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Academic literature on the topic 'Quality of life – United States – Statistics'

Author: Grafiati

Published: 4 June 2021

Last updated: 1 February 2022

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Journal articles on the topic "Quality of life – United States – Statistics"

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Saucer, Patrick R. "Education and Suicide: The Quality of Life among Modern Americans." Psychological Reports 73, no. 2 (October 1993): 637–38. http://dx.doi.org/10.2466/pr0.1993.73.2.637.

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Analysis of data from 1976 on education as reported in the U.S. Census and on suicide and homicide rates as reported in the Statistical Abstract of the United States, 1978 showed, contrary to earlier findings, that amount of education was not associated with the suicide and homicide rates among Americans.

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Agodoa, Irene, Deborah Lubeck, Nickhill Bhakta, Mark Danese, Kartik Pappu, Robin Howard, Michelle Gleeson, Marc Halperin, and Sophie Lanzkron. "Societal Costs of Sickle Cell Disease in the United States." Blood 132, Supplement 1 (November 29, 2018): 4706. http://dx.doi.org/10.1182/blood-2018-99-119420.

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Abstract Introduction Sickle cell disease (SCD) is a lifelong and costly chronic disease characterized by hemolytic anemia, pain crisis, and multi-end organ damage. Published estimates of SCD prevalence in the United States (US) range from approximately 85,000 to 100,000 people, most of whom are African American or Hispanic American. Individuals with SCD on average live two to three decades less than the general US population (Piel et al 2017). They also have markedly impaired patient-reported health-related quality-of-life (HRQOL) due in part to fatigue, pain, and impaired physical functioning, which leads to a significant reduction in work productivity. However, there are limited data available on the societal costs of SCD, such as lost lifetime earnings, which may lead to an underestimate of the true impact of this disease in a vulnerable population. Objectives We developed a simulation model to estimate the differences in life expectancy measured in years, quality-adjusted life-years (QALY) and income lost due to reduced life expectancy. Results were compared between a population of patients born with SCD in the US and a sex- and race-matched US population born without SCD and to the general US population. Methods To build the model, we (1) generated a Poisson regression from published birth and mortality estimates for SCD supplemented with data from the Centers for Disease Control (CDC) Multiple Cause of Death database to create age-specific life tables for a population of individuals with SCD (SCD population); (2) used published life tables from the CDC to develop age-specific death rates for a population without SCD (non-SCD population); (3) incorporated published utility weights for SCD adolescents and adults, and for the US general population to estimate the impact of the disease on HRQOL; (4) used US Bureau of Labor Statistics Supplemental Survey of Annual Personal Income data to calculate the expected annual personal income based on age, race, and gender; (5) built a cohort simulation model using R (version 3.4.2) to estimate the life expectancy, QALYs, and lost income for the SCD population compared to the non-SCD population, and the US general population. All analyses used Monte Carlo sampling to characterize uncertainty. Results We estimated that there would be 1,950 newborns with SCD born in the US annually. The projected life expectancy at birth is 54 years for the SCD population compared with 76 years for the age- and race-matched non-SCD population and 79 years for the general US population. Moreover, the quality-adjusted life expectancy of the SCD population (33 years) is less than half that of the matched non-SCD population (67 years) and general US population (69 years). Projected lifetime income for an individual in the SCD population is approximately $1.2 million compared with $1.9 million for an individual in the matched non-SCD population and $2.0 million in the general US population (Figure). Therefore, our model estimates that each individual with SCD loses over $700,000 in lifetime income due to early mortality associated with SCD. Conclusions A contemporary simulated cohort of individuals born with SCD is projected to live 22 years less than a matched population of individuals without SCD. Moreover, when adjusted for diminished HRQOL, our model suggests that patients living with SCD lose over three decades in life expectancy compared to a matched non-SCD population. Given the 22-year difference in life expectancy results in approximately $700,000 in lost lifetime income for each person born with SCD, a contemporary SCD birth cohort of 1,950 individuals would lose over $1.4 billion in lifetime income due to premature mortality. These losses are a conservative estimate since they do not include any direct medical costs or other societal costs such as lost educational potential, lost workdays due to caregivers caring for their affected children, or patient time spent in the hospital or visiting the emergency department; nor do they account for additional challenges in finding and maintaining active employment that have been previously described as substantial among individuals with SCD. In conclusion, SCD has devastating societal consequences beyond the resources required to provide medical care for patients underscoring the urgent need to develop disease-modifying therapies that can improve the underlying morbidity and mortality of individuals living with SCD. Disclosures Agodoa: Global Blood Therapeutics: Employment. Lubeck:Global Blood Therapeutics: Research Funding. Danese:Global Blood Therapeutics: Consultancy, Research Funding. Pappu:Global Blood Therapeutics: Employment. Howard:Global Blood Therapeutics: Employment. Gleeson:Global Blood Therapeutics: Consultancy, Research Funding. Halperin:Global Blood Therapeutics: Consultancy, Research Funding. Lanzkron:PCORI: Research Funding; NHLBI: Research Funding; GBT: Research Funding; selexys: Research Funding; Ironwood: Research Funding; Pfizer: Research Funding; Prolong: Research Funding; HRSA: Research Funding.

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Casida, Jesus M., Pamela Combs, Sarah E. Schroeder, and Caty Johnson. "Burnout and Quality of Work Life Among Nurse Practitioners in Ventricular Assist Device Programs in the United States." Progress in Transplantation 29, no. 1 (December 5, 2018): 67–72. http://dx.doi.org/10.1177/1526924818817018.

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Background: A mixed-method study of role stress and work intensity among nurse practitioners (NPs) in mechanical circulatory support (MCS) programs in the United States reported a qualitative data related to burnout. We empirically investigated this phenomenon by pursuing the following specific aims: (1) describe levels of personal burnout (PB), work-related (WB) burnout, and client-related burnout (CB) and quality of work life (QOWL) among MCS-NPs; (2) determine the relationship between burnout and QOWL variables; and (3) identify which type of burnout is a predictor of QOWL. Methods: We employed an exploratory correlational research design. Demographics, work characteristics, and psychometrically robust measures of burnout and QOWL were completed by 47 MCS-NPs from various regions of the United States. Data were analyzed with descriptive and inferential statistics. Results: Higher levels of burnout (PB, WB, and CB) were associated with lower levels of QOWL ( r = −.52 to −.64, P < .001). Of the 3 types of burnout, WB burnout showed a significant predictor of QOWL ( R2 = .44, P < .01). Multiple regression models showed that a 1 point increase in mean score of WB would decrease a mean QOWL score by 0.64 after controlling the effect of PB and CB. Some dimensions of QOWL were associated with work/hospital characteristics ( r > −.30, P values <.05). Conclusion: Work-related burnout is negatively associated with low QOWL among NPs. Hospital/work environment was contributing factors to high burnout and low QOWL. Further research is needed to confirm the findings including the effect of burnout and QOWL on patient and ventricular assist device program outcomes.

