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Smoking,depression,and hospital costs of respiratory cancers:Examining race and sex variation

Family Medicine and Community Health 2017年第1期5卷 29-42页

作者： baqar A.husaini Robert S.Levine Phillip Lammers Pam Hull Meggan Novotny Majaz Moonis Tennessee State University NashvilleTNUSA Department of Family and Community Medicine Baylor College of MedicineHoustonTXUSA Meharry Medical College NashvilleTNUSA Division of Epidemiology Vanderbilt UniversityNashvilleTNUSA Counseling Psychology Tennessee State UniversityNashvilleTNUSA Department of Medicine-Neurology University of Massachusetts Medical SchoolWorcesterMAUSA

Objective:To investigate the effect of smoking and depression on hospital costs for lung cancer(LC).Methods:We extracted data on depression,smoking history,demographics,and hospital charges for patients with respiratory cancers(ICD-9 codes 161-163,165)from the 2008 Tennessee Hospital Discharge Data *** sample(n=6665)was mostly white(86%)and male(57%).Age-adjusted rates were developed in accordance with Centers for Disease Control and Prevention methods,and hospital costs were compared for patients with LC with versus without depression and a smoking ***:Three findings(P<0.001)emerged:(1)the LC rate was higher among blacks than among whites,and higher among men than among women;(2)while 66%of LC patients smoked(more men than women without racial variation),24%had depression(more females and whites were depressed);(3)the LC hospital cost was 54%higher than the non-LC hospital cost,and this cost doubled for patients with LC with depression and smoking versus those without such ***:While LC is more prevalent among blacks and men,depression is higher among female and white *** depression with higher costs existed among LC patients,our find-ings point to(1)the possibility of cost savings by diagnosing and treating depression among LC patients,and(2)implementation of proven smoking cessation programs to reduce LC morbidity and hospital costs.

关键词： Smoking depression lung cancer race sex

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Depression and race affect hospitalization costs of heart failure patients

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Family Medicine and Community Health 2015年第2期3卷 39-47页

作者： baqar A.husaini Robert S.Levine Meggan L.Novotny Van A.Cain Uchechukwu K.A.Sampson Majaz Moonis Center for Prevention Research Tennessee State UniversityNashvilleTNUSA Department of Family and Community Medicine Baylor College of MedicineHoustonTXUSA Vanderbilt University Medical Center NashvilleTNUSA Department of Neurology Memorial HospitalWorcesterMAUSA

Objective:Depression and anxiety are frequently observed in heart failure(HF)patients;however,the effect of such factors on hospitalization costs of HF patients,and whether such costs vary by race and gender remain poorly *** analysis delineated the preva-lence of depression/anxiety among HF patients and estimated the effect of race and gender on hospitalization ***:We examined the 2008 files of the Tennessee Hospital Discharge Data System(HDDS)on patients(≥20 years of age)with a primary diagnosis of HF(ICD-9 codes 402,404,and 428)along with demographic data,depression/anxiety diagnoses,hospital costs,and *** the HF sample(n=16,889)53%were female and 23%were *** and gender differences in hospital costs were evaluated for the following three groups:(1)HF patients with depression/anxiety(HF+D);(2)HF-only patients without depression/anxiety(HFO);and(3)HF patients with other mental diagnoses(HF+M).Results:HF was significantly(p<0.000)higher among blacks compared to whites,and higher among males than *** 25%of HF patients had depression/anxiety(more whites and females were depressed).HF patients averaged more than 3 comorbidities(blacks had a greater number of comorbidities and hospitalization cost for the year).Costs were higher among HF+D patients compared to HFO *** HF+D patients,costs were higher for black males compared with white *** cost patterns prevailed largely because of higher comorbidities that required more re-admissions and longer hospital ***:Race and depression/anxiety are associated with increased hospitalization costs of HF *** higher costs among blacks reflect the higher burden of comorbidities,such as hypertension and diabetes,which calls for widespread dissemination,adoption,and implementation of proven interventions for the control of these comorbidities.

关键词： Hospitalization costs heart failure race gender depression

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Rural congestive heart failure mortality among US elderly, 1999-2013: Identifying counties with promising outcomes and opportunities for implementation research

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Family Medicine and Community Health 2015年第2期3卷 27-38页

作者： Maria C.Mejia de Grubb Robert S.Levine Barbara Kilbourne baqar A.husaini Tyler Skelton Lisa Gittner Michael A.Langston George E.Rust Department of Family and Community Medicine Baylor College of MedicineHoustonTXUSA Department of Sociology Tennessee State UniversityNashvilleTennesseeUSA Center for PreventionResearch Tennessee State University College of AgricultureNashvilleTennesseeUSA Department of Political Science Texas Tech UniversityLubbockTXUSA Department of Electrical Engineering and Computer Science University of TennesseeKnoxvilleTennesseeUSA Department of Family Medicine National Center for Primary CareMorehouse School of MedicineAtlantaGeorgiaUSA

