDs were selected based on drug utilization profile among 13.7 million NSAID users. The adjusted odds ratio, aOR (95% confidence interval, for risk of AMI and use of oral and parenteral non-selective NSAIDs were 1.42 (1.29, 1.56 and 3.35 (2.50, 4.47, respectively, and significantly greater for parenteral than oral drugs (p for interaction Conclusions The collective evidence revealed the tendency of increased AMI risk with current use of some NSAIDs. A higher AMI risk associated with use of parenteral NSAIDs was observed in the present study. Ketorolac had the highest associated risk in both oral and parenteral NSAIDs studied. Though further investigation to confirm the association is warranted, prescribing physicians and the general public should be cautious about the potential risk of AMI when using NSAIDs.

  6. 32 CFR 536.120 - Claims payable as maritime claims.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Claims payable as maritime claims. 536.120 Section 536.120 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES Maritime Claims § 536.120 Claims payable as maritime claims. A claim is cognizable under this subpart if...

  7. Examining Fluoroquinolone Claims Among Gonorrhea-Associated Prescription Drug Claims, 2000-2010.

    Science.gov (United States)

    Owusu-Edusei, Kwame; Carroll, Danya S; Gift, Thomas L

    2015-11-01

    After the release of CDC's revised gonorrhea treatment guidelines in April 2007, a study reported the declining use of fluoroquinolones to treat gonorrhea among health departments participating in the Sexually Transmitted Disease Surveillance Network. In this study, we examine the proportion of fluoroquinolone claims among gonorrhea-associated prescription drug claims from a large insurance database from 2000 through 2010. We extracted drug claims associated with gonorrhea diagnosis claims from the MarketScan database for 2000-2010 and calculated the proportion of the drug claims for fluoroquinolones on a monthly basis. We then used an interrupted time series analysis to investigate trend characteristics of fluoroquinolone claims before and after the gonorrhea treatment guidelines were revised in April 2007. Although there was a monthly decline in the proportion of fluoroquinolone claims before April 2007 (-0.11 percentage points, pfluoroquinolones after April 2007, implying a gradual permanent decline over the analytic period. Our results are consistent with the findings of the previous study and indicate a gradual and permanent decline (over the analytic period) in the proportion of fluoroquinolone claims among gonorrhea-associated prescription drug claims. However, because this is a convenience sample of claims data, these findings cannot be generalized to the entire privately insured population in the U.S. Published by Elsevier Inc.

  8. Resource use and costs associated with coeliac disease before and after diagnosis in 3,646 cases: results of a UK primary care database analysis.

    Directory of Open Access Journals (Sweden)

    Mara Violato

    Full Text Available BACKGROUND: Despite the considerable health impact of coeliac disease (CD, reliable estimates of the impact of diagnosis on health care use and costs are lacking. AIMS: To quantify the volume, type and costs, in a United Kingdom primary care setting, of healthcare resources used by individuals diagnosed with CD up to ten years before and after diagnosis, and to estimate medical costs associated with CD. METHODS: A cohort of 3,646 CD cases and a parallel cohort of 32,973 matched controls, extracted from the General Practice Research Database (GPRD over the period 1987-2005 were used i to evaluate the impact of diagnosis on the average resource use and costs of cases; ii to assess direct healthcare costs due to CD by comparing average resource use and costs incurred by cases vs. controls. RESULTS: Average annual healthcare costs per patient increased by £310 (95% CI £299, £320 after diagnosis. CD cases experienced higher healthcare costs than controls both before diagnosis (mean difference £91; 95% CI: £86, £97 and after diagnosis (mean difference £354; 95% CI: £347, £361. These differences were driven mainly by higher test and referral costs before diagnosis, and by increased prescription costs after diagnosis. CONCLUSIONS: This study shows significant additional primary care costs associated with coeliac disease. It provides novel evidence that will assist researchers evaluating interventions in this area, and will challenge policymakers, clinicians, researchers and the public to develop strategies that maximise the health benefits of the resources associated with this disease.

  9. Resource Use and Costs Associated with Coeliac Disease before and after Diagnosis in 3,646 Cases: Results of a UK Primary Care Database Analysis

    Science.gov (United States)

    Violato, Mara; Gray, Alastair; Papanicolas, Irini; Ouellet, Melissa

    2012-01-01

    Background Despite the considerable health impact of coeliac disease (CD), reliable estimates of the impact of diagnosis on health care use and costs are lacking. Aims To quantify the volume, type and costs, in a United Kingdom primary care setting, of healthcare resources used by individuals diagnosed with CD up to ten years before and after diagnosis, and to estimate medical costs associated with CD. Methods A cohort of 3,646 CD cases and a parallel cohort of 32,973 matched controls, extracted from the General Practice Research Database (GPRD) over the period 1987–2005 were used i) to evaluate the impact of diagnosis on the average resource use and costs of cases; ii) to assess direct healthcare costs due to CD by comparing average resource use and costs incurred by cases vs. controls. Results Average annual healthcare costs per patient increased by £310 (95% CI £299, £320) after diagnosis. CD cases experienced higher healthcare costs than controls both before diagnosis (mean difference £91; 95% CI: £86, £97) and after diagnosis (mean difference £354; 95% CI: £347, £361). These differences were driven mainly by higher test and referral costs before diagnosis, and by increased prescription costs after diagnosis. Conclusions This study shows significant additional primary care costs associated with coeliac disease. It provides novel evidence that will assist researchers evaluating interventions in this area, and will challenge policymakers, clinicians, researchers and the public to develop strategies that maximise the health benefits of the resources associated with this disease. PMID:22815991

  10. 40 CFR 14.13 - Items fraudulently claimed.

    Science.gov (United States)

    2010-07-01

    ... intentionally misrepresented the cost, condition, cost of repair or a material fact concerning a claim, he/she... Officer determines that the employee intentionally has materially misrepresented the costs, conditions or...

  11. Management and cost analysis of cancer patients treated with G-CSF: a cohort study based on the French national healthcare insurance database.

    Science.gov (United States)

    Tilleul, Patrick; Jacot, William; Emery, Corinne; Lafuma, Antoine; Gourmelen, Julie

    2017-09-04

    To describe the management and costs associated with G-CSF therapy in cancer patients in France. This study analyzed a representative random population sample from the French national healthcare insurance database, focusing on 1,612 patients with hematological or solid malignancies who were reimbursed in 2013 or 2014 for at least one G-CSF treatment dispensed in a retail pharmacy. Patient characteristics and treatment costs were analyzed according to the type of cancer. Then the costs and characteristics of patients associated with the use of different G-CSF products were analyzed in the sub-set of breast cancer patients. The most frequent malignancies in the database population were breast cancer (23.3%), hematological malignancies (22.2%), and lung cancer (12.4%). The reimbursed G-CSF was pegfilgrastim in 34.1% of cases, lenograstim in 26.7%, and filgrastim in 17.9%. More than one G-CSF product was reimbursed to 21.3% of patients. The total annual reimbursed health expenses per patient, according to the type of G-CSF, were €27,001, €24,511, and €20,802 for patients treated with filgrastim, lenograstim, and pegfilgrastim, respectively. Ambulatory care accounted for, respectively, 35%, 38%, and 41% of those costs. In patients with breast cancer, ambulatory care cost was €7,915 with filgrastim, €7,750 with lenograstim, and €6,989 with pegfilgrastim, and the respective cost of G-CSF was €1,733, €1,559, and €3,668. All available G-CSF products have been shown to be effective in cancer patients, and both daily G-CSFs and pegylated G-CSF are recommended in international guidelines. Nevertheless, this analysis of G-CSF reimbursement indicates that the choice of product can markedly affect the total cost of ambulatory care.

  12. Helicobacter pylori test-and-treat program can be cost-effective to prevent gastric cancer in Taiwanese adults: referred to the nationwide reimbursement database.

    Science.gov (United States)

    Cheng, Hsiu-Chi; Wang, Jung-Der; Chen, Wei-Ying; Chen, Chian-Wei; Chang, Shun-Chiao; Sheu, Bor-Shyang

    2015-04-01

    Helicobacter pylori infection increases the risk of gastric cancer. The study aimed to compare cost-effectiveness ratios of H. pylori test-and-treat programs to prevent gastric cancer in Taiwan, referring to the nationwide reimbursement database and expected years of life lost. During 1998-2009, there were 12,857 females and 24,945 males with gastric adenocarcinoma in Taiwan National Cancer Registry. They were followed up to 2010 and linked to the reimbursement database of National Health Insurance and the national mortality registry to determine lifetime health expenditures and expected years of life lost. Cost-effectiveness ratios of H. pylori test-and-treat programs for prevention of gastric adenocarcinoma were compared between screenings with (13) C-urea breath test and with anti-H. pylori IgG. The test-and-treat program with anti-H. pylori IgG to prevent gastric adenocarcinoma had lower incremental cost-effectiveness ratios than that with (13) C-urea breath test in both sexes (females: 244 vs 1071 US dollars/life-year; males: 312 vs 1431 US dollars/life-year). Cost saving would be achieved in an endemic area where H. pylori prevalence was >73.5%, or by selecting subpopulations with high absolute risk reduction rates of cancer after eradication. Moreover, expected years of life lost of gastric adenocarcinoma were higher and the incremental cost-effectiveness ratios of test-and-treat programs were more cost-effective in young adults (30-69 y/o) than in elders (≥70 y/o). The test-and-treat program with anti-H. pylori IgG shall be cost-effective to prevent gastric adenocarcinoma in a high endemic area, especially beginning at 30 years of age when H. pylori prevalence rates become stabilized. © 2014 John Wiley & Sons Ltd.

  13. Awareness during anesthesia: a closed claims analysis.

    Science.gov (United States)

    Domino, K B; Posner, K L; Caplan, R A; Cheney, F W

    1999-04-01

    Awareness during general anesthesia is a frightening experience, which may result in serious emotional injury and post-traumatic stress disorder. We performed an in-depth analysis of cases from the database of the American Society of Anesthesiologists Closed Claims Project to explore the contribution of intraoperative awareness to professional liability in anesthesia. The database of the Closed Claims Project is composed of closed US malpractice claims that have been collected in a standardized manner. All claims for intraoperative awareness were reviewed by the reviewers to identify patterns of causation and standard of care. Logistic regression analysis was used to identify independent patient and anesthetic factors associated with claims for recall during general anesthesia compared to other general anesthesia malpractice claims. Awareness claims accounted for 79 (1.9%) of 4,183 claims in the database, including 18 claims for awake paralysis, i.e., the inadvertent paralysis of an awake patient, and 61 claims for recall during general anesthesia, ie., recall of events while receiving general anesthesia. The majority of awareness claims involved women (77%), younger than 60 yr of age (89%), American Society of Anesthesiologists physical class I-II (68%), who underwent elective surgery (87%). Most (94%) claims for awake paralysis represented substandard care involving errors in labeling and administration, whereas care was substandard in only 43% of the claims for recall during general anesthesia (P recall during general anesthesia were more likely to involve women (odds ratio [OR] = 3.08, 95% confidence interval [CI] = 1.58, 6.06) and anesthetic techniques using intraoperative opioids (OR = 2.12, 95% CI = 1.20, 3.74), intraoperative muscle relaxants (OR = 2.28, 95% CI = 1.22, 4.25), and no volatile anesthetic (OR = 3.20, 95% CI = 1.88, 5.46). Deficiencies in labeling and vigilance were common causes for awake paralysis. Claims for recall during general anesthesia

  14. Global Earthquake and Volcanic Eruption Economic losses and costs from 1900-2014: 115 years of the CATDAT database - Trends, Normalisation and Visualisation

    Science.gov (United States)

    Daniell, James; Skapski, Jens-Udo; Vervaeck, Armand; Wenzel, Friedemann; Schaefer, Andreas

    2015-04-01

    Over the past 12 years, an in-depth database has been constructed for socio-economic losses from earthquakes and volcanoes. The effects of earthquakes and volcanic eruptions have been documented in many databases, however, many errors and incorrect details are often encountered. To combat this, the database was formed with socioeconomic checks of GDP, capital stock, population and other elements, as well as providing upper and lower bounds to each available event loss. The definition of economic losses within the CATDAT Damaging Earthquakes Database (Daniell et al., 2011a) as of v6.1 has now been redefined to provide three options of natural disaster loss pricing, including reconstruction cost, replacement cost and actual loss, in order to better define the impact of historical disasters. Similarly for volcanoes as for earthquakes, a reassessment has been undertaken looking at the historical net and gross capital stock and GDP at the time of the event, including the depreciated stock, in order to calculate the actual loss. A normalisation has then been undertaken using updated population, GDP and capital stock. The difference between depreciated and gross capital can be removed from the historical loss estimates which have been all calculated without taking depreciation of the building stock into account. The culmination of time series from 1900-2014 of net and gross capital stock, GDP, direct economic loss data, use of detailed studies of infrastructure age, and existing damage surveys, has allowed the first estimate of this nature. The death tolls in earthquakes from 1900-2014 are presented in various forms, showing around 2.32 million deaths due to earthquakes (with a range of 2.18 to 2.63 million) and around 59% due to masonry buildings and 28% from secondary effects. For the death tolls from the volcanic eruption database, 98000 deaths with a range from around 83000 to 107000 is seen from 1900-2014. The application of VSL life costing from death and injury

  15. Medicaid Drug Claims Statistics

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Medicaid Drug Claims Statistics CD is a useful tool that conveniently breaks up Medicaid claim counts and separates them by quarter and includes an annual count.

  16. Workers Compensation Claim Data -

    Data.gov (United States)

    Department of Transportation — This data set contains DOT employee workers compensation claim data for current and past DOT employees. Types of data include claim data consisting of PII data (SSN,...

  17. Teradata University Network: A No Cost Web-Portal for Teaching Database, Data Warehousing, and Data-Related Subjects

    Science.gov (United States)

    Jukic, Nenad; Gray, Paul

    2008-01-01

    This paper describes the value that information systems faculty and students in classes dealing with database management, data warehousing, decision support systems, and related topics, could derive from the use of the Teradata University Network (TUN), a free comprehensive web-portal. A detailed overview of TUN functionalities and content is…

  18. 40 CFR 307.21 - Nature of eligible claims.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 27 2010-07-01 2010-07-01 false Nature of eligible claims. 307.21... Nature of eligible claims. (a) Claims may be asserted against the Fund for necessary costs incurred for... nature, differing materially from those ordinarily encountered and generally recognized as inherent...

  19. Development of a Cost-Effective Database Software for Psychiatric Research: A Study From Tertiary Care Teaching Hospital

    OpenAIRE

    Sabu Karakkamandapam; Narayanan Sree Kumaran Nair; PSVN Sharma

    2010-01-01

    Background: Technological progression made drastic changes in health care. Still there is a growing concern about proper utilization of health information within hospitals for various research activities. Huge volumes of such health information in majority of hospitals are redundant due to lack of appropriate and cost-effective technological tools for retrieving relevant health information for research purpose. Objective: To develop a cost-effective and user-friendly computerized medical reco...

  20. Handling the Dependence of Claim Severities with Copula Models

    Directory of Open Access Journals (Sweden)

    Yulia Resti

    2010-01-01

    Full Text Available Problem statement: Several studies have been carried out on the modeling of claim severity data in actuarial literature as well as in insurance practice. Since it is well established that the claim cost distributions generally have positive support and are positively skewed, the regression models of Gamma and Lognormal have been used by practitioners for modeling claim severities. However, the fitting of claim severities via regression models assumes that the claim types are independent. Approach: In this study, independent assumption between claim types will be investigated as we will consider three types of Malaysian motor insurance claims namely Third Party Body Injury (TPBI, Third Party Property Damage (TPPD and Own Damage (OD and applied the normal, t, Frank and Clayton copulas for modeling dependence structures between these claim types. Results: The AIC and BIC indicated that the Clayton is the best copula for modeling dependence between TPBI and OD claims and between TPPD and OD claims, whereas the t-copula is the best copula for modeling dependence between TPBI and TPPD claims. Conclusion: This study modeled the dependence between insurance claim types using copulas on the Malaysian motor insurance claim severity data. The main advantage of using copula is that each marginal distribution can be specified independently based on the distribution of individual variable and then joined by the copula which takes into account the dependence between these variables. Based on the results, the estimated of copula parameter for claim severities indicate that the dependence between claim types is significant.

  1. Financing and budgetary impact of landslide losses for highways and urban infrastructures in NW Germany - an economic analysis using landslide database information and cost survey data

    Science.gov (United States)

    Maurischat, Philipp; Klose, Martin

    2014-05-01

    Recent studies show that landslides cause even in low mountain areas of Central and Western Europe millions of dollars in annual losses (Klose et al., 2012; Vranken et al., 2013). The objective of this study has therefore been to model landslide disaster financing and to assess budgetary impacts of landslide losses for highways and urban infrastructures in the Lower Saxon Uplands, NW Germany. The present contribution includes two case studies on the financial burden of landslides for public budgets using the examples of the Lower Saxony Department of Transportation and the city of Hann. Münden. The basis of this research is a regional subset of a landslide database for the Federal Republic of Germany. Using a toolset for landslide cost modeling based on landslide databases (Klose et al., 2013), the direct costs of more than 30 landslide damage events to highways in a local case study area were determined. The annual average landslide maintenance, repair, and mitigation costs for highways in this case study area are estimated at 0.76 million between 1980 and 2010. Alternatively, a cost survey based on expert interviews has been conducted to collect landslide loss data for urban infrastructures. This cost survey for the city of Hann. Münden shows annual landslide losses of up to 3.4 million during the previous 10 years. Further expert interviews at city and highway agency level were focused on identifying procedure, resources, and limits of financing landslide damage costs. The information on landslide disaster financing and cost survey data on annual maintenance and construction budgets for highways, city sewer lines, and urban roads were used to evaluate the fiscal significance of estimated landslide losses. The results of this economic impact assessment prove variable financial burdens of analyzed public budgets. Thus, in costly years with landslide losses of more than 7 million, the Lower Saxony Department of Transportation is required to shift up to 19% of its

  2. Linking the US transplant registry to administrative claims data: expanding the potential of transplant research.

    Science.gov (United States)

    Gilmore, Amanda S; Helderman, J Harold; Ricci, Jean-Francois; Ryskina, Kira L; Feng, Sandy; Kang, Ning; Legorreta, Antonio P

    2007-06-01

    In the United States, data on transplanted and waitlisted patients collected by the Organ Procurement and Transplantation Network (OPTN) have been widely used in transplantation research. Administrative claims data, collected by health plans for reimbursement purposes, are also commonly used in health-services research. This study linked OPTN and private payer claims data to assess the relationship between data elements common to both sources. All transplanted or waitlisted patients in the registry were considered for inclusion. A multistep match algorithm was employed to link OPTN and payer data from years 1995 to 2004. Variables common to both datasets that contained relevant information for similar time periods were compared. A total of 21,419 solid organ transplant recipients and 8808 waitlist patients were included in the final linked database. Organ type and demographic variable distributions in the linked dataset were similar to the overall OPTN database. Using claims as the reference group, sensitivity and specificity values were on average 0.72 and 0.69, respectively, and were highest for the indicators of immunosuppression use at discharge and follow-up. This comparison of payer data with information reported by transplant centers to the OPTN provides important insight into the value of both data sources. Using administrative claims to augment the registry data with utilization and cost information will be useful for evaluation of both economic and clinical endpoints in solid organ transplantation.

  3. Use, cost, complications, and mortality of robotic versus nonrobotic general surgery procedures based on a nationwide database.

    Science.gov (United States)

    Salman, Muhammad; Bell, Theodore; Martin, Jennifer; Bhuva, Kalpesh; Grim, Rod; Ahuja, Vanita

    2013-06-01

    Since its introduction in 1997, robotic surgery has overcome many limitations, including setup costs and surgeon training. The use of robotics in general surgery remains unknown. This study evaluates robotic-assisted procedures in general surgery by comparing characteristics with its nonrobotic (laparoscopic and open) counterparts. Weighted Healthcare Cost and Utilization Project Nationwide Inpatient Sample data (2008, 2009) were used to identify the top 12 procedures for robotic general surgery. Robotic cases were identified by Current Procedural Terminology codes 17.41 and 17.42. Procedures were grouped: esophagogastric, colorectal, adrenalectomy, lysis of adhesion, and cholecystectomy. Analyses were descriptive, t tests, χ(2)s, and logistic regression. Charges and length of stay were adjusted for gender, age, race, payer, hospital bed size, hospital location, hospital region, median household income, Charlson score, and procedure type. There were 1,389,235 (97.4%) nonrobotic and 37,270 (2.6%) robotic cases. Robotic cases increased from 0.8 per cent (2008) to 4.3 per cent (2009, P robotic surgery had significantly shorter lengths of stay (4.9 days) than open surgery (6.1 days) and lower charges (median $30,540) than laparoscopic ($34,537) and open ($46,704) surgery. Fewer complications were seen in robotic-assisted colorectal, adrenalectomy and lysis of adhesion; however, robotic cholecystectomy and esophagogastric procedures had higher complications than nonrobotic surgery (P robotic surgery had a lower mortality rate (0.097%) than nonrobotic surgeries per 10,000 procedures (laparoscopic 0.48%, open 0.92%; P robotic surgery is generally considered a prohibitive factor. In the present study, when overall cost was considered, including length of stay, robotic surgery appeared to be cost-effective and as safe as nonrobotic surgery except in cholecystectomy and esophagogastric procedures. Further study is needed to fully understand the long-term implications of

  4. Epidemiology and cost of hospital care for Lyme borreliosis in Germany: lessons from a health care utilization database analysis.

    Science.gov (United States)

    Lohr, B; Müller, I; Mai, M; Norris, D E; Schöffski, O; Hunfeld, K-P

    2015-02-01

    To date, relatively little is known about the economic and medical impact of Lyme borreliosis (LB) on European health care systems, especially for the inpatient sector. This retrospective analysis is based on data provided for the years 2007-2011 by a German statutory health insurance company (DAK-Gesundheit) covering approximately 6 million insured. Total cost was calculated for a 1-year period both from the third-party payers and from the societal perspective, respectively. In our cohort the incident diagnosis of LB was coded for 2163 inpatient cases during the years 2008-2011. The median inpatient time was 9 days resulting in a median direct medical cost per hospital stay of 3917€ for adolescents and 2843€ for adults. Based on extrapolation of our findings to the German population, we would expect an average hospital admission of 5200 adults and 2300 adolescents (<18 years) for LB treatment incurring direct medical costs of more than 23 million Euro annually. The annual indirect costs due to loss of productivity would add up to more than 7 million Euro as assessed by the human capital method. Cases tended to accumulate between June and September with remarkable changes in disease manifestations in the course of the year documented in the coded secondary diagnoses. Also specific differences in the disease pattern of adolescents and adults became obvious. Age-specific incidence showed male predominance and a bimodal distribution. Incidence was highest in children aged between 3 and 17 (highest mean incidence of 29 cases/100,000 inhabitants in 6-9 year olds) with a second peak in 60-79 year old individuals. During the study period the nationwide inpatient incidence was 9/100,000 with marked regional variability. In summary, our study is one of the first European investigations on hospital care for LB inpatients and identifies LB as a possibly underestimated socioeconomic factor for health care in Germany.

  5. Using linked administrative and disease-specific databases to study end-of-life care on a population level.

    Science.gov (United States)

    Maetens, Arno; De Schreye, Robrecht; Faes, Kristof; Houttekier, Dirk; Deliens, Luc; Gielen, Birgit; De Gendt, Cindy; Lusyne, Patrick; Annemans, Lieven; Cohen, Joachim

    2016-10-18

    The use of full-population databases is under-explored to study the use, quality and costs of end-of-life care. Using the case of Belgium, we explored: (1) which full-population databases provide valid information about end-of-life care, (2) what procedures are there to use these databases, and (3) what is needed to integrate separate databases. Technical and privacy-related aspects of linking and accessing Belgian administrative databases and disease registries were assessed in cooperation with the database administrators and privacy commission bodies. For all relevant databases, we followed procedures in cooperation with database administrators to link the databases and to access the data. We identified several databases as fitting for end-of-life care research in Belgium: the InterMutualistic Agency's national registry of health care claims data, the Belgian Cancer Registry including data on incidence of cancer, and databases administrated by Statistics Belgium including data from the death certificate database, the socio-economic survey and fiscal data. To obtain access to the data, approval was required from all database administrators, supervisory bodies and two separate national privacy bodies. Two Trusted Third Parties linked the databases via a deterministic matching procedure using multiple encrypted social security numbers. In this article we describe how various routinely collected population-level databases and disease registries can be accessed and linked to study patterns in the use, quality and costs of end-of-life care in the full population and in specific diagnostic groups.

  6. Consumer Health: CAM Claims

    Science.gov (United States)

    Healthy Lifestyle Consumer health Don't take all CAM claims at face value. Do your homework when considering CAM therapies. By ... dose of skepticism. Federal Trade Commission. http://www.consumer.ftc.gov/articles/0167-miracle-health-claims. Accessed ...

  7. Federal Tort Claims Act.

    Science.gov (United States)

    1998-04-01

    1992) (claim based on insertion and removal of elbow prosthesis more than two years before filing claims barred by SOL); but see Jastremski v...States, 957 F.2d 108 (4th Cir. 1992) (operator of mobile lounge at Dulles Airport is not U.S. employee, but independent contractor); Bird v. United

  8. Formalizing Probabilistic Safety Claims

    Science.gov (United States)

    Herencia-Zapana, Heber; Hagen, George E.; Narkawicz, Anthony J.

    2011-01-01

    A safety claim for a system is a statement that the system, which is subject to hazardous conditions, satisfies a given set of properties. Following work by John Rushby and Bev Littlewood, this paper presents a mathematical framework that can be used to state and formally prove probabilistic safety claims. It also enables hazardous conditions, their uncertainties, and their interactions to be integrated into the safety claim. This framework provides a formal description of the probabilistic composition of an arbitrary number of hazardous conditions and their effects on system behavior. An example is given of a probabilistic safety claim for a conflict detection algorithm for aircraft in a 2D airspace. The motivation for developing this mathematical framework is that it can be used in an automated theorem prover to formally verify safety claims.

  9. Future database machine architectures

    OpenAIRE

    Hsiao, David K.

    1984-01-01

    There are many software database management systems available on many general-purpose computers ranging from micros to super-mainframes. Database machines as backened computers can offload the database management work from the mainframe so that we can retain the same mainframe longer. However, the database backend must also demonstrate lower cost, higher performance, and newer functionality. Some of the fundamental architecture issues in the design of high-performance and great-capacity datab...

  10. Unfalsifiability of security claims.

    Science.gov (United States)

    Herley, Cormac

    2016-06-01

    There is an inherent asymmetry in computer security: Things can be declared insecure by observation, but not the reverse. There is no observation that allows us to declare an arbitrary system or technique secure. We show that this implies that claims of necessary conditions for security (and sufficient conditions for insecurity) are unfalsifiable. This in turn implies an asymmetry in self-correction: Whereas the claim that countermeasures are sufficient is always subject to correction, the claim that they are necessary is not. Thus, the response to new information can only be to ratchet upward: Newly observed or speculated attack capabilities can argue a countermeasure in, but no possible observation argues one out. Further, when justifications are unfalsifiable, deciding the relative importance of defensive measures reduces to a subjective comparison of assumptions. Relying on such claims is the source of two problems: once we go wrong we stay wrong and errors accumulate, and we have no systematic way to rank or prioritize measures.

  11. Closed Claim Query File

    Data.gov (United States)

    Social Security Administration — This file is used to hold information about disability claims that have been closed and have been selected for sampling.Sampling is the process whereby OQR reviews...

  12. SSA Disability Claim Data

    Data.gov (United States)

    Social Security Administration — The dataset includes fiscal year data for initial claims for SSA disability benefits that were referred to a state agency for a disability determination. Specific...

  13. Health Claims Data Warehouse (HCDW)

    Data.gov (United States)

    Office of Personnel Management — The Health Claims Data Warehouse (HCDW) will receive and analyze health claims data to support management and administrative purposes. The Federal Employee Health...

  14. Automating claims management improves revenue cycle.

    Science.gov (United States)

    Nivison, Matthew

    2008-02-01

    One healthcare organization was able to improve revenue cycle operations by automating its claims management. Using web-based technology enabled the organization to streamline internal workflow processes, redeploy staff, and reduce overhead costs. As a result, cash flow increased 7 percent, and A/R days dropped 16 percent.

  15. 22 CFR 33.8 - Claim procedures.

    Science.gov (United States)

    2010-04-01

    ... must be supported by documentary evidence. Foreign language documents must be accompanied by an... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Claim procedures. 33.8 Section 33.8 Foreign..., including: (i) The date and cost of acquisition supported by invoices or other acceptable proof of...

  16. The economic impact of acute coronary syndrome on length of stay: an analysis using the Healthcare Cost and Utilization Project (HCUP) databases.

    Science.gov (United States)

    LaMori, Joyce C; Shoheiber, Omar; Dudash, Kellie; Crivera, Concetta; Mody, Samir H

    2014-03-01

    To assess the economic impact of initial and repeat hospitalizations associated with acute coronary syndrome (ACS) over 1 year (2009). National- and state-level data on length of stay (LOS) and related charges for ACS-associated hospital admissions were assessed using two Healthcare Utilization Project databases. The first, the Nationwide Inpatient Sample (NIS), provided clinical and resource use information from ∼8 million hospital stays, representing a 20% stratified sample of ∼40 million annual hospital stays in the US in 2009. The second, the State Inpatient Databases, provided 100% of inpatient data from nine states that included both patient age and linked information on multiple patient admissions within the same calendar year. For patients with repeat admissions, the LOS, primary diagnosis, and total charges between the first and subsequent admissions were evaluated. All patients≥18 years of age with at least one diagnosis of ACS, defined using the International Classification of Diseases, 9th Revision, were included (code 410.xx [except 410.x2], 411.1x and 411.8x). Variables evaluated for each discharge included demographics, cardiovascular events and procedures, LOS, discharge status, and total charges. The NIS reported 1,437,735 discharges for ACS in 2009. In this dataset, mean LOS for an initial ACS event was 5.56 days. Patients>65 years of age had the highest numbers of admissions; this group also had the most comorbidities. Approximately 40% of ACS patients with data on repeat visits had more than one admission, >70% of these within 2 months of the primary discharge. Mean charges were $71,336 for the first admission and $53,290 for the second admission. Despite a variety of new therapies to prevent ACS, it remains a common condition. Better therapies are called for if the clinical and cost burden of ACS is to be alleviated.

  17. 37 CFR 1.75 - Claim(s).

    Science.gov (United States)

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Claim(s). 1.75 Section 1.75... GENERAL RULES OF PRACTICE IN PATENT CASES National Processing Provisions Specification § 1.75 Claim(s). (a.... (35 U.S.C. 6; 15 U.S.C. 1113, 1126)...

  18. The claim from adoption.

    Science.gov (United States)

    Petersen, Thomas Sobirk

    2002-08-01

    In this article several justifications of what I call 'the claim from adoption' are examined. The claim from adoption is that, instead of expending resources on bringing new children into the world using reproductive technology and then caring for these children, we ought to devote these resources to the adoption and care of existing destitute children. Arguments trading on the idea that resources should be directed to adoption instead of assisted reproduction because already existing people can benefit from such a use of resources whereas we cannot benefit individuals by bringing them into existence are rejected. It is then argued that a utilitarian argument proposed by Christian Munthe that supports the claim from adoption in some situations should be rejected because the support it offers does not extend to certain situations in which it seems morally obvious that resources should be expended on adoption rather than assisted reproduction. A version of the Priority View improves upon Munthe's utilitarianism by supporting the claim from adoption in the cases in which Munthe's argument failed. Some allegedly counterintuitive implications of the Priority View are then discussed, and it is concluded that the Priority View is more plausible than utilitarianism. In a concluding section on policy issues it is argued that, even though the claim from adoption can be justified in a variety of situations, it does not follow that, in these situations, governments should direct resources away from assisted reproduction and towards adoption.

  19. 10 CFR 765.21 - Procedures for processing reimbursement claims.

    Science.gov (United States)

    2010-01-01

    ... AND THORIUM PROCESSING SITES Procedures for Submitting and Processing Reimbursement Claims § 765.21... uranium or thorium processing site licensees for approved costs of remedial action will be made... Department's determination to approve, approve in part, or deny a claim will be provided to the licensee...

  20. Public Claims: A Legal Evaluation

    Directory of Open Access Journals (Sweden)

    Tamer Budak

    2011-04-01

    Full Text Available In order for a claim to exist, the host there has to be two parties. In case of public claims one of the parties is the state, special provincial administration and municipalities; while the debtor consists of the natural and legal persons. The definition of public claims is provided by The Procedure Law of Collection of Public Claims. One claims, the quality of the public claims not cause any, may be excluded from the scope of Law No. 6183. All the claims of public administration are not public claims. However, any private claim can have the security of a public claim. For this reason the criteria used to define a public claim differ. Arrangements, which can render a public claim a privileged claim, exist in the relevant Code. The aim of this study is to define the concept of public claim expressed in the relevant code and to determine the conditions under which a claim not stated in the Code can be considered a public claim in the light of court decisions.

  1. Handbook of Veterinary Claims.

    Science.gov (United States)

    1983-03-01

    11. I recoend disapproval of this claim due to lack of proof of causa - tion by the USAF. At the time this report is being written, there is no...alleged that nonsterile surgical technique resulted in peritonitis and subsequent lack of appetite, and that the latter resulted in bloody diarrhea, anemia

  2. Cloud Databases: A Paradigm Shift in Databases

    Directory of Open Access Journals (Sweden)

    Indu Arora

    2012-07-01

    Full Text Available Relational databases ruled the Information Technology (IT industry for almost 40 years. But last few years have seen sea changes in the way IT is being used and viewed. Stand alone applications have been replaced with web-based applications, dedicated servers with multiple distributed servers and dedicated storage with network storage. Cloud computing has become a reality due to its lesser cost, scalability and pay-as-you-go model. It is one of the biggest changes in IT after the rise of World Wide Web. Cloud databases such as Big Table, Sherpa and SimpleDB are becoming popular. They address the limitations of existing relational databases related to scalability, ease of use and dynamic provisioning. Cloud databases are mainly used for data-intensive applications such as data warehousing, data mining and business intelligence. These applications are read-intensive, scalable and elastic in nature. Transactional data management applications such as banking, airline reservation, online e-commerce and supply chain management applications are write-intensive. Databases supporting such applications require ACID (Atomicity, Consistency, Isolation and Durability properties, but these databases are difficult to deploy in the cloud. The goal of this paper is to review the state of the art in the cloud databases and various architectures. It further assesses the challenges to develop cloud databases that meet the user requirements and discusses popularly used Cloud databases.

  3. 21 CFR 101.71 - Health claims: claims not authorized.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Health claims: claims not authorized. 101.71 Section 101.71 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION FOOD LABELING Specific Requirements for Health Claims § 101.71...

  4. Assessing Treatment Effects of Inhaled Corticosteroids on Medical Expenses and Exacerbations among COPD Patients: Longitudinal Analysis of Managed Care Claims

    Science.gov (United States)

    Akazawa, Manabu; Stearns, Sally C; Biddle, Andrea K

    2008-01-01

    Objective To assess costs, effectiveness, and cost-effectiveness of inhaled corticosteroids (ICS) augmenting bronchodilator treatment for chronic obstructive pulmonary disease (COPD). Data Sources Claims between 1997 and 2005 from a large managed care database. Study Design Individual-level, fixed-effects regression models estimated the effects of initiating ICS on medical expenses and likelihood of severe exacerbation. Bootstrapping provided estimates of the incremental cost per severe exacerbation avoided. Data Extraction Methods COPD patients aged 40 or older with ≥15 months of continuous eligibility were identified. Monthly observations for 1 year before and up to 2 years following initiation of bronchodilators were constructed. Principal Findings ICS treatment reduced monthly risk of severe exacerbation by 25 percent. Total costs with ICS increased for 16 months, but declined thereafter. ICS use was cost saving 46 percent of the time, with an incremental cost-effectiveness ratio of $2,973 per exacerbation avoided; for patients ≥50 years old, ICS was cost saving 57 percent of time. Conclusions ICS treatment reduces exacerbations, with an increase in total costs initially for the full sample. Compared with younger patients with COPD, patients aged 50 or older have reduced costs and improved outcomes. The estimated cost per severe exacerbation avoided, however, may be high for either group because of uncertainty as reflected by the large standard errors of the parameter estimates. PMID:18671750

  5. Dermatological legal claims in Japan.

    Science.gov (United States)

    Ogawa, Sachiko; Isogawa, Naoyuki; Ushiro, Shin; Ayuzawa, Junko; Furue, Masutaka

    2008-07-01

    Health-care safety management has recently been highlighted for patient safety. However, specialist-based risks in clinical settings have hardly been discussed in Japan so far. A review of dermatological legal claims may delineate these risks. This study examined court precedents from the databases "Courts in Japan" and LEX/DB. Thirty-four dermatology-related civil cases were found from 1968-2006. Of the 34 cases, 32 (94%) were judged and two (6%) were retried. Of these 32 cases, 11 (34%) were appealed to higher courts. Among the 34 litigations, the defendants of eight (23%) were dermatology specialists, 20 (59%) were non-dermatologists and six (18%) of unknown specialty. The defendants' negligence was determined at either level in court in 25 of the 34 cases. The negligence in these 25 cases was categorized into five groups: (i) delayed diagnosis (none); (ii) complication during diagnosis procedure (one, 4%); (iii) inappropriate treatment (nine, 36%); (iv) complication during treatment procedure (10, 40%); and (v) insufficient informed consent (five, 20%). The present study may help to improve strategies for health-care safety management in the dermatological field in Japan.