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Lakhan, Ram, Sean Y. Gillette, Sean Lee, and Manoj Sharma. "Satisfaction with health care system: A comparative study between market-based insurance model of the United States and “out-of-pocket” model in developing and low-income countries." International Journal of Healthcare 6, no. 1 (February 24, 2020): 41. http://dx.doi.org/10.5430/ijh.v6n1p41.

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Background and purpose: Access to healthcare services is an essential component for ensuring the quality of life. Globally, there is inequity and disparities regarding access to health care. To meet the global healthcare needs, different models of healthcare have been adopted around the world. However, all healthcare models have some strengths and weaknesses. The purpose of this study was to examine the satisfaction among a group of undergraduate students from different countries with their health care models namely, insurance-based model in the United States and “out-of-pocket” model prevalent in low-income countries.Methods and materials: The study utilized a cross-sectional research design. Undergraduate students, representing different nationalities from a private Southeastern College, were administered a researcher-designed 14-item self-reported electronic questionnaire. Independent t-test and χ2 statistics were used to examine the differences between two health care systems and the qualitative responses were analyzed thematically.Results: Satisfaction towards health care system between the United States and low-income countries was found significantly different (p < .05). However, students in both settings experienced an inability toward affording quality healthcare due to economic factors and disparities.Conclusions: There is dissatisfaction with health care both in the United States and low-income developing countries among a sample of undergraduate students representing these countries. Efforts to ensure low-cost affordable health care should be a global goal.

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Gzhegotsky, M. R., O. V. Tymoschuk, V. G. Cherkasov, S. V. Dmytrenko, and O. M. Shapoval. "Features of the interaction of indicators of peculiarities of personality and characteristics of the quality of life of pupils and student youth by the cluster analysis." Reports of Morphology 25, no. 1 (February 28, 2019): 25–31. http://dx.doi.org/10.31393/morphology-journal-2019-25(1)-04.

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Recently, while conducting scientific research in the field of theoretical and preventive medicine, biomedical preventive anthropology and statistical processing of their results, one of the leading places is the cluster analysis procedure, which involves the search for the patterns of grouping as research objects and their leading features in separate local plural and subset, that is, in separate clusters. Researches that provided for determining the leading characteristics of the quality of life and the peculiarities of the course of psychological adaptation processes based on the use of commonly accepted psychohygienic practices of personal questionnaires were conducted on the basis of educational institutions in Ivano-Frankivsk. Statistical analysis of the obtained data provided for the use of descriptive statistics and cluster analysis procedures using the licensed standardized application package of the multivariate statistical analysis “Statistica 6.1 for Windows” (license number ВXXR901E245722FA). The results of the conducted research indicate the existence of an extremely stable structure of the identified groups, among which in all investigated cases, it necessary to note the cluster associated with the leading indicators of quality of life, which united in its structure characteristics of quality of life on the scales Bodily Pain (BP, scale (Physical Functioning), Mental Health (MH, Mental Health Scale), General Health (GH, General Health Scale), Vitality (VT, Viability Scale), and Social Functioning (SF, scale of social functioning), neuro-psychical cluster combining personal and situational anxiety, depressive and asthenic states, as well as an integral cluster that included in its structure the characteristics of quality of life on the scale of Role-Emotional (RE, role-playing role scale) and Role-Physical (RP, scale of role-physical functioning) and indicators of subjective control in health and disease and neuroticism. The obtained data should further find a proper place in the structure of diagnostic and preventive approaches to assess the state of health and functional state of the body of pupils and students.

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Feinberg, Bruce A., Yolaine Jeune-Smith, Stephanie Fortier, Ting-Chun Yeh, Jonathan Kish, and Ajeet Gajra. "Linking reimbursement to patient-reported quality of life: Provider perspectives." Journal of Clinical Oncology 38, no. 29_suppl (October 10, 2020): 75. http://dx.doi.org/10.1200/jco.2020.38.29_suppl.75.

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75 Background: In the value-based era, policymakers have begun incorporating quality of life (QoL) components into payment models, such as the Merit-based Incentive Payment System (MIPs), Oncology Care Model (OCM), and Accountable Care Organization (ACO), to increase accountability. This qualitative research study sought to understand how providers address their patients’ QoL issues in a value-based environment. Methods: A live meeting in September 2019 brought together community oncology healthcare providers (HCPs) from across the United States. Participants submitted their demographic information via a web-based pre-meeting survey and their responses pertaining to patient QoL via an audience response system during the live meeting. Participant responses and their practice demographics were analyzed using descriptive statistics. Results: 71 HCPs participated in this live market research program: 51 medical oncologists/hematologists (herein referred to as physicians) and 20 nurse practitioners or physician assistants (herein referred to as APPs). 50% of physicians and 25% of APPs were from privately owned community practices. Half of HCPs indicated that their practices are collecting and reporting QoL data through value-based programs: 28% of physicians and 60% of APPs were in OCM-participating practices. Regarding accountability, over 80% of HCPs strongly agreed that they have a role in improving patients’ QoL. However, 32% of physicians and 25% of APPs agreed that their payment should be tied to patients’ QoL improvement. According to HCPs, the top factor impacting patients’ QoL was symptom and symptom burden (83%). To address QoL in their patients, HCPs reported addressing patients’ psychosocial needs (78%), implementing survivorship care planning (76%), and using nurse navigators (69%). 70% of physicians and 95% of APPs were confident that their patients have reliable resources for managing their QoL issues. Conclusions: HCPs recognize their role in improving patients’ QoL, and their practices have made several transformations to improve patients’ QoL; they are confident that their patients have resources for managing QoL issues. However, many HCPs disagree with linking QoL improvements to their payment. Further studies are needed to understand QoL from patients’ perspectives in the value-based environment.

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Dingli, David, Joana E. Matos, Kerri Lehrhaupt, Sangeeta Krishnan, Scott B. Baver, and Sujata P. Sarda. "Work Productivity Loss and Quality of Life in Paroxysmal Nocturnal Hemoglobinuria Among Patients Receiving C5 Inhibitors in the United States." Blood 136, Supplement 1 (November 5, 2020): 3. http://dx.doi.org/10.1182/blood-2020-142327.

