Although it is known that people with sickle cell disease (SCD) have relatively high utilization of medical care, most previous estimates of SCD-attributable expenditures have been limited to either inpatient care or single-state data.
To extend known findings by measuring the attributable or incremental expenditures per child with SCD compared to children without this illness and to thereby estimate SCD-attributable expenditures among children in the U.S.
MarketScan Medicaid and Commercial Claims databases for 2005 were used to estimate total medical expenditures of children with and without SCD. Expenditures attributable to SCD were calculated as the difference in age-adjusted mean expenditures during 2005 for children with SCD relative to children without SCD in the two databases.
Children with SCD incurred medical expenditures that were $9369 and $13,469 higher than those of children without SCD enrolled in Medicaid and private insurance, respectively. In other words, expenditures of children with SCD were 6 and 11 times those of children without SCD enrolled in Medicaid and private insurance, respectively.
Using a large, multistate, multipayer patient sample, SCD-attributable medical expenditures in children were conservatively and approximately estimated at $335 million in 2005.
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"Clinical complications of SCD include vaso-occlusive pain crises, anemic episodes, infections, and stroke (Frank, Allison, & Cant, 1999; Smith, 1989). Health care utilization for children with SCD has been well documented largely due to an increase of studies using administrative claims data (Grosse, Boulet, Amendah, & Oyeku, 2010). Children with SCD have mean expenditures 8.8 times that of children in general (Bilenker, Weller, Shaffer, Dover, & Anderson, 1998). "
[Show abstract][Hide abstract] ABSTRACT: Health care utilization of children with sickle cell disease (SCD) has been well documented due to an increase in the use of administrative data sets. While use of such data sources is relatively efficient and low cost, questions remain as to whether they provide sufficient information to fully characterize health care use. The aim of this study was to determine whether administrative data have the capacity to fully assess health care utilization among children with SCD. We studied the health care utilization of 154 low-income children with SCD in a managed care organization combining administrative data and medical record review. In our comparison, we found that administrative claims provided key information on the scope and location of health service use and that sole reliance on medical record review may undercount unique members and encounters.
[Show abstract][Hide abstract] ABSTRACT: Ocean imagery obtained by satellite carried sensors in the visible, microwave and IR frequency bands contain synoptic data about the state of the ocean that is available in close to "real time" on a global scale. The information includes quantitative data about surface waves, temperatures, velocity, shear, chlorophyl content and bathymetry in shallow water. Here we will report on two examples of the use of remote sensing in ocean measurements: 1. The use of high resolution ocean images of swell to determine wavelength and direction of the dominant waves as well as to detect and measure surface currents and horizontal shears. 2. The use of infra red ocean imagery to determine water velocities and circulation patterns. Archived imagery of both types can be used for obtaining historic data on a global scale.
[Show abstract][Hide abstract] ABSTRACT: Density evolution is a new method for analyzing the asymptotic performance of network capability approaching error-correcting codes. For irregular LDPC codes with message-passing decoding, the density evolution method can track the messages to find out the threshold, enabling optimization of the degree distribution. In this paper, the principle of density evolution combined with the decoding process is firstly explored. Then, two algorithms for programming the evolution proceeding are discussed: the discretized density evolution and the Gaussian approximation, as well as their application conditions. Finally, simulation results are presented.