  6. The implications for information system design of how health care costs are determined.

    Science.gov (United States)

    Ehreth, J

    1996-03-01

    As the costs of health care assume increasing importance in national health policy, information systems will be required to supply better information about how costs are generated and how resources are distributed. Costs, as determined by accounting systems, often are inadequate for policy analysis because they represent resources consumed (expenditures) to produce given outputs but do not measure forgone alternative uses of the resources (opportunity costs). To accommodate cost studies at the program level and the system level, relational information systems must be developed that allow costs to be summed across individuals to determine an organization's costs, across providers to determine an individual patient's costs, and across both to determine system and population costs. Program level studies require that cost variables be grouped into variable costs that are tied to changes in volume of output and fixed costs that are allocated rationally. Data sources for program-level analyses are organizational financial statements, cost center accounting records, Medicare cost reports, American Hospital Association surveys, and the Department of Veterans Affairs (VA) cost distribution files. System-level studies are performed to predict future costs and to compare costs of alternative modes of treatment. System-level analyses aggregate all costs associated with individuals to produce population-based costs. Data sources for system-level analyses include insurance claims;n Medicare files; hospital billing records; and VA inpatient, outpatient, and management databases. Future cost studies will require the assessment of costs from all providers, regardless of organizational membership status, for all individuals in defined populations.

  7. Relational databases

    CERN Document Server

    Bell, D A

    1986-01-01

    Relational Databases explores the major advances in relational databases and provides a balanced analysis of the state of the art in relational databases. Topics covered include capture and analysis of data placement requirements; distributed relational database systems; data dependency manipulation in database schemata; and relational database support for computer graphics and computer aided design. This book is divided into three sections and begins with an overview of the theory and practice of distributed systems, using the example of INGRES from Relational Technology as illustration. The

  8. Claiming health in food products

    DEFF Research Database (Denmark)

    Lähteenmäki, Liisa

    2013-01-01

    Health-related information is increasingly used on food products to convey their benefits. Health claims as a subcategory of these messages link the beneficial component, functions or health outcomes with specific products. For consumers, health claims seem to carry the message of increased...... healthiness, but not necessarily making the product more appealing. The wording of the claim seems to have little impact on claim perception, yet the health image of carrier products is important. From consumer-related factors the relevance and attitudes towards functional foods play a role, whereas socio...... the information, but we still know relatively little about consumer understanding of the message content in claims and even less about the assessment of personal relevance of the claimed benefits. In future studies more emphasis should be put on including contextual influences and realistic conditions...

  9. Surgical research using national databases.

    Science.gov (United States)

    Alluri, Ram K; Leland, Hyuma; Heckmann, Nathanael

    2016-10-01

    Recent changes in healthcare and advances in technology have increased the use of large-volume national databases in surgical research. These databases have been used to develop perioperative risk stratification tools, assess postoperative complications, calculate costs, and investigate numerous other topics across multiple surgical specialties. The results of these studies contain variable information but are subject to unique limitations. The use of large-volume national databases is increasing in popularity, and thorough understanding of these databases will allow for a more sophisticated and better educated interpretation of studies that utilize such databases. This review will highlight the composition, strengths, and weaknesses of commonly used national databases in surgical research.

  10. Association between refill compliance to oral bisphosphonate treatment, incident fractures, and health care costs--an analysis using national health databases

    DEFF Research Database (Denmark)

    Olsen, K R; Hansen, C; Abrahamsen, Bo

    2013-01-01

    major osteoporotic fractures, and the direct costs related to hospital care, primary care, and pharmaceutical treatment for these excess fractures reached almost 14 M DKK (2.5 M USD) for the study population which compares to a national annual excess cost of around 17 M DKK (3.1 M USD) using 2011...

  11. Fashion Information Database

    Institute of Scientific and Technical Information of China (English)

    LI Jun; WU Hai-yan; WANG Yun-yi

    2002-01-01

    In the field of fashion industry, it is a bottleneck of how to control and apply the information in the procedure of fashion merchandising. By the aid of digital technology,a perfect and practical fashion information database could be established so that high- quality and efficient,low-cost and characteristic fashion merchandising system could be realized. The basic structure of fashion information database is discussed.

  12. Performance evaluation of court in construction claims settlement of litigation

    Science.gov (United States)

    Hayati, Kemala; Latief, Yusuf; Rarasati, Ayomi Dita; Siddik, Arief

    2017-06-01

    Claim construction has a major influence on the implementation of projects, such as the cost and time. The success of the construction project is highly dependent on the effective resolution of claims. Although it has been recognized that litigation or court is not the best way because it may reduce or eliminate profits and damage the relationship, it is a method of resolving claims and disputes that is common in the world of construction. The method of resolving claims and disputes through litigation or court may solve the problem in an alternative method, namely the implementation of the judgment which can be enforced effectively against the losing party and the ruling which has the force of law of the country where the claims and disputes are examined. However, litigation or court may take longer time and require high cost. Thus, it is necessary to identify factors affecting the performance of the court and to develop a system capable of improving an existing system in order to run more effectively and efficiently. Resolution in the claims management of construction projects with the method of litigation is a procedure that can be used by the courts in order to shorten the time in order to reduce the cost. The scope of this research is directed to all parties involved in the construction, both the owners and the contractors as implementers and practitioners, as well as experts who are experienced in construction law.

  13. Biofuel Database

    Science.gov (United States)

    Biofuel Database (Web, free access)   This database brings together structural, biological, and thermodynamic data for enzymes that are either in current use or are being considered for use in the production of biofuels.

  14. Onzekere databases

    NARCIS (Netherlands)

    van Keulen, Maurice

    Een recente ontwikkeling in het databaseonderzoek betret zogenaamde 'onzekere databases'. Dit artikel beschrijft wat onzekere databases zijn, hoe ze gebruikt kunnen worden en welke toepassingen met name voordeel zouden kunnen hebben van deze technologie.

  15. Community Database

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This excel spreadsheet is the result of merging at the port level of several of the in-house fisheries databases in combination with other demographic databases such...

  16. Regulatory environment and claims - limits and opportunities.

    Science.gov (United States)

    Martin, Ambroise

    2010-01-01

    During the past decade, the use of claims became more and more important in many countries in relation to the increased awareness of consumer about the link between foods and health, offering to industry a valuable opportunity to differentiate and valorize their products and to promote innovation. However, more and more stringent regulations are developed, all based on the general principles adopted by the Codex Alimentarius Commission. In addition to the different regulatory processes and administrative requirements according to the country, the high level (and cost) of scientific substantiation of claims, the constraints introduced by nutrient profiles and the poor knowledge of the impact on consumer depending on the cultural contexts may limit these opportunities or, at least complicate their use. All these issues are briefly analyzed, highlighting some striking convergences and differences between countries.

  17. Nutrition and health claims on healthy and less-healthy packaged food products in New Zealand.

    Science.gov (United States)

    Al-Ani, Haya H; Devi, Anandita; Eyles, Helen; Swinburn, Boyd; Vandevijvere, Stefanie

    2016-09-01

    Nutrition and health claims are displayed to influence consumers' food choices. This study assessed the extent and nature of nutrition and health claims on the front-of-pack of 'healthy' and 'less-healthy' packaged foods in New Zealand. Foods from eight categories, for which consumption may affect the risk of obesity and diet-related chronic diseases, were selected from the 2014 Nutritrack database. The internationally standardised International Network for Food and Obesity/Non-Communicable Diseases Research, Monitoring and Action Support (INFORMAS) taxonomy was used to classify claims on packages. The Nutrient Profiling Scoring Criterion (NPSC) was used to classify products as 'healthy' or 'less healthy'. In total, 7526 products were included, with 47 % (n 3557) classified as 'healthy'. More than one-third of products displayed at least one nutrition claim and 15 % featured at least one health claim on the front-of-pack. Claims were found on one-third of 'less-healthy' products; 26 % of those products displayed nutrition claims and 7 % featured health claims. About 45 % of 'healthy' products displayed nutrition claims and 23 % featured health claims. Out of 7058 individual claims, the majority (69 %) were found on 'healthy' products. Cereals displayed the greatest proportion of nutrition and health claims (1503 claims on 564 products), of which one-third were displayed on 'less-healthy' cereals. Such claims could be misleading consumers' perceptions of nutritional quality of foods. It needs to be explored how current regulations on nutrition and health claims in New Zealand could be further strengthened (e.g. using the NPSC for nutrition claims, including general health claims as per the INFORMAS taxonomy) to ensure consumers are protected and not misled.

  18. Characteristics of Orthopaedic Malpractice Claims of Pediatric and Adult Patients in Private Practice.

    Science.gov (United States)

    Oetgen, Matthew E; Parikh, P Divya

    2016-03-01

    Medical liability exposure varies based on scope of practice, patient demographics, and location of practice. There is a generally held belief that treatment of pediatric patients increases one's medicolegal risk. We examined a large national database of orthopaedic malpractice claims to determine if pediatric malpractice claims were associated with a less favorable medicolegal outcome compared with adults. Physician Insurers Association of America is an association of medical liability insurance carriers providing liability coverage for 60% of private practice physicians in the United States. The Physician Insurers Association of America data registry of closed medical liability claims was examined, including all orthopaedic claims between 1985 and 2012 in this review. Claims were categorized based on the age of the claimant (pediatric: less than 21 y, adult: 21 y or older). These groups were compared based on percentage of claims resulting in payment, indemnity paid, and years between occurrence of incident and filing of claim. In addition, the top 10 most prevalent claims were identified and compared between groups. A total of 25,702 closed orthopaedic claims were included. Pediatric claims accounted for 13% of the data. The average time from incident to claim filing was 1.92 years for pediatrics and 1.59 years for adults. Pediatric claims resulted in a higher percent of payment (33% vs. 30%) and average indemnity paid ($189,732 vs. $180,171) compared with adults. Five of the top 10 conditions resulting in a claim in each group were the same. Comparing these 5 conditions, in general there were minimal differences in the average time to claim filing between the groups, but larger average indemnity paid in the pediatric group. There appear to be moderate differences in outcomes of orthopaedic malpractice claims between adult and pediatric patients. The longer statute of limitations associated with pediatric claims does not appear to portend a less favorable

  19. Database Administrator

    Science.gov (United States)

    Moore, Pam

    2010-01-01

    The Internet and electronic commerce (e-commerce) generate lots of data. Data must be stored, organized, and managed. Database administrators, or DBAs, work with database software to find ways to do this. They identify user needs, set up computer databases, and test systems. They ensure that systems perform as they should and add people to the…

  20. Database Administrator

    Science.gov (United States)

    Moore, Pam

    2010-01-01

    The Internet and electronic commerce (e-commerce) generate lots of data. Data must be stored, organized, and managed. Database administrators, or DBAs, work with database software to find ways to do this. They identify user needs, set up computer databases, and test systems. They ensure that systems perform as they should and add people to the…

  1. A statistical analysis of insurance damage claims related to rainfall extremes

    NARCIS (Netherlands)

    Spekkers, M.H.; Kok, M.; Clemens, F.H.L.R.; Ten Veldhuis, J.A.E.

    2012-01-01

    In this paper, a database of water-related insurance damage claims related to private properties and content was analysed. The aim was to investigate whether high numbers of damage claims were associated with high rainfall intensities. Rainfall data were used for the period of 2003–2010 in the Nethe

  2. Treatments, complications, and healthcare utilization associated with acromegaly: a study in two large United States databases.

    Science.gov (United States)

    Broder, M S; Neary, M P; Chang, E; Cherepanov, D; Katznelson, L

    2014-08-01

    The economic burden of acromegaly in the US has been largely unknown. We describe the prevalence of treatment patterns, complication rates, and associated healthcare utilization and costs of acromegaly in the US. Patients were identified between 1/1/2002 and 12/31/2009 in claims databases. During 1-year after each continuously-enrolled patient's first acromegaly claim, pharmacy and medical claims were used to estimate outcomes. Regression models were used to adjust outcomes. There were 2,171 acromegaly patients (mean age: 45.3 years; 49.7% female); 77.8% received the majority of their care from non-endocrinologists. Pharmacologic treatment was used by 30.8% of patients: octreotide-LAR in 18.6%, dopamine agonists in 9.8%, short-acting octreotide in 4.7%, pegvisomant in 4.1%, and lanreotide in 1.2%; 56% had biochemical monitoring. Comorbidities were common, ranging from 6.6% (colon neoplasms) to 25.6% (musculoskeletal abnormalities). Mean healthcare costs were $24,900. Adjusted analyses indicated comorbidities increased the odds of hospitalization: by 76% for musculoskeletal abnormalities; 193% for cardiovascular abnormalities; and 56% for sleep apnea (p acromegaly patients. Cardiovascular complications nearly tripled the odds of hospitalization (OR 2.93) and increased annual mean cost by $13,331. Adequate management of this disease may be able to reduce health care utilization and cost associated with these complications and with acromegaly in general.

  3. Adverse events during pediatric dental anesthesia and sedation: a review of closed malpractice insurance claims.

    Science.gov (United States)

    Chicka, Maggie C; Dembo, Jeffrey B; Mathu-Muju, Kavita R; Nash, David A; Bush, Heather M

    2012-01-01

    The purpose of this study of closed malpractice insurance claims was to provide descriptive data of adverse events related to child sedation and anesthesia in the dental office. The malpractice claims databases of two professional liability carriers were searched using pre-determined keywords for all closed claims involving anesthesia in pediatric dental patients from 1993-2007. The database searches resulted in 17 claims dealing with adverse anesthesia events of which 13 involved sedation, 3 involved local anesthesia alone, and 1 involved general anesthesia. Fifty-three percent of the claims involved patient death or permanent brain damage; in these claims, the average patient age was 3.6 years, 6 involved general dentists as the anesthesia provider, and 2 involved local anesthesia alone. Local anesthetic overdoses were observed in 41% of the claims. The location of adverse event occurrence was in the dental office where care was being provided in 71% of the claims. Of the 13 claims involving sedation, only 1 claim involved the use of physiologic monitoring. Very young patients (≤ 3-years-old) are at greatest risk during administration of sedative and/or local anesthetic agents. Some practitioners are inadequately monitoring patients during sedation procedures. Adverse events have a high chance of occurring at the dental office where care is being provided.

  4. Application of Recursive Partitioning to Derive and Validate a Claims-Based Algorithm for Identifying Keratinocyte Carcinoma (Nonmelanoma Skin Cancer).

    Science.gov (United States)

    Chan, An-Wen; Fung, Kinwah; Tran, Jennifer M; Kitchen, Jessica; Austin, Peter C; Weinstock, Martin A; Rochon, Paula A

    2016-10-01

    Keratinocyte carcinoma (nonmelanoma skin cancer) accounts for substantial burden in terms of high incidence and health care costs but is excluded by most cancer registries in North America. Administrative health insurance claims databases offer an opportunity to identify these cancers using diagnosis and procedural codes submitted for reimbursement purposes. To apply recursive partitioning to derive and validate a claims-based algorithm for identifying keratinocyte carcinoma with high sensitivity and specificity. Retrospective study using population-based administrative databases linked to 602 371 pathology episodes from a community laboratory for adults residing in Ontario, Canada, from January 1, 1992, to December 31, 2009. The final analysis was completed in January 2016. We used recursive partitioning (classification trees) to derive an algorithm based on health insurance claims. The performance of the derived algorithm was compared with 5 prespecified algorithms and validated using an independent academic hospital clinic data set of 2082 patients seen in May and June 2011. Sensitivity, specificity, positive predictive value, and negative predictive value using the histopathological diagnosis as the criterion standard. We aimed to achieve maximal specificity, while maintaining greater than 80% sensitivity. Among 602 371 pathology episodes, 131 562 (21.8%) had a diagnosis of keratinocyte carcinoma. Our final derived algorithm outperformed the 5 simple prespecified algorithms and performed well in both community and hospital data sets in terms of sensitivity (82.6% and 84.9%, respectively), specificity (93.0% and 99.0%, respectively), positive predictive value (76.7% and 69.2%, respectively), and negative predictive value (95.0% and 99.6%, respectively). Algorithm performance did not vary substantially during the 18-year period. This algorithm offers a reliable mechanism for ascertaining keratinocyte carcinoma for epidemiological research in the absence of

  5. HMO strategies for managing workers' compensation claims.

    Science.gov (United States)

    Gallagher, P A

    1996-03-01

    Health maintenance organizations (HMOs) have become very active in managing workers' compensation medical expense benefits. A survey of 316 HMOs shows that this activity takes the form of various network models and a range of services--such as utilization review and case management--that may not be linked to a provider network. Of the HMOs surveyed, 78 reported that, by using managed care services and provider discounts, they were able to save from 20 percent to 30 percent on occupational health claim costs.

  6. Medicare Part D Claims Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — This page contains information on Part D claims data for the purposes of research, analysis, reporting, and public health functions. These data will also be used to...

  7. Medicare Hospital Spending by Claim

    Data.gov (United States)

    U.S. Department of Health & Human Services — Also known as Medicare Spending per Beneficiary (MSPB) Spending Breakdowns by Claim Type file. The data displayed here show average spending levels during...

  8. Database Manager

    Science.gov (United States)

    Martin, Andrew

    2010-01-01

    It is normal practice today for organizations to store large quantities of records of related information as computer-based files or databases. Purposeful information is retrieved by performing queries on the data sets. The purpose of DATABASE MANAGER is to communicate to students the method by which the computer performs these queries. This…

  9. Database Engines: Evolution of Greenness

    OpenAIRE

    Miranskyy, Andriy V.; Al-zanbouri, Zainab; Godwin, David; Bener, Ayse Basar

    2017-01-01

    Context: Information Technology consumes up to 10\\% of the world's electricity generation, contributing to CO2 emissions and high energy costs. Data centers, particularly databases, use up to 23% of this energy. Therefore, building an energy-efficient (green) database engine could reduce energy consumption and CO2 emissions. Goal: To understand the factors driving databases' energy consumption and execution time throughout their evolution. Method: We conducted an empirical case study of energ...

  10. Genome databases

    Energy Technology Data Exchange (ETDEWEB)

    Courteau, J.

    1991-10-11

    Since the Genome Project began several years ago, a plethora of databases have been developed or are in the works. They range from the massive Genome Data Base at Johns Hopkins University, the central repository of all gene mapping information, to small databases focusing on single chromosomes or organisms. Some are publicly available, others are essentially private electronic lab notebooks. Still others limit access to a consortium of researchers working on, say, a single human chromosome. An increasing number incorporate sophisticated search and analytical software, while others operate as little more than data lists. In consultation with numerous experts in the field, a list has been compiled of some key genome-related databases. The list was not limited to map and sequence databases but also included the tools investigators use to interpret and elucidate genetic data, such as protein sequence and protein structure databases. Because a major goal of the Genome Project is to map and sequence the genomes of several experimental animals, including E. coli, yeast, fruit fly, nematode, and mouse, the available databases for those organisms are listed as well. The author also includes several databases that are still under development - including some ambitious efforts that go beyond data compilation to create what are being called electronic research communities, enabling many users, rather than just one or a few curators, to add or edit the data and tag it as raw or confirmed.

  11. Codex recommendations on the scientific basis of health claims.

    Science.gov (United States)

    Grossklaus, Rolf

    2009-12-01

    Within the framework of Codex Alimentarius, attempts are being made at international level to establish guidelines for use of nutrition and health claims. An important issue that has to be addressed is the process of scientific substantiating of claims on foods. To provide an insight into the current step procedure of the proposed draft recommendations on the scientific basis of health claims. These Codex recommendations are intended to facilitate governments' own evaluation of health claims made by the industry. Review of comments of governments, observers and non-governmental organizations (NGOs) and relevant references to the proposed draft recommendations of the last sessions of the Codex Committee on Nutrition and Food for Special Dietary Uses (CCNFSDU). A literature search was performed using the PubMed database. Several proposed draft recommendations on the scientific substantiation of health claims have been considered and amended by the CCNFSDU in recent years but the work is not yet complete. The current work draws on the work of FUFOSE and PASSCLAIM and also on that of WHO and FDA. Given the important role of Codex in food safety, the draft recommendations emphasize circumstances where additional evaluation of safety or nutritional safety needs to be considered. High quality human intervention studies are the prime evidence needed to substantiate claims but there is recognition that, in some cases, only observational studies may be available. Animal and in vitro studies will also be evaluated as part of the totality of the evidence. It has been suggested that the recommendations should include re-evaluation of claims after a certain time period, or if new evidence calls into question the scientific validity underpinning the claims. Setting out a common approach for the substantiation of health claims is an important step in the use of health claims around the world. There is a need to reflect emerging as well as consensus science. The substantiating

  12. Database Replication

    CERN Document Server

    Kemme, Bettina

    2010-01-01

    Database replication is widely used for fault-tolerance, scalability and performance. The failure of one database replica does not stop the system from working as available replicas can take over the tasks of the failed replica. Scalability can be achieved by distributing the load across all replicas, and adding new replicas should the load increase. Finally, database replication can provide fast local access, even if clients are geographically distributed clients, if data copies are located close to clients. Despite its advantages, replication is not a straightforward technique to apply, and

  13. Probabilistic Databases

    CERN Document Server

    Suciu, Dan; Koch, Christop

    2011-01-01

    Probabilistic databases are databases where the value of some attributes or the presence of some records are uncertain and known only with some probability. Applications in many areas such as information extraction, RFID and scientific data management, data cleaning, data integration, and financial risk assessment produce large volumes of uncertain data, which are best modeled and processed by a probabilistic database. This book presents the state of the art in representation formalisms and query processing techniques for probabilistic data. It starts by discussing the basic principles for rep

  14. Treatment persistence and cost-effectiveness of latanoprost/latanoprost–timolol, bimatoprost/bimatoprost–timolol, and travoprost/travoprost–timolol in glaucoma: an analysis based on the United Kingdom general practitioner research database

    Directory of Open Access Journals (Sweden)

    Antoine Lafuma

    2011-03-01

    Full Text Available Antoine Lafuma1, John F Salmon2, Julien Robert1, Gilles Berdeaux31Cemka, Bourg-la-Reine, France; 2Oxford Eye Hospital, Oxford, UK; 3Conservatoire National des Arts et Métiers, Chaire Economie et Gestion des Services de Santé, Paris, FranceObjective: To compare treatment persistence and costs with 3 glaucoma treatment sequences (first-line/second-line: latanoprost/latanoprost–timolol (LLT, bimatoprost/bimatoprost–timolol (BBT, and travoprost/travoprost–timolol (TTT, derived from the UK General Practitioner Research Database (UK-GPRD.Methods: Patient records referring to ocular hypertension, topical glaucoma treatment, surgery, or laser therapy were extracted. Patients prescribed LLT, BBT, or TTT sequences were selected. Treatment failure was inferred from glaucoma prescription change (adding or removing a topical treatment, surgery, or laser therapy. Treatment durations preceding failure were compared by applying Wilcoxon’s test to survival curves. Adjustment on confounding variables was performed with a Cox model and a propensity score method. Unit costs were estimated from a UK National Health Service perspective.Results: A total of 1592 patients received LLT, 110 BBT, and 114 TTT. Their mean age was 68 years and the sex ratio almost 1 male:1 female. No significant demographic or comorbidity differences were observed between treatment sequences. Treatment persistence at 36 months was achieved in 60.0% of LLT, 55.5% of BBT, and 70.3% of TTT patients (P = 0.005. Resources consumed and associated monthly costs were significantly less for the TTT group (£17.74 compared with BBT (£21.30 and LLT (£22.37 groups.Conclusion: Analysis of data obtained from the UK-GPRD suggests that the TTT treatment sequence achieved longer treatment persistence at lower cost than LLT and BBT.Keywords: glaucoma, travoprost, timolol, latanoprost, bimatoprost, persistency, costs

  15. Comparative treatment-related adverse event cost burden in immune thrombocytopenic purpura.

    Science.gov (United States)

    Donga, Prina Z; Bilir, Sara P; Little, Gregg; Babinchak, Tim; Munakata, Julie

    2017-09-08

    Real-world evidence on the safety profile and costs associated with immune thrombocytopenic purpura (ITP) treatment in adults is lacking. This study quantifies and compares adverse event (AE) crude rates and costs associated with ITP treatments as found in claims data. A retrospective claims-based analysis was conducted using IMS Pharmetrics Plus database. Included patients were ≥18 years old, with a diagnosis of ITP (2007-2012); an ITP-related claim for anti-D, intravenous immunoglobulin (IVIG), rituximab, romiplostim, or eltrombopag; and 1-year continuous enrollment (3-years for rituximab) during follow-up. AEs and event costs were identified during active treatment, defined from the first claim of each drug to a pre-defined treatment gap or end of study period. Descriptive statistics were reported with Wilcoxon rank-sum significance tests. A total of 2,518 patients were identified (mean age = 50.8 (±16.3 years); 55.8% male). Of all patients, 22.8% experienced any AE. Significantly fewer anti-D patients had any AE (13.8% vs IVIG: 21.1%, rituximab: 29.4%, romiplostim: 28.1%, eltrombopag: 22.4%). Nausea/vomiting and arthralgia/musculoskeletal pain were most common across treatments, and hemolytic events did not differ significantly across treatments. Most costly AEs were urinary tract infection, aseptic meningitis, and fever ($5000+/case); headache, nasal congestion, and hemolytic event were $4,000-5,000/case. Cost per AE did not differ by treatment. Although lower than trial-based AE rates, claims for ITP treatment-related AEs are common, with higher numbers for rituximab and lower numbers for anti-D. This disparity suggests a possible differential cost burden overall that future analysis should explore.

  16. Dealer Database

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The dealer reporting databases contain the primary data reported by federally permitted seafood dealers in the northeast. Electronic reporting was implemented May 1,...

  17. RDD Databases

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This database was established to oversee documents issued in support of fishery research activities including experimental fishing permits (EFP), letters of...

  18. National database

    DEFF Research Database (Denmark)

    Kristensen, Helen Grundtvig; Stjernø, Henrik

    1995-01-01

    Artikel om national database for sygeplejeforskning oprettet på Dansk Institut for Sundheds- og Sygeplejeforskning. Det er målet med databasen at samle viden om forsknings- og udviklingsaktiviteter inden for sygeplejen.......Artikel om national database for sygeplejeforskning oprettet på Dansk Institut for Sundheds- og Sygeplejeforskning. Det er målet med databasen at samle viden om forsknings- og udviklingsaktiviteter inden for sygeplejen....

  19. FEEDBACK ON A PUBLICLY DISTRIBUTED IMAGE DATABASE: THE MESSIDOR DATABASE

    Directory of Open Access Journals (Sweden)

    Etienne Decencière

    2014-08-01

    Full Text Available The Messidor database, which contains hundreds of eye fundus images, has been publicly distributed since 2008. It was created by the Messidor project in order to evaluate automatic lesion segmentation and diabetic retinopathy grading methods. Designing, producing and maintaining such a database entails significant costs. By publicly sharing it, one hopes to bring a valuable resource to the public research community. However, the real interest and benefit of the research community is not easy to quantify. We analyse here the feedback on the Messidor database, after more than 6 years of diffusion. This analysis should apply to other similar research databases.

  20. Healthcare costs and utilization for Medicare beneficiaries with Alzheimer's

    Directory of Open Access Journals (Sweden)

    Kuo Tzu-Chun

    2008-05-01

    Full Text Available Abstract Background Alzheimer's disease (AD is a neurodegenerative disorder incurring significant social and economic costs. This study uses a US administrative claims database to evaluate the effect of AD on direct healthcare costs and utilization, and to identify the most common reasons for AD patients' emergency room (ER visits and inpatient admissions. Methods Demographically matched cohorts age 65 and over with comprehensive medical and pharmacy claims from the 2003–2004 MEDSTAT MarketScan® Medicare Supplemental and Coordination of Benefits (COB Database were examined: 1 25,109 individuals with an AD diagnosis or a filled prescription for an exclusively AD treatment; and 2 75,327 matched controls. Illness burden for each person was measured using Diagnostic Cost Groups (DCGs, a comprehensive morbidity assessment system. Cost distributions and reasons for ER visits and inpatient admissions in 2004 were compared for both cohorts. Regression was used to quantify the marginal contribution of AD to health care costs and utilization, and the most common reasons for ER and inpatient admissions, using DCGs to control for overall illness burden. Results Compared with controls, the AD cohort had more co-morbid medical conditions, higher overall illness burden, and higher but less variable costs ($13,936 s. $10,369; Coefficient of variation = 181 vs. 324. Significant excess utilization was attributed to AD for inpatient services, pharmacy, ER visits, and home health care (all p Conclusion Patients with AD have significantly more co-morbid medical conditions and higher healthcare costs and utilization than demographically-matched Medicare beneficiaries. Even after adjusting for differences in co-morbidity, AD patients incur excess ER visits and inpatient admissions.

  1. Frequency and Type of Situational Awareness Errors Contributing to Death and Brain Damage: A Closed Claims Analysis.

    Science.gov (United States)

    Schulz, Christian M; Burden, Amanda; Posner, Karen L; Mincer, Shawn L; Steadman, Randolph; Wagner, Klaus J; Domino, Karen B

    2017-08-01

    Situational awareness errors may play an important role in the genesis of patient harm. The authors examined closed anesthesia malpractice claims for death or brain damage to determine the frequency and type of situational awareness errors. Surgical and procedural anesthesia death and brain damage claims in the Anesthesia Closed Claims Project database were analyzed. Situational awareness error was defined as failure to perceive relevant clinical information, failure to comprehend the meaning of available information, or failure to project, anticipate, or plan. Patient and case characteristics, primary damaging events, and anesthesia payments in claims with situational awareness errors were compared to other death and brain damage claims from 2002 to 2013. Anesthesiologist situational awareness errors contributed to death or brain damage in 198 of 266 claims (74%). Respiratory system damaging events were more common in claims with situational awareness errors (56%) than other claims (21%, P situational awareness error claims compared to 46% in other claims (P = 0.001), with no significant difference in payment size. Among 198 claims with anesthesia situational awareness error, perception errors were most common (42%), whereas comprehension errors (29%) and projection errors (29%) were relatively less common. Situational awareness error definitions were operationalized for reliable application to real-world anesthesia cases. Situational awareness errors may have contributed to catastrophic outcomes in three quarters of recent anesthesia malpractice claims.Situational awareness errors resulting in death or brain damage remain prevalent causes of malpractice claims in the 21st century.

  2. 38 CFR 3.155 - Informal claims.

    Science.gov (United States)

    2010-07-01

    ... organization, an attorney, or agent may not be accepted as an informal claim if a power of attorney was not... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Informal claims. 3.155..., Compensation, and Dependency and Indemnity Compensation Claims § 3.155 Informal claims. (a) Any...

  3. 40 CFR 716.55 - Confidentiality claims.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Confidentiality claims. 716.55 Section... ACT HEALTH AND SAFETY DATA REPORTING General Provisions § 716.55 Confidentiality claims. (a)(1... clearly identify the material subject to the claim. (3) Any respondent may assert a confidentiality claim...

  4. 44 CFR 62.20 - Claims appeals.

    Science.gov (United States)

    2010-10-01

    ... OF CLAIMS Claims Adjustment, Claims Appeals, and Judicial Review § 62.20 Claims appeals. (a... resolution by appraisal or other pre-litigation remedies. (d) Litigation preclusion. An insured who files... resolution. (1) FEMA will acknowledge, in writing, receipt of a policyholder's appeal and include in...

  5. Economic and gastrointestinal safety comparisons of etodolac, nabumetone, and oxaprozin from insurance claims data from patients with arthritis.

    Science.gov (United States)

    Simon, L S; Zhao, S Z; Arguelles, L M; Lefkowith, J B; Dedhiya, S D; Fort, J G; Johnson, K E

    1998-01-01

    This study was conducted to compare the effect of etodolac, nabumetone, and oxaprozin use on gastrointestinal (GI) safety and associated costs based on insurance claims information from practice settings. Data were obtained from a national claims database (MarketScan) for the years 1992 to 1994. The claims data of interest were for patients with arthritis who had used etodolac, nabumetone, or oxaprozin exclusively during a 9-month follow-up period (ONLY groups), or these drugs plus (PLUS groups) the other nonsteroidal anti-inflammatory drugs (NSAIDs) ibuprofen, naproxen, diclofenac, sulindac, piroxicam, ketoprofen, or indomethacin. For each group, we obtained information on the use of inpatient and outpatient services for GI-related events and the associated costs. All GI admissions were classified as NSAID-induced or possibly NSAID-induced events based on International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9 CM) codes. All outpatient upper GI ulcers or bleeding episodes were also identified by specific ICD-9 CM code. There were no significant between-group demographic differences. The proportions of patients with NSAID-induced and possibly NSAID-induced GI admissions were 0.1% and 0.4% for the etodolac-ONLY, 0.3% and 1.0% for the nabumetone-ONLY, and 0.1% and 0.5% for the oxaprozin-ONLY groups, respectively (P > 0.05), and a similar pattern was observed among the PLUS groups. In outpatient settings, 3.9%, 4.2%, and 4.9% of the etodolac-, nabumetone-, and oxaprozin-ONLY patients, respectively (P > 0.05), and 6.0%, 5.3%, and 4.7% of the etodolac-, nabumetone-, and oxaprozin-PLUS patients, respectively, had at least one upper GI ulcer/bleeding claim (P > 0.05). The total health care costs for 9 months were approximately $3000 each for the etodolac-, nabumetone-, and oxaprozin-ONLY groups. Oxaprozin, nabumetone, and etodolac had similar GI-safety and associated-costs profiles based on information from practice settings. Also, in

  6. Analysis of Actual Versus Projected Medical Claims Under the First Year of ACA-Mandated Coverage

    Directory of Open Access Journals (Sweden)

    Michael J. McCue DBA

    2016-11-01

    Full Text Available For the individual market, 2014 was the first year Affordable Care Act medical claims experience data were available to set 2016 rates. Accessing Centers for Medicare and Medicaid Services rate data for 175 state insurers, this study compares projected medical claims with actual medical claims of 2014, as well as the cost and utilization of benefit categories for inpatient, outpatient, professional, and prescription drug spending. Actual costs per member per month (pmpm were greater than projected in 2014 for inpatient, outpatient, and prescription spending but not for professional care. Overall, actual median medical cost was $443 pmpm, which was significantly higher by $41 than projected cost. Greater utilization of health care was primarily responsible for higher realized medical claims. In terms of the specific benefit categories—inpatient, outpatient, and prescription—actual costs pmpm were significantly higher than projected values. In terms of the drivers of inpatient costs, on an admission basis, higher costs and greater utilization of admissions resulted in higher inpatient costs. For outpatient costs pmpm, higher utilization rather than unit cost per visit drove increased costs. Higher than expected prescription drug costs were driven by both greater utilization and cost per prescription.

  7. Cost Analysis of MRI Services in Iran: An Application of Activity Based Costing Technique

    Directory of Open Access Journals (Sweden)

    Bayati

    2015-09-01

    Full Text Available Background Considerable development of MRI technology in diagnostic imaging, high cost of MRI technology and controversial issues concerning official charges (tariffs have been the main motivations to define and implement this study. Objectives The present study aimed to calculate the unit-cost of MRI services using activity-based costing (ABC as a modern cost accounting system and to fairly compare calculated unit-costs with official charges (tariffs. Materials and Methods We included both direct and indirect costs of MRI services delivered in fiscal year 2011 in Shiraz Shahid Faghihi hospital. Direct allocation method was used for distribution of overhead costs. We used micro-costing approach to calculate unit-cost of all different MRI services. Clinical cost data were retrieved from the hospital registering system. Straight-line method was used for depreciation cost estimation. To cope with uncertainty and to increase the robustness of study results, unit costs of 33 MRI services was calculated in terms of two scenarios. Results Total annual cost of MRI activity center (AC was calculated at USD 400,746 and USD 532,104 based on first and second scenarios, respectively. Ten percent of the total cost was allocated from supportive departments. The annual variable costs of MRI center were calculated at USD 295,904. Capital costs measured at USD 104,842 and USD 236, 200 resulted from the first and second scenario, respectively. Existing tariffs for more than half of MRI services were above the calculated costs. Conclusion As a public hospital, there are considerable limitations in both financial and administrative databases of Shahid Faghihi hospital. Labor cost has the greatest share of total annual cost of Shahid Faghihi hospital. The gap between unit costs and tariffs implies that the claim for extra budget from health providers may not be relevant for all services delivered by the studied MRI center. With some adjustments, ABC could be

  8. Cost Analysis of MRI Services in Iran: An Application of Activity Based Costing Technique.

    Science.gov (United States)

    Bayati, Mohsen; Mahboub Ahari, Alireza; Badakhshan, Abbas; Gholipour, Mahin; Joulaei, Hassan

    2015-10-01

    Considerable development of MRI technology in diagnostic imaging, high cost of MRI technology and controversial issues concerning official charges (tariffs) have been the main motivations to define and implement this study. The present study aimed to calculate the unit-cost of MRI services using activity-based costing (ABC) as a modern cost accounting system and to fairly compare calculated unit-costs with official charges (tariffs). We included both direct and indirect costs of MRI services delivered in fiscal year 2011 in Shiraz Shahid Faghihi hospital. Direct allocation method was used for distribution of overhead costs. We used micro-costing approach to calculate unit-cost of all different MRI services. Clinical cost data were retrieved from the hospital registering system. Straight-line method was used for depreciation cost estimation. To cope with uncertainty and to increase the robustness of study results, unit costs of 33 MRI services was calculated in terms of two scenarios. Total annual cost of MRI activity center (AC) was calculated at USD 400,746 and USD 532,104 based on first and second scenarios, respectively. Ten percent of the total cost was allocated from supportive departments. The annual variable costs of MRI center were calculated at USD 295,904. Capital costs measured at USD 104,842 and USD 236, 200 resulted from the first and second scenario, respectively. Existing tariffs for more than half of MRI services were above the calculated costs. As a public hospital, there are considerable limitations in both financial and administrative databases of Shahid Faghihi hospital. Labor cost has the greatest share of total annual cost of Shahid Faghihi hospital. The gap between unit costs and tariffs implies that the claim for extra budget from health providers may not be relevant for all services delivered by the studied MRI center. With some adjustments, ABC could be implemented in MRI centers. With the settlement of a reliable cost accounting system

  9. Reserving by detailed conditioning on individual claim

    Science.gov (United States)

    Kartikasari, Mujiati Dwi; Effendie, Adhitya Ronnie; Wilandari, Yuciana

    2017-03-01

    The estimation of claim reserves is an important activity in insurance companies to fulfill their liabilities. Recently, reserving method of individual claim have attracted a lot of interest in the actuarial science, which overcome some deficiency of aggregated claim method. This paper explores the Reserving by Detailed Conditioning (RDC) method using all of claim information for reserving with individual claim of liability insurance from an Indonesian general insurance company. Furthermore, we compare it to Chain Ladder and Bornhuetter-Ferguson method.