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INTRODUCTION Paroxysmal nocturnal hemoglobinuria (PNH) is a rare, acquired, hematologic disease characterized by chronic complement-mediated hemolysis. Treatment with the C5 inhibitor eculizumab has resulted in a reduction in intravascular hemolysis and improvements in morbidity and mortality. Even with the clinical benefit in PNH, eculizumab entails twice-monthly intravenous infusions in a hospital setting in most countries, adversely impacting patients' work productivity (Mastellos DC, et al.Semin Hematol. 2018;55(3):167-175). Lost productivity associated with eculizumab ranged from $344,000 in Russia to $4.3 million in the United States, without caregivers (Levy AR, et al.Blood. 2019;134(Supplement_1):4803). Furthermore, patients in a real-world study treated with eculizumab for 1 year experienced continued impairment in overall quality-of-life relative-to-normative reference scores for the general adult population (Ueda Y, et al.Int J Hematol. 2018;107(6):656-665). This study aims to understand the clinical, humanistic, and economic outcomes associated with burden of illness in about 150 patients with PNH globally. In these preliminary analyses, productivity loss and quality of life (QoL) in patients with PNH currently being treated with C5 inhibitors (eculizumab and ravulizumab) are assessed in patients in the United States. METHODS This cross-sectional survey administered to adult patients in the United States, ≥18 years of age, with self-reported diagnosis of PNH, was initiated in July 2020 and is ongoing. Patients were recruited through a patient advocacy group. Inclusion criteria to complete the secure online survey include current treatment with either eculizumab or ravulizumab, and agreement to provide informed consent and adverse event reporting. To investigate the impact of PNH on employment and activity, the Work Productivity and Activity Impairment-General Health (WPAI-GH) questionnaire was used. QoL was assessed using Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue scale and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). For the preliminary WPAI-GH analysis presented here, descriptive statistics are reported for patients who have completed the survey thus far. Analyses examining the impact of PNH on FACIT-Fatigue, EORTC QLQ-C30, and other clinical outcomes assessments among patients on anti-C5 therapy are ongoing. RESULTS A total of 58 adult patients completed the survey as of August 6, 2020. Patients' median age was 52 years (range, 21-88) and 78% of patients were female. Twenty patients (34%) were on eculizumab and 38 (66%) were on ravulizumab. Most patients (93%) had initiated treatment ≥3 months prior to enrollment. In total, 23 (40%) patients reported that they were gainfully employed. Overall, 52% of employed patients reported missing hours of work in the prior 7 days due to their health problems (67% eculizumab and 43% ravulizumab). About 77% of working patients reported that their illness affected their productivity at work (89% eculizumab and 69% ravulizumab) due to the same reason. Employed patients reported an average of 13% (standard deviation, 21%) absenteeism (ie, work time lost due to being absent for illness in the previous week; eculizumab, 22% ± 29%, ravulizumab, 7% ± 12%). Patients reported 26 ± 27% impairment while working over the past 7 days (ie, presenteeism; eculizumab, 39 ± 31%, ravulizumab, 18 ± 22%). Total work productivity impairment was on average 32 ± 31% (eculizumab, 46 ± 35%; ravulizumab, 23 ± 24%). Nearly all patients (n = 54 [93%]) reported at least some impairment in their usual activities regardless of employment (eculizumab, 100%; ravulizumab, 90%). On average, patients reported 38 ± 23% of impaired activity in the previous week (eculizumab, 43 ± 20%; ravulizumab, 36 ± 25%). CONCLUSIONS Preliminary results from this burden of illness survey evaluating humanistic and economic outcomes in patients with PNH demonstrated substantial loss of work-related productivity, greatly diminished ability to work, and limitations in patients' usual activities while being treated with the C5 inhibitors eculizumab and ravulizumab. Disclosures Dingli: Karyopharm Therapeutics:Research Funding;Alexion:Consultancy;Bristol Myers Squibb:Research Funding;Janssen:Consultancy;Rigel:Consultancy;Apellis:Consultancy;Sanofi-Genzyme:Consultancy;Millenium:Consultancy.Matos:Kantar:Current Employment.Lehrhaupt:Kantar:Current Employment.Krishnan:Apellis:Current Employment, Current equity holder in publicly-traded company.Baver:Apellis:Current Employment, Current equity holder in publicly-traded company.Sarda:Apellis:Current Employment, Current equity holder in publicly-traded company.

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Kraft, Robert M., Melissa C. Larson, Kathleen J. Yost, Thomas M. Habermann, Matthew J. Maurer, William R. Macon, Umar Farooq, et al. "Quality of Life after Diagnosis in Survivors of Aggressive Lymphomas." Blood 136, Supplement 1 (November 5, 2020): 15–16. http://dx.doi.org/10.1182/blood-2020-134897.

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Background: Aggressive lymphomas are potentially curable; however, long-term effects of treatment and the disease may adversely affect patients' quality of life (QoL). We investigated QoL at baseline, and up to nine years after diagnosis in survivors of aggressive lymphomas. Methods: Patients newly diagnosed with lymphoma were prospectively enrolled within nine months of diagnosis in the Molecular Epidemiology Resource (MER) of the University of Iowa/Mayo Clinic Lymphoma Specialized Program of Research Excellence (SPORE) and systematically followed. Patients were enrolled from September 1, 2002 until June 30, 2015. Eligibility criteria included being a United States resident, English-speaking, no history of HIV, and aged 18 years and older. All pathology was reviewed by a lymphoma hematopathologist. Aggressive lymphoma subtypes included in this analysis were diffuse large B-cell lymphoma (DLBCL), Follicular lymphoma grade III, Hodgkin lymphoma, T-cell lymphoma, other non-Hodgkin lymphoma not otherwise specified (NOS), other B-cell lymphoma NOS, and composite lymphomas. We assessed QoL using the Functional Assessment of Cancer Therapy-General (FACT-G) scale at baseline enrollment, and 1, 2, 3, 6, and 9 years post-diagnosis. FACT-G measures well-being (WB) in four domains-physical (PWB), social/family (SFWB), emotional (EWB), and functional (FWB), which are added to create a total (TOT) score. Those who completed <80% of FACT-G questions at any given time point were excluded. "Survivor" was defined as alive at 1, 2, 3, 6, and 9 year follow-up with no active disease or treatment within six months of a given time point. Because patients could be enrolled at any time within the first 9 months from diagnosis, the timing of initial QoL assessment was variable with respect to the start of lymphoma treatment. We estimated longitudinal change in QoL using mixed models incorporating scores from all available time points. The minimally important difference (MID) of 5 points for TOT and 2 points for each of the domains was used to determine clinical significance. Scores were compared to United States (US) general population normative data. All statistical analyses were performed using SAS (v 9.4). Results: From September 1, 2002 to June 30, 2015, 3,028 patients with aggressive lymphomas were prospectively enrolled in the MER, of which 2,018 completed the FACT-G baseline assessment (47% prior to therapy initiation). Of these patients, 1,144 at 1 year, 1,002 at 2 years, 943 at 3 years, 562 at 6 years, and 289 at 9 years post-diagnosis completed the FACT-G at both baseline and each of the respective time points after diagnosis, and met the definition of survivor. The median age at diagnosis of patients analyzed was 59 years (range 18-93). The cohort included 844 female patients (42%). DLBCL comprised 44% of cases, Hodgkin lymphoma 19%, T-cell lymphoma 11%, composite lymphomas 8%, other B-cell NOS 6%, other non-Hodgkin lymphoma NOS 7%, and Follicular lymphoma grade III 5%. QoL increased from baseline enrollment; the largest increase was seen from baseline to 1 year after diagnosis with a statistically and clinically significant mean TOT score difference of 6.7 points. This mean increase in TOT scores sustained over time with an increase of 7.8 points above baseline at 9 years after diagnosis. At baseline, PWB, EWB, and FWB scores were significantly lower in patients with aggressive lymphomas compared to the US general population, and SFWB scores were significantly higher (all p <0.01); however, only SFWB and EWB score differences were clinically significant as defined by MID. SFWB showed only a mild decline from baseline over the course of 9 years. Despite this, all SFWB scores were statistically and clinically significantly higher than the US general population at 1, 2, 3, 6, and 9 years after diagnosis (all p <0.01 and MID >2). Patients with aggressive lymphomas TOT scores at baseline did not differ from the US general population, while TOT scores at 1, 2, 3, 6, and 9 years post-diagnosis were statistically and clinically significantly higher. Overall, the results in the pre-treatment QoL subset were consistent with the cohort as a whole. Conclusions: In survivors of aggressive lymphomas, QoL improved primarily in the first year after diagnosis, and sustained over the course of nine years. QoL in survivors of aggressive lymphomas is higher than the United States general population at 1, 2, 3, 6, and 9 years after diagnosis. Figure Disclosures Maurer: Pfizer: Membership on an entity's Board of Directors or advisory committees; Nanostring: Research Funding; Morphosys: Membership on an entity's Board of Directors or advisory committees; Celgene / BMS: Research Funding; Kite: Membership on an entity's Board of Directors or advisory committees. Farooq:Kite, a Gilead Company: Honoraria. Cerhan:BMS/Celgene: Research Funding; NanoString: Research Funding.

