Healthcare resource utilization among commercially insured patients with cold agglutinin disease in the United States

Abstract

Aims: Cold agglutinin disease (CAD) is a rare subtype of autoimmune hemolytic anemia associated with increased thromboembolism risk and early mortality. Healthcare resource utilization (HRU) in CAD has not been reported. We aimed to compare HRU of patients with CAD with a matched non-CAD cohort in the United States.

Materials and methods: Patients with CAD were identified from 2006 to 2016 in the Optum-Humedica database using CAD terms in clinical notes and hematologist review. Patients were required to have Integrated Delivery Network records and ≥6 months’ follow-up before and after the first CAD mention date (index date). Patients with CAD were matched to a non-CAD cohort based on demographics. Multivariate analyses assessed inpatient hospitalizations, outpatient visits, emergency room visits, and transfusion use between cohorts 6 months before and 12 months after the index date.

Results: Of 814 patients with CAD, 410 met inclusion criteria and were matched to 3,390 patients without CAD. Mean age of patients with CAD was 68.0 years; approximately 62% were female. In the 12 months after the index date, mean inpatient hospitalizations (0.83 vs. 0.25), outpatient visits (17.26 vs. 6.77), emergency room visits (0.55 vs. 0.32), and transfusion days (1.05 vs. 0.05) were higher for patients with CAD than the matched non-CAD cohort (all p?<?.0001). Similarly, in the 6 months before the index date, patients with CAD had higher HRU than matched patients without CAD for all measures evaluated.

Limitations: Results of this study are based on patient information from the Optum-Humedica database, which is limited to commercially insured patients and may not represent the overall CAD population.

Conclusions: CAD places a substantial burden on patients and healthcare systems. In addition, the high HRU for patients with CAD observed in the 6 months before diagnosis indicates that disease awareness and better diagnostic practices may be needed.     

牛病毒性腹泻-粘膜病的检测技术研究进展

对牛病毒性腹泻-粘膜病的病毒分离、琼脂扩散试验、微量中和试验、免疫荧光技术、酶联免疫吸附试验、核酸杂交技术、聚合酶链反应等检测技术进行了综述,对7种技术运用于牛病毒性腹泻-粘膜病的检测作了简要介绍,为进一步研究牛病毒性腹泻病毒提供参考。     

中国式荷兰病影响中国收入分配的实证分析

文章以源于入世后外向型劳动力密集型产业繁荣的中国式荷兰病理论为基础,对中国式荷兰病通过体制惰性效应、人民币汇率效应、资源转移效应等渠道影响中国收入分配问题进行了深入细致的实证研究。文章发现,在体制惰性效应影响下,我国国富民穷、东西部差距以及城乡差距问题日益恶化;但在人民币汇率效应作用下,东西部差距呈明显减缓趋势。文章最后建议加快城乡统筹发展步伐,积极推行改善民生和扩大内需的财政税收体制改革,适时扩大人民币汇率浮动区间,以确保中国经济增长方式顺利转变以及社会经济健康、协调与可持续发展。     

Planning of the cow milk assortment for large retail chains in North Italy: A comparison of two metropolitan cities

This research has assessed what large retail chains actually do, in terms of assortment depth and size of conventional cow milk, by comparing different retail formats and two metropolitan cities (Milan and Turin). The differences in the composition of the assortment were determined considering the milk categories according to their brand, origin, packaging, fat content and price. The differences in association between the milk categories and the retail formats were also analyzed. The results show differences in wide and deep of milk offer between the two areas and that retailers develop a composition offer that is not fully in agreement with the local preferences.     

粤东温室蝴蝶兰有害生物调查及发生规律分析

通过对温室蝴蝶兰有害生物的调查,发现危害蝴蝶兰的斜纹夜蛾、介壳虫、螨类、粉虱、蓟马、蜗牛以及病毒等是出口值得关注的有害生物,同时发现鳞长跳虫对蝴蝶兰根部的危害和太平洋细须螨的传入扩散;蝴蝶兰的细菌性褐斑病和眼蕈蚊在粤东危害较为严重,尤其要重点预防。由于温室栽培过程高温高湿,有害生物常年发生,其中虫害发生不规则,细菌性和真菌性病害多以夏季及初秋发生较为严重,而病毒应以防止感染传播为主。     

中国式“荷兰病”与中国城乡就业研究

文章从来源于入世后外向型劳动力密集型产业繁荣的中国式"荷兰病"理论出发,对中国式"荷兰病"通过"支出效应"、"资源转移效应"和"人民币汇率效应"等渠道影响中国城乡就业的情况进行了实证研究。在"中国式荷兰病"的影响下,我国就业城镇化趋势明显,传统就业主渠道丧失,特别是就业增长越来越严重地依赖于外向型劳动力密集型产业的持续繁荣以及大规模从事加工贸易的东部沿海地区。文章建议规范和鼓励城镇服务业发展、支持企业产品与产业结构调整、扩大人民币汇率浮动区间以及加大中央政府财政反哺农业和中西部地区等措施来确保中国经济与城乡就业的可持续发展。     