  10. Valuation of Non-Life Liabilities from Claims Triangles

    Directory of Open Access Journals (Sweden)

    Mathias Lindholm

    2017-07-01

    Full Text Available This paper provides a complete program for the valuation of aggregate non-life insurance liability cash flows based on claims triangle data. The valuation is fully consistent with the principle of valuation by considering the costs associated with a transfer of the liability to a so-called reference undertaking subject to capital requirements throughout the runoff of the liability cash flow. The valuation program includes complete details on parameter estimation, bias correction and conservative estimation of the value of the liability under partial information. The latter is based on a new approach to the estimation of mean squared error of claims reserve prediction.

  11. Mouse genome database 2016.

    Science.gov (United States)

    Bult, Carol J; Eppig, Janan T; Blake, Judith A; Kadin, James A; Richardson, Joel E

    2016-01-01

    The Mouse Genome Database (MGD; http://www.informatics.jax.org) is the primary community model organism database for the laboratory mouse and serves as the source for key biological reference data related to mouse genes, gene functions, phenotypes and disease models with a strong emphasis on the relationship of these data to human biology and disease. As the cost of genome-scale sequencing continues to decrease and new technologies for genome editing become widely adopted, the laboratory mouse is more important than ever as a model system for understanding the biological significance of human genetic variation and for advancing the basic research needed to support the emergence of genome-guided precision medicine. Recent enhancements to MGD include new graphical summaries of biological annotations for mouse genes, support for mobile access to the database, tools to support the annotation and analysis of sets of genes, and expanded support for comparative biology through the expansion of homology data.

  12. Multi-stage methodology to detect health insurance claim fraud.

    Science.gov (United States)

    Johnson, Marina Evrim; Nagarur, Nagen

    2016-09-01

    Healthcare costs in the US, as well as in other countries, increase rapidly due to demographic, economic, social, and legal changes. This increase in healthcare costs impacts both government and private health insurance systems. Fraudulent behaviors of healthcare providers and patients have become a serious burden to insurance systems by bringing unnecessary costs. Insurance companies thus develop methods to identify fraud. This paper proposes a new multistage methodology for insurance companies to detect fraud committed by providers and patients. The first three stages aim at detecting abnormalities among providers, services, and claim amounts. Stage four then integrates the information obtained in the previous three stages into an overall risk measure. Subsequently, a decision tree based method in stage five computes risk threshold values. The final decision stating whether the claim is fraudulent is made by comparing the risk value obtained in stage four with the risk threshold value from stage five. The research methodology performs well on real-world insurance data.

  13. 32 CFR 536.97 - Scope for claims under the National Guard Claims Act.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Scope for claims under the National Guard Claims Act. 536.97 Section 536.97 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES Claims Cognizable Under the National Guard...

  14. 32 CFR 536.98 - Claims payable under the National Guard Claims Act.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Claims payable under the National Guard Claims Act. 536.98 Section 536.98 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES Claims Cognizable Under the National Guard...

  15. 32 CFR 536.99 - Claims not payable under the National Guard Claims Act.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Claims not payable under the National Guard Claims Act. 536.99 Section 536.99 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES Claims Cognizable Under the National...

  16. 14 CFR 331.17 - How will the Department verify and audit claims under this part?

    Science.gov (United States)

    2010-01-01

    ... Department of Justice. If an audit is necessary, a ceiling amount reached, and the audit does not support the claimed amount, your reimbursement may be reduced to cover one-third the cost of the audit. ...

  17. Biological Databases

    Directory of Open Access Journals (Sweden)

    Kaviena Baskaran

    2013-12-01

    Full Text Available Biology has entered a new era in distributing information based on database and this collection of database become primary in publishing information. This data publishing is done through Internet Gopher where information resources easy and affordable offered by powerful research tools. The more important thing now is the development of high quality and professionally operated electronic data publishing sites. To enhance the service and appropriate editorial and policies for electronic data publishing has been established and editors of article shoulder the responsibility.

  18. Responding to Claims of Misrepresentation

    Science.gov (United States)

    Santelices, Maria Veronica; Wilson, Mark

    2010-01-01

    In their paper "Unfair Treatment? The Case of Freedle, the SAT, and the Standardization Approach to Differential Item Functioning" (Santelices & Wilson, 2010), the authors studied claims of differential effects of the SAT on Latinos and African Americans through the methodology of differential item functioning (DIF). Previous…

  19. Nordic scepticism towards health claims

    DEFF Research Database (Denmark)

    Pedersen, Susanne; Grunert, Klaus G.

    2008-01-01

    Imagine that you are shopping in a supermarket and find a package of pork chops labelled "omega-3 added" or that the yogurt "contains phosphatidylserine, which can improve your memory"; would you buy these pork chops or this yogurt? Most Nordic consumers would choose products without health claims....

  20. Tibia shaft fractures: costly burden of nonunions

    Directory of Open Access Journals (Sweden)

    Antonova Evgeniya

    2013-01-01

    Full Text Available Abstract 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. Methods We retrospectively analyzed medical claims in large U.S. managed care claims databases (Thomson Reuters MarketScan®, 16 million lives. We studied patients ≥ 18 years old with a TSF diagnosis (ICD-9 codes: 823.20, 823.22, 823.30, 823.32 in 2006 with continuous pharmaceutical and medical benefit enrollment 1 year prior and 2 years post-fracture. Nonunion was defined by ICD-9 code 733.82 (after the TSF date. Results Among the 853 patients with TSF, 99 (12% had nonunion. Patients with nonunion had more comorbidities (30 vs. 21, pre-fracture and were more likely to have their TSF open (87% vs. 70% than those without nonunion. Patients with nonunion were more likely to have additional fractures during the 2-year follow-up (of lower limb [88.9% vs. 69.5%, P  Conclusions Nonunions in TSF’s are associated with substantial healthcare resource use, common use of strong opioids, and high per-patient costs. Open fractures are associated with higher likelihood of nonunion than closed ones. Effective screening of nonunion risk may decrease this morbidity and subsequent healthcare resource use and costs.

  1. How much does curation cost?

    Science.gov (United States)

    Karp, Peter D

    2016-01-01

    NIH administrators have recently expressed concerns about the cost of curation for biological databases. However, they did not articulate the exact costs of curation. Here we calculate the cost of biocuration of articles for the EcoCyc database as $219 per article over a 5-year period. That cost is 6-15% of the cost of open-access publication fees for publishing biomedical articles, and we estimate that cost is 0.088% of the cost of the overall research project that generated the experimental results. Thus, curation costs are small in an absolute sense, and represent a miniscule fraction of the cost of the research.

  2. Clinician feedback on using episode groupers with Medicare claims data.

    Science.gov (United States)

    Thomas, Fred; Caplan, Craig; Levy, Jesse M; Cohen, Marty; Leonard, James; Caldis, Todd; Mueller, Curt

    2010-01-01

    CMS is investigating techniques that might help identify costly physician practice patterns. One method presently under evaluation is to compare resource use for certain episodes of care using commercially available episode grouping software. Although this software has been used by the private sector to classify insured individuals' medical claims into episodes of care, it has never been used with fee-for-service Medicare claims except in the studies by the Medicare Payment Advisory Commission (MedPAC) and CMS. This study reviews and reports on clinician feedback on the most obvious and important decisions that must be faced by Medicare to use grouped claims data as the foundation for a physician performance measurement system. The panel reactions show the importance of bringing persons with clinical knowledge into the development process. The clinician feedback confirms that additional research is needed.

  3. Cluster analysis and its application to healthcare claims data: a study of end-stage renal disease patients who initiated hemodialysis.

    Science.gov (United States)

    Liao, Minlei; Li, Yunfeng; Kianifard, Farid; Obi, Engels; Arcona, Stephen

    2016-03-02

    Cluster analysis (CA) is a frequently used applied statistical technique that helps to reveal hidden structures and "clusters" found in large data sets. However, this method has not been widely used in large healthcare claims databases where the distribution of expenditure data is commonly severely skewed. The purpose of this study was to identify cost change patterns of patients with end-stage renal disease (ESRD) who initiated hemodialysis (HD) by applying different clustering methods. A retrospective, cross-sectional, observational study was conducted using the Truven Health MarketScan® Research Databases. Patients aged ≥18 years with ≥2 ESRD diagnoses who initiated HD between 2008 and 2010 were included. The K-means CA method and hierarchical CA with various linkage methods were applied to all-cause costs within baseline (12-months pre-HD) and follow-up periods (12-months post-HD) to identify clusters. Demographic, clinical, and cost information was extracted from both periods, and then examined by cluster. A total of 18,380 patients were identified. Meaningful all-cause cost clusters were generated using K-means CA and hierarchical CA with either flexible beta or Ward's methods. Based on cluster sample sizes and change of cost patterns, the K-means CA method and 4 clusters were selected: Cluster 1: Average to High (n = 113); Cluster 2: Very High to High (n = 89); Cluster 3: Average to Average (n = 16,624); or Cluster 4: Increasing Costs, High at Both Points (n = 1554). Median cost changes in the 12-month pre-HD and post-HD periods increased from $185,070 to $884,605 for Cluster 1 (Average to High), decreased from $910,930 to $157,997 for Cluster 2 (Very High to High), were relatively stable and remained low from $15,168 to $13,026 for Cluster 3 (Average to Average), and increased from $57,909 to $193,140 for Cluster 4 (Increasing Costs, High at Both Points). Relatively stable costs after starting HD were associated with more stable scores

  4. Estimation of Missed Statin Prescription Use in an Administrative Claims Dataset.

    Science.gov (United States)

    Wade, Rolin L; Patel, Jeetvan G; Hill, Jerrold W; De, Ajita P; Harrison, David J

    2017-09-01

    Nonadherence to statin medications is associated with increased risk of cardiovascular disease and poses a challenge to lipid management in patients who are at risk for atherosclerotic cardiovascular disease. Numerous studies have examined statin adherence based on administrative claims data; however, these data may underestimate statin use in patients who participate in generic drug discount programs or who have alternative coverage. To estimate the proportion of patients with missing statin claims in a claims database and determine how missing claims affect commonly used utilization metrics. This retrospective cohort study used pharmacy data from the PharMetrics Plus (P+) claims dataset linked to the IMS longitudinal pharmacy point-of-sale prescription database (LRx) from January 1, 2012, through December 31, 2014. Eligible patients were represented in the P+ and LRx datasets, had ≥1 claim for a statin (index claim) in either database, and had ≥ 24 months of continuous enrollment in P+. Patients were linked between P+ and LRx using a deterministic method. Duplicate claims between LRx and P+ were removed to produce a new dataset comprised of P+ claims augmented with LRx claims. Statin use was then compared between P+ and the augmented P+ dataset. Utilization metrics that were evaluated included percentage of patients with ≥ 1 missing statin claim over 12 months in P+; the number of patients misclassified as new users in P+; the number of patients misclassified as nonstatin users in P+; the change in 12-month medication possession ratio (MPR) and proportion of days covered (PDC) in P+; the comparison between P+ and LRx of classifications of statin treatment patterns (statin intensity and patients with treatment modifications); and the payment status for missing statin claims. Data from 965,785 patients with statin claims in P+ were analyzed (mean age 56.6 years; 57% male). In P+, 20.1% had ≥ 1 missing statin claim post-index; 13.7% were misclassified as

  5. Political liberalism and religious claims

    Science.gov (United States)

    2016-01-01

    This article gives an overview of 4 important lacunae in political liberalism and identifies, in a preliminary fashion, some trends in the literature that can come in for support in filling these blind spots, which prevent political liberalism from a correct assessment of the diverse nature of religious claims. Political liberalism operates with implicit assumptions about religious actors being either ‘liberal’ or ‘fundamentalist’ and ignores a third, in-between group, namely traditionalist religious actors and their claims. After having explained what makes traditionalist religious actors different from liberal and fundamentalist religious actors, the author develops 4 areas in which political liberalism should be pushed further theoretically in order to correctly theorize the challenge which traditional religious actors pose to liberal democracy. These 4 areas (blind spots) are: (1) the context of translation; (2) the politics of exemptions; (3) the multivocality of theology; and (4) the transnational nature of norm-contestation. PMID:28344375

  6. Positive Aesthetics : claims and problems

    OpenAIRE

    Alcaraz León, María José

    2010-01-01

    In this paper I present an overview of the doctrine known as Positive Aesthetics regarding aesthetic judgements about nature. According to this view, all pristine nature is always beautiful and, generally, although not necessarily, human intervention tends to introduce ugliness in nature. One of the strong practical motivations behind this claim is an attempt to ground our reasons to preserve natural environments in aesthetic reasons. Positive Aesthetics has been defended within contrary appr...

  7. Degrees of Truthfulness in Accepted Scientific Claims

    National Research Council Canada - National Science Library

    Ahmed Hassan Mabrouk

    2008-01-01

    ...";">: Sciences adopt different methodologies in deriving claims and establishing theories. As a result, two accepted claims or theories belonging to two different sciences may not necessarily carry the same degree of truthfulness...

  8. The Instrumentation of the Multibackend Database System

    Science.gov (United States)

    1993-06-10

    COSATI CODES 18. SUBJECT TERMS (Continue on reverse if necessary and identify by block number) FIELD IGROUP SUB-GROUP Parallel Database, Multilingual ...identify by block number) Most database system designs and implementations are limited to single language ( monolingual ) and single model (mono- model...solution to the processing cost and data sharing problems of hetero- geneous database systems. One solution is a multimodel and multilingual database

  9. First-year treatment costs among new initiators of topical prostaglandin analogs

    Directory of Open Access Journals (Sweden)

    Jordana K Schmier

    2009-11-01

    Full Text Available Jordana K Schmier1, David W Covert2, Alan L Robin3,41Exponent Inc., Alexandria, VA, USA; 2Health Economics, Alcon Research Ltd., Fort Worth, TX, USA; 3Department of Ophthalmology, University of Maryland, Baltimore, MD, USA; 4Wilmer Eye Institute, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USAObjective: To estimate first-year costs among new initiators of topical prostaglandin analogs in a managed care population.Research design and methods: We developed a model to estimate first-year direct medical costs. We derived treatment patterns from a claims database analysis. Published studies were used to estimate visit-related resource use. Costs were obtained from standard sources.Results: The database analysis identified 9,063 patients meeting study criteria, 41% (n = 3,672 of whom remained on their initial prostaglandin therapy for 12 months after initiation. Adjunctive intraocular pressure lowering therapy was needed in 20.7%, 16.5%, 13.9%, and 8.9% of bimatoprost, latanoprost, travoprost, and BAK-free travoprost patients, respectively. Median numbers of days to the first prescription filled for adjunctive therapy (if required were 69.5, 67.0, 123.0, and 158.5 for patients initiating on bimatoprost, latanoprost, travoprost, and BAK-free travoprost. Total estimated first-year costs were $1,457, $1,360, $1,278, and $1,307 for patients initiating therapy with bimatoprost, latanoprost, travoprost, and BAK-free travoprost. Findings were consistent through sensitivity analysis.Conclusions: A BAK-free prostaglandin analog may permit longer duration of monotherapy and be associated with lower first-year direct medical costs. Use of a claims database and the selection of new initiators of prostaglandin analogs limit projecting findings to all glaucoma patients.Keywords: costs and cost analysis, drug therapy, combination, glaucoma, prostaglandin analogs

  10. Methodological challenges in assessing the impact of comorbidities on costs in Alzheimer's disease clinical trials.

    Science.gov (United States)

    Kahle-Wrobleski, Kristin; Fillit, Howard; Kurlander, Jonathan; Reed, Catherine; Belger, Mark

    2015-12-01

    Alzheimer's disease (AD) is associated with considerable costs and has a significant impact on health and social care systems. This study assessed whether baseline comorbidities present in 2,594 patients with AD participating in two semagacestat randomized placebo-controlled trials (RCTs) would significantly impact overall costs. Resource utilization was captured using the Resource Utilization in Dementia Scale-Lite. Comorbidities and concomitant medications were tabulated via patient and caregiver reports. Only baseline data were analyzed. Direct and indirect costs per month were calculated per patient. The relationship between cost and explanatory variables was explored in a regression model. The baseline monthly cost of care in this RCT population was £1,147 ± 2,483, with informal care costs accounting for 75% of costs. Gender, age, and functional status were significant predictors of costs (p ≤ 0.0001). The cost ratio was not impacted when the number of comorbidities was added to the model (cost ratio = 0.95; 95% CI 0.91-0.99) or when combined with the number of concomitant medications (cost ratio = 0.97; 95% CI 0.95-1.00). Inconsistent findings related to the impact of individual comorbidities on costs were noted in sensitivity analyses. The number of comorbidities, alone or when combined with concomitant medications, did not impact baseline costs of care, perhaps because RCTs often enroll less severely ill and more medically stable patients. However, higher costs were consistently associated with greater functional impairment similar to non-RCT databases. Supplemental sources (e.g., claims databases) are likely needed to better estimate the effects of disease and treatment on costs of illness captured in RCTs for AD.

  11. Cost of acute hospitalization and post-discharge follow-up care for meningococcal disease in the US.

    Science.gov (United States)

    Davis, Keith L; Misurski, Derek; Miller, Jacqueline M; Bell, Timothy J; Bapat, Bela

    2011-01-01

    The combined costs of acute hospitalization and post-discharge follow-up care in patients with meningococcal disease have not been widely documented. In this study, data were retrospectively analyzed from three large databases of hospital discharge records and commercial insurance claims in the US. Cases of meningococcal disease were defined as admissions with an ICD-9-CM diagnosis code in the range of 036.x. From the 2005 HCUP Nationwide Inpatient Sample, 349 (weighted N=1,710) meningococcal-related hospitalizations were identified with a mean facility cost (in 2009 dollars) of $19,526 per admission. Similar estimates ($18,119 and $20,066, respectively) were obtained from 268 admissions identified in the LifeLink (formerly PharMetrics) database during 1999-2007 and from 1,058 hospitalizations in the Perspective Comparative Database (PCD) during 2000-2007. Using insurance claims from LifeLink, we estimated that payers incur an additional $26,178 in non-facility (professional and other ancillary) costs during the course of a meningococcal admission, as well as $22,230 in additional medical and pharmacy expenses for post-discharge care during the ensuing year. The majority of follow-up costs ($14,637) were attributed to repeat hospitalizations. Mean length of stay for meningococcal disease was consistently estimated across databases at 8 to 9 days. Data from the PCD further suggested that meningococcal disease carries, on average, nearly 2 days of intensive care unit utilization. In conclusion, hospital admissions for meningococcal disease are costly to payers. These costs are heightened when non-facility services and post-discharge care are also considered. Awareness of the full cost burden of meningococcal disease is needed when evaluating vaccination programs targeting the disease.

  12. 38 CFR 14.665 - Claims.

    Science.gov (United States)

    2010-07-01

    ... writing on VA Form 2-4760, Employee's Claim for Reimbursement for Personal Property Damaged or Lost Incident to Employment. It will be submitted to the personnel office where the claim originates within 2... of the reasonable market value of the article or articles. (3) A statement as to any claims...

  13. 32 CFR 757.14 - Claims asserted.

    Science.gov (United States)

    2010-07-01

    ... of an insurance contract of the injured party. (2) Recovery may also be possible under State workers... Medical Care Recovery Act (MCRA) Claims and Claims Asserted Pursuant to 10 U.S.C. 1095 § 757.14 Claims... Government to non-Federal medical care providers. (e) Alternate theories of recovery. (1) Often,...

  14. 5 CFR 180.104 - Allowable claims.

    Science.gov (United States)

    2010-01-01

    ... mobile homes may be allowed only in cases of collision, theft, or vandalism. (5) Money. Claims for money... claimant's supervisor. (4) Mobile homes. Claims may be allowed for damage to or loss of mobile homes and their contents under the provisions of § 180.104(c)(2). Claims for structural damage to mobile...

  15. 14 CFR 1261.105 - Unallowable claims.

    Science.gov (United States)

    2010-01-01

    ... agency of the Government other than NASA. (d) Business property. Claims may not be allowed for property... property. Claims may not be allowed for worn-out unserviceable property. (g) Illegal possession. Claims may... (official Government business, as used here, does not include travel between quarters and place of...

  16. Classical databases and knowledge organization

    DEFF Research Database (Denmark)

    Hjørland, Birger

    2015-01-01

    examines this claim and argues for the continued value of Boolean systems, which suggests two further considerations: (1) the important role of human expertise in searching (expert searchers and “information literate” users) and (2) the role of library and information science and knowledge organization (KO......) in the design and use of classical databases. An underlying issue is the kind of retrieval system for which one should aim. Warner’s (2010) differentiation between the computer science traditions and an older library-oriented tradition seems important; the former aim to transform queries automatically...

  17. Perception of health claims among Nordic consumers

    DEFF Research Database (Denmark)

    Grunert, Klaus G.; Lähteenmäki, Liisa; Boztug, Yasemin

    2009-01-01

    . Claims were constructed from an underlying universe combining different active ingredients (familiar, unfamiliar), type of claim (combination of information about ingredient, physiological function and health benefit), framing (positive, negative) and use of qualifier (with, without 'may'). Across pairs......Health claim perception was investigated by a web-based instrument with a sample of 4612 respondents in the Nordic countries (Denmark, Finland, Iceland, Norway, Sweden). Respondents decided which of a pair of claims sounded better, was easier to understand, and was more convincing in their opinion......, the claims differed in the health benefit addressed (cardiovascular health, dementia, bodyweight). Results showed that respondents could be grouped into two roughly equally sized classes that differed in the type of claim preferred: one class prefers 'long' claims that give the full story consisting...

  18. Classical databases and knowledge organization

    DEFF Research Database (Denmark)

    Hjørland, Birger

    2015-01-01

    This paper considers classical bibliographic databases based on the Boolean retrieval model (such as MEDLINE and PsycInfo). This model is challenged by modern search engines and information retrieval (IR) researchers, who often consider Boolean retrieval a less efficient approach. The paper...... examines this claim and argues for the continued value of Boolean systems, which suggests two further considerations: (1) the important role of human expertise in searching (expert searchers and “information literate” users) and (2) the role of library and information science and knowledge organization (KO......) in the design and use of classical databases. An underlying issue is the kind of retrieval system for which one should aim. Warner’s (2010) differentiation between the computer science traditions and an older library-oriented tradition seems important; the former aim to transform queries automatically...

  19. A retrospective review over 1999 to 2007 of head, shoulder and knee soft tissue and fracture dislocation injuries and associated costs for rugby league in New Zealand.

    Science.gov (United States)

    King, D; Hume, P; Gianotti, S; Clark, T

    2011-04-01

    King et al. reported that of 5 941 moderate to serious claims resulting in medical treatment for rugby league injuries, the knee, shoulder, and head and neck body sites and soft tissue and fracture-dislocation injuries were most frequent and costly in the New Zealand national no-fault injury compensation corporation database during 1999 to 2007. However, additional analyses of knee, shoulder and head and neck body sites by soft tissue and fracture-dislocation injury types was required to enable a greater understanding of the nature of injuries most likely to be seen by sports medical personnel dealing with rugby league players. From 1999 to 2007 the injury claims and costs for head and neck soft tissue, fracture-dislocations, shoulders soft tissue significantly increased. Knee soft tissue injury claims and costs significantly decreased from 1999 to 2007. There was no significant difference in knee fracture-dislocation injury claims but there was a significant increase in knee fracture-dislocation injury costs from 1999 to 2007. Changes in the nature of injuries may be related to changes in defensive techniques employed in rugby league during this time. Sports medical personnel dealing with rugby league players should focus their injury prevention strategies on reducing musculoskeletal injuries to the head and shoulder. There should be a focus on increasing awareness of correct tackling technique, head injury awareness and management of suspected cervical spine injuries. © Georg Thieme Verlag KG Stuttgart · New York.

  20. An analysis of the warning letters issued by the FDA to pharmaceutical manufacturers regarding misleading health outcomes claims

    Directory of Open Access Journals (Sweden)

    Chatterjee S

    2012-12-01

    Full Text Available Objective: To evaluate the number and type of warning letters issued by the US Food and Drug Administration (FDA to pharmaceutical manufacturers for promotional violations.Methods: Two reviewers downloaded, printed and independently evaluated warning letters issued by the FDA to pharmaceutical manufacturers from years 2003-2008. Misleading claims were broadly classified as clinical, Quality-of-Life (QoL, and economic claims. Clinical claims included claims regarding unsubstantiated efficacy, safety and tolerability, superiority, broadening of indication and/or omission of risk information. QoL claims included unsubstantiated quality of life and/or health-related quality of life claims. Economic claims included any form of claim made on behalf of the pharmaceutical companies related to cost superiority of or cost savings from the drug compared to other drugs in the market.Results: In the 6-year study period, 65 warning letters were issued by FDA, which contained 144 clinical, three QoL, and one economic claim. On an average, 11 warning letters were issued per year. Omission of risk information was the most frequently violated claim (30.6% followed by unsubstantiated efficacy claims (18.6%. Warning letters were primarily directed to manufacturers of cardiovascular (14.6%, anti-microbial (14.6%, and CNS (12.5% drugs. Majority of the claims referenced in warning letters contained promotional materials directed to physicians (57%. Conclusion: The study found that misleading clinical outcome claims formed the majority of the promotional violations, and majority of the claims were directed to physicians. Since inadequate promotion of medications may lead to irrational prescribing, the study emphasizes the importance of disseminating reliable, credible, and scientific information to patients, and more importantly, physicians to protect public health.

  1. An analysis of the warning letters issued by the FDA to pharmaceutical manufacturers regarding misleading health outcomes claims.

    Science.gov (United States)

    Chatterjee, Satabdi; Patel, Harshali K; Sansgiry, Sujit S

    2012-10-01

    To evaluate the number and type of warning letters issued by the US Food and Drug Administration (FDA) to pharmaceutical manufacturers for promotional violations. Two reviewers downloaded, printed and independently evaluated warning letters issued by the FDA to pharmaceutical manufacturers from years 2003-2008. Misleading claims were broadly classified as clinical, Quality-of-Life (QoL), and economic claims. Clinical claims included claims regarding unsubstantiated efficacy, safety and tolerability, superiority, broadening of indication and/or omission of risk information. QoL claims included unsubstantiated quality of life and/or health-related quality of life claims. Economic claims included any form of claim made on behalf of the pharmaceutical companies related to cost superiority of or cost savings from the drug compared to other drugs in the market. In the 6-year study period, 65 warning letters were issued by FDA, which contained 144 clinical, three QoL, and one economic claim. On an average, 11 warning letters were issued per year. Omission of risk information was the most frequently violated claim (30.6%) followed by unsubstantiated efficacy claims (18.6%). Warning letters were primarily directed to manufacturers of cardiovascular (14.6%), anti-microbial (14.6%), and CNS (12.5%) drugs. Majority of the claims referenced in warning letters contained promotional materials directed to physicians (57%). The study found that misleading clinical outcome claims formed the majority of the promotional violations, and majority of the claims were directed to physicians. Since inadequate promotion of medications may lead to irrational prescribing, the study emphasizes the importance of disseminating reliable, credible, and scientific information to patients, and more importantly, physicians to protect public health.

  2. The estimated economic burden of genital herpes in the United States. An analysis using two costing approaches

    Directory of Open Access Journals (Sweden)

    Fisman David N

    2001-06-01

    Full Text Available Abstract Background Only limited data exist on the costs of genital herpes (GH in the USA. We estimated the economic burden of GH in the USA using two different costing approaches. Methods The first approach was a cross-sectional survey of a sample of primary and secondary care physicians, analyzing health care resource utilization. The second approach was based on the analysis of a large administrative claims data set. Both approaches were used to generate the number of patients with symptomatic GH seeking medical treatment, the average medical expenditures and estimated national costs. Costs were valued from a societal and a third party payer's perspective in 1996 US dollars. Results In the cross-sectional study, based on an estimated 3.1 million symptomatic episodes per year in the USA, the annual direct medical costs were estimated at a maximum of $984 million. Of these costs, 49.7% were caused by drug expenditures, 47.7% by outpatient medical care and 2.6% by hospital costs. Indirect costs accounted for further $214 million. The analysis of 1,565 GH cases from the claims database yielded a minimum national estimate of $283 million direct medical costs. Conclusions GH appears to be an important public health problem from the health economic point of view. The observed difference in direct medical costs may be explained with the influence of compliance to treatment and possible undersampling of subpopulations in the claims data set. The present study demonstrates the validity of using different approaches in estimating the economic burden of a specific disease to the health care system.

  3. Telehealth Delivery of Mental Health Services: An Analysis of Private Insurance Claims Data in the United States.

    Science.gov (United States)

    Wilson, Fernando A; Rampa, Sankeerth; Trout, Kate E; Stimpson, Jim P

    2017-09-01

    This study characterizes telehealth claims for mental health and substance abuse (MH/SA) services by using national private claims data. Telehealth-related mental health service claims were identified with private claims data from 2009 to 2013. These data-provided by the Health Care Cost Institute-included claims from Aetna, Humana, and UnitedHealth for more than 50 million individuals per year. In 2009-2013, there were 13,480 MH/SA telehealth provider claims out of 3,986,159 claims, with the majority of telehealth claims submitted by psychiatrists. For telehealth services, there was a decreasing trend for average reimbursements ($54.61 in 2009 to $43.28 in 2013). Average reimbursements for telehealth claims were half those for nontelehealth claims. Reimbursements for nine of the top 10 telehealth services were lower in 2015 dollars than for the same services provided during face-to-face treatment. Widespread adoption and use of costly telehealth technologies for mental health services may be limited by low reimbursements for telehealth services.

  4. Open Geoscience Database

    Science.gov (United States)

    Bashev, A.

    2012-04-01

    Currently there is an enormous amount of various geoscience databases. Unfortunately the only users of the majority of the databases are their elaborators. There are several reasons for that: incompaitability, specificity of tasks and objects and so on. However the main obstacles for wide usage of geoscience databases are complexity for elaborators and complication for users. The complexity of architecture leads to high costs that block the public access. The complication prevents users from understanding when and how to use the database. Only databases, associated with GoogleMaps don't have these drawbacks, but they could be hardly named "geoscience" Nevertheless, open and simple geoscience database is necessary at least for educational purposes (see our abstract for ESSI20/EOS12). We developed a database and web interface to work with them and now it is accessible at maps.sch192.ru. In this database a result is a value of a parameter (no matter which) in a station with a certain position, associated with metadata: the date when the result was obtained; the type of a station (lake, soil etc); the contributor that sent the result. Each contributor has its own profile, that allows to estimate the reliability of the data. The results can be represented on GoogleMaps space image as a point in a certain position, coloured according to the value of the parameter. There are default colour scales and each registered user can create the own scale. The results can be also extracted in *.csv file. For both types of representation one could select the data by date, object type, parameter type, area and contributor. The data are uploaded in *.csv format: Name of the station; Lattitude(dd.dddddd); Longitude(ddd.dddddd); Station type; Parameter type; Parameter value; Date(yyyy-mm-dd). The contributor is recognised while entering. This is the minimal set of features that is required to connect a value of a parameter with a position and see the results. All the complicated data

  5. The 1997 IDA Cost Research Symposium.

    Science.gov (United States)

    1997-07-01

    Indices IDA-26 Evaluation of Uniformed Services Treatment Facilities IDA-27 Evaluation of TRICARE Program Costs IDA-28 Financial Databases of...update the database. The financial databases for the original contractors will be updated and extended to include most recent data available. These data... financial databases for the shipyards initiated in last year’s study will be extended to most aspects of cost distribution and allocations in cost

  6. The 1996 IDA Cost Research Symposium.

    Science.gov (United States)

    1996-08-01

    Financial Databases of Defense Manufactures IDA-17 Private Shipbuilders Overhead Costs IDA-18 Economic Drivers of Defense Overhead Costs IDA-19...Sponsor: Financial Databases of Defense Manufactures The Weapon Systems Cost Analysis Division of PA&E is continually involved in both acquisition...extended to update the database. The financial databases for the original contractors will be updated and extended to include most recent data

  7. Some pain, no gain: experiences with the no-claim rebate in the Dutch health care system

    NARCIS (Netherlands)

    J. Holland; N.J.A. van Exel (Job); F.T. Schut (Erik); W.B.F. Brouwer (Werner)

    2009-01-01

    textabstractTo contain expenditures in an increasingly demand driven health care system, in 2005 a no-claim rebate was introduced in the Dutch health insurance system. Since demand-side cost sharing is a very controversial issue, the no-claim rebate was launched as a consumer friendly bonus system t

  8. 32 CFR 536.119 - Scope for maritime claims.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Scope for maritime claims. 536.119 Section 536.119 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES Maritime Claims § 536.119 Scope for maritime claims. The AMCSA applies worldwide and includes claims that arise on...

  9. The Direct Cost of Managing a Rare Disease: Assessing Medical and Pharmacy Costs Associated with Duchenne Muscular Dystrophy in the United States.

    Science.gov (United States)

    Thayer, Sarah; Bell, Christopher; McDonald, Craig M

    2017-06-01

    A Duchenne muscular dystrophy (DMD) cohort was identified using a claims-based algorithm to estimate health care utilization and costs for commercially insured DMD patients in the United States. Previous analyses have used broad diagnosis codes that include a range of muscular dystrophy types as a proxy to estimate the burden of DMD. To estimate DMD-associated resource utilization and costs in a sample of patients identified via a claims-based algorithm using diagnosis codes, pharmacy prescriptions, and procedure codes unique to DMD management based on DMD clinical milestones. DMD patients were selected from a commercially insured claims database (2000-2009). Patients with claims suggestive of a non-DMD diagnosis or who were aged 30 years or older were excluded. Each DMD patient was matched by age, gender, and region to controls without DMD in a 1:10 ratio (DMD patients n = 75; controls n = 750). All-cause health care resource utilization, including emergency department, inpatient, outpatient, and physician office visits, and all-cause health care costs were examined over a minimum 1-year period. Costs were computed as total health-plan and patient-paid amounts of adjudicated medical claims (in annualized U.S. dollars). The average age of the DMD cohort was 13 years. Patients in the DMD cohort had a 10-fold increase in health care costs compared with controls ($23,005 vs. $2,277, P costs were significantly higher for the DMD cohort across age strata and, in particular, for DMD patients aged 14-29 years ($40,132 vs. $2,746, P costs of DMD are substantial and increase with age. Funding for this study (GHO-10-4441) was provided by GlaxoSmithKline (GSK). Optum was contracted by GSK to conduct the study. Thayer was an employee of Optum Health Economics and Outcomes Research at the time of this study and was not compensated for her participation as an author of this manuscript. Bell is an employee and shareholder of GSK. McDonald has been a consultant for GSK, Sarepta

  10. Estimating medical costs of gastroenterological diseases

    Institute of Scientific and Technical Information of China (English)

    Li-Fang Chou

    2004-01-01

    AIM: To estimate the direct medical costs of gastroenterological diseases within the universal health insurance program among the population of local residents in Taiwan.METHODS: The data sources were the first 4 cohort datasets of 200 000 people from the National Health Insurance Research Database in Taipei. The ambulatory,inpatient and pharmacy claims of the cohort in 2001 were analyzed. Besides prevalence and medical costs of diseases,both amount and costs of utilization in procedures and drugs were calculated.RESULTS: Of the cohort with 183 976 eligible people, 44.2% had ever a gastroenterological diagnosis during the year.The age group 20-39 years had the lowest prevalence rate(39.2%) while the elderly had the highest (58.4%). The prevalence rate was higher in women than in men (48.5%vs. 40.0%). Totally, 30.4% of 14 888 inpatients had ever a gastroenterological diagnosis at discharge and 18.8% of 51 359 patients at clinics of traditional Chinese medicine had such a diagnosis there. If only the principal diagnosis on each daim was considered, 16.2% of admissions, 8.0% of outpatient visits, and 10.1% of the total medical costs (8 469 909 US dollars/83 830 239 US dollars) were attributed to gastroenterological diseases. On average, 46.0 US dollars per insured person in a year were spent in treating gastroenterological diseases.Diagnostic procedures related to gastroenterological diseases accounted for 24.2% of the costs for all diagnostic procedures and 2.3% of the total medical costs. Therapeutic procedures related to gastroenterological diseases accounted for 4.5% of the costs for all therapeutic procedures and 1.3% of thetotal medical costs. Drugs related to gastroenterological diseases accounted for 7.3% of the costs for all drugs and 1.9% of the total medical costs.CONCLUSION: Gastroenterological diseases are prevalent among the population of local residents in Taiwan, account ingfor a tenth of the total medical costs. Further investigations are needed to

  11. Risk Adjustment, Reinsurance Improved Financial Outcomes For Individual Market Insurers With The Highest Claims.

    Science.gov (United States)

    Jacobs, Paul D; Cohen, Michael L; Keenan, Patricia

    2017-04-01

    The Affordable Care Act (ACA) reformed the individual health insurance market. Because insurers can no longer vary their offers of coverage based on applicants' health status, the ACA established a risk adjustment program to equalize health-related cost differences across plans. The ACA also established a temporary reinsurance program to subsidize high-cost claims. To assess the impact of these programs, we compared revenues to claims costs for insurers in the individual market during the first two years of ACA implementation (2014 and 2015), before and after the inclusion of risk adjustment and reinsurance payments. Before these payments were included, for the 30 percent of insurers with the highest claims costs, claims (not including administrative expenses) exceeded premium revenues by $90-$397 per enrollee per month. The effect was reversed after these payments were included, with revenues exceeding claims costs by $0-$49 per month. The risk adjustment and reinsurance programs were relatively well targeted in the first two years. While there is ongoing discussion regarding the future of the ACA, our findings can shed light on how risk-sharing programs can address risk selection among insurers-a pervasive issue in all health insurance markets.