Objective:Describe modern trends in congestive heart failure(CHF)among elderly(>65 years of age)in the United States,to identify potentially successful rural *** CHF mortality using multiple-(MCOD)versus underlying-(UCOD)cause of death ***:*** for Disease Control and Prevention mortality files(WONDER internet site).Results:Using MCOD data,overall mortality rates/100,000 population(and 95%confidence intervals)for CHF among persons>65 years of age(1999-2013)were 482.0(481.2-482.8)for large central and large fringe metropolitan(LCLF)counties,549.6(548.6-550.7)in small and medium metropolitan(SM)counties,and 652.6(650.9-654.0)in micropolitan and non-core,non-metropolitan(MNCNM)*** positive deviance NCNM counties(collectively including 198,581 residents>65 years of age)had an overall CHF rate of 300.9(275.0-326.9)in *** was significantly lower than the LCLF rate for 2013(482.0[481.2-482.8]),and rep-resented a reduction of 47%since *** CHF occurrence as estimated with MCOD was 3.4-fold higher than that obtained with ***:These data illustrate underestimation of CHF by UCOD data and the importance of correct death *** CHF mortality rates are higher than urban rates,but some positive deviance counties demonstrate that this is not *** research is needed to understand the relative contribution of research innovation,medical care,and public health to rural-urban disparities and the relative success of positive deviance counties.

关键词： Congestive heart failure elderly mortality rural

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Variation in risk factors of dementia among four elderly patient cohorts

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World Journal of Neurology 2014年第2期4卷 7-11页

作者： baqar husaini Van Cain Meggan Novotny Zahid Samad Robert Levine Majaz Moonis Center For Prevention Research Tennessee State UniversityNashville TN 37209 United States Department of Preventive and Family Medicine Meharry Medical College Nashville TN 37208 United States Stroke Center Department of Neurology University of Massachusetts Memorial Hospital Worcester MA 01655 United States

AIM: To examine variation in risk factors that contributed to dementia among four elderly cohorts by race and gender. METHODS: We examined 2008 Tennessee Hospital Discharged database for vascular factors that play a role in both stroke and dementia. Risk factors for dementia were examined for black and white patients aged 65+. Four race-gender groups of patients-white males(WM), black males(BM), white females(WF), and black females(BF) were compared for prevalence of dementia and stroke. A logistic model predicting dementia in each group separately used several vascular factors affectingdementia directly or indirectly through stroke. RESULTS: Three point six percent of patients hospitalized in 2008 had dementia and dementia was higher among females than males(3.9% vs 3.2%, P < 0.001), and higher among blacks than whites(4.2% vs 3.5%, P < 0.000). Further, BF had higher prevalence of dementia than WF(4.2% vs 3.8%, P < 0.001); similarly BM had more dementia than WM(4.1% vs 3.1%, P < 0.001). In logistic regression models, however, different patterns of risk factors were associated with dementia in four groups: among WF and WM, hypertension, diabetes, congestive heart failure, and stroke predicted dementia. Among BF and BM, only stroke and diabetes were related to ***: Aggressive management of risk factors(hypertension and diabetes) may subsequently reduce stroke and dementia hospitalization.

关键词： Dementia Race Gender Stroke Vascular factors

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Lack of validity of self-reported mammography data

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Family Medicine and Community Health 2019年第1期7卷 42-53页

作者： Robert S Levine Barbara J Kilbourne Maureen Sanderson Mary K Fadden Maria Pisu Jason L Salemi Maria Carmenza Mejia de Grubb Heather O’Hara baqar a husaini Roget J Zoorob Charles H Hennekens Department of Family and Community Medicine Baylor College of MedicineHoustonTexasUSA Department of Sociology Tennessee State UniversityNashvilleTennesseeUSA Department of Family and Community Medicine Meharry Medical CollegeNashvilleTennesseeUSA University of Alabama School of Medicine at Birmingham BirminghamAlabamaUSA Charles E Schmidt School of Medicine Florida Atlantic UniversityBoca RatonFloridaUSA

This qualitative literature review aimed to describe the totality of peer-reviewed scientific evidence from 1990 to 2017 concerning validity of self-reported *** review included articles about mammography containing the words accuracy,validity,specificity,sensitivity,reliability or reproducibility;titles containing self-report,recall or patient reports,and breast or‘mammo’;and references of identified citations focusing on evaluation of 2-year *** 45 publications meeting the eligibility criteria,2 conducted in 1993 and 1995 at health maintenance organisations in Western USA which primarily served highly educated whites provided support for self-reports of mammography over 2 *** concerns about validity of self-reports included(1)telescoping,(2)biased overestimates particularly among black women,(3)failure to distinguish screening and diagnostic mammography,and(4)failure to address episodic versus consistent mammography *** current totality of evidence supports the need for research to reconsider the validity of self-reported mammography data as well as the feasibility of alternative surveillance data sources to achieve the goals of the Healthy People Initiative.

关键词： validity qualitative concerning

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