The American journal of managed care
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Observational Study
Roles of prices, poverty, and health in Medicare and private spending in Texas.
To investigate the roles of prices, poverty, and health in divergences between Medicare and private spending in Texas. ⋯ Variation in private spending appears to reflect the ability of the local population to pay for healthcare, whereas variation in Medicare is more heavily driven by health status, and presumably, by clinical need. These findings highlight the inadvisability of using Medicare spending as a proxy for systemwide spending, and the need for comprehensive market-level spending data that allow comparisons among populations with different sources of insurance coverage.
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Voluntary patient uptake and use of electronic health record (EHR) features have been low. It is unknown whether EHRs fully meet needs of providers or patients with chronic diseases. ⋯ Our results underscore the importance of user-centered design when constructing the content and features of the EHR. As technology evolves, an ongoing understanding of patient and provider experiences will be critical to improve uptake, increase use, and ensure engagement, optimizing the potential of EHRs.
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Glycemic control can lower the risk of diabetes-related complications, and delayed treatment intensification can impede optimal diabetes care. This study examines trends in hyperglycemia treatment intensification between 2002 and 2010. ⋯ There was a significant increase in diabetes treatment intensification between 2002 and 2010. Choice of secondline agents changed as well, with decreasing prevalence of thiazolidinedione and sulfonylurea use and rising prevalence of incretin use.
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More than 29 million people in the United States have diabetes, up from the previous estimate of 26 million in 2010, according to the latest report from the CDC. Another 86 million adults more than 1 in 3 have prediabetes, meaning that their blood glucose levels are higher than normal but not high enough to classify them as having type 2 diabetes mellitus (T2DM).1 Only about 10% of these people know they have prediabetes.2 The costs for treating and managing diabetes continue to rise. Besides the actual daily demands of the condition, the American Diabetes Association's estimate is $245 billion annually in direct and indirect costs.3.