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Atrash, Hani K. "Health Disparities: Challenges, Opportunities, and What You Can Do About It." Journal of Human Growth and Development 28, no. 3 (November 28, 2018): 223–31. http://dx.doi.org/10.7322/jhgd.152156.

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Racial disparities in health outcomes, access to health care, insurance coverage, and quality of care in the United States have existed for many years. The Development and implementation of effective strategies to reduce or eliminate health disparities are hindered by our inability to accurately assess the extent and types of health disparities due to the limited availability of race/ethnicity-specific information, the limited reliability of existing data and information, and the increasing diversity of the American population. Variations in racial and ethnic classification used to collect data hinders the ability to obtain reliable and accurate health-indicator rates and in some instances cause bias in estimating the race/ethnicity-specific health measures. In 1978, The Office of Management and Budget (OMB) issued "Directive 15" titled "Race and Ethnic Standards for Federal Statistics and Administrative Reporting" and provided a set of clear guidelines for classifying people by race and ethnicity. Access to health care, behavioral and psychosocial factors as well as cultural differences contribute to the racial and ethnic variations that exist in a person’s health. To help eliminate health disparities, we must ensure equal access to health care services as well as quality of care. Health care providers must become culturally competent and understand the differences that exist among the people they serve in order to eliminate disparities. Enhancement of data collection systems is essential for developing and implementing interventions targeted to deal with population-specific problems. Developing comprehensive and multi-level programs to eliminate healthcare disparities requires coordination and collaboration between the public (Local, state and federal health departments), private (Health Insurance companies, private health care providers), and professional (Physicians, nurses, pharmacists, laboratories, etc) sectors.

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SCHARFF, ROBERT L. "Economic Burden from Health Losses Due to Foodborne Illness in the United States." Journal of Food Protection 75, no. 1 (January 1, 2012): 123–31. http://dx.doi.org/10.4315/0362-028x.jfp-11-058.

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The Centers for Disease Control and Prevention (CDC) recently revised their estimates for the annual number of foodborne illnesses; 48 million Americans suffer from domestically acquired foodborne illness associated with 31 identified pathogens and a broad category of unspecified agents. Consequently, economic studies based on the previous estimates are now obsolete. This study was conducted to provide improved and updated estimates of the cost of foodborne illness by adding a replication of the 2011 CDC model to existing cost-of-illness models. The basic cost-of-illness model includes economic estimates for medical costs, productivity losses, and illness-related mortality (based on hedonic value-of-statistical-life studies). The enhanced cost-of-illness model replaces the productivity loss estimates with a more inclusive pain, suffering, and functional disability measure based on monetized quality-adjusted life year estimates. Costs are estimated for each pathogen and a broader class of unknown pathogens. The addition of updated cost data and improvements to methodology enhanced the performance of each existing economic model. Uncertainty in these models was characterized using Monte Carlo simulations in @Risk version 5.5. With this model, the average cost per case of foodborne illness was $1,626 (90% credible interval [CI], $607 to $3,073) for the enhanced cost-of-illness model and $1,068 (90% CI, $683 to $1,646) for the basic model. The resulting aggregated annual cost of illness was $77.7 billion (90% CI, $28.6 to $144.6 billion) and $51.0 billion (90% CI, $31.2 to $76.1 billion) for the enhanced and basic models, respectively.

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Dissertations / Theses on the topic "Quality of life – United States – Statistics"

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August, Debra S. "Army life v. life in the Army the relationship between quality of life program utilization and army career intentions /." Santa Monica, CA : Rand, 1996. http://catalog.hathitrust.org/api/volumes/oclc/34619150.html.

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Cardona, Laura A. "Understanding Quality of Life in Older Adults." Thesis, University of North Texas, 2010. https://digital.library.unt.edu/ark:/67531/metadc28402/.

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I analyzed the 2004 and 2006 Health and Retirement Study data to test structural equation models of the quality of life (QOL) construct. The participants (N = 1352) were non-institutionalized individuals aged 42 and older (M = 65.70, SD = 10.88), with an average education of 12.73 years (SD = 2.96) and of varied ethnicities. The results indicated that physical functioning, affective experience, life satisfaction and social support could serve as indicators for a second order QOL factor. Furthermore, the developed QOL model explained 96% of the variance of the CASP-19 (Control, Autonomy, Self-realization and Pleasure), a QOL measure that reflects fulfillment of psychological needs. The results also indicated that Depression and Life Satisfaction are related through reciprocal causation and that Physical Functioning is more likely to cause a change in Depression than the reverse. The results suggest that QOL is a complex, multidimensional concept that should be studied at different levels of analysis.

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Ingle, William Von. "Life for the city : evaluating the pedestrian quality of the street." Thesis, Georgia Institute of Technology, 1986. http://hdl.handle.net/1853/23778.

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Smith, Elaine S. "Quality of life and nutritional risk in elderly home-delivered meal recipients and non-recipients." Virtual Press, 1999. http://liblink.bsu.edu/uhtbin/catkey/1154781.

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This study evaluated the impact of receiving a home-delivered meal on the quality of life and nutritional risk of elders who were unable to attend congregate meal sites and who were unable to safely prepare a hot meal. Forty-three subjects on a waiting list were matched with a group currently receiving home-delivered meals. Matching criteria were functional needs measure, age, gender, and living arrangement.Home visits were conducted to collect the data and verify demographic information. Nutritional risk was assessed by the Nutrition Screening Initiative's Determine Checklist. Quality of life was measured across various domains including a global quality of life self-rating, mental health appraisal, functional ability, and food enjoyment. Two tailed t-tests failed to show differences in quality of life and nutritional risk between the groups at the 0.05 level of significance.In addition, the study reviewed the resources for meal preparation and grocery shopping possessed by the meal non-recipients that allowed them to remain at home without a meal provided. A significant difference was seen in the number of resources reported for meal preparation assistance with the meal non-recipient group reporting more informal resources.
Department of Family and Consumer Sciences

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Lancaster, Lydia Anne. "Longitudinal Effects of Surgical Orthodontics Treatment on Quality of Life in a United States Population." The Ohio State University, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=osu1553856528855052.