  12. Depression in Parents of Children Diagnosed with Autism Spectrum Disorder: A Claims-Based Analysis

    Science.gov (United States)

    Cohrs, Austin C.; Leslie, Douglas L.

    2017-01-01

    Previous studies showing that Autism Spectrum Disorder (ASD) in children can have secondary effects on the child's parents are limited by small sample sizes and parent self-report. We examined the odds of depression in parents of children with ASD compared to parents of children without ASD using a large national claims database. Mothers (OR 2.95,…

  13. EuroFIR eBASIS: application for health claims submissions and evaluations

    DEFF Research Database (Denmark)

    Kiely, M.; Black, L.J.; Plumb, J.;

    2010-01-01

    Background: The European Food Information Resource (EuroFIR) network has established the eBASIS (Bioactive Substances in Food Information System) online food composition and biological effects database for plant-derived bioactive compounds (phytochemicals). On the basis of submitted evidence......BASIS. Of the 222 defined article 14 claims, 21 pertain to plants or plant-based bioactive compounds, of which 19 are in eBASIS. Conclusions: There is extensive overlap between eBASIS and the submitted health claims that relate to plant-based bioactive compounds. EuroFIR eBASIS is a useful tool for regulators...... to independently check completeness of health claims applications relating to phytochemicals and is a potentially valuable resource to assist claimants in the compilation of dossiers on functional foods and health claims. European Journal of Clinical Nutrition (2010) 64, S101-S107; doi:10.1038/ejcn.2010.219...

  14. Probiotics and prebiotics: health claim substantiation

    OpenAIRE

    Salminen, Seppo; van Loveren, Henk

    2012-01-01

    ‘Probiotics’ and ‘prebiotics’ by definition should have health benefits. Health claims on microorganisms proposed as probiotics and probiotic stimulating agents (prebiotics) suggest that there is a relationship between the specific food and maintaining good health or that the food can reduce the risk of a disease. The Health Claim Regulation in European Union aims at a level consumer protection. Thereby, health claim assessment focuses on defining the probiotics and prebiotics, assessing the ...

  15. Why the European Food Safety Authority was right to reject health claims for probiotics.

    Science.gov (United States)

    Katan, M B

    2012-06-01

    Probiotics are microbes that are claimed to promote health and well-being when added to foods. However, the European Food Safety Authority (EFSA) has so far advised negatively about health claims for probiotics. Companies and scientists have protested against these rejections, sometimes in vigorous language. I argue that EFSA could not have acted differently, given EU regulations and the lack of convincing evidence for some of the claimed effects of probiotics on human health and well-being. One EU regulation that makes it hard to demonstrate the benefits of probiotics is the prohibition of medical claims, i.e. claims that a food prevents or cures a disease. If this prohibition did not exist, manufacturers of nutritional treatments might circumvent the costly procedures required for drugs, and market their products to ill people without thorough proof that they are effective and safe. However, the prohibition is also a legal fiction, because promotion of health and prevention of disease is largely the same thing. EFSA has recently indicated that it will allow health claims based on the ability of probiotics to reduce infections. To a certain extent, this abolishes the distinction between health claims and medical claims. It remains to be seen if probiotics producers can convince EFSA that their products prevent or cure infections and other diseases in humans.

  16. Determinants of consumer understanding of health claims

    DEFF Research Database (Denmark)

    Grunert, Klaus G; Scholderer, Joachim; Rogeaux, Michel

    2011-01-01

    as safe, risky or other. In addition to the open questions on claim understanding, respondents rated a number of statements on claim interpretation for agreement and completed scales on interest in healthy eating, attitude to functional foods, and subjective knowledge on food and health. Results showed...... that respondents with a positive attitude to functional foods are more likely to be classified as riskywith regard to their claim understanding, whereas respondents with negative or neutral attitudes are more likely to be classified into the other category. Implications for testing claim understanding...

  17. Knowledge Discovery from Massive Healthcare Claims Data

    Energy Technology Data Exchange (ETDEWEB)

    Chandola, Varun [ORNL; Sukumar, Sreenivas R [ORNL; Schryver, Jack C [ORNL

    2013-01-01

    The role of big data in addressing the needs of the present healthcare system in US and rest of the world has been echoed by government, private, and academic sectors. There has been a growing emphasis to explore the promise of big data analytics in tapping the potential of the massive healthcare data emanating from private and government health insurance providers. While the domain implications of such collaboration are well known, this type of data has been explored to a limited extent in the data mining community. The objective of this paper is two fold: first, we introduce the emerging domain of big"healthcare claims data to the KDD community, and second, we describe the success and challenges that we encountered in analyzing this data using state of art analytics for massive data. Specically, we translate the problem of analyzing healthcare data into some of the most well-known analysis problems in the data mining community, social network analysis, text mining, and temporal analysis and higher order feature construction, and describe how advances within each of these areas can be leveraged to understand the domain of healthcare. Each case study illustrates a unique intersection of data mining and healthcare with a common objective of improving the cost-care ratio by mining for opportunities to improve healthcare operations and reducing hat seems to fall under fraud, waste,and abuse.

  18. Menu Costs and Dynamic Duopoly

    OpenAIRE

    Kano, Kazuko

    2011-01-01

    Examining a state-dependent pricing model in the presence of menu costs and dynamic duopolistic interactions, this paper claims that the assumption regarding market structure is crucial for iden- tifying the menu costs for price changes. Prices in a dynamic duopolistic market can be more rigid than those in more competitive markets, such as a monopolistic-competition market. Therefore, the estimates of menu costs under monopolistic competition are potentially biased upward due to the price ri...

  19. First-year treatment costs among new initiators of topical prostaglandin analogs: pooled results

    Directory of Open Access Journals (Sweden)

    Jordana K Schmier

    2010-05-01

    Full Text Available Jordana K Schmier1, David W Covert21Managing Scientist, Exponent Inc., Alexandria, VA, USA; 2Associate Director, Health Economics, Alcon Research Ltd., Ft. Worth, TX, USAObjective: To estimate first-year treatment costs among new initiators of topical prostaglandin analogs in a managed care population.Research design and methods: A model was developed to estimate first-year medical costs. Model inputs were based on weighted results from three previous studies. Treatment patterns were derived from a claims database analysis. Published studies were used to estimate visit-related resource use. Costs were obtained from standard sources.Results: Across studies, 27,809 patients met study criteria, 44.2% of whom remained on their index therapy for 12 months. Adjunctive therapy was needed in 22.5%, 18.5%, and 11.9% of bimatoprost, latanoprost, and benzalkonium chloride (BAK-free travoprost patients, respectively. Median days to initiating adjunctive therapy were 64, 67, and 127 for bimatoprost, latanoprost, and BAK-free travoprost patients. Estimated first-year medical costs were $1,945, $1,803, and $1,730 for patients initiating therapy with bimatoprost, latanoprost, and BAK-free travoprost. Findings were consistent through sensitivity analysis.Conclusions: A BAK-free prostaglandin analog may permit longer duration of monotherapy and be associated with lower first-year treatment costs. Use of a claims database and the selection of new initiators of prostaglandin analogs limit the ability to project findings to all glaucoma patients.Keywords: costs and cost analysis, drug therapy, combination, glaucoma, prostaglandin analogs

  20. Colorado's Voucher Law:Examining the Claim of Fiscal Neutrality

    Directory of Open Access Journals (Sweden)

    Kevin G. Welner

    2004-07-01

    Full Text Available Colorado's voucher law was declared unconstitutional by the Colorado Supreme Court on June 28, 2004. Voucher supporters have begun drafting revised legislation designed to address the legal problem. This article calls into question the key financial claim of revenue neutrality'a claim that was central to the promotion and passage of the departing voucher law. The author concludes that the voucher law was not revenue neutral, even though it attempts to exclude from eligibility those children already enrolled in private schools. In fact, this law, as well as any revised law with similar eligibility provisions, would actually cost taxpayers an additional $10 million per year once fully implemented because the eligibility provision provides little more than a short-term damper on the law's long-term fiscal impact.

  1. Healthcare costs of urinary tract infections and genital mycotic infections among patients with type 2 diabetes mellitus initiated on canagliflozin: a retrospective cohort study.

    Science.gov (United States)

    Amos, Tony B; Montejano, Leslie; Juneau, Paul; Bolge, Susan C

    2017-03-01

    To assess the economic impact of urinary tract infections (UTIs) and genital mycotic infections (GMIs) among patients with type 2 diabetes mellitus (T2DM) initiated on canagliflozin. Administrative claims data from April 2013 through June 2014 MarketScan(®) databases were extracted. Adults with ≥1 claim for canagliflozin, T2DM diagnosis, and ≥90 days enrollment before and after canagliflozin initiation were propensity score matched to controls with T2DM initiated on other anti-hyperglycemic agents (AHAs). UTI and GMI healthcare costs were evaluated 90-days post-index and reported as cohort means. Rates of UTI claims 90 days post-index were similar in patients receiving canagliflozin for T2DM (n = 31,257) and matched controls (2.7% vs 2.8%, p = .677). More canagliflozin than control patients had GMI claims (1.2% vs 0.6%, p canagliflozin patients vs matched controls ($27.61 vs $37.33, p = .150). GMI treatment costs were higher for the canagliflozin cohort ($3.68 vs $2.44, p = .041). Combined costs to treat either UTI and/or GMI averaged $31.29 per patient for the canagliflozin cohort v $39.77 for controls (p = .211). Rates and costs of UTIs and GMIs were higher for females than males, but the canagliflozin vs control trends observed for the overall sample were similar for both sexes. There were no significant cost differences between the canagliflozin and control cohorts among patients aged 18-64. Among patients aged 65 and above, GMI treatment costs were not significantly different, but costs to treat UTIs and either UTI and/or GMI were significantly lower for canagliflozin patients vs controls. In a real-world setting, the costs to payers of treating UTIs and GMIs are generally similar for patients with T2DM initiated on canagliflozin vs other AHAs.

  2. Database development and management

    CERN Document Server

    Chao, Lee

    2006-01-01

    Introduction to Database Systems Functions of a DatabaseDatabase Management SystemDatabase ComponentsDatabase Development ProcessConceptual Design and Data Modeling Introduction to Database Design Process Understanding Business ProcessEntity-Relationship Data Model Representing Business Process with Entity-RelationshipModelTable Structure and NormalizationIntroduction to TablesTable NormalizationTransforming Data Models to Relational Databases .DBMS Selection Transforming Data Models to Relational DatabasesEnforcing ConstraintsCreating Database for Business ProcessPhysical Design and Database

  3. 76 FR 36176 - Fully Developed Claim (Fully Developed Claims-Applications for Compensation, Pension, DIC, Death...

    Science.gov (United States)

    2011-06-21

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Fully Developed Claim (Fully Developed Claims--Applications for Compensation, Pension, DIC, Death Pension, and/or Accrued Benefits); Correction AGENCY: Veterans Benefits Administration, Department...

  4. Comparison of Two Data Mining Techniques in Labeling Diagnosis to Iranian Pharmacy Claim Dataset: Artificial Neural Network (ANN) Versus Decision Tree Model

    National Research Council Canada - National Science Library

    Ehsan Rezaei-Darzi; Farshad Farzadfar; Amir Hashemi-Meshkini; Iman Navidi; Mahmoud Mahmoudi; Mehdi Varmaghani; Parinaz Mehdipour; Mahsa Soudi Alamdari; Batool Tayefi; Shohreh Naderimagham; Fatemeh Soleymani; Alireza Mesdaghinia; Alireza Delavari; Kazem Mohammad

    2014-01-01

    .... A sample from a database consisting of 23 million pharmacy insurance claim records, from 2004 to 2011 was used, in which a total of 330 prescriptions were assessed and used to train and test the models simultaneously...

  5. Outcomes of medical malpractice claims in assisted reproductive technology over a 10-year period from a single carrier.

    Science.gov (United States)

    Letterie, Gerard

    2017-04-01

    Medical malpractice claims vary by specialty. Contributory factors to malpractice in reproductive endocrinology and infertility (REI) are not well defined. We sought to determine claims' frequency, basis of claims, and outcomes of settled claims in REI. This is a retrospective, descriptive review of 10 years of claims. The setting is private practices. Claims were monitored within one malpractice carrier between 2006 and 2015 covering 10 practices and 184,015 IVF cycles. Total claims, basis of claims, and indemnity paid were evaluated. There were 176 incidents resulting in 30 settled claims with indemnity payments in 21. Categories of claims settled included misdiagnosis (N = 4), lack of informed consent (N = 5), embryology errors (N = 8), and surgical complications (N = 4). Total and average awards were $15,062,000 and $717,238, respectively. Misdiagnosis and lack of informed consent had highest total award amount at $11,583,000 accounting for 76% of award dollars. The two highest awards were $4.5 million and $3.0 million for cancer and genetic misdiagnosis, respectively. Excluding these two awards, payments totaled $7,562,000, ranged from $6000 to $900,000 and averaged $170,363. Errors in handling of embryos were highest in frequency accounting for 38% of claims paid for a total of $1,593,000 with average payment of $199,188. Settlements for surgical complications totaled $1,855,000 and averaged $463,750 per claim. Misdiagnosis and lack of informed consent are the highest award categories. Embryology lab errors are the most frequent causes of claims with the lowest award per settlement. The average cost for claims settled is relatively high compared to settlements in other specialties.

  6. 45 CFR 304.15 - Cost allocation.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 2 2010-10-01 2010-10-01 false Cost allocation. 304.15 Section 304.15 Public... FEDERAL FINANCIAL PARTICIPATION § 304.15 Cost allocation. A State agency in support of its claims under title IV-D of the Social Security Act must have an approved cost allocation plan on file with...

  7. SmallSat Database

    Science.gov (United States)

    Petropulos, Dolores; Bittner, David; Murawski, Robert; Golden, Bert

    2015-01-01

    The SmallSat has an unrealized potential in both the private industry and in the federal government. Currently over 70 companies, 50 universities and 17 governmental agencies are involved in SmallSat research and development. In 1994, the U.S. Army Missile and Defense mapped the moon using smallSat imagery. Since then Smart Phones have introduced this imagery to the people of the world as diverse industries watched this trend. The deployment cost of smallSats is also greatly reduced compared to traditional satellites due to the fact that multiple units can be deployed in a single mission. Imaging payloads have become more sophisticated, smaller and lighter. In addition, the growth of small technology obtained from private industries has led to the more widespread use of smallSats. This includes greater revisit rates in imagery, significantly lower costs, the ability to update technology more frequently and the ability to decrease vulnerability of enemy attacks. The popularity of smallSats show a changing mentality in this fast paced world of tomorrow. What impact has this created on the NASA communication networks now and in future years? In this project, we are developing the SmallSat Relational Database which can support a simulation of smallSats within the NASA SCaN Compatability Environment for Networks and Integrated Communications (SCENIC) Modeling and Simulation Lab. The NASA Space Communications and Networks (SCaN) Program can use this modeling to project required network support needs in the next 10 to 15 years. The SmallSat Rational Database could model smallSats just as the other SCaN databases model the more traditional larger satellites, with a few exceptions. One being that the smallSat Database is designed to be built-to-order. The SmallSat database holds various hardware configurations that can be used to model a smallSat. It will require significant effort to develop as the research material can only be populated by hand to obtain the unique data

  8. 31 CFR 535.222 - Suspension of claims eligible for Claims Tribunal.

    Science.gov (United States)

    2010-07-01

    ... Iran, dated January 19, 1981, and all claims for equitable or other judicial relief in connection with... or counterclaim in any pending or subsequent judicial proceeding commenced by the Government of Iran... on a claim or part thereof shall operate as a final resolution and discharge of such claim or...

  9. 32 CFR 751.6 - Claims payable.

    Science.gov (United States)

    2010-07-01

    ... was not authorized for the convenience of the Government. The maximum payment authorized by the... not vandalism. The amount payable on vandalism claims is limited to the maximum payment authorized by...) Mobile homes and contents in shipment. Claims for damage to mobile homes and contents in shipment...

  10. 49 CFR 22.69 - Claim process.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Claim process. 22.69 Section 22.69 Transportation Office of the Secretary of Transportation SHORT-TERM LENDING PROGRAM (STLP) Loan Administration § 22.69 Claim process. After reasonable efforts have been exhausted to collect on a delinquent debt,...

  11. 32 CFR 279.4 - Claims process.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Claims process. 279.4 Section 279.4 National... RETROACTIVE STOP LOSS SPECIAL PAY COMPENSATION § 279.4 Claims process. (a) The last day for submission of... members may not be knowledgeable of the process and will require additional assistance after filing...

  12. Perception of health claims among Nordic consumers

    DEFF Research Database (Denmark)

    Grunert, Klaus G.; Lähteenmäki, Liisa; Boztug, Yasemin;

    2009-01-01

    Health claim perception was investigated by a web-based instrument with a sample of 4612 respondents in the Nordic countries (Denmark, Finland, Iceland, Norway, Sweden). Respondents decided which of a pair of claims sounded better, was easier to understand, and was more convincing in their opinio...

  13. 27 CFR 24.29 - Claims.

    Science.gov (United States)

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Claims. 24.29 Section 24.29 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS WINE Administrative and Miscellaneous Provisions Authorities § 24.29 Claims....

  14. 16 CFR 460.22 - Tax claims.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Tax claims. 460.22 Section 460.22 Commercial Practices FEDERAL TRADE COMMISSION TRADE REGULATION RULES LABELING AND ADVERTISING OF HOME INSULATION § 460.22 Tax claims. Do not say or imply that your product qualifies for a tax benefit unless it is true....

  15. 16 CFR 460.19 - Savings claims.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Savings claims. 460.19 Section 460.19 Commercial Practices FEDERAL TRADE COMMISSION TRADE REGULATION RULES LABELING AND ADVERTISING OF HOME INSULATION § 460.19 Savings claims. (a) If you say or imply in your ads, labels, or other...

  16. 16 CFR 460.21 - Government claims.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Government claims. 460.21 Section 460.21 Commercial Practices FEDERAL TRADE COMMISSION TRADE REGULATION RULES LABELING AND ADVERTISING OF HOME INSULATION § 460.21 Government claims. Do not say or imply that a government agency uses,...

  17. A Claim of Falsification of History.

    Science.gov (United States)

    Kirman, Joseph M.

    1994-01-01

    Presents excerpts from the draft Statement of Claim filed by Canadian World War II veterans against the Canadian Broadcasting Corporation and others associated with the making of the documentary series, "The Valour and the Horror." Includes an overview and two examples of what the plaintiffs claimed were historical errors. (CFR)

  18. 32 CFR 1659.1 - Claims.

    Science.gov (United States)

    2010-07-01

    ... Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM EXTRAORDINARY EXPENSES OF REGISTRANTS § 1659.1 Claims. (a) Claims for payment of actual and reasonable expenses of: (1) Emergency medical care, including hospitalization of registrants who suffer illness or injury; and (2) The...

  19. CLAIM HEDGING IN AN INCOMPLETE MARKET

    Institute of Scientific and Technical Information of China (English)

    SUN Wangui; WANG Chunfeng

    2005-01-01

    In this paper,we compare the performance of the optimal attainable payoffs (of a general claim) derived by the variance-optimal approach and the indifference argument under the mean-variance preference in an incomplete market.Both payoffs are expressed by the signed variance-optimal martingale measure.Our results are applied to the claim hedging under partial information.

  20. 24 CFR 17.43 - Allowable claims.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Allowable claims. 17.43 Section 17.43 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development..., superior authority. (6) Clothing and accessories. Claims may be allowed for damage to, or loss of, clothing...

  1. Forecasting claims in motor vehicle insurance

    NARCIS (Netherlands)

    Berridge, S.J.

    1998-01-01

    The forecasting of claims is central to the successful operation of an insurance company. Based on six years of claim and policy data for full cover car insurance from a major New Zealand insurance company, we set premiums for rating categories using a simple credibility method, a modified credibili

  2. Forecasting claims in motor vehicle insurance

    NARCIS (Netherlands)

    Berridge, S.J.

    1998-01-01

    The forecasting of claims is central to the successful operation of an insurance company. Based on six years of claim and policy data for full cover car insurance from a major New Zealand insurance company, we set premiums for rating categories using a simple credibility method, a modified credibili

  3. Optimal claim behaviour for vehicle damage insurances

    NARCIS (Netherlands)

    N.P. Dellaert (Nico); J.B.G. Frenk (Hans); L.P. van Rijsoort

    1993-01-01

    textabstractIn this paper we analyse the optimal claim behaviour of a risk sensitive policy holder having a vehicle damage insurance. It is proved that the optimal decision is of the form: to claim for damages only if its amount exceeds a certain limit. Moreover, we also derive the optimal stopping

  4. Psychotropic medication claims among religious clergy.

    Science.gov (United States)

    Frenk, Steven M; Mustillo, Sarah A; Foy, Steven L; Arroyave, Whitney D; Hooten, Elizabeth G; Lauderback, Kari H; Meador, Keith G

    2013-03-01

    This study examined psychotropic medication claims in a sample of Protestant clergy. It estimated the proportion of clergy in the sample who had a claim for psychotropic medication (i.e., anti-depressants and anxiolytics) in 2005 and examined associations between sociodemographic characteristics, occupational distress and having a claim. Protestant clergy (n = 749) from nine denominations completed a mail survey and provided access to their pharmaceutical records. Logistic regression models assessed the effect of sociodemographic characteristics and occupational distress on having a claim. The descriptive analysis revealed that 16 % (95 % Confidence interval [CI] 13.3 %-18.5 %) of the clergy in the sample had a claim for psychotropic medication in 2005 and that, among clergy who experienced frequent occupational distress, 28 % (95 % CI 17.5 %-37.5 %) had a claim. The regression analysis found that older clergy, female clergy, and those who experienced frequent occupational distress were more likely to have a claim. Due to recent demographic changes in the clergy population, including the increasing mean age of new clergy and the growing number of female clergy, the proportion of clergy having claims for psychotropic medication may increase in the coming years. To the best of our knowledge, this is the first study to examine the use of psychotropic medication among clergy.

  5. 33 CFR 136.107 - Subrogated claims.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Subrogated claims. 136.107 Section 136.107 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED... PROCEDURES; DESIGNATION OF SOURCE; AND ADVERTISEMENT General Procedure § 136.107 Subrogated claims. (a)...

  6. 22 CFR 213.5 - Fraud claims.

    Science.gov (United States)

    2010-04-01

    ... of the debtor or any party having an interest in the claim to the USAID Office of Inspector General... the Department of Justice (DOJ), and/or returning it to the CFO for further action. (b) The CFO will... presentation of a false claim or misrepresentation on the part of the debtor or any party having an interest...

  7. Databases and their application

    NARCIS (Netherlands)

    E.C. Grimm; R.H.W Bradshaw; S. Brewer; S. Flantua; T. Giesecke; A.M. Lézine; H. Takahara; J.W.,Jr Williams

    2013-01-01

    During the past 20 years, several pollen database cooperatives have been established. These databases are now constituent databases of the Neotoma Paleoecology Database, a public domain, multiproxy, relational database designed for Quaternary-Pliocene fossil data and modern surface samples. The poll

  8. Comparison of resource use by COPD patients on inhaled therapies with long-acting bronchodilators: a database study

    Directory of Open Access Journals (Sweden)

    Kozma Chris M

    2011-12-01

    Full Text Available Abstract Background The purpose of this analysis was to compare health care costs and utilization among COPD patients who had long-acting beta-2 agonist (LABA OR long-acting muscarinic antagonist (LAMA; LABA AND LAMA; or LABA, LAMA, AND inhaled corticosteroid (ICS prescription claims. Methods This was a 12 month pre-post, retrospective analysis using COPD patients in a national administrative insurance database. Propensity score and exact matching were used to match patients 1:1:1 between the LABA or LAMA (formoterol, salmeterol, or tiotropium, LABA and LAMA (tiotropium/formoterol or tiotropium/salmeterol, and LABA, LAMA and ICS (bronchodilators plus steroid groups. Post-period comparisons were evaluated with analysis of covariance. Costs were evaluated from a commercial payer perspective. Results A total of 523 patients were matched using 29 pre-period variables (e.g., demographics, medication exposure. Post-match assessments indicated balance among the cohorts. COPD-related costs differed among groups (LABA or LAMA $2,051 SE = 91; LABA and LAMA $2,823 SE = 62; LABA, LAMA and ICS $3,546 SE = 89; all p Conclusions Significant cost differences driven mainly by pharmaceuticals were observed among LABA or LAMA, LABA and LAMA and LABA, LAMA and ICS therapies. A COPD-related cost offset was observed from single bronchodilator to two bronchodilators. Addition of an ICS with two bronchodilators resulted in higher treatment costs without reduction in other COPD-related costs compared with two bronchodilators.

  9. A longitudinal analysis of costs associated with change in disease activity in systemic lupus erythematosus.

    Science.gov (United States)

    Kan, Hong; Guerin, Annie; Kaminsky, Michael S; Yu, Andrew P; Wu, Eric Q; Denio, Alfred; Priti, Jhingran; Narayanan, Siva; Molta, Charles

    2013-01-01

    To estimate the economic consequences of changes in disease activity on healthcare resource utilization (HRU) and costs. A retrospective longitudinal study of systemic lupus erythematosus (SLE) patients receiving care in a regional integrated health delivery system in the US from 01/2004 through 03/2011 was conducted using electronic health records, medical chart reviews, and claims. Eligible patients were ≥18 years old, with ≥1 rheumatologist-confirmed SLE diagnosis and ≥1 eligible rheumatology encounter. Patients were continuously enrolled ≥90 days before and ≥30 days after the encounters. Charts were manually reviewed to estimate SLEDAI scores. Average unit costs of each medical procedure, facility use, and prescription were estimated from a payer perspective (2011 USD) using a managed care claims database. HRU and costs were calculated for the 30-day period surrounding every SLEDAI score date (10 days before and 19 after). Relationships between HRU/costs and SLEDAI scores were estimated using mixed-effect models. Overall, 178 SLE patients were included; mean age was 50.6 years, 91% were female, and 95.5% Caucasian. Patients had a total of 1343 encounters with SLEDAI scores over an average period of 1035 days. Reductions of SLEDAI scores were associated with reductions in HRU and costs. SLEDAI score reductions of 4-points were associated with reductions of 10% HRU and 14% costs over a 30-day period; reductions of 8-points had associated reductions of 19% HRU and 26% costs; and reductions of 10-points had associated reductions of 23% HRU and 31% costs. Annualized, changes in SLEDAI scores are associated with changes of $2485 (SLEDAI score change: 10-6), $4624 (10-2), and $5579 (10-0), respectively. Reductions in disease activity were associated with substantial reductions of HRU and costs. Only short-term effects of disease activity change were investigated, disregarding other potential benefits of low disease activity on long-term organ damage

  10. A cost-effectiveness analysis to illustrate the impact of cost definitions on results, interpretations and comparability of pharmacoeconomic studies in the US.

    Science.gov (United States)

    Tunis, Sandra L

    2009-01-01

    There is a lack of a uniform proxy for defining direct medical costs in the US. This potentially important source of variation in modelling and other types of economic studies is often overlooked. The extent to which increased expenditures for an intervention can be offset by reductions in subsequent service costs can be directly related to the choice of cost definitions. To demonstrate how different cost definitions for direct medical costs can impact results and interpretations of a cost-effectiveness analysis. The IMS-CORE Diabetes Model was used to project the lifetime (35-year) cost effectiveness in the US of one pharmacological intervention 'medication A' compared with a second 'medication B' (both unspecified) for type 2 diabetes mellitus. The complications modelled included cardiovascular disease, renal disease, eye disease and neuropathy. The model had a Markov structure with Monte Carlo simulations. Utility values were derived from the published literature. Complication costs were obtained from a retrospective database study that extracted anonymous patient-level data from (primarily private payer) adjudicated medical and pharmaceutical claims. Costs for pharmacy services, outpatient services and inpatient hospitalizations were included. Cost definitions for complications included charged, allowed and paid amounts, and for medications included both wholesale acquisition cost (WAC) and average wholesale price (AWP). Costs were reported in year 2007 values. The cost-effectiveness results differed according to the particular combination of cost definitions employed. The use of charges greatly increased costs for complications. When the analysis incorporated WAC medication prices with charged amounts for complication costs, the incremental cost-effectiveness ratio (ICER) for medication A versus medication B was $US6337 per QALY. When AWP prices were used with charged amounts, medication A became a dominant treatment strategy, i.e. lower costs with greater

  11. Medical cost impact of intrathecal drug delivery for noncancer pain.

    Science.gov (United States)

    Guillemette, Scott; Witzke, Susan; Leier, Jacqueline; Hinnenthal, Jennifer; Prager, Joshua P

    2013-04-01

    As healthcare budgets continue to contract, there is increased payer scrutiny on the use of implantable intrathecal drug-infusion devices. This study utilizes claims data to evaluate the economic effects of intrathecal drug delivery (IDD) based on health services utilization and costs of care before and after implantation. We performed a retrospective database study involving 555 noncancer pain patients that received an IDD system implant within a 3-year service period (1/2006-1/2009). IDD patient costs were temporally aligned to implant month and repriced to a standardized, national pricing schedule over a 6-year episode cycle (3 years preimplant, implant month, and 3 years postimplant). Additionally, we made an actuarial projection of postimplant experience, in the absence of IDD intervention, simulating a conventional pain therapy (CPT) protocol by assuming the same slope in costs prior to implantation at standardized, national price levels. Cost projections were produced over a 30-year time horizon at various reimplantation rates. IDD therapy was less costly than the CPT protocol over our baseline implantation cycle. Costs in the month of IDD implantation, and in the year following, are cumulatively $17,317 more than the CPT protocol; however, IDD financial break-even occurs soon after the second year postimplant. The lifetime analysis indicates that IDD per patient per year savings is $3,111 compared with CPT. The authors found that patients receiving an implantable IDD system may experience reduced cumulative future medical costs relative to anticipated costs in the absence of receiving IDD. This finding complements published literature on the cost-effectiveness of IDD. Wiley Periodicals, Inc.

  12. Dietary Supplement Ingredient Database

    Science.gov (United States)

    ... and US Department of Agriculture Dietary Supplement Ingredient Database Toggle navigation Menu Home About DSID Mission Current ... values can be saved to build a small database or add to an existing database for national, ...

  13. 42 CFR 456.722 - Electronic claims management system.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Electronic claims management system. 456.722... Electronic Claims Management System for Outpatient Drug Claims § 456.722 Electronic claims management system... electronic claims management (ECM) system to perform on-line, real-time (that is, immediate)...

  14. NoSQL Databases

    OpenAIRE

    2013-01-01

    This thesis deals with database systems referred to as NoSQL databases. In the second chapter, I explain basic terms and the theory of database systems. A short explanation is dedicated to database systems based on the relational data model and the SQL standardized query language. Chapter Three explains the concept and history of the NoSQL databases, and also presents database models, major features and the use of NoSQL databases in comparison with traditional database systems. In the fourth ...

  15. USAID Anticorruption Projects Database

    Data.gov (United States)

    US Agency for International Development — The Anticorruption Projects Database (Database) includes information about USAID projects with anticorruption interventions implemented worldwide between 2007 and...

  16. Collecting Taxes Database

    Data.gov (United States)

    US Agency for International Development — The Collecting Taxes Database contains performance and structural indicators about national tax systems. The database contains quantitative revenue performance...

  17. HEALTH INFO SANTE ANNUAL DEDUCTIBLE AND REIMBURSEMENT CLAIMS: HINTS FOR USE

    CERN Multimedia

    1999-01-01

    Information from the CHIS Board and the Personnel DivisionOne should bear in mind that the annual deductible is an amount (currently CHF 100) charged automatically by the Administrator of the scheme for every adult aged 18 and above. This is what happens: The amount is deducted annually for all medical services received over a calendar year.It is triggered by the date of the treatment and not by the date of the bill nor that of the reimbursement claim.In other words, if you receive medical treatment in December for the first time in a given year, the CHF 100 will be deducted from the claim for that treatment. So, except for urgent cases, it would be better to wait till the following month, thus avoiding one annual deductible.It is also worth remembering that the cost of processing our reimbursement claims - and there were 55, 000 in 1998 - is part of the cost of our insurance.Help keep administrative costs down : do not submit reimbursement claims for amounts less than the annual deductible unless your claims...

  18. 33 CFR 25.109 - Insurance and other subrogated claims.

    Science.gov (United States)

    2010-07-01

    ... single claim. The total award of combined claims may not exceed the monetary jurisdiction of the... of insurance; (3) The policy number; (4) Whether a claim has been or will be presented to an insurer...

  19. Maize microarray annotation database

    Directory of Open Access Journals (Sweden)

    Berger Dave K

    2011-10-01

    Full Text Available Abstract Background Microarray technology has matured over the past fifteen years into a cost-effective solution with established data analysis protocols for global gene expression profiling. The Agilent-016047 maize 44 K microarray was custom-designed from EST sequences, but only reporter sequences with EST accession numbers are publicly available. The following information is lacking: (a reporter - gene model match, (b number of reporters per gene model, (c potential for cross hybridization, (d sense/antisense orientation of reporters, (e position of reporter on B73 genome sequence (for eQTL studies, and (f functional annotations of genes represented by reporters. To address this, we developed a strategy to annotate the Agilent-016047 maize microarray, and built a publicly accessible annotation database. Description Genomic annotation of the 42,034 reporters on the Agilent-016047 maize microarray was based on BLASTN results of the 60-mer reporter sequences and their corresponding ESTs against the maize B73 RefGen v2 "Working Gene Set" (WGS predicted transcripts and the genome sequence. The agreement between the EST, WGS transcript and gDNA BLASTN results were used to assign the reporters into six genomic annotation groups. These annotation groups were: (i "annotation by sense gene model" (23,668 reporters, (ii "annotation by antisense gene model" (4,330; (iii "annotation by gDNA" without a WGS transcript hit (1,549; (iv "annotation by EST", in which case the EST from which the reporter was designed, but not the reporter itself, has a WGS transcript hit (3,390; (v "ambiguous annotation" (2,608; and (vi "inconclusive annotation" (6,489. Functional annotations of reporters were obtained by BLASTX and Blast2GO analysis of corresponding WGS transcripts against GenBank. The annotations are available in the Maize Microarray Annotation Database http://MaizeArrayAnnot.bi.up.ac.za/, as well as through a GBrowse annotation file that can be uploaded to

  20. Modern utilization of penile prosthesis surgery: a national claim registry analysis.

    Science.gov (United States)

    Segal, R L; Camper, S B; Burnett, A L

    2014-01-01

    The objective of this study was to evaluate the modern utilization of penile prosthesis surgery based on data derived from national claim databases and contrast to an analysis of patients similarly treated at an academic center during a contemporaneous period. A retrospective claim analysis utilizing a national database (MarketScan, Thomson Reuters) was performed for Commercial insurer and Medicare databases between January 2000 and March 2011. A retrospective analysis of contemporaneous penile prosthesis implantation at the Johns Hopkins Hospital (JHH) was done. Population demographics, comorbidities, previous (ED) therapies and time from ED diagnosis to surgery were assessed. Median ages for patients undergoing penile prosthesis implantation were 58, 70 and 63 years for the Commercial, Medicare and JHH cohorts, respectively. For the claim databases (Commercial, Medicare, respectively), hypertension (72%, 78%), dyslipidemia (71%, 56%) and diabetes mellitus (45%, 40%) were predominant comorbidities, whereas for the JHH database prostate cancer (51%) and its management by prostatectomy (45%) or radiation (12%) were predominant. Previous use of PDE5 inhibitors was similar across databases (60, 58 and 69% for Commercial, Medicare and JHH cohorts, respectively), although previous use of non-oral ED therapies was greater in the JHH database. Median time to surgery from initial ED diagnosis was 2, 2 and 4 years for the Commercial, Medicare and JHH patients, respectively. Demographic variables and ED risk factors associated with penile prosthesis surgery at a national population-based level over a contemporary period were defined. Some differences in utilization trends of penile prosthesis surgery exist at a single institutional level.

