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Observed CRN prevalence and persistence pre- and during COVID-19 pandemic (N = 677).
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Patient characteristics by race. Shown are the number and percentage of patients in each level for categorical variables, and the Median and Interquartile Range (IQR) for continuous variables in patients of White race versus Black race.
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BackgroundInfluenza-related healthcare utilization among Medicaid patients and commercially insured patients is not well-understood. This study compared influenza-related healthcare utilization and assessed disease management among individuals diagnosed with influenza during the 2015–2019 influenza seasons.MethodsThis retrospective cohort study identified influenza cases among adults (18–64 years) using data from the Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) Research Identifiable Files (RIF) and Optum’s de-identified Clinformatics® Data Mart Database (CDM). Influenza-related healthcare utilization rates were calculated per 100,000 patients by setting (outpatient, emergency department (ED), inpatient hospitalizations, and intensive care unit (ICU) admissions) and demographics (sex, race, and region). Rate ratios were computed to compare results from both databases. Influenza episode management assessment included the distribution of the index point-of-care, antiviral prescriptions, and laboratory tests obtained.ResultsThe Medicaid population had a higher representation of racial/ethnic minorities than the CDM population. In the Medicaid population, influenza-related visits in outpatient and ED settings were the most frequent forms of healthcare utilization, with similar rates of 652 and 637 visits per 100,000, respectively. In contrast, the CDM population predominantly utilized outpatient settings. Non-Hispanic Blacks and Hispanics exhibited the highest rates of influenza-related ED visits in both cohorts. In the Medicaid population, Black (64.5%) and Hispanic (51.6%) patients predominantly used the ED as their index point-of-care for influenza. Overall, a greater proportion of Medicaid beneficiaries (49.8%) did not fill any influenza antiviral prescription compared to the CDM population (37.0%).ConclusionAddressing disparities in influenza-related healthcare utilization between Medicaid and CDM populations is crucial for equitable healthcare access. Targeted interventions are needed to improve primary care and antiviral access and reduce ED reliance, especially among racial/ethnic minorities and low-income populations.
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IntroductionUse of oral anticoagulants (OACs) for stroke reduction in atrial fibrillation (AF) varies by race and geography within the United States. We seek to better understand the relationship between OAC underutilization, race, and US geography.MethodsPatients with AF were selected from the US Centers for Medicare & Medicaid Services claims database from January 1, 2013, to December 31, 2016. The final population consisted of patients with 12 months of health plan enrollment before and after their index AF diagnosis, with a baseline CHAD2S2-VASc ≥2 and of either Black or White race (other races are underrepresented in the data). Among those with AF that met the inclusion criteria, patients who were prescribed warfarin or DOACs within 12 months after the index date were extracted. Each patient was assigned to a US county based on their 5-digit zip code and OAC use was stratified by race. Statistically significant differences were determined by student’s t-test and chi-square.ResultsOf the 2,390,830 final patients, 94.1% were White and 5.9% were Black patients. Mean (SD) age and HASBLED scores were 78 (9) and 3.9 (1.2) respectively, for Black patients and 80 (9) and 3.3 (1.2), respectively, for White patients (p
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Logistic regressions of preconception care measures from 2012 PRAMS and Medicaid MAX on age, race/ethnicity and chronic conditions, estimated using data from 26 states available in PRAMS (odds ratios and 95% CI).
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Attribution 4.0 (CC BY 4.0)https://creativecommons.org/licenses/by/4.0/
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Observed CRN prevalence and persistence pre- and during COVID-19 pandemic (N = 677).