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Fletcher, Rickie D. "Rural-urban differences in subjective psychological well-being in the United States." Virtual Press, 1986. http://liblink.bsu.edu/uhtbin/catkey/454455.

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This study looked at people's self-reports of satisfaction with various aspects of life and personal happiness. The sample was divided into three categories regarding the size of the community of the respondent: rural, urban and large urban. Similarly to other studies of this nature, we found that rural people expressed higher levels of subjective psychological wellbeing than did people who live in urban and large urban communities. The concept of social desirability was incorporated into this paper. A rather large percentage of all three categories (rural, urban and large urban) of respondents, across a wide range of demographic characteristics (such as age, sex, race, etc.), indicated substantial amounts of satisfaction and happiness. This seems partially due to the fact that people have a tendency to give very positive answers to questions regarding subjective psychological well-being. In other words, it is socially desirable to indicate that one is satisfied and happy with various aspects of one's life; while it is socially undesirable to indicate that one is dissatisfied or unhappy.

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Shareef, Reginald A. T. "Assessing organizational change: quality of work life interventions in the United States Postal Service." Diss., Virginia Polytechnic Institute and State University, 1989. http://hdl.handle.net/10919/54419.

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Because of the changing nature of our society, it is agreed by scholars and practitioners that both private and public organizations face many uncertainties. Diverse solutions have been advanced to remedy these organizational maladies. One of the most popular solutions, theoretical and applied, has been the utilization of Quality of WorkLife (QWL) interventions. The position taken in this dissertation is that in spite of the glowing testimonials about the effectiveness of QWL applications, it is still difficult to reach any definitive conclusions pertaining to the success(es) of this approach to the organizational change process. Previous research has offered little empirical data to support many of the theoretical assumptions QWL is based on. Furthermore, most organizations have utilized the human relations conceptual framework (i.e., satisfaction causes performance) to describe the implementation and diffusion of the QWL process. Indeed, the organization evaluated in this study utilized this approach in its QWL endeavor. However, this investigation endorses a different concept, subsystems congruence, to achieve the institutionalization of QWL. A growing body of research literature strongly suggests that this integrated approach offers the best model for successful QWL intervention. Enhancing our understanding of QWL applications and processes is the focus of this study. This knowledge is necessary so organizational leaders, consultants, and academicians will better understand the nature and complexity of implementing, evaluating and institutionalizing various QWL interventions.
Ph. D.

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Edwards, Douglas W. "Impact of quality of life on the reenlistment intentions of junior enlisted United States marines." Thesis, Monterey, California. Naval Postgraduate School, 2002. http://hdl.handle.net/10945/6069.

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Approved for public release, distribution is unlimited
The purpose of this thesis was to investigate the impact of Quality of Life (QOL) programs and QOL domains on the reenlistment intentions of junior enlisted United States Marines. Data were extracted from the FY 2001 USMC Retention Survey. The data set was restricted to junior enlisted Marines in paygrades E2 through E4 with Active Duty Base Dates of calendar year 1998 and 1999 and was further stratified by gender. A complete conceptual model for reenlistment was developed which incorporated demographic characteristics, QOL programs, QOL domains, and civilian employment opportunities. Cross-tabulations of survey responses were performed by gender, race, marital status, and geographic location. Logit maximum likelihood estimation techniques were used to determine the marginal and percentage effects of QOL programs and QOL domains. The results confirm previous research in this area.

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Parkhomenko, Daria. "Quality of Life and Migration Experiences among Russian Speaking Immigrants to the United States of America." Thesis, The Chicago School of Professional Psychology, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3709268.

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This study was an exploration of factors that impact the perceived quality of life among Russian-speaking immigrants in the United States. Specifically, the study was designed to investigate what type of relationship (if any) exists (direction and strength) between one’s desire to immigrate, sense of having a choice, the accuracy of preimmigration expectations, and quality of life after immigration. This researcher sought to understand whether desire and choice to immigrate and accuracy of one’s expectations about immigration as measured by a survey can significantly predict changes in quality of life as measured by Q-LES-Q-18 (in general and in its facets). This research question was examined using a series of multiple regressions. Post hoc studies included an examination of the relationship between quality of life as measured by participant responses to the Q-LES-Q-18 and subjective happiness, as measured by modified SHS. Posthoc analyses further explored relationships between demographic factors, income, language fluency, relationship status, and other variables with quality of life after immigration. Finally, open-ended questions were used to provide pertinent narrative to help explain the conclusions gathered from quantitative data. The perceived accuracy of expectations about immigration was found to be a major predictor of quality of life after immigration. It had unique, significant contributions to the prediction of physical heath, subjective feelings, leisure time, and general activities aspects of quality of life. Quality of life in all of its aspects was highly connected to ability to use the language (speak, understand, and communicate) of the dominant culture. Income strongly and positively correlated with participants’ subjective feelings, general activity, and life satisfaction.

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Perry, MacKenna Laine. "Supervisor-Specific Outcomes of a Work-Family Intervention: Evidence from the Work, Family, & Health Study." PDXScholar, 2015. https://pdxscholar.library.pdx.edu/open_access_etds/2509.

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Workplace interventions provide a practical and important means of providing support for employees' work-family needs. However, work-family interventions are rare and are generally not thoroughly evaluated. The current study seeks to better understand the impacts of STAR ("Support. Transform. Achieve. Results."), the large-scale work-family intervention developed and implemented by the Work, Family, & Health Network (see Bray et al., 2013). Drawing on Conservation of Resources theory (Hobfoll, 1989), this study examines supervisors' participation in STAR through assessment of three primary supervisor-specific outcomes: training-related views and behaviors, well-being, and the work-family interface. The sample, consisting of 184 supervisors from 30 extended-care facilities throughout the northeastern United States, comes from archival data that were collected by the Work, Family, & Health Network. Results show a lack of support for STAR intervention effects on supervisor-level outcomes. Despite the lack of statistically significant effects on supervisors, it is important to note the lack of iatrogenic effects, indicating that participation in the STAR intervention did not harm supervisor outcomes. Implications, future directions, and limitations of the study are discussed.

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Books on the topic "Quality of life – United States – Statistics"

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R, Loftus Geoffrey, ed. Places rated almanac. 5th ed. New York: Macmillan, 1997.

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Deleuze beyond Badiou: Ontology, multiplicity, and event. New York: Columbia University Press, 2013.

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A, Hovey Harold, and Congressional Quarterly inc, eds. CQ's state fact finder 2007: Rankings across America. Washington, D.C: CQ Press, 2007.

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Exploring the association between military base neighborhood characteristics and soldiers' and airmen's outcomes: Technical report. Santa Monica, CA: RAND Corporation, 2013.

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Kristen, Lewis, and Martins Eduardo Borges, eds. The measure of America: American human development report, 2008-2009. New York: Columbia University Press, 2008.

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Meadows, Sarah O. The association between base-area social and economic characteristics and airmen's outcomes. Santa Monica, CA: Rand Corporation, 2014.