  1. 75 FR 8105 - Alaska Native Claims Selection

    Science.gov (United States)

    2010-02-23

    ... Native Claims Settlement Act will be issued to NANA Regional Corporation, Inc., Successor in Interest to... these lands will also be conveyed to NANA Regional Corporation, Inc. when the surface estate is...

  2. FDA Warns About Stem Cell Claims

    Science.gov (United States)

    ... Home For Consumers Consumer Updates FDA Warns About Stem Cell Claims Share Tweet Linkedin Pin it More sharing ... blood-forming system. back to top Regulation of Stem Cells FDA regulates stem cells in the U.S. to ...

  3. Must Metaethical Realism Make a Semantic Claim?

    Science.gov (United States)

    Kahane, Guy

    2013-02-01

    Mackie drew attention to the distinct semantic and metaphysical claims made by meta ethical realists, arguing that although our evaluative discourse is cognitive and objective, there are no objective evaluative facts. This distinction, however, also opens up a reverse possibility: that our evaluative discourse is antirealist, yet objective values do exist. I suggest that this seemingly far-fetched possibility merits serious attention; realism seems com mitted to its intelligibility, and, despite appearances, it isn't incoherent, ineffable, inherently implausible or impossible to defend. I argue that reflection on this possibility should lead us to revise our understanding of the debate between realists and antirealists. It is not only that the realist's semantic claim is insufficient for realism to be true, as Mackie argued; it's not even necessary. Robust metaethical realism is best understood as making a purely metaphysical claim. It is thus not enough for antirealists to show that our discourse is antirealist. They must directly attack the realist's metaphysical claim.

  4. Basic Stand Alone Medicare Inpatient Claims PUF

    Data.gov (United States)

    U.S. Department of Health & Human Services — This release contains the Basic Stand Alone (BSA) Inpatient Public Use Files (PUF) named CMS 2008 BSA Inpatient Claims PUF with information from 2008 Medicare...

  5. Cost of Outpatient Arthroscopic Anterior Cruciate Ligament Reconstruction Among Commercially Insured Patients in the United States, 2005-2013

    Science.gov (United States)

    Herzog, Mackenzie M.; Marshall, Stephen W.; Lund, Jennifer L.; Pate, Virginia; Spang, Jeffrey T.

    2017-01-01

    Background: Despite the significance of anterior cruciate ligament (ACL) injuries, these conditions have been under-researched from a population-level perspective. It is important to determine the economic effect of these injuries in order to document the public health burden in the United States. Purpose: To describe the cost of outpatient arthroscopic ACL reconstruction and health care utilization among commercially insured beneficiaries in the United States. Study Design: Economic and decision analysis; Level of evidence, 3. Methods: The study used the Truven Health Analytics MarketScan Commercial Claims and Encounters database, an administrative claims database that contains a large sample (approximately 148 million) of privately insured individuals aged <65 years and enrolled in employer-sponsored plans. All claims with Current Procedural Terminology (CPT) code 29888 (arthroscopically aided ACL reconstruction or augmentation) from 2005 to 2013 were included. “Immediate procedure” cost was computed assuming a 3-day window of care centered on date of surgery. “Total health care utilization” cost was computed using a 9-month window of care (3 months preoperative and 6 months postoperative). Results: There were 229,446 outpatient arthroscopic ACL reconstructions performed over the 9-year study period. Median immediate procedure cost was $9399.49. Median total health care utilization cost was $13,403.38. Patients who underwent concomitant collateral ligament (medial [MCL], lateral [LCL]) repair or reconstruction had the highest costs for both immediate procedure ($12,473.24) and health care utilization ($17,006.34). For patients who had more than 1 reconstruction captured in the database, total health care utilization costs were higher for the second procedure than the first procedure ($16,238.43 vs $15,000.36), despite the fact that immediate procedure costs were lower for second procedures ($8685.73 vs $9445.26). Conclusion: These results provide a

  6. Nutrition and health claims as marketing tools.

    Science.gov (United States)

    van Buul, Vincent J; Brouns, Fred J P H

    2015-01-01

    European regulations mandate that only substantiated and approved statements can be used as nutrition- and health-related claims in food marketing. A thorough understanding of consumer perceptions of these approved claims is needed to assess their impact on both the purchase intention of functional foods and the development of innovative functional food concepts. In this paper, a conceptual framework on the European consumers' perception of nutrition and health claims on these functional foods is proposed. Through a literature review, common independent variables are structured, and an analysis of these variables shows that nutrition and health claims are mostly only perceived positive by specific target consumers (who need the product, accept the ingredient, understand the benefit, and trust the brand). These consumers indicate that the products with substantiated and approved claims help them in reaching overall health goals. This increased expectation in functional efficacy may mediate an increase in repurchase intent, overall liking, and the amount consumers are willing to spend. Other consumers, however, may have adverse reactions towards nutrition and health claims on functional foods. Implications for the consumer and the industry are discussed.

  7. Trajectories of health care service utilization and differences in patient characteristics among adults with specific chronic pain: analysis of health plan member claims

    Directory of Open Access Journals (Sweden)

    Ruetsch C

    2013-02-01

    Full Text Available Charles Ruetsch,1 Joseph Tkacz,1 Peter G Kardel,1 Andrew Howe,2 Helen Pai,2 Bennett Levitan31Health Analytics, LLC, Columbia, Maryland, 2Janssen Research & Development, Raritan, New Jersey, 3Janssen Research & Development, Titusville, New Jersey, USAIntroduction: The lack of consistency surrounding the diagnosis of chronic non-cancer pain, treatment approaches, and patient management suggests the need for further research to better characterize the chronic non-cancer pain population.Objective: The purpose of this study was to identify distinct trajectories of health care service utilization of chronic non-cancer pain patients and describe the characteristic differences between trajectory groups.Patients and methods: This study utilized the MarketScan claims databases. A total of 71,392 patients diagnosed with either low back pain or osteoarthritis between 2006 and 2009 served as the study sample. Each subject's claims data were divided into three time periods around an initial diagnosis date: pre-period, post-Year 1, and post-Year 2. Subjects were categorized as either high (H or low (L cost at each post period, resulting in the creation of four trajectory groups based on the post-Year 1 and 2 cost pattern: H-H, H-L, L-H, and L-L. Multivariate statistical tests were used to predict and discriminate between trajectory group memberships.Results: The H-H, L-H, and H-L groups each utilized significantly greater pre-period high-cost venue services, post-Year 1 outpatient services, and post-Year 1 opioids compared to the L-L group (P <0.001. Additionally, the H-H and L-H groups displayed elevated Charlson comorbidity index scores compared with the L-L group (P <0.001, with each showing increased odds of having both opioid dependence and cardiovascular disease diagnoses (P <0.01.Conclusion: This study identified patient characteristics among chronic pain patients that discriminated between different levels of post-index high-cost venue service

  8. Nuclear Concrete Materials Database Phase I Development

    Energy Technology Data Exchange (ETDEWEB)

    Ren, Weiju [ORNL; Naus, Dan J [ORNL

    2012-05-01

    The FY 2011 accomplishments in Phase I development of the Nuclear Concrete Materials Database to support the Light Water Reactor Sustainability Program are summarized. The database has been developed using the ORNL materials database infrastructure established for the Gen IV Materials Handbook to achieve cost reduction and development efficiency. In this Phase I development, the database has been successfully designed and constructed to manage documents in the Portable Document Format generated from the Structural Materials Handbook that contains nuclear concrete materials data and related information. The completion of the Phase I database has established a solid foundation for Phase II development, in which a digital database will be designed and constructed to manage nuclear concrete materials data in various digitized formats to facilitate electronic and mathematical processing for analysis, modeling, and design applications.

  9. A review of workers' compensation claims: the frequency of claim denial and medical treatment delay.

    Science.gov (United States)

    Kelley, C R; Amparo, J M

    2000-01-01

    A retrospective chart review of 257 patients who presented between January to March 1998, was conducted to identify the frequency of workers' compensation claim denial among patients who reported to Straub Clinic and Hospital. Results showed that 12.8% of claims were either "denied" or temporarily "denied pending investigation". Analysis of all the claims found that only 2% resulted in delayed medical care. Further analysis of the denied claims revealed the vast majority of claims (78.8%) were denied because the medical provider and the patient had incorrect workers' compensation carrier information. Other independent variables studied (size of the employer, category of employer, injury type, status of case, length of case and number of visits) did not predict either denial of the claim or treatment delay. This study suggests that the efficiency of our State's Workers' Compensation system would be greatly improved by developing a system to provide medical care providers with accurate insurance information.

  10. Resource use and cost of care with biologicals in Crohn's disease in South Africa: a retrospective analysis from a payer perspective.

    Science.gov (United States)

    Miot, Jacqui; Smith, Susan; Bhimsan, Niri

    2016-08-01

    Background Crohn's disease is a relapsing remitting inflammatory disease of the gastrointestinal tract. Treatment may require expensive biological therapy in severe patients. Affordability of the high cost anti-TNF-α agents has raised concern although evidence suggests cost-offsets can be achieved. There is little information on the resource utilisation of Crohn's patients in low and middle income countries. Objective The objective of this study is to investigate the resource utilisation and costs associated with biologicals treatment of Crohn's disease. Setting The setting for this study is in private healthcare in South Africa from a payer perspective. Method A retrospective longitudinal analysis of an administrative claims database from a large private healthcare insurer of patients who had at least 1 year claims exposure prior to starting biologicals and 2 years follow-up thereafter. Resource utilisation and costs including total Crohn's costs, hospital admissions and surgery, out of hospital costs, biologicals and chronic medicines were analysed. Main outcome measure The primary objective was to compare the change in resource utilisation and costs for Crohn's related conditions before and after starting biological treatment. Results A cohort of 72 patients was identified with a 35% (p = 0.005) reduction in Crohn's related costs (excluding the cost of biologicals) from ZAR 55,925 (U$5369) 1 year before compared to ZAR 36,293 (U$3484) 2 years after starting biological medicines. However, inclusion of the cost of biologicals more than doubled the total costs to ZAR 150,915 (±91,642) U$14,488 (±8798) in Year 2. Significant reductions in out-of hospital Crohn's related spend was also observed. Conclusions A reduction in healthcare costs is seen following starting biologicals in patients with moderate to severe Crohn's disease. However, the high cost of biological therapy outweighs any possible savings achieved in other areas of healthcare utilisation.

  11. European consumers and health claims: attitudes, understanding and purchasing behaviour

    National Research Council Canada - National Science Library

    Wills, Josephine M; Storcksdieck genannt Bonsmann, Stefan; Kolka, Magdalena; Grunert, Klaus G

    2012-01-01

    .... But do consumers understand and trust health claims? This paper provides an overview of recent research on consumers and health claims including attitudes, understanding and purchasing behaviour...

  12. Costs of tumor necrosis factor blockers per treated patient using real-world drug data in a managed care population.

    Science.gov (United States)

    Schabert, Vernon F; Watson, Crystal; Joseph, George J; Iversen, Paige; Burudpakdee, Chakkarin; Harrison, David J

    2013-10-01

    Several anti-inflammatory biologic medications are available in the United States for the treatment of moderate-to-severe rheumatoid arthritis, moderate-to-severe psoriasis, psoriatic arthritis, or ankylosing spondylitis. The tumor necrosis factor (TNF) blockers etanercept, adalimumab, and infliximab are approved for use in adults with any of these conditions, but predicting the annual costs of TNF-blocker treatment is complex due to differences in dosing schedules, treatment gaps, switching between TNF blockers, and dose escalation over time. To estimate the annual cost per treated patient from the payer perspective for etanercept, adalimumab, or infliximab in adults with rheumatoid arthritis, psoriasis, psoriatic arthritis, or ankylosing spondylitis. Adults in the IMS LifeLink Health Plan Claims Database were analyzed if they had at least 1 claim for etanercept, adalimumab, or infliximab between February 1, 2008, and July 5, 2010, and were continuously enrolled for at least 180 days before (pre-index period) through 360 days after the index claim (the first TNF-blocker claim after 6 months of continuous enrollment in the study period). Patients had a diagnosis of rheumatoid arthritis, psoriasis, psoriatic arthritis, or ankylosing spondylitis, or a combination of these conditions, in the pre-index period. Cost was based on dose and price using April 2012 wholesale acquisition cost. Costs of administration were included for the first subcutaneous dose (etanercept or adalimumab) for new patients and for every intravenous dose (infliximab). Total TNF-blocker drug and administration costs, including nonindex TNF-blocker costs among patients who switched treatments, were divided by number of patients to yield cost per treated patient for each index TNF blocker. Subgroup analyses included cost by condition and cost for patients who were new to TNF-blocker treatment (no index TNF-blocker claim in the pre-index period) or continuing TNF-blocker treatment. Of the 30

  13. Ontological interpretation of biomedical database content.

    Science.gov (United States)

    Santana da Silva, Filipe; Jansen, Ludger; Freitas, Fred; Schulz, Stefan

    2017-06-26

    Biological databases store data about laboratory experiments, together with semantic annotations, in order to support data aggregation and retrieval. The exact meaning of such annotations in the context of a database record is often ambiguous. We address this problem by grounding implicit and explicit database content in a formal-ontological framework. By using a typical extract from the databases UniProt and Ensembl, annotated with content from GO, PR, ChEBI and NCBI Taxonomy, we created four ontological models (in OWL), which generate explicit, distinct interpretations under the BioTopLite2 (BTL2) upper-level ontology. The first three models interpret database entries as individuals (IND), defined classes (SUBC), and classes with dispositions (DISP), respectively; the fourth model (HYBR) is a combination of SUBC and DISP. For the evaluation of these four models, we consider (i) database content retrieval, using ontologies as query vocabulary; (ii) information completeness; and, (iii) DL complexity and decidability. The models were tested under these criteria against four competency questions (CQs). IND does not raise any ontological claim, besides asserting the existence of sample individuals and relations among them. Modelling patterns have to be created for each type of annotation referent. SUBC is interpreted regarding maximally fine-grained defined subclasses under the classes referred to by the data. DISP attempts to extract truly ontological statements from the database records, claiming the existence of dispositions. HYBR is a hybrid of SUBC and DISP and is more parsimonious regarding expressiveness and query answering complexity. For each of the four models, the four CQs were submitted as DL queries. This shows the ability to retrieve individuals with IND, and classes in SUBC and HYBR. DISP does not retrieve anything because the axioms with disposition are embedded in General Class Inclusion (GCI) statements. Ambiguity of biological database content is

  14. 47 CFR 69.120 - Line information database.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Line information database. 69.120 Section 69...) ACCESS CHARGES Computation of Charges § 69.120 Line information database. (a) A charge that is expressed... from a local exchange carrier database to recover the costs of: (1) The transmission facilities...

  15. Direct and indirect cost burden associated with multiple sclerosis relapses: excess costs of persons with MS and their spouse caregivers.

    Science.gov (United States)

    Parisé, Hélène; Laliberté, François; Lefebvre, Patrick; Duh, Mei Sheng; Kim, Edward; Agashivala, Neetu; Abouzaid, Safiya; Weinstock-Guttman, Bianca

    2013-07-15

    MS relapses are unpredictable and can be concerning to patients and their caregivers. To assess the direct and indirect cost burden associated with relapses of different severities in MS patients and with MS relapse frequency on spouse caregivers. Using a U.S. insurance claims and employee disability database (1999-2011), we studied adult MS patients (ICD-9-CM: 340.x) and their spouse caregivers. A previously published algorithm to identify relapses was used to stratify: (1) MS patients into cohorts of no, low/moderate, and high severity relapse based on the most severe relapse within one year of follow-up (if any); (2) caregivers into cohorts of no, less, and more frequent relapses based on the overall frequency of relapses of their spouse. Adjusted cost differences and 95% confidence intervals evaluating the yearly incremental costs at 12 months of follow-up (MS patients) and overall (caregivers) associated with relapses are reported. Among the 9421 MS patients (N: no relapse=7686; low/moderate severity relapse=1220; high severity relapse=515) identified, both relapse cohorts incurred significantly higher annual incremental direct costs than the no relapse cohort (low/moderate severity=$8269 [6565-10,115]; high severity=$24,180 [20,263-28,482]) and indirect costs (low/moderate severity=$1429 [759-2147]; high severity=$2714 [1468-4035]). More frequent relapses versus no relapse also translated into a significantly greater cost burden for caregivers (direct+indirect=$1725 [376-2885]) but less frequent relapses did not. Relapse severity was significantly and increasingly associated with greater direct and indirect costs in MS patients. More frequent relapses also translated into a significant cost burden in spouse caregivers. Copyright © 2013 Elsevier B.V. All rights reserved.

  16. Logical database design principles

    CERN Document Server

    Garmany, John; Clark, Terry

    2005-01-01

    INTRODUCTION TO LOGICAL DATABASE DESIGNUnderstanding a Database Database Architectures Relational Databases Creating the Database System Development Life Cycle (SDLC)Systems Planning: Assessment and Feasibility System Analysis: RequirementsSystem Analysis: Requirements Checklist Models Tracking and Schedules Design Modeling Functional Decomposition DiagramData Flow Diagrams Data Dictionary Logical Structures and Decision Trees System Design: LogicalSYSTEM DESIGN AND IMPLEMENTATION The ER ApproachEntities and Entity Types Attribute Domains AttributesSet-Valued AttributesWeak Entities Constraint

  17. An Interoperable Cartographic Database

    OpenAIRE

    Slobodanka Ključanin; Zdravko Galić

    2007-01-01

    The concept of producing a prototype of interoperable cartographic database is explored in this paper, including the possibilities of integration of different geospatial data into the database management system and their visualization on the Internet. The implementation includes vectorization of the concept of a single map page, creation of the cartographic database in an object-relation database, spatial analysis, definition and visualization of the database content in the form of a map on t...

  18. Drug utilization and cost in a Medicaid population: A simulation study of community vs. mail order pharmacy

    Directory of Open Access Journals (Sweden)

    Seoane-Vazquez Enrique

    2007-07-01

    Full Text Available Abstract Background Outpatient drugs are dispensed through both community and mail order pharmacies. There is no empirical evidence that substitution of community pharmacy with mail order reduces overall drug expenditures. The need for evaluating the potential effects on utilization and costs of the possible extension of mail order services in Medicaid provides the rationale for conducting this study. This study compares drug utilization and drug product cost in community vs. mail order pharmacy dispensing services in a Medicaid population. Methods This study is a retrospective cohort study comparing utilization and cost patterns in community vs. mail order pharmacy. A simulation model was employed to assess drug utilization and cost in mail order pharmacy using community pharmacy claim data. The model assumed that courses of drug therapy (CDT in mail order pharmacy would have utilization patterns similar to those found in community pharmacy. A 95% confidence interval surrounding changes in average utilization and average cost were estimated using bootstrap analysis. A sensitivity analysis was performed by varying drug selection criteria and supply, fill point, and medication possession ratio (MPR. Sub-analyses were performed to address differences between mail order and community pharmacy related to therapeutic class and dual-eligible patients. Data for the study derived from pharmacy claims database of Ohio Medicaid State program for the period January 2000-September 2004. Drug claims were aggregated to obtain a set of CDTs representing unique patient IDs and unique drug products. Drug product cost estimates excluded dispensing fees and were used to estimate the cost reduction required in mail order to become cost neutral in comparison with community pharmacy. Results The baseline model revealed that the use of mail order vs. community pharmacy would result in a 5.5% increase in drug utilization and a 5.4% cost reduction required in mail order

  19. Use of administrative medical databases in population-based research.

    Science.gov (United States)

    Gavrielov-Yusim, Natalie; Friger, Michael

    2014-03-01

    Administrative medical databases are massive repositories of data collected in healthcare for various purposes. Such databases are maintained in hospitals, health maintenance organisations and health insurance organisations. Administrative databases may contain medical claims for reimbursement, records of health services, medical procedures, prescriptions, and diagnoses information. It is clear that such systems may provide a valuable variety of clinical and demographic information as well as an on-going process of data collection. In general, information gathering in these databases does not initially presume and is not planned for research purposes. Nonetheless, administrative databases may be used as a robust research tool. In this article, we address the subject of public health research that employs administrative data. We discuss the biases and the limitations of such research, as well as other important epidemiological and biostatistical key points specific to administrative database studies.

  20. Value Creation and Value Claiming in Make-Or-Buy Decisions

    NARCIS (Netherlands)

    E. Verwaal (Ernst); W.J.M.I. Verbeke (Willem); H.R. Commandeur (Harry)

    2002-01-01

    textabstractTransaction value analysis (TVA) integrates the concepts of resource heterogeneity and transaction cost economics into a single framework, which emphasizes both value creation and value claiming in firms' vertical integration decisions. Using a TVA perspective, we develop hypotheses to e

  1. Mean direct medical care costs associated with cervical cancer for commercially insured patients in Texas.

    Science.gov (United States)

    Lairson, David R; Fu, Shuangshuang; Chan, Wenyaw; Xu, Li; Shelal, Zeena; Ramondetta, Lois

    2017-04-01

    To determine the mean cervical cancer medical care costs for patients enrolled in commercial insurance in Texas. Cost is represented by insurer and patient payments for care. We estimated the mean medical care costs during the first 2years after the index diagnosis date for patients with cervical cancer (cases). Cases were identified using claims-based International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9), diagnosis codes and matched to controls without a claims-based ICD-9 code for cancer using a 2-step propensity score matching method. Index dates for the cases were randomly assigned to potential controls, and cases and controls were matched by index date. Data for cancer cases and controls were obtained from the de-identified 2011-2014 U.S. MarketScan databases. A generalized linear model was employed to compute the cost for censored months during the 2-year follow-up period. Differential costs were assessed by subtracting the medical costs incurred by controls from those incurred by cases. During 2011-2014, 475 commercially insured Texas patients with newly diagnosed cervical cancer met the inclusion criteria. The first-year and second-year mean medical costs were $60,828 and $37,721 for cases and $9982 and $10,066 for controls, respectively. The differential costs of cervical cancer for the first and second years were $50,846 and $27,656, respectively. The major correlates of higher monthly cervical cancer costs were higher Charlson Comorbidity Index score during 6months period prior to diagnosis, higher healthcare costs between 6months and 3months prior to diagnosis, and residence in the western region of Texas. Costs for cervical cancer patients decreased steeply between month 1 and month 5 after diagnosis and then were stable, while costs for the control group were stable throughout the follow-up period. Mean direct medical costs associated with cervical cancer in Texas were substantial. These data will serve as key cost

  2. Impact of Renal Disease on Patients with Hepatitis C: A Retrospective Analysis of Disease Burden, Clinical Outcomes, and Health Care Utilization and Cost.

    Science.gov (United States)

    Solid, Craig A; Peter, Senaka A; Natwick, Tanya; Guo, Haifeng; Collins, Allan J; Arduino, Jean Marie

    2017-01-01

    Few studies explore the magnitude of the disease burden and health care utilization imposed by renal disease among patients with hepatitis C virus (HCV). We aimed to describe the characteristics, outcomes, and health care utilization and costs of patients with HCV with and without renal impairment. This retrospective analysis used 2 administrative claims databases: the US commercially insured population in Truven Health MarketScan® data (aged 20-64 years), and the US Medicare fee-for-service population in the Medicare 20% sample (aged ≥65 years). Baseline characteristics and comorbid conditions were identified from claims during 2011; patients were followed for up to 1 year (beginning January 1, 2012) to identify health outcomes of interest and health care utilization and costs. In the MarketScan and Medicare databases, 35,965 and 10,608 patients with HCV were identified, 8.5 and 26.5% with evidence of renal disease (chronic kidney disease [CKD] or end-stage renal disease [ESRD]). Most comorbid conditions and unadjusted outcome rates increased across groups from patients with no evidence of renal disease to non-ESRD CKD to ESRD. Health care utilization followed a similar pattern, as did the costs. Our findings suggest that HCV patients with concurrent renal disease have significantly more comorbidity, a higher likelihood of negative health outcomes, and higher health care utilization and costs. © 2017 S. Karger AG, Basel.

  3. Everyday Citizenship: Identity Claims and Their Reception

    Directory of Open Access Journals (Sweden)

    Nick Hopkins

    2015-10-01

    Full Text Available Citizenship involves being able to speak and be heard as a member of the community. This can be a formal right (e.g., a right to vote. It can also be something experienced in everyday life. However, the criteria for being judged a fellow member of the community are multiple and accorded different weights by different people. Thus, although one may self-define alongside one’s fellows, the degree to which these others reciprocate depends on the weight they give to various membership criteria. This suggests we approach everyday community membership in terms of an identity claims-making process in which first, an individual claims membership through invoking certain criteria of belonging, and second, others evaluate that claim. Pursuing this logic we report three experiments investigating the reception of such identity-claims. Study 1 showed that in Scotland a claim to membership of the national ingroup was accepted more if couched in terms of place of birth and ancestry rather than just in terms of one’s subjective identification. Studies 2 and 3 showed that this differential acceptance mattered for the claimant’s ability to be heard as a community member. We discuss the implications of these studies for the conceptualization of community membership and the realization of everyday citizenship rights.

  4. CLAIMS FOR REIMBURSEMENT OF EDUCATION FEES

    CERN Document Server

    Personnel Division

    1999-01-01

    REMINDERYou are reminded that, in accordance with Article R A 8.07 of the Staff Regulations 'the relevant bills shall be grouped so that not more than three claims in respect of each child are submitted in an academic year'.For this purpose:the academic year is defined as the period going from 1st September to 31st August, only paid bills can be subject to reimbursement, a claim for reimbursement of education fees may only include bills for expenses incurred during a given academic year for a given child, bills for one child may be grouped on a claim by periods of term, semester or academic year, the months of July and August should be included in the third term, or the second semester, or the academic year, for each dependent child, a maximum of 3 claims can be submitted for the reimbursement of expenses incurred during one academic year, therefore, any bill submitted for reimbursement after the third claim will not be reimbursed.Please make sure that you have received and paid all bills, including those for...

  5. CLAIMS FOR REINBURSEMENT OF EDUCATION FEES

    CERN Multimedia

    PE-ADS

    1999-01-01

    You are reminded that, in accordance with Article R A 8.07 of the Staff Regulations 'the relevant bills shall be grouped so that not more than three claims in respect of each child are submitted in an academic year'.For this purpose:-\tthe academic year is defined as the period going from 1st September to 31st August,-\tonly paid bills can be subject to reimbursement,-\ta claim for reimbursement of education fees may only include bills for expenses incurred during a given academic year for a given child,-\tbills for one child may be grouped on a claim by periods of term, semester or academic year,-\tthe months of July and August should be included in the third term, or the second semester, or the academic year,-\tfor each dependent child, a maximum of 3 claims can be submitted for the reimbursement of expenses incurred during one academic year, therefore, any bill submitted for reimbursement after the third claim will not be reimbursed.Please make sure that you have receive...

  6. Leveraging Real-World Evidence in Disease-Management Decision-Making with a Total Cost of Care Estimator.

    Science.gov (United States)

    Nguyen, Thanh-Nghia; Trocio, Jeffrey; Kowal, Stacey; Ferrufino, Cheryl P; Munakata, Julie; South, Dell

    2016-12-01

    Health management is becoming increasingly complex, given a range of care options and the need to balance costs and quality. The ability to measure and understand drivers of costs is critical for healthcare organizations to effectively manage their patient populations. Healthcare decision makers can leverage real-world evidence to explore the value of disease-management interventions in shifting total cost trends. To develop a real-world, evidence-based estimator that examines the impact of disease-management interventions on the total cost of care (TCoC) for a patient population with nonvalvular atrial fibrillation (NVAF). Data were collected from a patient-level real-world evidence data set that uses the IMS PharMetrics Health Plan Claims Database. Pharmacy and medical claims for patients meeting the inclusion or exclusion criteria were combined in longitudinal cohorts with a 180-day preindex and 360-day follow-up period. Descriptive statistics, such as mean and median patient costs and event rates, were derived from a real-world evidence analysis and were used to populate the base-case estimates within the TCoC estimator, an exploratory economic model that was designed to estimate the potential impact of several disease-management activities on the TCoC for a patient population with NVAF. Using Microsoft Excel, the estimator is designed to compare current direct costs of medical care to projected costs by varying assumptions on the impact of disease-management activities and applying the associated changes in cost trends to the affected populations. Disease-management levers are derived from literature-based concepts affecting costs along the NVAF disease continuum. The use of the estimator supports analyses across 4 US geographic regions, age, cost types, and care settings during 1 year. All patients included in the study were continuously enrolled in their health plan (within the IMS PharMetrics Health Plan Claims Database) between July 1, 2010, and June 30

  7. Database Description - RMOS | LSDB Archive [Life Science Database Archive metadata

    Lifescience Database Archive (English)

    Full Text Available List Contact us RMOS Database Description General information of database Database name RMOS Alternative nam...arch Unit Shoshi Kikuchi E-mail : Database classification Plant databases - Rice Microarray Data and other Gene Expression Database...s Organism Taxonomy Name: Oryza sativa Taxonomy ID: 4530 Database description The Ric...e Microarray Opening Site is a database of comprehensive information for Rice Mic...es and manner of utilization of database You can refer to the information of the

  8. 76 FR 35086 - Proposed Information Collection (Fully Developed Claim (Fully Developed Claims-Applications for...

    Science.gov (United States)

    2011-06-15

    ... Compensation, Pension, DIC, Death Pension, and/or Accrued Benefits)) Activity: Comment Request AGENCY: Veterans... to process compensation and pension claims within 90 days after receipt of the claim. DATES: Written... Docket Management System (FDMS) at http://www.Regulations.gov ; or to Nancy J. Kessinger,...

  9. 48 CFR 52.232-23 - Assignment of Claims.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Assignment of Claims. 52....232-23 Assignment of Claims. As prescribed in 32.806(a)(1), insert the following clause: Assignment of Claims (JAN 1986) (a) The Contractor, under the Assignment of Claims Act, as amended, 31 U.S.C. 3727, 41...

  10. 32 CFR 536.19 - Disaster claims planning.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Disaster claims planning. 536.19 Section 536.19... AGAINST THE UNITED STATES The Army Claims System § 536.19 Disaster claims planning. All ACOs will prepare... requirements related to disaster claims planning. ...

  11. Worst-Case-Optimal Dynamic Reinsurance for Large Claims

    DEFF Research Database (Denmark)

    Korn, Ralf; Menkens, Olaf; Steffensen, Mogens

    2012-01-01

    We control the surplus process of a non-life insurance company by dynamic proportional reinsurance. The objective is to maximize expected (utility of the) surplus under the worst-case claim development. In the large claim case with a worst-case upper limit on claim numbers and claim sizes, we fin...

  12. 20 CFR 702.441 - Claims for loss of hearing.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Claims for loss of hearing. 702.441 Section... and Supervision Hearing Loss Claims § 702.441 Claims for loss of hearing. (a) Claims for hearing loss... regulations. (b) An audiogram shall be presumptive evidence of the amount of hearing loss on the...

  13. 47 CFR 64.1 - Traffic damage claims.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Traffic damage claims. 64.1 Section 64.1... RULES RELATING TO COMMON CARRIERS Traffic Damage Claims § 64.1 Traffic damage claims. (a) Each carrier... files for each damage claim of a traffic nature filed with the carrier, showing the name, address, and...

  14. 34 CFR 35.5 - Investigation of claims.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Investigation of claims. 35.5 Section 35.5 Education Office of the Secretary, Department of Education TORT CLAIMS AGAINST THE GOVERNMENT Procedures § 35.5 Investigation of claims. When a claim is received, the Department will make such investigation as may be...

  15. 5 CFR 831.1808 - Special processing for fraud claims.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Special processing for fraud claims. 831... Retirement and Disability Fund § 831.1808 Special processing for fraud claims. When an agency sends a claim indicating fraud, presentation of a false claim, misrepresentation by the debtor or any other party...

  16. 5 CFR 845.408 - Special processing for fraud claims.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Special processing for fraud claims. 845... Recovery of a Debt From the Civil Service Retirement Fund § 845.408 Special processing for fraud claims. When an agency sends a claim indicating fraud, presentation of a false claim, misrepresentation by the...

  17. 37 CFR 7.12 - Claim of color.

    Science.gov (United States)

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Claim of color. 7.12 Section... § 7.12 Claim of color. (a) If color is claimed as a feature of the mark in the basic application and/or registration, the international application must include a statement that color is claimed as...

  18. 20 CFR 638.526 - Tort and other claims.

    Science.gov (United States)

    2010-04-01

    ... shall collect all of the facts, including accident and medical reports and the names and addresses of witnesses, and submit the claim for a decision to the DOL Regional Solicitor's Office. All tort claims for... claimant to the Regional Solicitor, who shall determine if the claim is cognizable under the Tort Claims...

  19. 20 CFR 211.15 - Verification of compensation claimed.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Verification of compensation claimed. 211.15... CREDITABLE RAILROAD COMPENSATION § 211.15 Verification of compensation claimed. Compensation claimed by an... Board before it may be credited. An employee's claim to compensation not credited shall be processed...

  20. 49 CFR 1021.4 - Notice of claim and demand.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 8 2010-10-01 2010-10-01 false Notice of claim and demand. 1021.4 Section 1021.4... § 1021.4 Notice of claim and demand. Initiation of administrative collection of enforcement claims will be commenced by the enforcement collection designee mailing a letter of notice of claim and demand to...

  1. European Health Claims for Small and Medium-Sized Companies – Utopian Dream or Future Reality?

    Directory of Open Access Journals (Sweden)

    Sonja Brandenburger

    2015-02-01

    Full Text Available Background: In December 2007, the European Regulation (EC 1924/2006 on nutrition and health claims came into force. The European Union wanted to regulate the use of health claims on products. An online survey was carried out to evaluate the situation, particularly of small and medium-sized companies, dealing with the new regulation. Methods: The online survey on health claims was conducted with 16 enterprises. To underline the findings a SWOT (Strength, Weaknesses, Opportunities, Threats analysis was made of the nutrition and health claims regulation regarding small and medium-sized companies in the European food and drink market. Results: The findings of this study indicated that the European Union did a step in the right direction. Most companies defined the decent competition, the simplified trade within the inner-European market, and the consumer protection as positive aspects. The biggest threat is seen in false investment conditioned by the limited research and development budgets, especially of small and medium-sized enterprises, and the cost intensive scientific evaluation to reach an authorized health claim. Conclusions: Overall, there are several strengths and opportunities speaking for SMEs and health claims in the near future. The most promising ones are the publishing of the new European Union Register of Nutrition and Health Claims and the learning effects that will occur. The biggest threat is, and will remain to be, false investment and the possible loss of a lot of money. Nevertheless, health claims for small and medium-sized enterprises will inevitably be the future to keep the European food and drink market competitive.

  2. Modeling total expenditure on warranty claims

    CERN Document Server

    Mitra, Abhimanyu

    2010-01-01

    We approximate the distribution of total expenditure of a retail company over warranty claims incurred in a fixed period [0, T], say the following quarter. We consider two kinds of warranty policies, namely, the non-renewing free replacement warranty policy and the non-renewing pro-rata warranty policy. Our approximation holds under modest assumptions on the distribution of the sales process of the warranted item and the nature of arrivals of warranty claims. We propose a method of using historical data to statistically estimate the parameters of the approximate distribution. Our methodology is applied to the warranty claims data from a large car manufacturer for a single car model and model year.

  3. Risk of cardiovascular disease events in patients with type 2 diabetes prescribed the glucagon-like peptide 1 (GLP-1) receptor agonist exenatide twice daily or other glucose-lowering therapies: a retrospective analysis of the LifeLink database

    National Research Council Canada - National Science Library

    Best, Jennie H; Hoogwerf, Byron J; Herman, William H; Pelletier, Elise M; Smith, Daniel B; Wenten, Made; Hussein, Mohamed A

    2011-01-01

    ...) events among patients with type 2 diabetes compared with other glucose-lowering agent(s). A retrospective database analysis was performed of the LifeLink database of medical and pharmaceutical insurance claims for June 2005 through March 2009...

  4. E3 Staff Database

    Data.gov (United States)

    US Agency for International Development — E3 Staff database is maintained by E3 PDMS (Professional Development & Management Services) office. The database is Mysql. It is manually updated by E3 staff as...

  5. Native Health Research Database

    Science.gov (United States)

    ... APP WITH JAVASCRIPT TURNED OFF. THE NATIVE HEALTH DATABASE REQUIRES JAVASCRIPT IN ORDER TO FUNCTION. PLEASE ENTER ... To learn more about searching the Native Health Database, click here. Keywords Title Author Source of Publication ...

  6. Physiological Information Database (PID)

    Science.gov (United States)

    EPA has developed a physiological information database (created using Microsoft ACCESS) intended to be used in PBPK modeling. The database contains physiological parameter values for humans from early childhood through senescence as well as similar data for laboratory animal spec...

  7. Cell Centred Database (CCDB)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Cell Centered Database (CCDB) is a web accessible database for high resolution 2D, 3D and 4D data from light and electron microscopy, including correlated imaging.

  8. Database Urban Europe

    NARCIS (Netherlands)

    Sleutjes, B.; de Valk, H.A.G.

    2016-01-01

    Database Urban Europe: ResSegr database on segregation in The Netherlands. Collaborative research on residential segregation in Europe 2014–2016 funded by JPI Urban Europe (Joint Programming Initiative Urban Europe).