新冠疫情的经济金融影响与应对建议--基于传染病视角的分析

传染病疫情一直威胁着人类的生命健康,对经济社会发展造成较大影响。未来传染病疫情仍然会继续存在,并可能呈多发的趋势。虽然传染病疫情本身难以有效预测,传染病疫情对经济的冲击具有短期、外生性的特点,但是仍然有必要从传染病疫情应对政策方面进行总结研究,形成框架性的政策思路,以有效应对传染病疫情并降低其对经济金融的负面影响。本文结合新型冠状病毒肺炎疫情的经济金融影响和应对政策实践,探讨了传染病疫情应对的政策框架建议。     

数字经济、服务业效率提升与中国经济高质量发展

服务经济时代,传统服务业的高成本低效率,拉低了整体经济的发展速度,如何克服服务业低效率问题,需要进行深入分析。文章探讨了“鲍莫尔成本病”现象下,数字经济对城市经济高质量发展的影响及服务业效率在其中的关键作用。理论上,数字经济通过提升服务业效率为经济高质量发展赋能,通过构建一个两部门增长模型,提出数字拓展型技术可以推动服务业效率提升,且当服务业生产率达到和制造业同一水平时,经济可以稳定持续增长。实证上,文章测度了2011—2019年中国266个地级市的数字经济和高质量发展水平,在此基础上展开计量分析。结果表明：数字经济显著促进了城市经济高质量发展,数字经济通过改变传统生产方式、加速经济动态循环、知识溢出效应等路径促进服务业效率提升,从而成为新时代下推动中国经济高质量发展的重要动力。在异质性方面,数字经济对东部地区城市的影响显著大于中西部城市;数字经济对大城市的影响显著大于小城市。产业结构高级化自身不利于高质量发展,但数字经济发展推动下的产业结构高级化有利于高质量发展,数字经济可有效克服结构转型过程中服务业低效率问题。以上结论在系统GMM方法和“宽带中国”外生冲击检验下依然成立。文章研究有...     

Controlling diseases and nuisances: Time-based rights and agricultural production

In controlling diseases, governments take actions that denigrate property interests. Losses by property owners under a citrus canker eradication program led to a legal challenge concerning the Florida state government's authority to destroy property without compensation. A court adopted time-based rights to determine when the state needed to pay for property destroyed. Time-based rights have also been adopted by state legislatures to limit nuisance actions against agricultural producers. This paper addresses the adoption of time-based rights to determine whether the changes from space-based to time-based rights provide a superior response for eradicating plant diseases and responding to nuisances. The changes are projected to lead to different producer responses which in turn will affect agricultural production.     

Irritable bowel syndrome with constipation: a European-focused systematic literature review of disease burden

Abstract

Objective:

To conduct a systematic literature review to assess burden of disease and unmet medical needs in patients with irritable bowel syndrome (IBS) with constipation (IBS-C), with a focus on five European countries (France, Germany, Italy, Spain, UK).

Methods:

MEDLINE, EMBASE, and grey literature searches were carried out using terms for IBS and constipation, to identify studies reporting epidemiological, clinical, humanistic, or economic outcomes for IBS-C, published between 2000 and 2010.

Results:

Searches identified 885 unique abstracts and 33 supplementary articles, of which 100 publications and six grey literature sources met the inclusion criteria. Among patients with IBS, the prevalence estimates of IBS-C ranged from 1 to 44%. Co-morbid conditions, such as personality traits, psychological distress, and stress, were common. Patients with IBS-C had lower health-related quality-of-life (HRQoL) compared with the general population, and clinical trials suggested that effectively treating IBS-C improves HRQoL. The European societal cost of IBS-C is largely unknown, as no IBS-C-specific European cost-of-illness studies were identified. Two cost analyses demonstrated the substantial societal impact of IBS-C, including reduced productivity at work and work absenteeism. Guidelines offered similar recommendations for the diagnosis and management of IBS; however, recommendations specifically for IBS-C varied by country. Current IBS-C treatment options have limited efficacy and the risk:benefit profile of early 5-HT₄ agonists restricts clinical use.

Conclusions:

This systematic review indicates a clear need for European-focused IBS-C burden-of-disease and cost-of-illness studies to address identified evidence gaps. There is a need for new therapies for IBS-C that are effective, well tolerated, and have a positive impact on HRQoL.