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Orvis, Bruce R. Appendices to Pacer Share prodluctivity and personal management demonstration baseline evaluation. Santa Monica, CA: Rand Corporation, 1990.

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United States Department Of Labor. Bureau of Labor Statistics Quality Management: BLSQM. [Washington, D.C.?]: U.S. Dept. of Labor, Bureau of Labor Statistics, 1992.

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M, Groves Robert, Cork Daniel L, National Research Council (U.S.). Committee on National Statistics, and National Research Council (U.S.). Committee on Law and Justice, eds. Ensuring the quality, credibility, and relevance of U.S. justice statistics. Washington, DC: National Academies Press, 2009.

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Russel, Alec L. United States freight facts, figures, and air quality issues. Edited by Cox Sylvester F. New York: Nova Science Publishers, 2012.

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Book chapters on the topic "Quality of life – United States – Statistics"

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Phillips, Rhonda. "Quality of Life in the United States." In Global Handbook of Quality of Life, 573–81. Dordrecht: Springer Netherlands, 2014. http://dx.doi.org/10.1007/978-94-017-9178-6_25.

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Estes, Richard J., Kenneth C. Land, Alex C. Michalos, Rhonda Phillips, and M. Joseph Sirgy. "Well-Being in Canada and the United States." In International Handbooks of Quality-of-Life, 257–99. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-39101-4_9.

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Kirilenko, Andrei, Rebecca Romsdahl, and Svetlana Stepchenkova. "Precautionary Principle in the United States and United Kingdom." In Encyclopedia of Quality of Life and Well-Being Research, 1–6. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-319-69909-7_4211-2.

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Tanigawa, Kanae, and Kunio Tanaka. "Urbanization and Quality of Life in Asia." In Handbook of Japan-United States Environment-Behavior Research, 325–30. Boston, MA: Springer US, 1997. http://dx.doi.org/10.1007/978-1-4899-0286-3_22.

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Osada, Hisao. "Quality of Life in Japanese Older Adults." In Handbook of Japan-United States Environment-Behavior Research, 51–57. Boston, MA: Springer US, 1997. http://dx.doi.org/10.1007/978-1-4899-0286-3_5.

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Land, Kenneth C., Vicki L. Lamb, and Qiang Fu. "Measuring Trends in Child Well-Being and Child Suffering in the United States, 1975–2013." In A Life Devoted to Quality of Life, 23–41. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-20568-7_2.

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Inoguchi, Takashi. "Comparisons with Asian and Non-Asian Societies: The United States, Australia, Japan, Russia, China, and India." In Quality of Life in Asia, 201–34. Singapore: Springer Singapore, 2017. http://dx.doi.org/10.1007/978-981-10-4724-4_7.

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Muennig, P., M. Gold, E. Lubetkin, and H. Jia. "The Income-Associated Burden of Disease in the United States." In Handbook of Disease Burdens and Quality of Life Measures, 459–72. New York, NY: Springer New York, 2010. http://dx.doi.org/10.1007/978-0-387-78665-0_27.

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McFadden, Erica Skogebo. "The Impact of Government on Quality of Life for People with Disabilities in the United States and Guatemala." In Reframing Disability and Quality of Life, 211–31. Dordrecht: Springer Netherlands, 2013. http://dx.doi.org/10.1007/978-94-007-3018-2_13.

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Lang, C. T., and J. C. King. "The Burden of Maternal Mortality and Morbidity in the United States and Worldwide." In Handbook of Disease Burdens and Quality of Life Measures, 647–59. New York, NY: Springer New York, 2010. http://dx.doi.org/10.1007/978-0-387-78665-0_37.

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Conference papers on the topic "Quality of life – United States – Statistics"

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Gubarev, M., and V. Sirotin. "The level and quality of life in Russia and the United States of America: A comparative analysis." In 2017 Tenth International Conference Management of Large-Scale System Development (MLSD). IEEE, 2017. http://dx.doi.org/10.1109/mlsd.2017.8109634.

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Socolovsky, C., C. Petty, M. Green, M. Samnaliev, and W. Phipatanakul. "Impact of Asthma on Economic Productivity and Quality of Life in Urban Families in the United States." In American Thoracic Society 2020 International Conference, May 15-20, 2020 - Philadelphia, PA. American Thoracic Society, 2020. http://dx.doi.org/10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a4282.

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Zafari, Z., C. Shah, R. M. Reed, and M. Eakin. "Predicting Physical and Mental Health-Related Quality of Life in Patients with Chronic Obstructive Pulmonary Disease in the United States." In American Thoracic Society 2020 International Conference, May 15-20, 2020 - Philadelphia, PA. American Thoracic Society, 2020. http://dx.doi.org/10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a4821.

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Christon, L. M., B. Garcia, T. Nadig, W. Bullington, C. M. Mingora, S. Dorman, W. Barfield, L. McClary, and P. A. Flume. "Depression, Anxiety, and Quality of Life in Patients with Nontuberculous Mycobacterial Pulmonary Disease (NTM-PD) in the Southeastern United States." In American Thoracic Society 2021 International Conference, May 14-19, 2021 - San Diego, CA. American Thoracic Society, 2021. http://dx.doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1567.

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Thomas, Toms Vengaloor, Mary R. Nittala, Divyang Mehta, Madhava Rao Kanakamedala, Anu Abraham, Lacey Weatherall, Eldrin Bhanat, Ashley A. Albert, and Srinivasan Vijayakumar. "Abstract B20: Hypopharyngeal carcinoma management: 25-year experience from a tertiary care medical center in United States." In Abstracts: AACR-AHNS Head and Neck Cancer Conference: Optimizing Survival and Quality of Life through Basic, Clinical, and Translational Research; April 29-30, 2019; Austin, TX. American Association for Cancer Research, 2020. http://dx.doi.org/10.1158/1557-3265.aacrahns19-b20.

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Gernand, Jeremy M. "An Analysis of the Trends in US Offshore Oil and Gas Safety and Environmental Performance." In ASME 2019 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2019. http://dx.doi.org/10.1115/imece2019-11857.

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Abstract The production of oil and gas in the offshore waters of the United States continues to be a major part of US energy extraction activities amounting to just less than a third of total US oil and gas production. However, this industry has been marked by occasional safety and environmental disasters including most famously the Deepwater Horizon explosion and oil spill that resulted in the deaths of 11 workers and the release of more than 130 million gallons of oil in to the Gulf of Mexico. In response, the Bureau of Safety and Environmental Enforcement (BSEE) was created in 2011 to separate enforcement activities from federal lease management activities and reduce the possibility for conflicts of interests and regulatory capture. This paper presents an analysis of the safety and environmental performance of the US offshore oil and gas industry in the years before and after the creation of the BSEE to quantify the changes in the industry record and the level of risk that remains. Recorded events including fires and explosions, spills, and gas releases, collisions, and injuries and fatalities are included in the analysis. The overall level of exposure is estimated based on rig counts and oil and gas production quantities since detailed employment records by facility are not available. Data is sourced from the BSEE, Bureau of Labor Statistics (BLS), and the Energy Information Agency (EIA). In addition to linear regression analysis of trends, this paper presents the results of a random forest-based machine learning investigation of the characteristics of safety and environmental incidents to evaluate the most significant contributors that remain, especially those amenable to control through engineering system design. Facility type, water depth, distance to shore, and time of day or year in the relevant incident reports were included in the input dataset for the random forest model. Results indicate that the overall oil and gas industry has become safer in recent years, though significant risks remain. It is yet unclear whether the BSEE approach bears any responsibility for this change as the data are not yet sufficient to declare the post-2011 period as statistically significantly improved from prior years, though additional data in line with 2016–2017 level of performance would satisfy this condition. The random forest model indicates that increased risk is associated with time of day, quarter of the year, water depth, and distance to shore. Data quality concerns remain present as minor incidents and injuries may be under-reported. BSEE enforcement does not appear to be a direct cause of the noted improvements.

