The American journal of managed care
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To determine whether ethnic differences in the incidence of albuminuria are present in patients with diabetes, and to identify social, behavioral, and provider factors that explain ethnic differences. ⋯ Despite uniform medical care coverage, Filipinos, blacks, and Asians with diabetes developed albuminuria at higher rates than white and Hispanic adults.
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To describe persistence with teriparatide and other biologic therapies in Medicare Part D plans with and without a coverage gap. ⋯ For patients who reached the coverage gap, discontinuation was more likely for patients taking osteoporosis (OP) medication. Not having a coverage gap was associated with improved persistence with OP treatment.
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To examine prevalence of and factors associated with different types of potentially preventable hospitalizations (PPHs) among older adults with diabetes. ⋯ PPHs for common medical conditions are costly and prevalent among older patients with diabetes, suggesting a need for more comprehensive primary care, beyond glycemic control. The groups at risk for acute and chronic PPHs may differ, which suggests that more targeted and tailored approaches are necessary to reduce the rates of each type of PPH.
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To determine the 2-year impact of high-deductible health plans (HDHPs) on high-acuity, expensive medical care. ⋯ HDHP members experienced sustained reductions in emergency department visits over 2 years, but reductions in hospital utilization and costs were not apparent by the second year. Longer-term studies that assess deferred utilization and its effects are needed.
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To estimate the economic value of screening pregnant women for Staphylococcus aureus carriage before cesarean delivery. ⋯ Despite high rates of cesarean delivery, presurgical screening of pregnant women for S aureus and decolonization of carriers is unlikely to be cost-effective under prevailing epidemiologic circumstances.