  9. Scopus database: a review.

    Science.gov (United States)

    Burnham, Judy F

    2006-03-08

    The Scopus database provides access to STM journal articles and the references included in those articles, allowing the searcher to search both forward and backward in time. The database can be used for collection development as well as for research. This review provides information on the key points of the database and compares it to Web of Science. Neither database is inclusive, but complements each other. If a library can only afford one, choice must be based in institutional needs.

  10. MPlus Database system

    Energy Technology Data Exchange (ETDEWEB)

    1989-01-20

    The MPlus Database program was developed to keep track of mail received. This system was developed by TRESP for the Department of Energy/Oak Ridge Operations. The MPlus Database program is a PC application, written in dBase III+'' and compiled with Clipper'' into an executable file. The files you need to run the MPLus Database program can be installed on a Bernoulli, or a hard drive. This paper discusses the use of this database.

  11. Some pain, no gain: experiences with the no-claim rebate in the Dutch health care system.

    Science.gov (United States)

    Holland, J; Van Exel, N J A; Schut, F T; Brouwer, W B F

    2009-10-01

    To contain expenditures in an increasingly demand driven health care system, in 2005 a no-claim rebate was introduced in the Dutch health insurance system. Since demand-side cost sharing is a very controversial issue, the no-claim rebate was launched as a consumer friendly bonus system to reward prudent utilization of health services. Internationally, the introduction of a mandatory no-claim rebate in a social health insurance scheme is unprecedented. Consumers were entitled to an annual rebate of 255 eruos if no claims were made. During the year, all health care expenses except for GP visits and maternity care were deducted from the rebate until the rebate became zero. In this article, we discuss the rationale of the no-claim rebate and the available evidence of its effect. Using a questionnaire in a convenience sample, we examined people's knowledge, attitudes, and sensitivity to the incentive scheme. We find that only 4% of respondents stated that they would reduce consumption because of the no-claim rebate. Respondents also indicated that they were willing to accept a high loss of rebate in order to use a medical treatment. However, during the last month of the year many respondents seemed willing to postpone consumption until the next year in order to keep the rebate of the current year intact. A small majority of respondents considered the no-claim rebate to be unfair. Finally, we briefly discuss why in 2008 the no-claim rebate was replaced by a mandatory deductible.

  12. Transitions in Interface Objects: Searching Databases

    Directory of Open Access Journals (Sweden)

    Tim Gamble

    2016-01-01

    Full Text Available Two experiments demonstrate that a list-like database interface which benefits from the persistence of contextual information does not show the same degree of benefit of collocating objects over display changes that has been previously observed in a map-searching study. This provides some support for the claim that the nature of the task must be taken into account in choosing how to design dynamic displays. We discuss the benefit of basing design principles on theoretical models derived from film cutting methods used in cinematography, so that they can be extended to novel design situations.

  13. 32 CFR 537.16 - Scope for maritime claims.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Scope for maritime claims. 537.16 Section 537.16 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS CLAIMS ON BEHALF OF THE UNITED STATES § 537.16 Scope for maritime claims. The Army Maritime Claims Settlement Act (10 U.S.C. 4803-4804) applies...

  14. Approaches of the insurance companies to the settlement of claims

    OpenAIRE

    2010-01-01

    This paper analyzes the approaches of the insurance companies on the Czech insurance market to the settlement of claims. It deals with activities of the settlement of claims from report of a claim to the payment of an indemnity. In the analysis of the approaches of insurance companies to the settlement of claims this paper focuses on the five topics: direct settlement, elektronic file application, approach to the solutions of the insurance fraud, product advantage in connection with the claim...

  15. 32 CFR 537.15 - Statutory authority for maritime claims and claims involving civil works of a maritime nature.

    Science.gov (United States)

    2010-07-01

    ... claims involving civil works of a maritime nature. 537.15 Section 537.15 National Defense Department of....15 Statutory authority for maritime claims and claims involving civil works of a maritime nature. (a... affirmative claims involving civil works of a maritime nature is set out at 33 U.S.C. 408. ...

  16. Public chemical compound databases.

    Science.gov (United States)

    Williams, Anthony J

    2008-05-01

    The internet has rapidly become the first port of call for all information searches. The increasing array of chemistry-related resources that are now available provides chemists with a direct path to the information that was previously accessed via library services and was limited by commercial and costly resources. The diversity of the information that can be accessed online is expanding at a dramatic rate, and the support for publicly available resources offers significant opportunities in terms of the benefits to science and society. While the data online do not generally meet the quality standards of manually curated sources, there are efforts underway to gather scientists together and 'crowdsource' an improvement in the quality of the available data. This review discusses the types of public compound databases that are available online and provides a series of examples. Focus is also given to the benefits and disruptions associated with the increased availability of such data and the integration of technologies to data mine this information.

  17. HEALTH INFO SANTÉ – REMINDER ANNUAL DEDUCTIBLE AND REIMBURSEMENT CLAIMS HINTS FOR USE

    CERN Multimedia

    CHIS Board

    2000-01-01

    Information from the CHIS Board and the Human Resources Division:Annual deductible and reimbursement claims: hints for useOne should bear in mind that the annual deductible is an amount (currently CHF 100) charged automatically by the Administrator of the scheme for every adult aged 18 and above. This is what happens: The amount is deducted annually for all medical services received over a calendar year.It is triggered by the date of the treatment and neither by the date of the bill nor that of the reimbursement claim.In other words, if you receive medical treatment in December for the first time in a given year, the CHF 100 will be deducted from the claim for that treatment. So, except for urgent cases, it would be better to wait till the following month, thus avoiding one annual deductible.It is also worth remembering that the cost of processing our reimbursement claims - and there were 54, 000 in 1999 - is part of the cost of our insurance.Help keep administrative costs down: do not submit reimbursement cl...

  18. IDA Cost Research Symposium Held 25 May 1995.

    Science.gov (United States)

    1995-08-01

    cost trends. The financial databases for the ship yards initiated in last year’s study will be extended to most aspects of cost distribution and... Financial Databases of Defense Manufactures Summary: The Weapon Systems Cost Analysis Division of PA&E is continually involved in both...to be extended to update the database. The financial databases for the original contractors will be updated and extended to include most recent

  19. CTD_DATABASE - Cascadia tsunami deposit database

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The Cascadia Tsunami Deposit Database contains data on the location and sedimentological properties of tsunami deposits found along the Cascadia margin. Data have...

  20. Database Description - Trypanosomes Database | LSDB Archive [Life Science Database Archive metadata

    Lifescience Database Archive (English)

    Full Text Available [ Credits ] BLAST Search Image Search Home About Archive Update History Contact us Trypanosomes Database... Database Description General information of database Database name Trypanosomes Database...rmation and Systems Yata 1111, Mishima, Shizuoka 411-8540, JAPAN E mail: Database... classification Protein sequence databases Organism Taxonomy Name: Trypanosoma Taxonomy ID: 5690 Taxonomy Na...me: Homo sapiens Taxonomy ID: 9606 Database description The Trypanosomes database is a database providing th

  1. Database Description - PLACE | LSDB Archive [Life Science Database Archive metadata

    Lifescience Database Archive (English)

    Full Text Available [ Credits ] BLAST Search Image Search Home About Archive Update History Contact us PLACE Database... Description General information of database Database name A Database of Plant Cis-acting Regu...araki 305-8602, Japan National Institute of Agrobiological Sciences E-mail : Database classification Plant database...s Organism Taxonomy Name: Tracheophyta Taxonomy ID: 58023 Database description PLACE is a database of... motifs found in plant cis-acting regulatory DNA elements based on previously pub

  2. Changes in healthcare utilization and costs associated with sildenafil therapy for pulmonary arterial hypertension: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Berger Ariel

    2012-12-01

    Full Text Available Abstract Background Little is known concerning the degree to which initiation of sildenafil for pulmonary arterial hypertension (PAH impacts patterns of healthcare utilization and costs. Methods Using a large US health insurance claims database, we identified all patients with evidence of PAH (ICD-9-CM diagnosis codes 416.0, 416.8 who received sildenafil between 1/1/2005 and 9/30/2008. Date of the first-noted prescription for sildenafil was designated the “index date,” and claims data were compiled for all study subjects for 6 months prior to their index date (“pretreatment” and 6 months thereafter (“follow-up”; patients with incomplete data during either of these periods were excluded. Healthcare utilization and costs were then compared between pretreatment and follow-up for all study subjects. Results A total of 567 PAH patients were identified who began therapy with sildenafil and met all other study entry criteria. Mean (SD age was 52 (10 years; 73% were women. Healthcare utilization was largely unchanged between pretreatment and follow-up, the only exceptions being decreases in the mean number of emergency department visits (from 0.7 to 0.5 per patient; p  Conclusions The cost of sildenafil therapy may be partially offset by reductions in other healthcare costs.

  3. Keyword Search in Databases

    CERN Document Server

    Yu, Jeffrey Xu; Chang, Lijun

    2009-01-01

    It has become highly desirable to provide users with flexible ways to query/search information over databases as simple as keyword search like Google search. This book surveys the recent developments on keyword search over databases, and focuses on finding structural information among objects in a database using a set of keywords. Such structural information to be returned can be either trees or subgraphs representing how the objects, that contain the required keywords, are interconnected in a relational database or in an XML database. The structural keyword search is completely different from

  4. An Interoperable Cartographic Database

    Directory of Open Access Journals (Sweden)

    Slobodanka Ključanin

    2007-05-01

    Full Text Available The concept of producing a prototype of interoperable cartographic database is explored in this paper, including the possibilities of integration of different geospatial data into the database management system and their visualization on the Internet. The implementation includes vectorization of the concept of a single map page, creation of the cartographic database in an object-relation database, spatial analysis, definition and visualization of the database content in the form of a map on the Internet. 

  5. Lickona Promotes False Claims about Sex Education.

    Science.gov (United States)

    Bennetta, William J.

    1994-01-01

    In articles on sex and character education in the November 1993 "Educational Leadership," Thomas Lickona parrots slogans and fake history and statistics contrived by the Religious Right. Lickona blames Darwin's evolution theory for variable morality and repeats fabricated success claims for Teen-Aid and Sex Respect, right-wing programs funded…

  6. A multilevel analysis of intercompany claim counts

    NARCIS (Netherlands)

    Antonio, K.; Frees, E.W.; Valdez, E.A.

    2009-01-01

    In this paper, we use multilevel models to analyze data on claim counts provided by the General Insurance Association of Singapore, an organization consisting of most of the general insurers in Singapore. Our data comes from the financial records of automobile insurance policies followed over a peri

  7. 44 CFR 11.76 - Claims procedures.

    Science.gov (United States)

    2010-10-01

    ... over to a shipping officer, supply officer, or contract packer indicating: (i) Name (or designation) and address of the shipping officer, supply officer, or contract packer indicating; (ii) Date the... applicable case enumerated in § 11.73(c)(8). (h) Money. Claims for loss of money deposited for safekeeping...

  8. Issues surrounding health claims for barley.

    Science.gov (United States)

    Ames, Nancy P; Rhymer, Camille R

    2008-06-01

    Government-approved health claims support dietary intervention as a safe and practical approach to improving consumer health and provide industry with regulatory guidelines for food product labels. Claims already allowed in the United States, United Kingdom, Sweden, and The Netherlands for reducing cholesterol through consumption of oat or barley soluble fiber provide a basis for review, but each country may have different criteria for assessing clinical evidence for a physiological effect. For example, the FDA-approved barley health claim was based on a petition that included 39 animal model studies and 11 human clinical trials. Since then, more studies have been published, but with few exceptions, clinical data continue to demonstrate that the consumption of barley products is effective for lowering total and LDL cholesterol. More research is needed to fully understand the mechanism of cholesterol reduction and the role of beta-glucan molecular weight, viscosity, and solubility. In an assessment of the physiological efficacy of a dietary intervention, consideration should also be given to the potential impact of physical and thermal food-processing treatments and genotypic variation in the barley source. New barley cultivars have been generated specifically for food use, possessing increased beta-glucan, desirable starch composition profiles, and improved milling/processing traits. These advances in barley production, coupled with the establishment of a government-regulated health claim for barley beta-glucan, will stimulate new processing opportunities for barley foods and provide consumers with reliable, healthy food choices.

  9. Rejecting knowledge claims inside and outside science.

    Science.gov (United States)

    Collins, Harry

    2014-10-01

    Citizens, policy-makers and scientists all face the problem of assessing maverick scientific claims. Via a case study, I show the different resources available to experts and non-experts when they make these judgements and reflect upon what this means for technological decision-making in the public domain.

  10. Consumer perceptions of nutrition and health claims

    NARCIS (Netherlands)

    Trijp, van H.C.M.; Lans, van der I.A.

    2007-01-01

    The number of food products containing extra or reduced levels of specific ingredients (e.g. extra calcium) that bring particular health benefits (e.g. stronger bones) is still increasing. Nutrition- and health-related (NH) claims promoting these ingredient levels and their health benefit differ in

  11. A multilevel analysis of intercompany claim counts

    NARCIS (Netherlands)

    Antonio, K.; Frees, E.W.; Valdez, E.A.

    2009-01-01

    In this paper, we use multilevel models to analyze data on claim counts provided by the General Insurance Association of Singapore, an organization consisting of most of the general insurers in Singapore. Our data comes from the financial records of automobile insurance policies followed over a peri

  12. Competing jurisdictions : settling land claims in Africa

    NARCIS (Netherlands)

    Evers, Sandra; Spierenburg, M.; Wels, H.

    2005-01-01

    The papers included in this volume were earlier presented at a conference on the settlement of land claims in Africa, which was held in Amsterdam in September 2003. The papers are written primarily from an anthropological perspective. Contributions: Introduction: competing jurisdictions: settling la

  13. 75 FR 55344 - Alaska Native Claims Selection

    Science.gov (United States)

    2010-09-10

    ... conveyance of surface estate for certain lands to NANA Regional Corporation, Inc., Successor in Interest to... Claims Settlement Act. The subsurface estate in these lands will be conveyed to NANA Regional Corporation, Inc. when the surface estate is conveyed to NANA Regional Corporation, Inc., Successor in Interest...

  14. Micmac Indians Present Aboriginal Rights Claim

    Science.gov (United States)

    Northian, 1978

    1978-01-01

    Nova Scotia's Micmac Indian leaders presented their claim for aboriginal rights to the Federal Government April 25, 1977 in an historic and symbolic ceremony on their home ground at the Eskasoni Reserve. The article discusses this event and some of the Micmacs' demands. (NQ)

  15. Claimed walking distance of lower limb amputees

    NARCIS (Netherlands)

    Geertzen, JHB; Bosmans, JC; Van der Schans, CP; Dijkstra, PU

    2005-01-01

    Purpose: Walking ability in general and specifically for lower limb amputees is of major importance for social mobility and ADL independence. Walking determines prosthesis prescription. The aim of this study was to mathematically analyse factors influencing claimed walking distance of lower limb amp

  16. Competing jurisdictions : settling land claims in Africa

    NARCIS (Netherlands)

    Evers, S.; Spierenburg, M.; Wels, H.

    2005-01-01

    The papers included in this volume were earlier presented at a conference on the settlement of land claims in Africa, which was held in Amsterdam in September 2003. The papers are written primarily from an anthropological perspective. Contributions: Introduction: competing jurisdictions: settling

  17. Micmac Indians Present Aboriginal Rights Claim

    Science.gov (United States)

    Northian, 1978

    1978-01-01

    Nova Scotia's Micmac Indian leaders presented their claim for aboriginal rights to the Federal Government April 25, 1977 in an historic and symbolic ceremony on their home ground at the Eskasoni Reserve. The article discusses this event and some of the Micmacs' demands. (NQ)

  18. The NCBI Taxonomy database.

    Science.gov (United States)

    Federhen, Scott

    2012-01-01

    The NCBI Taxonomy database (http://www.ncbi.nlm.nih.gov/taxonomy) is the standard nomenclature and classification repository for the International Nucleotide Sequence Database Collaboration (INSDC), comprising the GenBank, ENA (EMBL) and DDBJ databases. It includes organism names and taxonomic lineages for each of the sequences represented in the INSDC's nucleotide and protein sequence databases. The taxonomy database is manually curated by a small group of scientists at the NCBI who use the current taxonomic literature to maintain a phylogenetic taxonomy for the source organisms represented in the sequence databases. The taxonomy database is a central organizing hub for many of the resources at the NCBI, and provides a means for clustering elements within other domains of NCBI web site, for internal linking between domains of the Entrez system and for linking out to taxon-specific external resources on the web. Our primary purpose is to index the domain of sequences as conveniently as possible for our user community.

  19. Annual costs of tumor necrosis factor inhibitors using real-world data in a commercially insured population in the United States.

    Science.gov (United States)

    Schabert, Vernon F; Watson, Crystal; Gandra, Shravanthi R; Goodman, Seth; Fox, Kathleen M; Harrison, David J

    2012-01-01

    To calculate annual cost per treated patient of tumor necrosis factor (TNF) inhibitors etanercept, adalimumab, and infliximab for common approved indications, based on actual TNF-inhibitor use in clinical practice. Adults with ≥1 claim for etanercept, adalimumab, or infliximab between January 2005 and March 2009 were identified from the IMS LifeLink™ Health Plan Claims Database. Patients new to therapy or continuing therapy (i.e., a prior claim for a TNF-inhibitor) were analyzed separately. Included patients had been enrolled from 180 days before the first TNF-inhibitor claim (index date) through 360 days after the index date and had a diagnosis during the pre-index period for rheumatoid arthritis, psoriasis, psoriatic arthritis, or ankylosing spondylitis. Patients with Crohn's disease, ulcerative colitis, or juvenile idiopathic arthritis were excluded. Annual costs were calculated using wholesale acquisition costs for the TNF-inhibitor and Medicare Physician Fee Schedule for drug administration. Costs from restarting or switching TNF-inhibitor therapy during the first year were included. A total of 27,704 patients (11,528 new, 16,176 continuing) had claims for etanercept, adalimumab, or infliximab, most commonly (65%) for treatment of rheumatoid arthritis. The most commonly used agent was etanercept (14,777 patients; 53%), followed by adalimumab (6862 patients; 25%) and infliximab (6065 patients; 22%). Annual cost per treated patient was etanercept $14,873, adalimumab $17,766, and infliximab $21,256 across all indications. Annual cost per treated patient by disease was (etanercept/adalimumab/infliximab): rheumatoid arthritis ($14,314/$17,700/$20,390), psoriasis ($17,182/$17,682/$23,935), psoriatic arthritis ($15,030/$18,483/$24,974), and ankylosing spondylitis ($14,254/$16,925/$23,056). New and continuing patients showed similar results, with etanercept having the lowest costs. This analysis is limited to three TNF-inhibitors and a US managed-care population

  20. The Cost-Effectiveness of Treatment Modalities for Ureteral Stones

    Directory of Open Access Journals (Sweden)

    Justin Ji-Yuen Siu MD

    2016-10-01

    Full Text Available Additional intervention and medical treatment of complications may follow the primary treatment of a ureteral stone. We investigated the cost of the treatment of ureteral stone(s within 45 days after initial intervention by means of retrospective analysis of the National Health Insurance Research Database of Taiwan. All patients of ages ≥20 years diagnosed with ureteral stone(s( International Classification of Diseases, Ninth Revision, Clinical Modification/ICD-9-CM: 592.1 from January 2001 to December 2011 were enrolled. We included a comorbidity code only if the diagnosis appeared in at least 2 separate claims in a patient’s record. Treatment modalities (code included extracorporeal shock-wave lithotripsy (SWL; 98.51, ureteroscopic lithotripsy (URSL; 56.31, percutaneous nephrolithotripsy (PNL; 55.04, (open ureterolithotomy (56.20, and laparoscopy (ie, laparoscopic ureterolithotomy; 54.21. There were 28 513 patients with ureteral stones (13 848 men and 14 665 women in the randomized sample of 1 million patients. The mean cost was 526.4 ± 724.1 United States Dollar (USD. The costs of treatment were significantly increased in patients with comorbidities. The costs of treatment among each primary treatment modalities were 1212.2 ± 627.3, 1146.7 ± 816.8, 2507.4 ± 1333.5, 1533.3 ± 1137.1, 2566.4 ± 2594.3, and 209.8 ± 473.2 USD in the SWL, URSL, PNL, (open ureterolithotomy, laparoscopy (laparoscopic ureterolithotomy, and conservative treatment group, respectively. In conclusion, URSL was more cost-effective than SWL and PNL as a primary treatment modality for ureteral stone(s when the possible additional costs within 45 days after the initial operation were included in the calculation.

  1. Do hospital mergers reduce costs?

    Science.gov (United States)

    Schmitt, Matt

    2017-03-01

    Proponents of hospital consolidation claim that mergers lead to significant cost savings, but there is little systematic evidence backing these claims. For a large sample of hospital mergers between 2000 and 2010, I estimate difference-in-differences models that compare cost trends at acquired hospitals to cost trends at hospitals whose ownership did not change. I find evidence of economically and statistically significant cost reductions at acquired hospitals. On average, acquired hospitals realize cost savings between 4 and 7 percent in the years following the acquisition. These results are robust to a variety of different control strategies, and do not appear to be easily explained by post-merger changes in service and/or patient mix. I then explore several extensions of the results to examine (a) whether the acquiring hospital/system realizes cost savings post-merger and (b) if cost savings depend on the size of the acquirer and/or the geographic overlap of the merging hospitals. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Identification of ovarian cancer symptoms in health insurance claims data.

    Science.gov (United States)

    Devlin, Sean M; Diehr, Paula H; Andersen, M Robyn; Goff, Barbara A; Tyree, Patrick T; Lafferty, William E

    2010-03-01

    Women with ovarian cancer have reported abdominal/pelvic pain, bloating, difficulty eating or feeling full quickly, and urinary frequency/urgency prior to diagnosis. We explored these findings in a general population using a dataset of insured women aged 40-64 and investigated the potential effectiveness of a routine review of claims data as a prescreen to identify women at high risk for ovarian cancer. Data from a large Washington State health insurer were merged with the Seattle-Puget Sound Surveillance, Epidemiology and End Results (SEER) cancer registry for 2000-2004. We estimated the prevalence of symptoms in the 36 months prior to diagnosis for early and late-stage ovarian cancer cases and for two comparison groups. The potential performance of a passive screener that would flag women with two or more visits for any of the symptoms in the previous 2-month period was examined. Of the 223,903 insured women, 161 had incident cases of ovarian cancer. Both early and late-stage patients had a higher prevalence of abdominal/pelvic pain and bloating than the comparison groups, primarily in the 3 months before diagnosis. The passive screener had a sensitivity of 0.31 and specificity of 0.83 and usually identified women right before diagnosis. Assuming an average cost of $500 per false positive, the screener would be considered cost-effective if the true positives had an average increase of 8.5 years of life expectancy. These results support previous findings that ovarian cancer symptoms were reported in health insurance claims and were more prevalent before diagnosis, but the symptoms may occur too close to the diagnosis date to provide useful diagnostic information. The passive screening approach should be reevaluated in the future using electronic medical records; if found to be effective, the method may be potentially useful for other incident diseases.

  3. Ultra-processed family foods in Australia: nutrition claims, health claims and marketing techniques.

    Science.gov (United States)

    Pulker, Claire Elizabeth; Scott, Jane Anne; Pollard, Christina Mary

    2017-07-17

    To objectively evaluate voluntary nutrition and health claims and marketing techniques present on packaging of high-market-share ultra-processed foods (UPF) in Australia for their potential impact on public health. Cross-sectional. Packaging information from five high-market-share food manufacturers and one retailer were obtained from supermarket and manufacturers' websites. Ingredients lists for 215 UPF were examined for presence of added sugar. Packaging information was categorised using a taxonomy of nutrition and health information which included nutrition and health claims and five common food marketing techniques. Compliance of statements and claims with the Australia New Zealand Food Standards Code and with Health Star Ratings (HSR) were assessed for all products. Almost all UPF (95 %) contained added sugars described in thirty-four different ways; 55 % of UPF displayed a HSR; 56 % had nutrition claims (18 % were compliant with regulations); 25 % had health claims (79 % were compliant); and 97 % employed common food marketing techniques. Packaging of 47 % of UPF was designed to appeal to children. UPF carried a mean of 1·5 health and nutrition claims (range 0-10) and 2·6 marketing techniques (range 0-5), and 45 % had HSR≤3·0/5·0. Most UPF packaging featured nutrition and health statements or claims despite the high prevalence of added sugars and moderate HSR. The degree of inappropriate or inaccurate statements and claims present is concerning, particularly on packaging designed to appeal to children. Public policies to assist parents to select healthy family foods should address the quality and accuracy of information provided on UPF packaging.

  4. Update History of This Database - Arabidopsis Phenome Database | LSDB Archive [Life Science Database Archive metadata

    Lifescience Database Archive (English)

    Full Text Available List Contact us Arabidopsis Phenome Database Update History of This Database Date Update contents 2017/02/27... Arabidopsis Phenome Database English archive site is opened. - Arabidopsis Phenome Database (http://jphenom...e.info/?page_id=95) is opened. About This Database Database Description Download License Update History of This Database... Site Policy | Contact Us Update History of This Database - Arabidopsis Phenome Database | LSDB Archive ...

  5. Update History of This Database - SKIP Stemcell Database | LSDB Archive [Life Science Database Archive metadata

    Lifescience Database Archive (English)

    Full Text Available List Contact us SKIP Stemcell Database Update History of This Database Date Update contents 2017/03/13 SKIP Stemcell Database... English archive site is opened. 2013/03/29 SKIP Stemcell Database ( https://www.skip.med.k...eio.ac.jp/SKIPSearch/top?lang=en ) is opened. About This Database Database Description Download License Upda...te History of This Database Site Policy | Contact Us Update History of This Database - SKIP Stemcell Database | LSDB Archive ...

  6. Database Description - RMG | LSDB Archive [Life Science Database Archive metadata

    Lifescience Database Archive (English)

    Full Text Available [ Credits ] BLAST Search Image Search Home About Archive Update History Contact us RMG Database... Description General information of database Database name RMG Alternative name Rice Mitochondri...ational Institute of Agrobiological Sciences E-mail : Database classification Nucleotide Sequence Databases ...Organism Taxonomy Name: Oryza sativa Japonica Group Taxonomy ID: 39947 Database description This database co...e of rice mitochondrial genome and information on the analysis results. Features and manner of utilization of database

  7. Nonparametric Fine Tuning of Mixtures: Application to Non-Life Insurance Claims Distribution Estimation

    Science.gov (United States)

    Sardet, Laure; Patilea, Valentin

    When pricing a specific insurance premium, actuary needs to evaluate the claims cost distribution for the warranty. Traditional actuarial methods use parametric specifications to model claims distribution, like lognormal, Weibull and Pareto laws. Mixtures of such distributions allow to improve the flexibility of the parametric approach and seem to be quite well-adapted to capture the skewness, the long tails as well as the unobserved heterogeneity among the claims. In this paper, instead of looking for a finely tuned mixture with many components, we choose a parsimonious mixture modeling, typically a two or three-component mixture. Next, we use the mixture cumulative distribution function (CDF) to transform data into the unit interval where we apply a beta-kernel smoothing procedure. A bandwidth rule adapted to our methodology is proposed. Finally, the beta-kernel density estimate is back-transformed to recover an estimate of the original claims density. The beta-kernel smoothing provides an automatic fine-tuning of the parsimonious mixture and thus avoids inference in more complex mixture models with many parameters. We investigate the empirical performance of the new method in the estimation of the quantiles with simulated nonnegative data and the quantiles of the individual claims distribution in a non-life insurance application.

  8. The impact of standardizing the definition of visits on the consistency of multi-database observational health research.

    Science.gov (United States)

    Voss, Erica A; Ma, Qianli; Ryan, Patrick B

    2015-03-08

    Use of administrative claims from multiple sources for research purposes is challenged by the lack of consistency in the structure of the underlying data and definition of data across claims data providers. This paper evaluates the impact of applying a standardized revenue code-based logic for defining inpatient encounters across two different claims databases. We selected members who had complete enrollment in 2012 from the Truven MarketScan Commercial Claims and Encounters (CCAE) and the Optum Clinformatics (Optum) databases. The overall prevalence of inpatient conditions in the raw data was compared to that in the common data model (CDM) with the standardized visit definition applied. In CCAE, 87.18% of claims from 2012 that were classified as part of inpatient visits in the raw data were also classified as part of inpatient visits after the data were standardized to CDM, and this overlap was consistent from 2006 to 2011. In contrast, Optum had 83.18% concordance in classification of 2012 claims from inpatient encounters before and after standardization, but the consistency varied over time. The re-classification of inpatient encounters substantially impacted the observed prevalence of medical conditions occurring in the inpatient setting and the consistency in prevalence estimates between the databases. On average, before standardization, each condition in Optum was 12% more prevalent than that same condition in CCAE; after standardization, the prevalence of conditions had a mean difference of only 1% between databases. Amongst 7,039 conditions reviewed, the difference in the prevalence of 67% of conditions in these two databases was reduced after standardization. In an effort to improve consistency in research results across database one should review sources of database heterogeneity, such as the way data holders process raw claims data. Our study showed that applying the Observational Medical Outcomes Partnership (OMOP) CDM with a standardized approach for

  9. National Database of Geriatrics

    DEFF Research Database (Denmark)

    Kannegaard, Pia Nimann; Vinding, Kirsten L; Hare-Bruun, Helle

    2016-01-01

    AIM OF DATABASE: The aim of the National Database of Geriatrics is to monitor the quality of interdisciplinary diagnostics and treatment of patients admitted to a geriatric hospital unit. STUDY POPULATION: The database population consists of patients who were admitted to a geriatric hospital unit....... Geriatric patients cannot be defined by specific diagnoses. A geriatric patient is typically a frail multimorbid elderly patient with decreasing functional ability and social challenges. The database includes 14-15,000 admissions per year, and the database completeness has been stable at 90% during the past......, percentage of discharges with a rehabilitation plan, and the part of cases where an interdisciplinary conference has taken place. Data are recorded by doctors, nurses, and therapists in a database and linked to the Danish National Patient Register. DESCRIPTIVE DATA: Descriptive patient-related data include...

  10. Hazard Analysis Database Report

    CERN Document Server

    Grams, W H

    2000-01-01

    The Hazard Analysis Database was developed in conjunction with the hazard analysis activities conducted in accordance with DOE-STD-3009-94, Preparation Guide for U S . Department of Energy Nonreactor Nuclear Facility Safety Analysis Reports, for HNF-SD-WM-SAR-067, Tank Farms Final Safety Analysis Report (FSAR). The FSAR is part of the approved Authorization Basis (AB) for the River Protection Project (RPP). This document describes, identifies, and defines the contents and structure of the Tank Farms FSAR Hazard Analysis Database and documents the configuration control changes made to the database. The Hazard Analysis Database contains the collection of information generated during the initial hazard evaluations and the subsequent hazard and accident analysis activities. The Hazard Analysis Database supports the preparation of Chapters 3 ,4 , and 5 of the Tank Farms FSAR and the Unreviewed Safety Question (USQ) process and consists of two major, interrelated data sets: (1) Hazard Analysis Database: Data from t...

  11. Conditioning Probabilistic Databases

    CERN Document Server

    Koch, Christoph

    2008-01-01

    Past research on probabilistic databases has studied the problem of answering queries on a static database. Application scenarios of probabilistic databases however often involve the conditioning of a database using additional information in the form of new evidence. The conditioning problem is thus to transform a probabilistic database of priors into a posterior probabilistic database which is materialized for subsequent query processing or further refinement. It turns out that the conditioning problem is closely related to the problem of computing exact tuple confidence values. It is known that exact confidence computation is an NP-hard problem. This has lead researchers to consider approximation techniques for confidence computation. However, neither conditioning nor exact confidence computation can be solved using such techniques. In this paper we present efficient techniques for both problems. We study several problem decomposition methods and heuristics that are based on the most successful search techn...

  12. Database design and database administration for a kindergarten

    OpenAIRE

    Vítek, Daniel

    2009-01-01

    The bachelor thesis deals with creation of database design for a standard kindergarten, installation of the designed database into the database system Oracle Database 10g Express Edition and demonstration of the administration tasks in this database system. The verification of the database was proved by a developed access application.

  13. ITS-90 Thermocouple Database

    Science.gov (United States)

    SRD 60 NIST ITS-90 Thermocouple Database (Web, free access)   Web version of Standard Reference Database 60 and NIST Monograph 175. The database gives temperature -- electromotive force (emf) reference functions and tables for the letter-designated thermocouple types B, E, J, K, N, R, S and T. These reference functions have been adopted as standards by the American Society for Testing and Materials (ASTM) and the International Electrotechnical Commission (IEC).

  14. Searching Databases with Keywords

    Institute of Scientific and Technical Information of China (English)

    Shan Wang; Kun-Long Zhang

    2005-01-01

    Traditionally, SQL query language is used to search the data in databases. However, it is inappropriate for end-users, since it is complex and hard to learn. It is the need of end-user, searching in databases with keywords, like in web search engines. This paper presents a survey of work on keyword search in databases. It also includes a brief introduction to the SEEKER system which has been developed.

  15. Specialist Bibliographic Databases

    OpenAIRE

    Gasparyan, Armen Yuri; Yessirkepov, Marlen; Voronov, Alexander A.; Trukhachev, Vladimir I.; Kostyukova, Elena I.; Gerasimov, Alexey N.; Kitas, George D.

    2016-01-01

    Specialist bibliographic databases offer essential online tools for researchers and authors who work on specific subjects and perform comprehensive and systematic syntheses of evidence. This article presents examples of the established specialist databases, which may be of interest to those engaged in multidisciplinary science communication. Access to most specialist databases is through subscription schemes and membership in professional associations. Several aggregators of information and d...

  16. Smart Location Database - Download

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Smart Location Database (SLD) summarizes over 80 demographic, built environment, transit service, and destination accessibility attributes for every census block...

  17. Database principles programming performance

    CERN Document Server

    O'Neil, Patrick

    2014-01-01

    Database: Principles Programming Performance provides an introduction to the fundamental principles of database systems. This book focuses on database programming and the relationships between principles, programming, and performance.Organized into 10 chapters, this book begins with an overview of database design principles and presents a comprehensive introduction to the concepts used by a DBA. This text then provides grounding in many abstract concepts of the relational model. Other chapters introduce SQL, describing its capabilities and covering the statements and functions of the programmi

  18. Smart Location Database - Service

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Smart Location Database (SLD) summarizes over 80 demographic, built environment, transit service, and destination accessibility attributes for every census block...

  19. Database Publication Practices

    DEFF Research Database (Denmark)

    Bernstein, P.A.; DeWitt, D.; Heuer, A.

    2005-01-01

    There has been a growing interest in improving the publication processes for database research papers. This panel reports on recent changes in those processes and presents an initial cut at historical data for the VLDB Journal and ACM Transactions on Database Systems.......There has been a growing interest in improving the publication processes for database research papers. This panel reports on recent changes in those processes and presents an initial cut at historical data for the VLDB Journal and ACM Transactions on Database Systems....

  20. The Danish Melanoma Database

    DEFF Research Database (Denmark)

    Hölmich, Lisbet Rosenkrantz; Klausen, Siri; Spaun, Eva

    2016-01-01

    AIM OF DATABASE: The aim of the database is to monitor and improve the treatment and survival of melanoma patients. STUDY POPULATION: All Danish patients with cutaneous melanoma and in situ melanomas must be registered in the Danish Melanoma Database (DMD). In 2014, 2,525 patients with invasive......, nature, and treatment hereof is registered. In case of death, the cause and date are included. Currently, all data are entered manually; however, data catchment from the existing registries is planned to be included shortly. DESCRIPTIVE DATA: The DMD is an old research database, but new as a clinical...

  1. Danish Gynecological Cancer Database

    DEFF Research Database (Denmark)

    Sørensen, Sarah Mejer; Bjørn, Signe Frahm; Jochumsen, Kirsten Marie

    2016-01-01

    AIM OF DATABASE: The Danish Gynecological Cancer Database (DGCD) is a nationwide clinical cancer database and its aim is to monitor the treatment quality of Danish gynecological cancer patients, and to generate data for scientific purposes. DGCD also records detailed data on the diagnostic measures...... is the registration of oncological treatment data, which is incomplete for a large number of patients. CONCLUSION: The very complete collection of available data from more registries form one of the unique strengths of DGCD compared to many other clinical databases, and provides unique possibilities for validation...

  2. Transporter Classification Database (TCDB)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Transporter Classification Database details a comprehensive classification system for membrane transport proteins known as the Transporter Classification (TC)...

  3. The Relational Database Dictionary

    CERN Document Server

    J, C

    2006-01-01

    Avoid misunderstandings that can affect the design, programming, and use of database systems. Whether you're using Oracle, DB2, SQL Server, MySQL, or PostgreSQL, The Relational Database Dictionary will prevent confusion about the precise meaning of database-related terms (e.g., attribute, 3NF, one-to-many correspondence, predicate, repeating group, join dependency), helping to ensure the success of your database projects. Carefully reviewed for clarity, accuracy, and completeness, this authoritative and comprehensive quick-reference contains more than 600 terms, many with examples, covering i

  4. IVR EFP Database

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This database contains trip-level reports submitted by vessels participating in Exempted Fishery projects with IVR reporting requirements.

