Cost of fractures commonly associated with osteoporosis in a managed-care population

Objective: To examine direct costs of hip, vertebral, and non-hip non-vertebral (NHNV) fractures, and to estimate the rate of osteoporosis (OA) diagnosis and treatment in the fracture population.

Methods: Subjects ≥ 45 years with a new hip, vertebral, or NHNV fragility (closed) fracture between June 30, 2002 and June 30, 2006 were studied retrospectively. All-cause and fracture-specific medical costs were calculated from medical claims in the 12-month baseline and follow-up periods. Total healthcare costs included pharmacy and medical costs. Diagnosis for OA and OA treatment were identified in both the baseline and follow-up period from diagnosis codes on medical claims for OA, and from pharmacy claims for treatment. Analyses were performed separately for commercial (COM) and Medicare Advantage (MA) populations and stratified by fracture type. Generalized linear models were estimated for total follow-up healthcare cost.

Results: The study sample included 36,521 COM and 10,160 MA subjects. Hip fracture subjects had the highest follow-up medical costs in unadjusted and adjusted analyses (COM: mean $35,898; median $22,945; MA: mean $32,919; median $26,047). Follow-up costs were much higher than baseline costs. Fracture-related costs accounted for a large proportion of follow-up medical costs. Although rates of osteoporosis diagnosis and treatment increased from baseline to follow-up, the majority of both COM and MA subjects had no evidence of osteoporosis diagnosis or treatment in either period.

Conclusions: Despite limitations of this study, including conventional generalizability issues, and sensitivity and specificity of claims-based diagnoses, results are consistent with other research and provide compelling results of substantial cost burden of fractures related to osteoporosis. Low rates of osteoporosis diagnosis and treatment among patients with costly fragility fractures underscore the opportunity for managed care organizations to initiate comprehensive disease management programs in osteoporosis.     

鹤煤二矿二部猴车支护整修及保运行方案

鹤煤二矿井下地质条件复杂,井下普遍压力较大、巷道变形严重,如不及时采取措施,二部猴车随时面临停运、瘫痪的可能。通过该方案的实施,整修期间没有出现任何工伤事故,而且巷道整体面貌焕然一新,为今后特殊支护段巷道整修积累了宝贵经验。     

ECONOMETRICS FOR GRUMBLERS: A NEW LOOK AT THE LITERATURE ON CROSS‐COUNTRY GROWTH EMPIRICS

Abstract Since the seminal contribution of N. Gregory Mankiw, David Romer and David N. Weil in 1992 the growth empirics literature has used increasingly sophisticated methods to select relevant growth determinants in estimating cross‐section growth regressions. The vast majority of empirical approaches, however, limit cross‐country heterogeneity in production technology to the specification of total factor productivity, the ‘measure of our ignorance’. In this survey, we present two general empirical frameworks for cross‐country growth and productivity analysis and demonstrate that they encompass the various approaches in the growth empirics literature of the past two decades. We then develop our central argument, that cross‐country heterogeneity in the impact of observables and unobservables on output as well as the time‐series properties of the data are important for reliable empirical analysis.     

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车站与动车运用所的关系有多种可能，其布置形式都要遵循动车组列车运行的客观规律。以动车运用所为例，分析动车组走行线与车站布置的关系，以及机车牵引的列车与动车组列车在始发终到客运站的作业区别，并给出只衔接1条客运专线的始发终到客运站动车组走行线、和衔接多条客运专线的始发终到客运站动车组走行线的布置形式。指出只有弄清高速铁路运行规律，才能做好动车组走行线的布置。     

浅谈10kV配电设计

一般情况下,按变压器的效率最高时的负荷率βM来计算变压器容量,计算负荷最好是2倍总功率P总,留有一定的缓冲空间,而母线采用的材料为铜、铝、钢或其他金属。电缆绝缘材料应根据电缆绝缘材料的种类来选用,电缆截面的选择应特别注意电缆允许载流量与敷设环境的温度。     

V型墩刚构桥合拢段施工技术

宜春明月大桥工程采用V型墩与连续箱梁刚性连接形成V型墩刚构桥。该连续刚构桥构造复杂,且受施工环境因素制约,增加了该桥施工难度。本文结合宜春明月大桥实例,详细阐述V墩刚构箱梁合拢段的施工工艺和技术要点。     

高速公路封闭改造对周边路网通行能力的影响分析

高速公路封闭改造会对周边路网的通行能力造成影响,对相关路网进行通行能力分析是论证施工交通组织方案切实可行的依据。本文结合京台高速蚌埠至合肥段改造工程论述了对周边路网通行能力分析的几个关键点。     

改进型SMA-13沥青混合料在广东某高速公路的应用实践

本文以SMA沥青混合料在广东沿海高温潮湿地区应用实例依据,阐述了SMA沥青混合料目标配合比的设计要点和误差改进措施以及生产配合比控制的注意事项,验证了MPE添加剂使用过程的基本方法、工艺流程及MPE改进型SMA-13混合料的优异性能,并提出了一些卓有成效的改进方法措施,供商榷。     

高职院校教育成本核算与控制研究

文章分析了高职院校教育成本核算存在的问题,提出了提高高校教育成本核算与控制水平的措施。