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Lide, Charles, Chris Kunc, Stefan Glista, Kent Barnett, Ric Alexander, and David Bielefeld. "Lessons Learned From Avionics Integrity Program (AVIP) Durability Life Testing (DLT)." In ASME 2010 International Mechanical Engineering Congress and Exposition. ASMEDC, 2010. http://dx.doi.org/10.1115/imece2010-37502.

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In the late 1980s the United States Air Force began requiring the implementation of the Avionics/ Electronics Integrity Program (AVIP). The purpose of AVIP was to utilize physics of failure analysis and test methods during development to eliminate fatigue and wearout failure mechanisms when systems are fielded. One of the key features of AVIP is the durability life test (DLT). The F-22 program was the first major weapons system to comprehensively require AVIP or the Mechanical Systems Integrity Program (MECSIP) for all equipment. The paper documents the findings and lessons learned from the F-22 program DLT for avionics and electronics. The paper discusses the driving environments of vibration and thermal cycling and test compression for those environments. Also discussed are test specifications, sample size, test setup, combined environments, failure criteria, and test instrumentation. Programmatic issues with DLT are presented. The data reduction for a large sample of tests is reported by failure type and as a function of test duration. Corrective action and corrective action verification is discussed and statistics presented. Finally, a cost-benefit analysis shows the benefit of DLT.

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Aghniya, Rofana, Bhisma Murti, Didik Gunawan Tamtomo, and Hanung Prasetya. "The Effect of Depression Comorbidity on the Quality of Life of Patients with Type 2 Diabetes Mellitus: Meta-Analysis." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.01.56.

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Background: The prevalence of depression is two to three times higher in diabetic patients, while most cases remain undiagnosed. The quality of life is substantially and adversely affected by depression. This study aimed to estimate the effect of depression comorbidity on patients’ quality of life with type 2 diabetes mellitus. Subjects and Method: This was a meta-analysis and systematic review. The study was conducted by collecting published articles from PubMed, ProQuest, Science Direct, Scopus, Spinger Link, Clinical Key, and Google Scholar databases. Keywords used “comorbidity depression and DM”, “depression and quality of life and DM and cross sectional study”, “depression and quality of life and DM and adjusted odd ratio”, “depression or diabetes”, “depression or quality of life or DM or adjusted odd ratio”. The study criteria were full text, using cross-sectional study design, and reporting adjusted Odds Ratio (aOR). The selected articles were analyzed using Revman 5.3 with fixed effect models. Results: 8 studies from Uganda, Iran, United States, United Kingdom, Australia, Nigeria, Brazil, and Nepal, were selected for this study. Current study reported that type 2 DM patients with depression had lower quality of life than those without depression (aOR= 2.72; 95% CI= 0.73 to 10.07; p<0.0001) Conclusion: Type 2 DM patient with depression has lower quality of life than those without depression. Keywords: depression, quality of life, diabetes mellitus Correspondence: Rofana Aghniya. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: rofanaaa@gmail.com. Mobile: +685523528340.

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David, Alicia. "Distance Education Accessibility and Quality Assurance." In InSITE 2009: Informing Science + IT Education Conference. Informing Science Institute, 2009. http://dx.doi.org/10.28945/3320.

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This presentation will discuss some of the current statistics regarding distance education in the United States. It will also address how student disabilities (and their associated accommodations) are and should be impacting these online course offerings. According to a recent government study, 66% of US colleges currently offer some form of for-credit distance education (National Center for Education Statistics [NCES], 2008). In 2007 more than 20% of higher education students were enrolled in at least one online course, and the 2007 online enrollments were 245% that of the online enrollment seen in 2002 (Allen & Seaman, 2008). These educational studies have revealed what most educators already knew: online education is becoming increasingly important to colleges nationwide. The number of online courses continues to increase, and larger numbers of students are taking significant portions of their coursework online. Students reporting disabilities (and requesting accommodation) have also been increasing. Eleven percent of undergraduates have reported or registered as having a disability (NCES, 2006). The 11% statistic suggests that at least 2.2% of the online student population are also students with disabilities, and that 2.2% is likely to be too low because the flexibly offered by online courses is likely to appeal to students with disabilities. Ensuring accessibility in online courses, therefore, is clearly a practical consideration. Education studies have also revealed that some schools aren’t doing all that they can or should to ensure accessibility. Schools were asked how commonly they received requests for academic accommodation. Nearly a quarter of the schools responding didn’t know whether or not requests of this type were ever received (NCES, 2008). Another study tracked how closely accessibility guidelines for online course web sites were followed. Nearly half of the schools reported only moderate to minor application of the guidelines while over one-third of the schools either didn’t follow any of the guidelines or were unaware if guidelines were being followed (NCES, 2003).

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Wan, Ping K., and Alice C. Carson. "Design- and Operating-Bases Regional Meteorological Conditions for Permitting New Nuclear Power Plants in the United States." In 17th International Conference on Nuclear Engineering. ASMEDC, 2009. http://dx.doi.org/10.1115/icone17-75111.

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Power generation is well recognized as a major prerequisite for a country’s economic development. Nuclear power has become an increasingly attractive alternative in the power market worldwide due to several factors: growing demand for electric power, increasing global competition for fossil fuels, concern over greenhouse gas emission impacts on global warming, and the desire for energy independence. Protecting people and the environment is of concern to nuclear power generators. Thus, sound engineering design that provides adequate protection against natural and man-made hazards is of utmost importance. Meteorological parameters related to structure design and system operation are the extreme and mean values for wind speed, temperature, humidity, and precipitation, as well as the seasonal and annual frequencies of severe weather conditions such as tornadoes and hurricanes, ice and snow accumulation, hail and lightning. Inherent in ascertaining values for these parameters is the need for reasonable assurance that the chosen values and frequencies will not be exceeded during the expected life of the plant. All regional meteorological and air quality conditions are classified as climate site characteristics for consideration in evaluating the design and operation of a nuclear power plant [1]. This paper discusses the regulatory requirements, methodology and sources of data for development of the design- and operating-basis regional meteorological conditions used in preparing a Combined License Permit Application (COLA) in the United States. Additionally, the differences in methodology for determination of these meteorological conditions by reactor type (i.e., Advanced Passive 1000–AP1000, Advanced Boiling Water Reactor–ABWR, Economic Simplified Boiling Water Reactor–ESBWR, U.S. Evolutionary Power Reactor–U.S. EPR, and Advanced Pressurized Water Reactor–APWR) are explored and summarized.