  5. Databases for Microbiologists

    Science.gov (United States)

    2015-01-01

    Databases play an increasingly important role in biology. They archive, store, maintain, and share information on genes, genomes, expression data, protein sequences and structures, metabolites and reactions, interactions, and pathways. All these data are critically important to microbiologists. Furthermore, microbiology has its own databases that deal with model microorganisms, microbial diversity, physiology, and pathogenesis. Thousands of biological databases are currently available, and it becomes increasingly difficult to keep up with their development. The purpose of this minireview is to provide a brief survey of current databases that are of interest to microbiologists. PMID:26013493

  6. Veterans Administration Databases

    Science.gov (United States)

    The Veterans Administration Information Resource Center provides database and informatics experts, customer service, expert advice, information products, and web technology to VA researchers and others.

  7. Residency Allocation Database

    Data.gov (United States)

    Department of Veterans Affairs — The Residency Allocation Database is used to determine allocation of funds for residency programs offered by Veterans Affairs Medical Centers (VAMCs). Information...

  8. Burden of diabetes mellitus estimated with a longitudinal population-based study using administrative databases.

    Directory of Open Access Journals (Sweden)

    Luciana Scalone

    Full Text Available OBJECTIVE: To assess the epidemiologic and economic burden of diabetes mellitus (DM from a longitudinal population-based study. RESEARCH DESIGN AND METHODS: Lombardy Region includes 9.9 million individuals. Its DM population was identified through a data warehouse (DENALI, which matches with a probabilistic linkage demographic, clinical and economic data of different Healthcare Administrative databases. All individuals, who, during the year 2000 had an hospital discharge with a IDC-9 CM code 250.XX, and/or two consecutive prescriptions of drugs for diabetes (ATC code A10XXXX within one year, and/or an exemption from co-payment healthcare costs specific for DM, were selected and followed up to 9 years. We calculated prevalence, mortality and healthcare costs (hospitalizations, drugs and outpatient examinations/visits from the National Health Service's perspective. RESULTS: We identified 312,223 eligible subjects. The study population (51% male had a mean age of 66 (from 0.03 to 105.12 years at the index date. Prevalence ranged from 0.4% among subjects aged ≤45 years to 10.1% among those >85 years old. Overall 43.4 deaths per 1,000 patients per year were estimated, significantly (p<0.001 higher in men than women. Overall, 3,315€/patient-year were spent on average: hospitalizations were the cost driver (54.2% of total cost. Drugs contributed to 31.5%, outpatient claims represented 14.3% of total costs. Thirty-five percent of hospital costs were attributable to cerebro-/cardiovascular reasons, 6% to other complications of DM, and 4% to DM as a main diagnosis. Cardiovascular drugs contributed to 33.5% of total drug costs, 21.8% was attributable to class A (16.7% to class A10 and 4.3% to class B (2.4% to class B01 drugs. CONCLUSIONS: Merging different administrative databases can provide with many data from large populations observed for long time periods. DENALI shows to be an efficient instrument to obtain accurate estimates of burden of

  9. A Regional Bibliographic Database on Videodisc.

    Science.gov (United States)

    Freund, Alfred L.

    1985-01-01

    Provides description of the initial creation of a regional union catalog containing 600,000 unique titles and 1.8 million physical items, the conversion of this database to interactive laserdisc, and the resultant advantages. Updates, costs, problems, and the application of laserdisc technology are discussed. (EJS)

  10. Dolphin-Assisted Therapy: Claims versus Evidence

    OpenAIRE

    Fiksdal, Britta L.; Daniel Houlihan; Barnes, Aaron C.

    2012-01-01

    The purpose of this paper is to review and critique studies that have been conducted on dolphin-assisted therapy for children with various disorders. Studies have been released claiming swimming with dolphins is therapeutic and beneficial for children with autism, attention deficit hyperactivity disorder, physical disabilities, and other psychological disorders. The majority of the studies conducted supporting the effectiveness of dolphin-assisted therapy have been found to have major methodo...

  11. Nowcasting, forecasting and warning for ionospheric propagation: supporting databases

    Directory of Open Access Journals (Sweden)

    N. Jakowski

    2004-06-01

    Full Text Available The use of data is essential in the context of nowcasting, forecasting and warning of ionospheric propagation conditions, with roles to play in the development, evaluation and operation of models and services. Descriptions are given of three databases that have been established in the course of the COST 271 Action: a database of prompt ionospheric soundings, an extension to a database generated by the EISCAT incoherent scatter radars, and a database intended to facilitate evaluation of TEC estimation methods. Each database includes some background information, a description of the contents and interface, and instructions as to how to gain access to it.

  12. Cost-utility analysis of direct VAD versus double bridges to heart transplantation in patients with refractory heart failure.

    Science.gov (United States)

    Chang, Hsiao-Huang; Chen, Po-Lin; Chen, I-Ming; Kuo, Tzu-Ting; Weng, Zen-Chung; Huang, Pei-Jung; Wu, Nai-Yuan; Cheng, Ching-Li

    2017-09-25

    This study compared the cost-utility of direct ventricular assist device (VAD) versus double bridges, extracorporeal membrane oxygenation (ECMO) before VAD, to heart transplantation in patients with refractory heart failure. From a health payer perspective, a Markov model was developed. The cycle length was one month and the time horizon was a lifetime. Probabilities and direct cost data were calculated from a nationwide claim database. Utility inputs were adopted from published sources. The utility was expressed as quality adjusted life years (QALYs). Both costs and utility were discounted by an annual rate of 3%. Deterministic and probabilistic sensitivity analyses were performed to test the stability of the model. The direct VAD group had less life time costs (USD 95,910] v. USD 129,516) but higher life time QALYs than the double bridges group (1.73 vs. 0.89). The sensitivity analysis revealed that the direct VAD group consistently had lower cost and higher QALYs during all variations in model parameters. The probability that direct VAD was cost-effective exceeded 75% at any levels of willing-to-pay. From a health-insurance payer perspective, direct VAD bridge to heart transplantation appeared to be more cost-effective than double bridges in patients with refractory heart failure. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  13. Rights as entitlements and rights as claims

    Directory of Open Access Journals (Sweden)

    Azevedo, Marco Antônio Oliveira de

    2010-01-01

    Full Text Available Há pelo menos dois registros diferentes sobre o significado de “direitos”. Segundo um deles, os direitos são relações entre dois termos: uma pessoa e um bem; para o outro, os direitos são relações entre três termos: um indivíduo, uma pessoa e uma ação ou algo. Os registros são diferentes, mas não são totalmente incompatíveis. De acordo com a interpretação de direitos como entitlements, trata-se de direitos morais ou legais, ou seja, as relações de ordem moral ou jurídica das pessoas com bens (de benefícios concedidos a pessoas por uma lei humana, moral ou legal. Como uma espécie de direitos, os direitos humanos são vistos como direitos (entitlements das pessoas ou dos indivíduos a bens essenciais, dos quais podem-se inferir reivindicações (claims contra outras pessoas ou contra governos e representantes. Falamos sobre direitos humanos geralmente desta forma. Mas de acordo com o outro registro, os direitos em sentido próprio têm que ser interpretados como claims. Neste artigo, pretendo apresentar alguns argumentos em favor da vantagem de expor todos os enunciados significativos dos direitos como entitlements em termos explícitos de claims

  14. 27 CFR 20.24 - Allowance of claims.

    Science.gov (United States)

    2010-04-01

    ... OF THE TREASURY LIQUORS DISTRIBUTION AND USE OF DENATURED ALCOHOL AND RUM Administrative Provisions Authorities § 20.24 Allowance of claims. The appropriate TTB officer is authorized to allow claims for...

  15. 27 CFR 22.23 - Allowance of claims.

    Science.gov (United States)

    2010-04-01

    ... OF THE TREASURY LIQUORS DISTRIBUTION AND USE OF TAX-FREE ALCOHOL Administrative Provisions Authorities § 22.23 Allowance of claims. The appropriate TTB officer is authorized to allow claims for...

  16. Center for Medicare & Medicaid Services (CMS) , Medicare Claims data

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2003 forward. CMS compiles claims data for Medicare and Medicaid patients across a variety of categories and years. This includes Inpatient and Outpatient claims,...

  17. 32 CFR 842.110 - Claims not payable.

    Science.gov (United States)

    2010-07-01

    ... property by a continuing trespass or by a technical trespass such as overflights of aircraft. (l) Claims... the provisions of the Trading With the Enemy Act. (q) Claims for damages caused by the United States...

  18. Unsupervised Labeling Of Data For Supervised Learning And Its Application To Medical Claims Prediction

    Directory of Open Access Journals (Sweden)

    Che Ngufor

    2013-01-01

    Full Text Available The task identifying changes and irregularities in medical insurance claim pay-ments is a difficult process of which the traditional practice involves queryinghistorical claims databases and flagging potential claims as normal or abnor-mal. Because what is considered as normal payment is usually unknown andmay change over time, abnormal payments often pass undetected; only to bediscovered when the payment period has passed.This paper presents the problem of on-line unsupervised learning from datastreams when the distribution that generates the data changes or drifts overtime. Automated algorithms for detecting drifting concepts in a probabilitydistribution of the data are presented. The idea behind the presented driftdetection methods is to transform the distribution of the data within a slidingwindow into a more convenient distribution. Then, a test statistics p-value ata given significance level can be used to infer the drift rate, adjust the windowsize and decide on the status of the drift. The detected concepts drifts areused to label the data, for subsequent learning of classification models by asupervised learner. The algorithms were tested on several synthetic and realmedical claims data sets.

  19. Patients with newly diagnosed carcinoma of the breast: validation of a claim-based identification algorithm.

    Science.gov (United States)

    Leung, K M; Hasan, A G; Rees, K S; Parker, R G; Legorreta, A P

    1999-01-01

    The objectives of this study were to validate a claims-based algorithm for identification of patients with newly diagnosed carcinoma of the breast and to optimize the algorithm. Claims data from all females aged 21 years or older who enrolled in a large California health maintenance organization during the study period from October 1, 1994 through March 31, 1996 were analyzed. Medical records of the patients identified through the claims-based algorithm were reviewed to determine whether the patients were correctly identified. The initial algorithm had a positive predictive value of 84% which was similar to the previous study. The percentages of correct identification significantly increased with the patient's age at diagnosis. Other patient demographic characteristics and facility characteristics were not related to the accuracy of the identification. Using a classification tree procedure and additional information from the false-positive cases, the initial algorithm was modified for improvement. The best-modified algorithm had a positive predictive value of 92% while only 0.5% (4/837) of the true-positive cases were excluded. The results once again demonstrated that patients with newly diagnosed carcinomas of the breast can be identified using claims data. These databases provide an efficient and effective tool for performing health services studies on large patient populations.

  20. License - Trypanosomes Database | LSDB Archive [Life Science Database Archive metadata

    Lifescience Database Archive (English)

    Full Text Available List Contact us Trypanosomes Database License License to Use This Database Last updated : 2014/02/04 You may use this database...pecifies the license terms regarding the use of this database and the requirements you must follow in using this database.... The license for this database is specified in the Creative Commons... Attribution-Share Alike 2.1 Japan . If you use data from this database, please be sure attribute this database...pan is found here . With regard to this database, you are licensed to: freely access part or whole of this database

  1. The Danish Nonmelanoma Skin Cancer Dermatology Database

    DEFF Research Database (Denmark)

    Lamberg, Anna Lei; Sølvsten, Henrik; Lei, Ulrikke

    2016-01-01

    AIM OF DATABASE: The Danish Nonmelanoma Skin Cancer Dermatology Database was established in 2008. The aim of this database was to collect data on nonmelanoma skin cancer (NMSC) treatment and improve its treatment in Denmark. NMSC is the most common malignancy in the western countries and represents...... a significant challenge in terms of public health management and health care costs. However, high-quality epidemiological and treatment data on NMSC are sparse. STUDY POPULATION: The NMSC database includes patients with the following skin tumors: basal cell carcinoma (BCC), squamous cell carcinoma, Bowen......'s disease, and keratoacanthoma diagnosed by the participating office-based dermatologists in Denmark. MAIN VARIABLES: Clinical and histological diagnoses, BCC subtype, localization, size, skin cancer history, skin phototype, and evidence of metastases and treatment modality are the main variables...

  2. Cost efficiency of canagliflozin versus sitagliptin for type 2 diabetes mellitus.

    Science.gov (United States)

    Ektare, Varun U; Lopez, Janice M S; Martin, Silas C; Patel, Dipen A; Rupnow, Marcia F T; Botteman, Marc F

    2014-10-01

    To compare 1-year clinical outcomes and cost efficiency of treating adults with type 2 diabetes mellitus (T2DM) with canagliflozin (300 mg/day) or sitagliptin (100 mg/day), both added on a background of metformin and sulfonylurea. An economic model integrated data from an active-controlled, randomized trial, claims database analyses, and published literature. The model adopted a US managed care payer perspective and included the clinical and economic impact of achieving specific clinical quality goals. The model was run separately for 2 single clinical quality metrics, glycated hemoglobin (A1C) canagliflozin 300 mg resulted in $215 in annual cost savings and 12.3 absolute percentage points more patients achieving goal. Similar findings were found across all other quality metrics (difference in proportion achieving goal ranging from 6.7% to 19.0% and annual savings ranging from $1 to $669). Canagliflozin remained cost saving versus sitagliptin in sensitivity analyses. Canagliflozin 300 mg may represent a cost-efficient T2DM treatment option versus sitagliptin 100 mg for patients on metformin plus sulfonylurea due to lower overall costs and better achievement of A1C and quality composite goals.

  3. Neutrosophic Relational Database Decomposition

    OpenAIRE

    Meena Arora; Ranjit Biswas; Dr. U.S.Pandey

    2011-01-01

    In this paper we present a method of decomposing a neutrosophic database relation with Neutrosophic attributes into basic relational form. Our objective is capable of manipulating incomplete as well as inconsistent information. Fuzzy relation or vague relation can only handle incomplete information. Authors are taking the Neutrosophic Relational database [8],[2] to show how imprecise data can be handled in relational schema.

  4. HIV Structural Database

    Science.gov (United States)

    SRD 102 HIV Structural Database (Web, free access)   The HIV Protease Structural Database is an archive of experimentally determined 3-D structures of Human Immunodeficiency Virus 1 (HIV-1), Human Immunodeficiency Virus 2 (HIV-2) and Simian Immunodeficiency Virus (SIV) Proteases and their complexes with inhibitors or products of substrate cleavage.

  5. Structural Ceramics Database

    Science.gov (United States)

    SRD 30 NIST Structural Ceramics Database (Web, free access)   The NIST Structural Ceramics Database (WebSCD) provides evaluated materials property data for a wide range of advanced ceramics known variously as structural ceramics, engineering ceramics, and fine ceramics.

  6. Odense Pharmacoepidemiological Database (OPED)

    DEFF Research Database (Denmark)

    Hallas, Jesper; Poulsen, Maja Hellfritzsch; Hansen, Morten Rix

    2017-01-01

    The Odense University Pharmacoepidemiological Database (OPED) is a prescription database established in 1990 by the University of Southern Denmark, covering reimbursed prescriptions from the county of Funen in Denmark and the region of Southern Denmark (1.2 million inhabitants). It is still active...

  7. The Danish Anaesthesia Database

    DEFF Research Database (Denmark)

    Antonsen, Kristian; Rosenstock, Charlotte Vallentin; Lundstrøm, Lars Hyldborg

    2016-01-01

    AIM OF DATABASE: The aim of the Danish Anaesthesia Database (DAD) is the nationwide collection of data on all patients undergoing anesthesia. Collected data are used for quality assurance, quality development, and serve as a basis for research projects. STUDY POPULATION: The DAD was founded in 2004...

  8. World Database of Happiness

    NARCIS (Netherlands)

    R. Veenhoven (Ruut)

    1995-01-01

    textabstractABSTRACT The World Database of Happiness is an ongoing register of research on subjective appreciation of life. Its purpose is to make the wealth of scattered findings accessible, and to create a basis for further meta-analytic studies. The database involves four sections:
    1.

  9. Balkan Vegetation Database

    NARCIS (Netherlands)

    Vassilev, Kiril; Pedashenko, Hristo; Alexandrova, Alexandra; Tashev, Alexandar; Ganeva, Anna; Gavrilova, Anna; Gradevska, Asya; Assenov, Assen; Vitkova, Antonina; Grigorov, Borislav; Gussev, Chavdar; Filipova, Eva; Aneva, Ina; Knollová, Ilona; Nikolov, Ivaylo; Georgiev, Georgi; Gogushev, Georgi; Tinchev, Georgi; Pachedjieva, Kalina; Koev, Koycho; Lyubenova, Mariyana; Dimitrov, Marius; Apostolova-Stoyanova, Nadezhda; Velev, Nikolay; Zhelev, Petar; Glogov, Plamen; Natcheva, Rayna; Tzonev, Rossen; Boch, Steffen; Hennekens, Stephan M.; Georgiev, Stoyan; Stoyanov, Stoyan; Karakiev, Todor; Kalníková, Veronika; Shivarov, Veselin; Russakova, Veska; Vulchev, Vladimir

    2016-01-01

    The Balkan Vegetation Database (BVD; GIVD ID: EU-00-019; http://www.givd.info/ID/EU-00- 019) is a regional database that consists of phytosociological relevés from different vegetation types from six countries on the Balkan Peninsula (Albania, Bosnia and Herzegovina, Bulgaria, Kosovo, Montenegro

  10. Balkan Vegetation Database

    NARCIS (Netherlands)

    Vassilev, Kiril; Pedashenko, Hristo; Alexandrova, Alexandra; Tashev, Alexandar; Ganeva, Anna; Gavrilova, Anna; Gradevska, Asya; Assenov, Assen; Vitkova, Antonina; Grigorov, Borislav; Gussev, Chavdar; Filipova, Eva; Aneva, Ina; Knollová, Ilona; Nikolov, Ivaylo; Georgiev, Georgi; Gogushev, Georgi; Tinchev, Georgi; Pachedjieva, Kalina; Koev, Koycho; Lyubenova, Mariyana; Dimitrov, Marius; Apostolova-Stoyanova, Nadezhda; Velev, Nikolay; Zhelev, Petar; Glogov, Plamen; Natcheva, Rayna; Tzonev, Rossen; Boch, Steffen; Hennekens, Stephan M.; Georgiev, Stoyan; Stoyanov, Stoyan; Karakiev, Todor; Kalníková, Veronika; Shivarov, Veselin; Russakova, Veska; Vulchev, Vladimir

    2016-01-01

    The Balkan Vegetation Database (BVD; GIVD ID: EU-00-019; http://www.givd.info/ID/EU-00- 019) is a regional database that consists of phytosociological relevés from different vegetation types from six countries on the Balkan Peninsula (Albania, Bosnia and Herzegovina, Bulgaria, Kosovo, Montenegro

  11. Biological Macromolecule Crystallization Database

    Science.gov (United States)

    SRD 21 Biological Macromolecule Crystallization Database (Web, free access)   The Biological Macromolecule Crystallization Database and NASA Archive for Protein Crystal Growth Data (BMCD) contains the conditions reported for the crystallization of proteins and nucleic acids used in X-ray structure determinations and archives the results of microgravity macromolecule crystallization studies.

  12. Database Publication Practices

    DEFF Research Database (Denmark)

    Bernstein, P.A.; DeWitt, D.; Heuer, A.

    2005-01-01

    There has been a growing interest in improving the publication processes for database research papers. This panel reports on recent changes in those processes and presents an initial cut at historical data for the VLDB Journal and ACM Transactions on Database Systems....

  13. A Quality System Database

    Science.gov (United States)

    Snell, William H.; Turner, Anne M.; Gifford, Luther; Stites, William

    2010-01-01

    A quality system database (QSD), and software to administer the database, were developed to support recording of administrative nonconformance activities that involve requirements for documentation of corrective and/or preventive actions, which can include ISO 9000 internal quality audits and customer complaints.

  14. An organic database system

    NARCIS (Netherlands)

    M.L. Kersten (Martin); A.P.J.M. Siebes (Arno)

    1999-01-01

    textabstractThe pervasive penetration of database technology may suggest that we have reached the end of the database research era. The contrary is true. Emerging technology, in hardware, software, and connectivity, brings a wealth of opportunities to push technology to a new level of maturity.

  15. Atomic Spectra Database (ASD)

    Science.gov (United States)

    SRD 78 NIST Atomic Spectra Database (ASD) (Web, free access)   This database provides access and search capability for NIST critically evaluated data on atomic energy levels, wavelengths, and transition probabilities that are reasonably up-to-date. The NIST Atomic Spectroscopy Data Center has carried out these critical compilations.

  16. World Database of Happiness

    NARCIS (Netherlands)

    R. Veenhoven (Ruut)

    1995-01-01

    textabstractABSTRACT The World Database of Happiness is an ongoing register of research on subjective appreciation of life. Its purpose is to make the wealth of scattered findings accessible, and to create a basis for further meta-analytic studies. The database involves four sections:
    1. Bib

  17. World Database of Happiness

    NARCIS (Netherlands)

    R. Veenhoven (Ruut)

    1995-01-01

    textabstractABSTRACT The World Database of Happiness is an ongoing register of research on subjective appreciation of life. Its purpose is to make the wealth of scattered findings accessible, and to create a basis for further meta-analytic studies. The database involves four sections:
    1. Bib

  18. Database Description - Yeast Interacting Proteins Database | LSDB Archive [Life Science Database Archive metadata

    Lifescience Database Archive (English)

    Full Text Available Yeast Interacting Proteins Database Database Description General information of database Database name Yeast... Interacting Proteins Database Alternative name - Creator Creator Name: Takashi Ito* Creator Affiliation: Di...-4-7136-3989 FAX: +81-4-7136-3979 E-mail : Database classification Metabolic and Signaling Pathways - Protei...n-protein interactions Organism Taxonomy Name: Saccharomyces cerevisiae Taxonomy ID: 4932 Database descripti...ive yeast two-hybrid analysis of budding yeast proteins. Features and manner of utilization of database Prot

  19. 48 CFR 32.1105 - Assignment of claims.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Assignment of claims. 32... CONTRACTING REQUIREMENTS CONTRACT FINANCING Electronic Funds Transfer 32.1105 Assignment of claims. The use of EFT payment methods is not a substitute for a properly executed assignment of claims in accordance...

  20. 76 FR 44504 - Claims for Patent and Copyright Infringement

    Science.gov (United States)

    2011-07-26

    ... SPACE ADMINISTRATION 14 CFR Part 1245 RIN 2700-AD63 Claims for Patent and Copyright Infringement AGENCY... considers necessary to file a claim for patent or copyright infringement, and they also provide for written... Act (51 U.S.C. 20113) authorizes the Administrator of NASA to settle administrative claims of...

  1. 32 CFR 1636.2 - The claim of conscientious objection.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false The claim of conscientious objection. 1636.2 Section 1636.2 National Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM CLASSIFICATION OF CONSCIENTIOUS OBJECTORS § 1636.2 The claim of conscientious objection. A claim...

  2. 19 CFR 191.0a - Claims filed under NAFTA.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Claims filed under NAFTA. 191.0a Section 191.0a Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) DRAWBACK § 191.0a Claims filed under NAFTA. Claims for drawback filed under the...

  3. 20 CFR 362.10 - Principal types of claims allowable.

    Science.gov (United States)

    2010-04-01

    ... which the loss or damage occurred: (1) In a common or natural disaster; (2) When the property was... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Principal types of claims allowable. 362.10... PROCEDURES EMPLOYEES' PERSONAL PROPERTY CLAIMS § 362.10 Principal types of claims allowable. (a) In...

  4. 33 CFR 211.22 - Real estate Claims Officers.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Real estate Claims Officers. 211..., DEPARTMENT OF DEFENSE REAL ESTATE ACTIVITIES OF THE CORPS OF ENGINEERS IN CONNECTION WITH CIVIL WORKS PROJECTS Real Estate Claims § 211.22 Real estate Claims Officers. In each Division Office the Division...

  5. 42 CFR 431.972 - Claims sampling procedures.

    Science.gov (United States)

    2010-10-01

    ... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Estimating Improper Payments in Medicaid and CHIP § 431.972 Claims sampling procedures. (a) Claims universe... been if the claim had not been denied) through Title XIX (Medicaid) or Title XXI (CHIP). (2) The State...

  6. 9 CFR 56.6 - Presentation of claims for indemnity.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Presentation of claims for indemnity. 56.6 Section 56.6 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT... LOW PATHOGENIC AVIAN INFLUENZA § 56.6 Presentation of claims for indemnity. Claims for the...

  7. 9 CFR 52.4 - Presentation of claims.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Presentation of claims. 52.4 Section 52.4 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF... PSEUDORABIES § 52.4 Presentation of claims. (a) When swine have been destroyed under § 52.2(a), any claim...

  8. 24 CFR 200.153 - Presentation of claim.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Presentation of claim. 200.153 Section 200.153 Housing and Urban Development Regulations Relating to Housing and Urban Development... Claims for Losses § 200.153 Presentation of claim. In the event the insured lender is entitled under...

  9. 49 CFR 378.4 - Documentation of claims.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 5 2010-10-01 2010-10-01 false Documentation of claims. 378.4 Section 378.4... Documentation of claims. (a) Claims for overcharge, duplicate payment, or overcollection shall be accompanied by... provide sufficient information and documentation to allow a carrier to conduct an investigation and pay...

  10. 42 CFR 430.40 - Deferral of claims for FFP.

    Science.gov (United States)

    2010-10-01

    ... accordance with 45 CFR part 16. ... 42 Public Health 4 2010-10-01 2010-10-01 false Deferral of claims for FFP. 430.40 Section 430.40... Medicaid Payments § 430.40 Deferral of claims for FFP. (a) Requirements for deferral. Payment of a claim...

  11. 77 FR 44155 - Administration of Mining Claims and Sites

    Science.gov (United States)

    2012-07-27

    ... (BLM) is issuing this rule to amend regulations on locating, recording, and maintaining mining claims... locate new placer mining claims; and Publishing the regulations in final form gives time to placer mining... regulation, a claimant who records a new 66-acre placer mining claim must pay an initial maintenance fee of...

  12. Truthiness and Falsiness of Trivia Claims Depend on Judgmental Contexts

    Science.gov (United States)

    Newman, Eryn J.; Garry, Maryanne; Unkelbach, Christian; Bernstein, Daniel M.; Lindsay, D. Stephen; Nash, Robert A.

    2015-01-01

    When people rapidly judge the truth of claims presented with or without related but nonprobative photos, the photos tend to inflate the subjective truth of those claims--a "truthiness" effect (Newman et al., 2012). For example, people more often judged the claim "Macadamia nuts are in the same evolutionary family as peaches" to…

  13. 15 CFR 2.5 - Adjudication and settlement of claims.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Adjudication and settlement of claims. 2.5 Section 2.5 Commerce and Foreign Trade Office of the Secretary of Commerce PROCEDURES FOR... claims. (a) Upon receipt of a claim by the Assistant General Counsel for Finance and Litigation, the...

  14. 38 CFR 17.114 - Submittal of claim for reimbursement.

    Science.gov (United States)

    2010-07-01

    ... amount of reimbursement claimed on each article of personal effects is not in excess of the fair value... MEDICAL Reimbursement for Loss by Natural Disaster of Personal Effects of Hospitalized Or Nursing Home Patients § 17.114 Submittal of claim for reimbursement. The claim for reimbursement for personal...

  15. 13 CFR 142.3 - What is a claim?

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false What is a claim? 142.3 Section 142.3 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION PROGRAM FRAUD CIVIL REMEDIES ACT REGULATIONS Overview and Definitions § 142.3 What is a claim? (a) Claim means any request, demand,...

  16. 32 CFR 842.6 - Signature on the claim form.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Signature on the claim form. 842.6 Section 842.6... ADMINISTRATIVE CLAIMS General Information § 842.6 Signature on the claim form. The claimant or authorized agent... authorized agent signing for a claimant shows, after the signature, the title or capacity and...

  17. Workers' compensation claims related to natural rubber latex gloves among Oregon healthcare employees from 1987–1998

    Directory of Open Access Journals (Sweden)

    Kammeyer-Mueller John

    2002-09-01

    Full Text Available Abstract Background Occupational reaction to natural rubber latex (NRL glove use by healthcare employees has been an area of increasing concern. Unfortunately, there is little data demonstrating the prevalence and severity of actual reactivity to NRL. Method Occupational reaction to NRL was estimated using workers' compensation claims filed by healthcare employees in Oregon for the period of 1987–1998. For the first ten years, these claims were estimated by source and conditions consistent with NRL glove reactions, while in the last two years a specific code developed in 1997 for NRL glove reactions was also employed. Results The claim rate was on average 0.58 per 10,000 healthcare workers annually, which constituted 0.29% of all workers' compensation claims. The most common condition experienced was dermatitis (80% and most common body part affected was the hands (55.4%. The majority of claimants, 45 (69.2%, reported taking less than a month off work, suggesting most reactions were minor in nature, although one fatality was reported. The average NRL claim cost was $8,309.48. Overall the average cost per insured healthcare worker was approximately $0.50 per year. The occupational groups with the highest number of claims were nurses (30.8% of claimants and nursing aides and orderlies (24.6% of claimants. Conclusions In comparison with other workers' compensation claims filed by healthcare workers during this period, 0.25% of the total was potentially related to NRL gloves. The rare incidence of respiratory and ocular claims is inconsistent with the hypothesis that asthmatic or conjunctival reactions to NRL gloves are common.

  18. Reclamation research database

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2007-07-01

    A reclamation research database was compiled to help stakeholders search publications and research related to the reclamation of Alberta's oil sands region. New publications are added to the database by the Cumulative Environmental Management Association (CEMA), a nonprofit association whose mandate is to develop frameworks and guidelines for the management of cumulative environmental effects in the oil sands region. A total of 514 research papers have been compiled in the database to date. Topics include recent research on hydrology, aquatic and terrestrial ecosystems, laboratory studies on biodegradation, and the effects of oil sands processing on micro-organisms. The database includes a wide variety of studies related to reconstructed wetlands as well as the ecological effects of hydrocarbons on phytoplankton and other organisms. The database format included information on research format availability, as well as information related to the author's affiliations. Links to external abstracts were provided where available, as well as details of source information.

  19. The LHCb configuration database

    CERN Document Server

    Abadie, L; Van Herwijnen, Eric; Jacobsson, R; Jost, B; Neufeld, N

    2005-01-01

    The aim of the LHCb configuration database is to store information about all the controllable devices of the detector. The experiment's control system (that uses PVSS ) will configure, start up and monitor the detector from the information in the configuration database. The database will contain devices with their properties, connectivity and hierarchy. The ability to store and rapidly retrieve huge amounts of data, and the navigability between devices are important requirements. We have collected use cases to ensure the completeness of the design. Using the entity relationship modelling technique we describe the use cases as classes with attributes and links. We designed the schema for the tables using relational diagrams. This methodology has been applied to the TFC (switches) and DAQ system. Other parts of the detector will follow later. The database has been implemented using Oracle to benefit from central CERN database support. The project also foresees the creation of tools to populate, maintain, and co...

  20. Cascadia Tsunami Deposit Database

    Science.gov (United States)

    Peters, Robert; Jaffe, Bruce; Gelfenbaum, Guy; Peterson, Curt

    2003-01-01

    The Cascadia Tsunami Deposit Database contains data on the location and sedimentological properties of tsunami deposits found along the Cascadia margin. Data have been compiled from 52 studies, documenting 59 sites from northern California to Vancouver Island, British Columbia that contain known or potential tsunami deposits. Bibliographical references are provided for all sites included in the database. Cascadia tsunami deposits are usually seen as anomalous sand layers in coastal marsh or lake sediments. The studies cited in the database use numerous criteria based on sedimentary characteristics to distinguish tsunami deposits from sand layers deposited by other processes, such as river flooding and storm surges. Several studies cited in the database contain evidence for more than one tsunami at a site. Data categories include age, thickness, layering, grainsize, and other sedimentological characteristics of Cascadia tsunami deposits. The database documents the variability observed in tsunami deposits found along the Cascadia margin.

  1. Database Description - DGBY | LSDB Archive [Life Science Database Archive metadata

    Lifescience Database Archive (English)

    Full Text Available [ Credits ] BLAST Search Image Search Home About Archive Update History Contact us DGBY Database... Description General information of database Database name DGBY Alternative name Database for G...-12 Kannondai, Tsukuba, Ibaraki 305-8642 Japan Akira Ando TEL: +81-29-838-8066 E-mail: Database classificati...on Microarray Data and other Gene Expression Databases Organism Taxonomy Name: Sa...ccharomyces cerevisiae Taxonomy ID: 4932 Database description Baker's yeast Saccharomyces cerevisiae is an e

  2. Database Description - RPSD | LSDB Archive [Life Science Database Archive metadata

    Lifescience Database Archive (English)

    Full Text Available [ Credits ] BLAST Search Image Search Home About Archive Update History Contact us RPSD Database... Description General information of database Database name RPSD Alternative name Summary inform...n National Institute of Agrobiological Sciences Toshimasa Yamazaki E-mail : Database classification Structure Database...idopsis thaliana Taxonomy ID: 3702 Taxonomy Name: Glycine max Taxonomy ID: 3847 Database description We have...nts such as rice, and have put together the result and related informations. This database contains the basi

  3. Short-term costs of preeclampsia to the United States health care system.

    Science.gov (United States)

    Stevens, Warren; Shih, Tiffany; Incerti, Devin; Ton, Thanh G N; Lee, Henry C; Peneva, Desi; Macones, George A; Sibai, Baha M; Jena, Anupam B

    2017-09-01

    Preeclampsia is a leading cause of maternal morbidity and mortality and adverse neonatal outcomes. Little is known about the extent of the health and cost burden of preeclampsia in the United States. This study sought to quantify the annual epidemiological and health care cost burden of preeclampsia to both mothers and infants in the United States in 2012. We used epidemiological and econometric methods to assess the annual cost of preeclampsia in the United States using a combination of population-based and administrative data sets: the National Center for Health Statistics Vital Statistics on Births, the California Perinatal Quality Care Collaborative Databases, the US Health Care Cost and Utilization Project database, and a commercial claims data set. Preeclampsia increased the probability of an adverse event from 4.6% to 10.1% for mothers and from 7.8% to 15.4% for infants while lowering gestational age by 1.7 weeks (P preeclampsia during the first 12 months after birth was $1.03 billion for mothers and $1.15 billion for infants. The cost burden per infant is dependent on gestational age, ranging from $150,000 at 26 weeks gestational age to $1311 at 36 weeks gestational age. In 2012, the cost of preeclampsia within the first 12 months of delivery was $2.18 billion in the United States ($1.03 billion for mothers and $1.15 billion for infants), and was disproportionately borne by births of low gestational age. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Cost Behavior

    DEFF Research Database (Denmark)

    Hoffmann, Kira

    The objective of this dissertation is to investigate determinants and consequences of asymmetric cost behavior. Asymmetric cost behavior arises if the change in costs is different for increases in activity compared to equivalent decreases in activity. In this case, costs are termed “sticky......” if the change is less when activity falls than when activity rises, whereas costs are termed “anti-sticky” if the change is more when activity falls than when activity rises. Understanding such cost behavior is especially relevant for decision-makers and financial analysts that rely on accurate cost information...

  5. Cost Behavior

    DEFF Research Database (Denmark)

    Hoffmann, Kira

    The objective of this dissertation is to investigate determinants and consequences of asymmetric cost behavior. Asymmetric cost behavior arises if the change in costs is different for increases in activity compared to equivalent decreases in activity. In this case, costs are termed “sticky......” if the change is less when activity falls than when activity rises, whereas costs are termed “anti-sticky” if the change is more when activity falls than when activity rises. Understanding such cost behavior is especially relevant for decision-makers and financial analysts that rely on accurate cost information...

  6. INCIDENCE AND PREVALENCE OF ACROMEGALY IN THE UNITED STATES: A CLAIMS-BASED ANALYSIS.

    Science.gov (United States)

    Broder, Michael S; Chang, Eunice; Cherepanov, Dasha; Neary, Maureen P; Ludlam, William H

    2016-11-01

    Acromegaly, a rare endocrine disorder, results from excessive growth hormone secretion, leading to multisystem-associated morbidities. Using 2 large nationwide databases, we estimated the annual incidence and prevalence of acromegaly in the U.S. We used 2008 to 2013 data from the Truven Health MarketScan(®) Commercial Claims and Encounters Database and IMS Health PharMetrics healthcare insurance claims databases, with health plan enrollees acromegaly (International Classification of Diseases, 9th Revision, Clinical Modification Code [ICD-9CM] 253.0), or 1 claim with acromegaly and 1 claim for pituitary tumor, pituitary surgery, or cranial stereotactic radiosurgery. Annual incidence was calculated for each year from 2009 to 2013, and prevalence in 2013. Estimates were stratified by age and sex. Incidence was up to 11.7 cases per million person-years (PMPY) in MarketScan and 9.6 cases PMPY in PharMetrics. Rates were similar by sex but typically lowest in ≤17 year olds and higher in >24 year olds. The prevalence estimates were 87.8 and 71.0 per million per year in MarketScan and PharMetrics, respectively. Prevalence consistently increased with age but was similar by sex in each database. The current U.S. incidence of acromegaly may be up to 4 times higher and prevalence may be up to 50% higher than previously reported in European studies. Our findings correspond with the estimates reported by a recent U.S. study that used a single managed care database, supporting the robustness of these estimates in this population. Our study indicates there are approximately 3,000 new cases of acromegaly per year, with a prevalence of about 25,000 acromegaly patients in the U.S. CT = computed tomography GH = growth hormone IGF-1 = insulin-like growth factor 1 ICD-9-CM Code = International Classification of Diseases, 9th Revision, Clinical Modification Codes MRI = magnetic resonance imaging PMPY = per million person-years.

