The American journal of managed care
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To evaluate treatment patterns, healthcare resource utilization, and costs among patients within a large managed care population chronically using opioids for non-cancer pain. ⋯ These results demonstrated that healthcare resource utilization and costs increased during the first 6 months following clinical scenarios that necessitated opioid initiation and subsequently declined, suggesting the need to monitor patients beyond the acute care period.
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To examine the relationship between patient characteristics and medication adherence trajectories for patients with congestive heart failure (CHF). ⋯ Population characteristics associated with sustained low adherence might be used to target interventions and improve vulnerable patients' prospects of heart health.
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To analyze the relationship between insurance and the likelihood of a nonurgent or primary care-sensitive (PCS) emergency department (ED) visit. ⋯ Lack of insurance was associated with a higher probability of a nonurgent or PCS ED visit when compared with private insurance. When uninsured individuals gain coverage under the Affordable Care Act through either Medicaid expansion (public coverage) or insurance exchanges (private coverage), the average nonurgent or PCS probabilities could change either way given the opposite effects of public and private insurance coverage. If a lower nonurgent or PCS likelihood materialized, it could be associated with higher ED costs.
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To examine contemporary trends in mortality following hip fracture among older postmenopausal women in an integrated healthcare delivery system. ⋯ While hip fracture morbidity and mortality remain high, temporal trends suggest recent declines in mortality risk, with risk of death following hip fracture lower for Asian and Hispanic women. Future studies should examine potential benefits of targeted interventions within integrated healthcare settings and factors contributing to observed racial/ethnic differences in post fracture survival.
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Presenteeism (decreased productivity while at work) is reported to be a major occupational problem in many countries. Challenges exist for identifying the optimal approach to measure presenteeism. Evidence of the relative value of presenteeism instruments to support their use in primary studies is needed. ⋯ Most presenteeism instruments have been examined for some form of validity; evidence for criterion validity is virtually absent. The selection of instruments for use in primary studies depends on weak forms of validity. Further research should focus on the goal of a comprehensive evaluation of the psychometric properties of existing tests of presenteeism, with emphasis on criterion validity.