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Reports on the topic "Quality of life – United States – Statistics"

1

Gindi, Renee. Health, United States, 2019. Centers for Disease Control and Prevention (U.S.), 2021. http://dx.doi.org/10.15620/cdc:100685.

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Health, United States, 2019 is the 43rd report on the health status of the nation and is submitted by the Secretary of the Department of Health and Human Services to the President and the Congress of the United States in compliance with Section 308 of the Public Health Service Act. This report was compiled by the National Center for Health Statistics (NCHS) of the Centers for Disease Control and Prevention (CDC). The Health, United States series presents an annual overview of national trends in key health indicators. The 2019 report presents trends and current information on selected measures of morbidity, mortality, health care utilization and access, health risk factors, prevention, health insurance, and personal health care expenditures in a 20-figure chartbook. The Health, United States, 2019 Chartbook is supplemented by several other products including Trend Tables, an At-a-Glance table, and Appendixes available for download on the Health, United States website at: https://www.cdc.gov/nchs/hus/ index.htm. The Health, United States, 2019 Chartbook contains 20 figures and 20 tables on health and health care in the United States. Examining trends in health informs the development, implementation, and evaluation of health policies and programs. The first section (Figures 1–13) focuses on health status and determinants: life expectancy, infant mortality, selected causes of death, overdose deaths, suicide, maternal mortality, teen births, preterm births, use of tobacco products, asthma, hypertension, heart disease and cancer, and functional limitations. The second section (Figures 14–15) presents trends in health care utilization: use of mammography and colorectal tests and unmet medical needs. The third section (Figures 16–17) focuses on health care resources: availability of physicians and dentists. The fourth section (Figures 18–20) describes trends in personal health care expenditures, health insurance coverage, and supplemental insurance coverage among Medicare beneficiaries. The Highlights section summarizes major findings from the Chartbook. Suggested citation: National Center for Health Statistics. Health, United States, 2019. Hyattsville, MD. 2021.

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Brown, Yolanda, Twonia Goyer, and Maragaret Harvey. Heart Failure 30-Day Readmission Frequency, Rates, and HF Classification. University of Tennessee Health Science Center, December 2020. http://dx.doi.org/10.21007/con.dnp.2020.0002.

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30 Day Hospital Readmission Rates, Frequencies, and Heart Failure Classification for Patients with Heart Failure Background Congestive heart failure (CHF) is the leading cause of mortality, morbidity, and disability worldwide among patients. Both the incidence and the prevalence of heart failure are age dependent and are relatively common in individuals 40 years of age and older. CHF is one of the leading causes of inpatient hospitalization readmission in the United States, with readmission rates remaining above the 20% goal within 30 days. The Center for Medicare and Medicaid Services imposes a 3% reimbursement penalty for excessive readmissions including those who are readmitted within 30 days from prior hospitalization for heart failure. Hospitals risk losing millions of dollars due to poor performance. A reduction in CHF readmission rates not only improves healthcare system expenditures, but also patients’ mortality, morbidity, and quality of life. Purpose The purpose of this DNP project is to determine the 30-day hospital readmission rates, frequencies, and heart failure classification for patients with heart failure. Specific aims include comparing computed annual re-admission rates with national average, determine the number of multiple 30-day re-admissions, provide descriptive data for demographic variables, and correlate age and heart failure classification with the number of multiple re-admissions. Methods A retrospective chart review was used to collect hospital admission and study data. The setting occurred in an urban hospital in Memphis, TN. The study was reviewed by the UTHSC Internal Review Board and deemed exempt. The electronic medical records were queried from July 1, 2019 through December 31, 2019 for heart failure ICD-10 codes beginning with the prefix 150 and a report was generated. Data was cleaned such that each patient admitted had only one heart failure ICD-10 code. The total number of heart failure admissions was computed and compared to national average. Using age ranges 40-80, the number of patients re-admitted withing 30 days was computed and descriptive and inferential statistics were computed using Microsoft Excel and R. Results A total of 3524 patients were admitted for heart failure within the six-month time frame. Of those, 297 were re-admitted within 30 days for heart failure exacerbation (8.39%). An annual estimate was computed (16.86%), well below the national average (21%). Of those re-admitted within 30 days, 50 were re-admitted on multiple occasions sequentially, ranging from 2-8 re-admissions. The median age was 60 and 60% male. Due to the skewed distribution (most re-admitted twice), nonparametric statistics were used for correlation. While graphic display of charts suggested a trend for most multiple re-admissions due to diastolic dysfunction and least number due to systolic heart failure, there was no statistically significant correlation between age and number or multiple re-admissions (Spearman rank, p = 0.6208) or number of multiple re-admissions and heart failure classification (Kruskal Wallis, p =0.2553).

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Pessino, Carola, and Teresa Ter-Minassian. Addressing the Fiscal Costs of Population Aging in Latin America and the Caribbean, with Lessons from Advanced Countries. Inter-American Development Bank, April 2021. http://dx.doi.org/10.18235/0003242.

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This paper presents projections for 18 Latin America and Caribbean countries of pensions and health expenditures over the next 50 years, compares them to advanced countries, and calculates estimates of the fiscal gap due to aging. The exercise is crucial since life expectancy is increasing and fertility rates are declining in virtually all advanced countries and many developing countries, but more so in Latin America and the Caribbean. While the populations of many of the regions countries are still relatively young, they are aging more rapidly than those in more developed countries. The fiscal implications of these demographic trends are severe. The paper proposes policy and institutional reforms that could begin to be implemented immediately and that could help moderate these trends in light of relevant international experience to date. It suggests that LAC countries need to include an intertemporal numerical fiscal limit or rule to the continuous increase in aging spending while covering the needs of the more vulnerable. They should consider also complementing public pensions with voluntary contribution mechanisms supported by tax incentives, such as those used in Australia, New Zealand (Kiwi Saver), and the United States (401k). In addition, LAC countries face an urgent challenge in curbing the growth of health care costs, while improving the quality of care. Efforts should focus on improving both the allocative and the technical efficiency of public health spending.

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Monitoring Long-Term Cardiovascular Risk from Estrogen Use in Transgender Women - Evidence Update for Clinicians. Patient-Centered Outcomes Research Institute (PCORI), February 2002. http://dx.doi.org/10.25302/eu11.2020.2.

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A PCORI-funded study provides new information for primary care clinicians about the need to monitor long-term cardiovascular risks in transgender women receiving hormone therapy. Approximately 1.4 million transgender people live in the United States. Many transgender women pursue medical transition with hormone therapy including estrogen to align their bodies with their female gender identity. Evidence suggests that medical transition confers significant psychological benefits including reduced depression, anxiety, and suicidality and improved quality of life. However, the risks of using estrogen, including cardiovascular risks, are not well understood. Recent evidence on these risks can help inform decisions and improve care for transgender women who are currently using or formerly used estrogen.

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