  7. Identification of volume overload hospitalizations among hemodialysis patients using administrative claims: a validation study.

    Science.gov (United States)

    Assimon, Magdalene M; Nguyen, Thuy; Katsanos, Suzanne L; Brunelli, Steven M; Flythe, Jennifer E

    2016-11-11

    High rates of volume overload hospitalizations may indicate inadequate dialysis facility fluid management. Administrative claims databases are often used to study such outcomes, but these data are generated for billing purposes and may not capture clinical nuance. It is unknown if volume overload admissions can be correctly identified in administrative data and if a single claims-based definition for volume overload can be used across epidemiologic surveillance studies, observational studies of exposure-outcome associations and quality assessments. We conducted a validation study to assess the accuracy of claims-based definitions for volume overload hospitalizations among hemodialysis patients. Data were taken from a random sample of 315 adult hemodialysis patients admitted to University of North Carolina Hospitals from January 2010 through June 2013. Standardized chart reviews were conducted to clinically adjudicate the presence or absence of volume overload at hospital admission. Claims-based definitions were constructed from varying combinations of fluid-related ICD-9 discharge diagnosis codes including fluid overload, pulmonary edema, pleural effusion, and heart failure. Using clinically adjudicated volume overload hospitalizations as the reference standard, validity metrics and their 95 % confidence intervals (CIs) were estimated for each definition. Of the 315 hospital admissions, 77 (24.4 %) were clinically adjudicated as volume overload hospitalizations. The prevalence of claims-identified volume overload admissions varied across definitions, ranging from 1.6 to 37.1 %. When definitions were constructed with discharge diagnosis codes present in any billing position, volume overload hospitalizations defined by fluid overload, pleural effusion or heart failure diagnosis codes had the highest sensitivity, 81.8 % (95 % CI: 71.4 %, 89.7 %). Volume overload hospitalizations defined by pulmonary edema diagnosis codes had the highest specificity, 98.3 % (95

  8. Factors influencing decisions on delay claims in construction contracts for Indian scenario

    OpenAIRE

    Nitin Balkrishna Chaphalkar; K. C. Iyer

    2014-01-01

      Construction industry in India is second largest next to agriculture. In current era of infrastructure development construction projects occupy a key position. In any construction project contract time and cost overrun is a common feature, which gives rise to claims leading to disputes. These disputes if not handled properly tend to consume time and money of all parties to the contract. To resolve the dispute in optimum time, it is essential to understand the root cause of disputes as early...

  9. Analysis of Cost Growth and Cost Composition in the Defense Aerospace Industry

    Science.gov (United States)

    1988-09-01

    poor management decisions (8-87). Miller and Vollman claim that results of their 1985 survey of North American manufacturers, show that mo:3t maaagers...appreciably decreased in favor of indirect costs (32:45). Miller and Vollman explain that overhead costs have been steadily increasing as a perrentage...of total manufacturing costs for more than 100 years (22:142). Results of a survey administered by Miller and Vollman indicate that manufacturing

  10. 77 FR 65631 - Retrospective Review Under E.O. 13563: Seamen's Claims; Admiralty Extension Act Claims; and...

    Science.gov (United States)

    2012-10-30

    ... process to more effectively address claims arising under the Suits in Admiralty Act, the Admiralty... added regulations implement a process to resolve administrative claims arising under the Admiralty... clarification of its regulations pertaining to seamen's claims, administrative action taken against MarAd, and...

  11. Electrochemical Journals, AIP's Scitation, Cost-Effectiveness

    OpenAIRE

    Roth, Dana L

    2004-01-01

    A review of the relative subscription costs, page & article counts of Electrochemical Society journals compared with commercial counterparts. A description of the AIP's Scitation database. The relative cost-effectiveness (normalized cost/article/Impact Factor) of society and commercial journals related to electrochemistry.

  12. Greenhouse Gas Mitigation Options Database(GMOD)and Tool

    Science.gov (United States)

    Greenhouse Gas Mitigation Options Database (GMOD) is a decision support database and tool that provides cost and performance information for GHG mitigation options for the power, cement, refinery, landfill and pulp and paper sectors. The GMOD includes approximately 450 studies fo...

  13. Towards the architecture of an instructional multimedia database

    NARCIS (Netherlands)

    Verhagen, Pleunes Willem; Bestebreurtje, R.; Bestebreurtje, R.

    1994-01-01

    The applicability of multimedia databases in education may be extended if they can serve multiple target groups, leading to affordable costs per unit for the user. In this contribution, an approach is described to build generic multimedia databases to serve that purpose. This approach is elaborated

  14. Creating a Database for a Small Corporate Library: NOMAD Bookcat.

    Science.gov (United States)

    Bates, Ellen

    1983-01-01

    Description of NOMAD, a database management system with flexibility and "friendly" design in use at the Bank of America library, focuses on costs, objectives, database structure, access, and its use to create an automated book catalog and spending reports. Six references are included. (EJS)

  15. Association between oral 5-ASA adherence and health care utilization and costs among patients with active ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Mitra Debanjali

    2012-09-01

    Full Text Available Abstract Background Observational cohort study to assess the association between adherence to oral 5-aminosalicylates (5-ASAs and all-cause costs and health care utilization among patients with active ulcerative colitis (UC in the United States. Methods Retrospective analysis of insurance claims from June 1997 to August 2006 in the LifeLink Database. Patient criteria: aged 18 or older with one or more claim(s between June 1997 and August 2005 for a UC diagnosis and at least one oral 5-ASA prescription on or after the first observed UC diagnosis; continuous enrollment for at least 6 months prior to and 12 months following 5-ASA initiation (index date. As a proxy for active disease, patients needed to have at least two UC-specific non-pharmacy claims, at least 30 days of 5-ASA treatment and at least one corticosteroid prescription within the 12-month post-index period. Cumulative exposure to oral 5-ASAs over the 12-month period was calculated using the medication possession ratio (MPR. Patients with an MPR of at least 0.80 were classified as adherent. All-cause medical and pharmacy resource utilization and costs were computed over the 12-month post-index period and compared between adherent and nonadherent patients. Results 1,693 UC patients met study inclusion criteria: 72% were nonadherent to 5-ASA treatment (n = 1,217 and 28% were adherent (n = 476 in the 12-month study period. Compared with nonadherent patients, adherent patients had 31% fewer hospitalizations (P = 0.0025 and 34% fewer emergency department admissions (P = 0.0016. Adherent patients had 25% more pharmacy prescriptions overall (P P P = 0.0002. After adjusting for covariates, total all-cause costs were 29% higher for nonadherent patients than for adherent patients (mean [95% confidence interval]: $13,465 [$13,094, $13,835] vs $17,339 [$17,033, $17,645]. Conclusions Approximately three-quarters of patients with active UC were not adherent with their

  16. PADB : Published Association Database

    Directory of Open Access Journals (Sweden)

    Lee Jin-Sung

    2007-09-01

    Full Text Available Abstract Background Although molecular pathway information and the International HapMap Project data can help biomedical researchers to investigate the aetiology of complex diseases more effectively, such information is missing or insufficient in current genetic association databases. In addition, only a few of the environmental risk factors are included as gene-environment interactions, and the risk measures of associations are not indexed in any association databases. Description We have developed a published association database (PADB; http://www.medclue.com/padb that includes both the genetic associations and the environmental risk factors available in PubMed database. Each genetic risk factor is linked to a molecular pathway database and the HapMap database through human gene symbols identified in the abstracts. And the risk measures such as odds ratios or hazard ratios are extracted automatically from the abstracts when available. Thus, users can review the association data sorted by the risk measures, and genetic associations can be grouped by human genes or molecular pathways. The search results can also be saved to tab-delimited text files for further sorting or analysis. Currently, PADB indexes more than 1,500,000 PubMed abstracts that include 3442 human genes, 461 molecular pathways and about 190,000 risk measures ranging from 0.00001 to 4878.9. Conclusion PADB is a unique online database of published associations that will serve as a novel and powerful resource for reviewing and interpreting huge association data of complex human diseases.

  17. Database and Expert Systems Applications

    DEFF Research Database (Denmark)

    Viborg Andersen, Kim; Debenham, John; Wagner, Roland

    submissions. The papers are organized in topical sections on workflow automation, database queries, data classification and recommendation systems, information retrieval in multimedia databases, Web applications, implementational aspects of databases, multimedia databases, XML processing, security, XML...... schemata, query evaluation, semantic processing, information retrieval, temporal and spatial databases, querying XML, organisational aspects of databases, natural language processing, ontologies, Web data extraction, semantic Web, data stream management, data extraction, distributed database systems...

  18. Assessment of Malpractice Claims Associated With Acute Compartment Syndrome.

    Science.gov (United States)

    DePasse, John Mason; Sargent, Rachel; Fantry, Amanda J; Bokshan, Steven L; Palumbo, Mark A; Daniels, Alan H

    2017-06-01

    Because acute compartment syndrome is one of the few limb-threatening and life-threatening orthopaedic conditions and is difficult to diagnose, it is a frequent source of litigation. Understanding the factors that lead to plaintiff verdicts and higher indemnity payments may improve patient care by identifying common pitfalls. The VerdictSearch legal claims database was queried for the term "compartment syndrome." After 46 cases were excluded for missing information or irrelevancy, 139 cases were reviewed. The effects of plaintiff demographics, mechanism of injury, and complications were assessed. Of 139 cases, 37 (27%) were settled, 69 (50%) resulted in a defendant ruling, and 33 (24%) resulted in a plaintiff ruling. Juries were more likely to rule in favor of juvenile plaintiffs than adult patients (P = 0.002) and female plaintiffs than male plaintiffs (P = 0.008), but indemnity payments were not affected by the age or sex of the plaintiff. Plaintiffs who experienced acute compartment syndrome as a complication of surgery were more likely to win their suit and receive higher awards (P compartment syndrome if the patient was a woman or child or if acute compartment syndrome developed as a complication of a surgical procedure.

  19. Validation of a method for identifying nursing home admissions using administrative claims

    Directory of Open Access Journals (Sweden)

    Hsu Van Doren

    2007-12-01

    Full Text Available Abstract Background Currently there is no standard algorithm to identify whether a subject is residing in a nursing home from administrative claims. Our objective was to develop and validate an algorithm that identifies nursing home admissions at the resident-month level using the MarketScan Medicare Supplemental and Coordination of Benefit (COB database. Methods The computer algorithms for identifying nursing home admissions were created by using provider type, place of service, and procedure codes from the 2000 – 2002 MarketScan Medicare COB database. After the algorithms were reviewed and refined, they were compared with a detailed claims review by an expert reviewer. A random sample of 150 subjects from the claims was selected and used for the validity analysis of the algorithms. Contingency table analysis, comparison of mean differences, correlations, and t-test analyses were performed. Percentage agreement, sensitivity, specificity, and Kappa statistics were analyzed. Results The computer algorithm showed strong agreement with the expert review (99.9% for identification of the first month of nursing home residence, with high sensitivity (96.7%, specificity (100% and a Kappa statistic of 0.97. Weighted Pearson correlation coefficient between the algorithm and the expert review was 0.97 (p Conclusion A reliable algorithm indicating evidence of nursing home admission was developed and validated from administrative claims data. Our algorithm can be a useful tool to identify patient transitions from and to nursing homes, as well as to screen and monitor for factors associated with nursing home admission and nursing home discharge.

  20. Estimating dollar-value outcomes of workman`s compensation claims using radial basis function networks

    Energy Technology Data Exchange (ETDEWEB)

    Hancock, M.F. Jr. [Rollins College, Winter Park, FL (United States)

    1995-12-31

    The National Council on Compensation Insurance (NCCI) maintains a national data base of outcomes of workers` compensation claims. We consider whether a radial basis function network can predict the total dollar value of a claim based upon medical and demographic indicators (MDI`s). This work used data from 12,130 workers` compensation claims collected over a period of four years from the state of New Mexico. Two problems were addressed: (1) How well can the total incurred medical expense for all claims be predicted from available MDI`s? For individual claims? (2) How well can the duration of disability be predicted from available MDI`s? The available features intuitively correlated with total medical cost were selected, including type of injury, part of body injured, person`s age at time of injury, gender, marital status, etc. These features were statistically standardized and sorted by correlation with outcome valuation. Principal component analysis was applied. A radial basis function neural network was applied to the feature sets in both supervised and unsupervised training modes. For sets used in training, individual case valuations could consistently be predicted to within $1000 over 98% of the time. For these sets, it was possible to predict total medical expense for the training sets themselves to within 10%. When applied as blind tests against sets which were NOT part of the training data, the prediction was within 15% on the whole sets. Results on individual cases were very poor in only 30% of the cases were the predictions for the training sets within $1000 of their actual valuations. Single-factor analysis suggested that the presence of an attorney strongly decorrelated the data. A simple stratification was performed to remove cases involving attorneys and contested claims, and the procedures above repeated. Preliminary results based upon the very limited effort applied indicate that NCCI data support population estimates, but not single-point estimates.

  1. Glycoproteomic and glycomic databases.

    Science.gov (United States)

    Baycin Hizal, Deniz; Wolozny, Daniel; Colao, Joseph; Jacobson, Elena; Tian, Yuan; Krag, Sharon S; Betenbaugh, Michael J; Zhang, Hui

    2014-01-01

    Protein glycosylation serves critical roles in the cellular and biological processes of many organisms. Aberrant glycosylation has been associated with many illnesses such as hereditary and chronic diseases like cancer, cardiovascular diseases, neurological disorders, and immunological disorders. Emerging mass spectrometry (MS) technologies that enable the high-throughput identification of glycoproteins and glycans have accelerated the analysis and made possible the creation of dynamic and expanding databases. Although glycosylation-related databases have been established by many laboratories and institutions, they are not yet widely known in the community. Our study reviews 15 different publicly available databases and identifies their key elements so that users can identify the most applicable platform for their analytical needs. These databases include biological information on the experimentally identified glycans and glycopeptides from various cells and organisms such as human, rat, mouse, fly and zebrafish. The features of these databases - 7 for glycoproteomic data, 6 for glycomic data, and 2 for glycan binding proteins are summarized including the enrichment techniques that are used for glycoproteome and glycan identification. Furthermore databases such as Unipep, GlycoFly, GlycoFish recently established by our group are introduced. The unique features of each database, such as the analytical methods used and bioinformatical tools available are summarized. This information will be a valuable resource for the glycobiology community as it presents the analytical methods and glycosylation related databases together in one compendium. It will also represent a step towards the desired long term goal of integrating the different databases of glycosylation in order to characterize and categorize glycoproteins and glycans better for biomedical research.

  2. Update History of This Database - Trypanosomes Database | LSDB Archive [Life Science Database Archive metadata

    Lifescience Database Archive (English)

    Full Text Available List Contact us Trypanosomes Database Update History of This Database Date Update contents 2014/05/07 The co...ntact information is corrected. The features and manner of utilization of the database are corrected. 2014/02/04 Trypanosomes Databas...e English archive site is opened. 2011/04/04 Trypanosomes Database ( http://www.tan...paku.org/tdb/ ) is opened. About This Database Database Description Download Lice...nse Update History of This Database Site Policy | Contact Us Update History of This Database - Trypanosomes Database | LSDB Archive ...

  3. Association Claims in the Sequencing Era

    Directory of Open Access Journals (Sweden)

    Sara L. Pulit

    2014-03-01

    Full Text Available Since the completion of the Human Genome Project, the field of human genetics has been in great flux, largely due to technological advances in studying DNA sequence variation. Although community-wide adoption of statistical standards was key to the success of genome-wide association studies, similar standards have not yet been globally applied to the processing and interpretation of sequencing data. It has proven particularly challenging to pinpoint unequivocally disease variants in sequencing studies of polygenic traits. Here, we comment on a number of factors that may contribute to irreproducible claims of association in scientific literature and discuss possible steps that we can take towards cultural change.

  4. Bargaining with Claims in Economic Environments

    OpenAIRE

    Herrero, Carmen

    1998-01-01

    In this paper a reconstruction of the theory of bargaining with claims in economic environments is addressed. The spirit of that reconstruction is similar to that of the standard bargaining theory made by Roemer. En este trabajo se aborda el problema de la reconstrucción de la teoría de negociación con derechos en entornos económicos. El espíritu de la reconstrucción y las técnicas son semejantes a las de Roemer para el problema clásico de negociación.

  5. Women Claimed Right to participate in Government

    Institute of Scientific and Technical Information of China (English)

    1994-01-01

    In the early 1900s, when Western women were just starting to fight for their rights to participate in government and political affairs, China’s women, who had just broken away from a feudal monarchy, also claimed that they wanted to participate in government and political affairs.In 1912, the Revolution of 1911, led by Sun Yat-sen-pioneer of China’s democratic revolution-overthrew the last feudal monarchy and the bourgeois Republic of China was founded. The women following sun Yat-sen were to put into action their demand to participate in government and political affairs.

  6. USAGE OF FOOD HEALTH CLAIMS AND RELATED CONSUMER UNDERSTANDING

    Directory of Open Access Journals (Sweden)

    Naima KHURSHID

    2014-11-01

    Full Text Available Very few studies in various countries have been conducted in the context of effect of food health claims onto consumer health and purchase behavior. Health claim messages vary from country to country; but overall consumers view these claims as useful. Generally it is observed that consumers prefer short and concise health claim messages as compared to more long and complex ones. Moreover consumers are of the viewpoint that health claims are more effective if supported and approved by government. Foods with health claims are viewed healthier by consumers, but in some cases consumers may get discouraged by health claims when they are unable to properly comprehend the intended message of nutrition claims. Consumers remain vague between distinguishing health claims, content and structure-function of nutrients. Furthermore there is past evidence that in few instances consumers have improved their dietary choices and knowledge regarding health concern because of use of health claims by manufacturers and governing bodies. This study is a review of contemporary health claim practices in the global upfront.

  7. Phase Equilibria Diagrams Database

    Science.gov (United States)

    SRD 31 NIST/ACerS Phase Equilibria Diagrams Database (PC database for purchase)   The Phase Equilibria Diagrams Database contains commentaries and more than 21,000 diagrams for non-organic systems, including those published in all 21 hard-copy volumes produced as part of the ACerS-NIST Phase Equilibria Diagrams Program (formerly titled Phase Diagrams for Ceramists): Volumes I through XIV (blue books); Annuals 91, 92, 93; High Tc Superconductors I & II; Zirconium & Zirconia Systems; and Electronic Ceramics I. Materials covered include oxides as well as non-oxide systems such as chalcogenides and pnictides, phosphates, salt systems, and mixed systems of these classes.

  8. LandIT Database

    DEFF Research Database (Denmark)

    Iftikhar, Nadeem; Pedersen, Torben Bach

    2010-01-01

    and reporting purposes. This paper presents the LandIT database; which is result of the LandIT project, which refers to an industrial collaboration project that developed technologies for communication and data integration between farming devices and systems. The LandIT database in principal is based...... on the ISOBUS standard; however the standard is extended with additional requirements, such as gradual data aggregation and flexible exchange of farming data. This paper describes the conceptual and logical schemas of the proposed database based on a real-life farming case study....

  9. ALICE Geometry Database

    CERN Document Server

    Santo, J

    1999-01-01

    The ALICE Geometry Database project consists of the development of a set of data structures to store the geometrical information of the ALICE Detector. This Database will be used in Simulation, Reconstruction and Visualisation and will interface with existing CAD systems and Geometrical Modellers.At the present time, we are able to read a complete GEANT3 geometry, to store it in our database and to visualise it. On disk, we store different geometry files in hierarchical fashion, and all the nodes, materials, shapes, configurations and transformations distributed in this tree structure. The present status of the prototype and its future evolution will be presented.

  10. Database machine performance

    Energy Technology Data Exchange (ETDEWEB)

    Cesarini, F.; Salza, S.

    1987-01-01

    This book is devoted to the important problem of database machine performance evaluation. The book presents several methodological proposals and case studies, that have been developed within an international project supported by the European Economic Community on Database Machine Evaluation Techniques and Tools in the Context of the Real Time Processing. The book gives an overall view of the modeling methodologies and the evaluation strategies that can be adopted to analyze the performance of the database machine. Moreover, it includes interesting case studies and an extensive bibliography.

  11. Product Licenses Database Application

    CERN Document Server

    Tonkovikj, Petar

    2016-01-01

    The goal of this project is to organize and centralize the data about software tools available to CERN employees, as well as provide a system that would simplify the license management process by providing information about the available licenses and their expiry dates. The project development process is consisted of two steps: modeling the products (software tools), product licenses, legal agreements and other data related to these entities in a relational database and developing the front-end user interface so that the user can interact with the database. The result is an ASP.NET MVC web application with interactive views for displaying and managing the data in the underlying database.

  12. Plant Genome Duplication Database.

    Science.gov (United States)

    Lee, Tae-Ho; Kim, Junah; Robertson, Jon S; Paterson, Andrew H

    2017-01-01

    Genome duplication, widespread in flowering plants, is a driving force in evolution. Genome alignments between/within genomes facilitate identification of homologous regions and individual genes to investigate evolutionary consequences of genome duplication. PGDD (the Plant Genome Duplication Database), a public web service database, provides intra- or interplant genome alignment information. At present, PGDD contains information for 47 plants whose genome sequences have been released. Here, we describe methods for identification and estimation of dates of genome duplication and speciation by functions of PGDD.The database is freely available at http://chibba.agtec.uga.edu/duplication/.

  13. LandIT Database

    DEFF Research Database (Denmark)

    Iftikhar, Nadeem; Pedersen, Torben Bach

    2010-01-01

    and reporting purposes. This paper presents the LandIT database; which is result of the LandIT project, which refers to an industrial collaboration project that developed technologies for communication and data integration between farming devices and systems. The LandIT database in principal is based...... on the ISOBUS standard; however the standard is extended with additional requirements, such as gradual data aggregation and flexible exchange of farming data. This paper describes the conceptual and logical schemas of the proposed database based on a real-life farming case study....

  14. Danish Pancreatic Cancer Database

    DEFF Research Database (Denmark)

    Fristrup, Claus; Detlefsen, Sönke; Palnæs Hansen, Carsten

    2016-01-01

    AIM OF DATABASE: The Danish Pancreatic Cancer Database aims to prospectively register the epidemiology, diagnostic workup, diagnosis, treatment, and outcome of patients with pancreatic cancer in Denmark at an institutional and national level. STUDY POPULATION: Since May 1, 2011, all patients......, and survival. The results are published annually. CONCLUSION: The Danish Pancreatic Cancer Database has registered data on 2,217 patients with microscopically verified ductal adenocarcinoma of the pancreas. The data have been obtained nationwide over a period of 4 years and 2 months. The completeness...

  15. Impact of corporate social responsibility claims on consumer food choice

    DEFF Research Database (Denmark)

    Mueller Loose, Simone; Remaud, Hervé

    2013-01-01

    Purpose - The study assesses the impact of two different corporate social responsibility (CSR) claims, relating to social and environmental dimensions, on consumers’ wine choice across international markets. It is analysed how point of purchase CSR claims compete with other food claims...... and their awareness, penetration and consumers’ trust are examined. Design/methodology/approach - A discrete choice experiment with a visual shelf simulation was used to elicit consumer preferences and to estimate marginal willingness to pay for CSR and other food claims across the UK, France, Germany, the US...... food categories and different origins. Practical implications - CSR claims are competing with existing food claims and have a lower awareness, lower purchase penetration and less positive impact on consumer choice than organic claims. Producers are recommended to focus on communicating environmental...

  16. Impact of corporate social responsibility claims on consumer food choice

    DEFF Research Database (Denmark)

    Mueller Loose, Simone; Remaud, Hervé

    2013-01-01

    Purpose - The study assesses the impact of two different corporate social responsibility (CSR) claims, relating to social and environmental dimensions, on consumers’ wine choice across international markets. It is analysed how point of purchase CSR claims compete with other food claims...... a higher marginal willingness to pay. Consumer valuation of CSR claims significantly differs across international markets, but is consistently lower than for organic claims. Research limitations/implications - The study was limited to wine and future research is required to generalise findings to other...... rather than social CSR activities. The relative value of CSR claims differs across countries and companies need to adapt their strategies to specific market conditions. Originality/value - This is the first cross-national study that analyses the impact of CSR claims on consumer food choice relative...

  17. Health claims in Europe: probiotics and prebiotics as case examples.

    Science.gov (United States)

    van Loveren, Henk; Sanz, Yolanda; Salminen, Seppo

    2012-01-01

    Health claims regarding foods imply a relationship between a specific food and maintenance of good health, or that food can reduce the risk of disease. Health claim legislation in the European Union sets out from the concept of consumer protection. Health claim assessment focuses on defining given foods, assessing their health relationship, and evaluating relevant studies with an emphasis on controlled human intervention research. Challenges include the focus of claims on healthy populations, although most intervention studies have been conducted among patients. A further problem attends the risk reduction claim, which requires changes in generally accepted biomarkers reflecting the risk of disease. Scientific assessment and guidance documents direct the development of health claims both in Europe and elsewhere. Experience from completed assessments should make it possible to provide consumers with reliable claims to help them make healthier choices and develop lifestyles supporting long-term well-being.

  18. The Danish Nonmelanoma Skin Cancer Dermatology Database

    Science.gov (United States)

    Lamberg, Anna Lei; Sølvsten, Henrik; Lei, Ulrikke; Vinding, Gabrielle Randskov; Stender, Ida Marie; Jemec, Gregor Borut Ernst; Vestergaard, Tine; Thormann, Henrik; Hædersdal, Merete; Dam, Tomas Norman; Olesen, Anne Braae

    2016-01-01

    Aim of database The Danish Nonmelanoma Skin Cancer Dermatology Database was established in 2008. The aim of this database was to collect data on nonmelanoma skin cancer (NMSC) treatment and improve its treatment in Denmark. NMSC is the most common malignancy in the western countries and represents a significant challenge in terms of public health management and health care costs. However, high-quality epidemiological and treatment data on NMSC are sparse. Study population The NMSC database includes patients with the following skin tumors: basal cell carcinoma (BCC), squamous cell carcinoma, Bowen’s disease, and keratoacanthoma diagnosed by the participating office-based dermatologists in Denmark. Main variables Clinical and histological diagnoses, BCC subtype, localization, size, skin cancer history, skin phototype, and evidence of metastases and treatment modality are the main variables in the NMSC database. Information on recurrence, cosmetic results, and complications are registered at two follow-up visits at 3 months (between 0 and 6 months) and 12 months (between 6 and 15 months) after treatment. Descriptive data In 2014, 11,522 patients with 17,575 tumors were registered in the database. Of tumors with a histological diagnosis, 13,571 were BCCs, 840 squamous cell carcinomas, 504 Bowen’s disease, and 173 keratoakanthomas. Conclusion The NMSC database encompasses detailed information on the type of tumor, a variety of prognostic factors, treatment modalities, and outcomes after treatment. The database has revealed that overall, the quality of care of NMSC in Danish dermatological clinics is high, and the database provides the necessary data for continuous quality assurance. PMID:27822110

  19. Validation of a novel claims-based stroke severity index in patients with intracerebral hemorrhage

    Directory of Open Access Journals (Sweden)

    Ling-Chien Hung

    2017-01-01

    Full Text Available Background: Stroke severity is an important outcome predictor for intracerebral hemorrhage (ICH but is typically unavailable in administrative claims data. We validated a claims-based stroke severity index (SSI in patients with ICH in Taiwan. Methods: Consecutive ICH patients from hospital-based stroke registries were linked with a nationwide claims database. Stroke severity, assessed using the National Institutes of Health Stroke Scale (NIHSS, and functional outcomes, assessed using the modified Rankin Scale (mRS, were obtained from the registries. The SSI was calculated based on billing codes in each patient's claims. We assessed two types of criterion-related validity (concurrent validity and predictive validity by correlating the SSI with the NIHSS and the mRS. Logistic regression models with or without stroke severity as a continuous covariate were fitted to predict mortality at 3, 6, and 12 months. Results: The concurrent validity of the SSI was established by its significant correlation with the admission NIHSS (r = 0.731; 95% confidence interval [CI], 0.705–0.755, and the predictive validity was verified by its significant correlations with the 3-month (r = 0.696; 95% CI, 0.665–0.724, 6-month (r = 0.685; 95% CI, 0.653–0.715 and 1-year (r = 0.664; 95% CI, 0.622–0.702 mRS. Mortality models with NIHSS had the highest area under the receiver operating characteristic curve, followed by models with SSI and models without any marker of stroke severity. Conclusions: The SSI appears to be a valid proxy for the NIHSS and an effective adjustment for stroke severity in studies of ICH outcome with administrative claims data.

  20. A framework for database optimization and workload control

    Directory of Open Access Journals (Sweden)

    ALVES JR., A. C.

    2010-06-01

    Full Text Available Nowadays, database optimizers take advantage of indexes and materialized views (MVs to produce query execution plans. While indexes and MVs can speed up the execution of queries, there are costs to store and manage them. This paper presents a mathematical model and a greedy implementation to recommend a set of indexes and MVs in order to optimize the database, given a database workload and a disk space constraint. Our approach is generic, so it can be used to any relational database system that takes advantage of MVs in plan selection. While it was developed for frequently updated databases, it also produced interesting results in read only databases and to estimate the behavior of new databases (with predefined workloads.

  1. XML: James Webb Space Telescope Database Issues, Lessons, and Status

    Science.gov (United States)

    Detter, Ryan; Mooney, Michael; Fatig, Curtis

    2003-01-01

    . In our review of the database requirements and the COTS software available, only very expensive COTS software will meet 90% of requirements. Even with the high projected initial cost of COTS, the development and support for custom code over the 19-year mission period was forecasted to be higher than the total licensing costs. A group did look at reusing existing database tools and formats. If the JWST database was already in a mature state, the reuse made sense, but with the database still needing to handing the addition of different types of command and telemetry structures, defining new spacecraft systems, accept input and export to systems which has not been defined yet, XML provided the flexibility desired. It remains to be determined whether the XML database will reduce the over all cost for the JWST mission.

  2. ARTI Refrigerant Database

    Energy Technology Data Exchange (ETDEWEB)

    Calm, J.M. [Calm (James M.), Great Falls, VA (United States)

    1994-05-27

    The Refrigerant Database consolidates and facilitates access to information to assist industry in developing equipment using alternative refrigerants. The underlying purpose is to accelerate phase out of chemical compounds of environmental concern.

  3. Kansas Cartographic Database (KCD)

    Data.gov (United States)

    Kansas Data Access and Support Center — The Kansas Cartographic Database (KCD) is an exact digital representation of selected features from the USGS 7.5 minute topographic map series. Features that are...

  4. Records Management Database

    Data.gov (United States)

    US Agency for International Development — The Records Management Database is tool created in Microsoft Access specifically for USAID use. It contains metadata in order to access and retrieve the information...

  5. OTI Activity Database

    Data.gov (United States)

    US Agency for International Development — OTI's worldwide activity database is a simple and effective information system that serves as a program management, tracking, and reporting tool. In each country,...

  6. Children's Culture Database (CCD)

    DEFF Research Database (Denmark)

    Wanting, Birgit

    a Dialogue inspired database with documentation, network (individual and institutional profiles) and current news , paper presented at the research seminar: Electronic access to fiction, Copenhagen, November 11-13, 1996...

  7. Danish Urogynaecological Database

    DEFF Research Database (Denmark)

    Hansen, Ulla Darling; Gradel, Kim Oren; Larsen, Michael Due

    2016-01-01

    The Danish Urogynaecological Database is established in order to ensure high quality of treatment for patients undergoing urogynecological surgery. The database contains details of all women in Denmark undergoing incontinence surgery or pelvic organ prolapse surgery amounting to ~5,200 procedures...... per year. The variables are collected along the course of treatment of the patient from the referral to a postoperative control. Main variables are prior obstetrical and gynecological history, symptoms, symptom-related quality of life, objective urogynecological findings, type of operation......, complications if relevant, implants used if relevant, 3-6-month postoperative recording of symptoms, if any. A set of clinical quality indicators is being maintained by the steering committee for the database and is published in an annual report which also contains extensive descriptive statistics. The database...

  8. Fine Arts Database (FAD)

    Data.gov (United States)

    General Services Administration — The Fine Arts Database records information on federally owned art in the control of the GSA; this includes the location, current condition and information on artists.

  9. Rat Genome Database (RGD)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Rat Genome Database (RGD) is a collaborative effort between leading research institutions involved in rat genetic and genomic research to collect, consolidate,...

  10. The Exoplanet Orbit Database

    CERN Document Server

    Wright, Jason T; Marcy, Geoffrey W; Han, Eunkyu; Feng, Ying; Johnson, John Asher; Howard, Andrew W; Valenti, Jeff A; Anderson, Jay; Piskunov, Nikolai

    2010-01-01

    We present a database of well determined orbital parameters of exoplanets. This database comprises spectroscopic orbital elements measured for 421 planets orbiting 357 stars from radial velocity and transit measurements as reported in the literature. We have also compiled fundamental transit parameters, stellar parameters, and the method used for the planets discovery. This Exoplanet Orbit Database includes all planets with robust, well measured orbital parameters reported in peer-reviewed articles. The database is available in a searchable, filterable, and sortable form on the Web at http://exoplanets.org through the Exoplanets Data Explorer Table, and the data can be plotted and explored through the Exoplanets Data Explorer Plotter. We use the Data Explorer to generate publication-ready plots giving three examples of the signatures of exoplanet migration and dynamical evolution: We illustrate the character of the apparent correlation between mass and period in exoplanet orbits, the selection different biase...

  11. National Geochemical Database: Concentrate

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — Geochemistry of concentrates from the National Geochemical Database. Primarily inorganic elemental concentrations, most samples are from the continental US and...

  12. National Geochemical Database: Soil

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — Geochemical analysis of soil samples from the National Geochemical Database. Primarily inorganic elemental concentrations, most samples are from the continental US...

  13. National Geochemical Database: Sediment

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — Geochemical analysis of sediment samples from the National Geochemical Database. Primarily inorganic elemental concentrations, most samples are of stream sediment in...

  14. The Danish Urogynaecological Database

    DEFF Research Database (Denmark)

    Guldberg, Rikke; Brostrøm, Søren; Hansen, Jesper Kjær

    2013-01-01

    INTRODUCTION AND HYPOTHESIS: The Danish Urogynaecological Database (DugaBase) is a nationwide clinical database established in 2006 to monitor, ensure and improve the quality of urogynaecological surgery. We aimed to describe its establishment and completeness and to validate selected variables....... This is the first study based on data from the DugaBase. METHODS: The database completeness was calculated as a comparison between urogynaecological procedures reported to the Danish National Patient Registry and to the DugaBase. Validity was assessed for selected variables from a random sample of 200 women...... in the DugaBase from 1 January 2009 to 31 October 2010, using medical records as a reference. RESULTS: A total of 16,509 urogynaecological procedures were registered in the DugaBase by 31 December 2010. The database completeness has increased by calendar time, from 38.2 % in 2007 to 93.2 % in 2010 for public...

  15. The Danish Depression Database

    DEFF Research Database (Denmark)

    Videbech, Poul Bror Hemming; Deleuran, Anette

    2016-01-01

    AIM OF DATABASE: The purpose of the Danish Depression Database (DDD) is to monitor and facilitate the improvement of the quality of the treatment of depression in Denmark. Furthermore, the DDD has been designed to facilitate research. STUDY POPULATION: Inpatients as well as outpatients...... as an evaluation of the risk of suicide are measured before and after treatment. Whether psychiatric aftercare has been scheduled for inpatients and the rate of rehospitalization are also registered. DESCRIPTIVE DATA: The database was launched in 2011. Every year since then ~5,500 inpatients and 7,500 outpatients...... have been registered annually in the database. A total of 24,083 inpatients and 29,918 outpatients have been registered. The DDD produces an annual report published on the Internet. CONCLUSION: The DDD can become an important tool for quality improvement and research, when the reporting is more...

  16. Molecular marker databases.

    Science.gov (United States)

    Lai, Kaitao; Lorenc, Michał Tadeusz; Edwards, David

    2015-01-01

    The detection and analysis of genetic variation plays an important role in plant breeding and this role is increasing with the continued development of genome sequencing technologies. Molecular genetic markers are important tools to characterize genetic variation and assist with genomic breeding. Processing and storing the growing abundance of molecular marker data being produced requires the development of specific bioinformatics tools and advanced databases. Molecular marker databases range from species specific through to organism wide and often host a variety of additional related genetic, genomic, or phenotypic information. In this chapter, we will present some of the features of plant molecular genetic marker databases, highlight the various types of marker resources, and predict the potential future direction of crop marker databases.

  17. Consumer Product Category Database

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Chemical and Product Categories database (CPCat) catalogs the use of over 40,000 chemicals and their presence in different consumer products. The chemical use...

  18. Eldercare Locator Database

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Eldercare Locator is a searchable database that allows a user to search via zip code or city/ state for agencies at the State and local levels that provide...

  19. Drycleaner Database - Region 7

    Data.gov (United States)

    U.S. Environmental Protection Agency — THIS DATA ASSET NO LONGER ACTIVE: This is metadata documentation for the Region 7 Drycleaner Database (R7DryClnDB) which tracks all Region7 drycleaners who notify...

  20. Reach Address Database (RAD)

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Reach Address Database (RAD) stores the reach address of each Water Program feature that has been linked to the underlying surface water features (streams,...