Last data update: Jun 11, 2024. (Total: 46992 publications since 2009)
Records 1-4 (of 4 Records) |
Query Trace: Lochner KA [original query] |
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Prevalence of dementia subtypes in United States Medicare fee-for-service beneficiaries, 2011-2013
Goodman RA , Lochner KA , Thambisetty M , Wingo TS , Posner SF , Ling SM . Alzheimers Dement 2017 13 (1) 28-37 INTRODUCTION: Rapid growth of the older adult population requires greater epidemiologic characterization of dementia. We developed national prevalence estimates of diagnosed dementia and subtypes in the highest risk United States (US) population. METHODS: We analyzed Centers for Medicare & Medicaid administrative enrollment and claims data for 100% of Medicare fee-for-service beneficiaries enrolled during 2011-2013 and age ≥68 years as of December 31, 2013 (n = 21.6 million). RESULTS: Over 3.1 million (14.4%) beneficiaries had a claim for a service and/or treatment for any dementia subtype. Dementia not otherwise specified was the most common diagnosis (present in 92.9%). The most common subtype was Alzheimer's (43.5%), followed by vascular (14.5%), Lewy body (5.4%), frontotemporal (1.0%), and alcohol induced (0.7%). The prevalence of other types of diagnosed dementia was 0.2%. DISCUSSION: This study is the first to document concurrent prevalence of primary dementia subtypes among this US population. The findings can assist in prioritizing dementia research, clinical services, and caregiving resources. |
County-level variation in per capita spending for multiple chronic conditions among fee-for-service Medicare beneficiaries, United States, 2014
Matthews KA , Holt J , Gaglioti AH , Lochner KA , Shoff C , McGuire LC , Greenlund KJ . Prev Chronic Dis 2016 13 E162 The prevalence of Medicare beneficiaries aged 65 years or older with 6 or more concurrent chronic conditions (MCC6+) varies geographically (1). Preventing chronic disease costs less than treating it. Chronic diseases that are well managed progress slower than those that are untreated (2). Thus, understanding how Medicare spending is distributed across the United States among older adults with the highest burden of multiple chronic conditions can assist with targeting prevention and disease management efforts. The objective of this analysis was to describe the county-level variation in per capita Medicare spending among MCC6+ beneficiaries. |
Multiple chronic conditions among Medicare beneficiaries: state-level variations in prevalence, utilization, and cost, 2011
Lochner KA , Goodman RA , Posner S , Parekh A . Medicare Medicaid Res Rev 2013 3 (3) E1-E19 OBJECTIVES: Individuals with multiple (>2) chronic conditions (MCC) present many challenges to the health care system, such as effective coordination of care and cost containment. To assist health policy makers and to fill research gaps on MCC, we describe state-level variation of MCC among Medicare beneficiaries, with a focus on those with six or more conditions. METHODS: Using Centers for Medicare & Medicaid Services administrative data for 2011, we characterized a beneficiary as having MCC by counting the number of conditions from a set of fifteen conditions, which were identified using diagnosis codes on the claims. The study population included fee-for-service beneficiaries residing in the 50 U.S. states and Washington, DC RESULTS: Among beneficiaries with six or more chronic conditions, prevalence rates were lowest in Alaska and Wyoming (7%) and highest in Florida and New Jersey (18%); readmission rates were lowest in Utah (19%) and highest in Washington, DC (31%); the number of emergency department visits per beneficiary were lowest in New York and Florida (1.6) and highest in Washington, DC (2.7); and Medicare spending per beneficiary was lowest in Hawaii ($24,086) and highest in Maryland, Washington, DC, and Louisiana (over $37,000). CONCLUSION: These findings expand upon prior research on MCC among Medicare beneficiaries at the national level and demonstrate considerable state-level variation in the prevalence, health care utilization, and Medicare spending for beneficiaries with MCC. State-level data on MCC is important for decision making aimed at improved program planning, financing, and delivery of care for individuals with MCC. |
Estimating standard errors for life expectancies based on complex survey data with mortality follow-up: a case study using the National Health Interview Survey Linked Mortality Files
Schenker N , Parsons VL , Lochner KA , Wheatcroft G , Pamuk ER . Stat Med 2011 30 (11) 1302-11 Life expectancy is an important measure for health research and policymaking. Linking individual survey records to mortality data can overcome limitations in vital statistics data used to examine differential mortality by permitting the construction of death rates based on information collected from respondents at the time of interview and facilitating estimation of life expectancies for subgroups of interest. However, use of complex survey data linked to mortality data can complicate the estimation of standard errors. This paper presents a case study of approaches to variance estimation for life expectancies based on life tables, using the National Health Interview Survey Linked Mortality Files. The approaches considered include application of Chiang's traditional method, which is straightforward but does not account for the complex design features of the data; balanced repeated replication (BRR), which is more complicated but accounts more fully for the design features; and compromise, 'hybrid' approaches, which can be less difficult to implement than BRR but still account partially for the design features. Two tentative conclusions are drawn. First, it is important to account for the effects of the complex sample design, at least within life-table age intervals. Second, accounting for the effects within age intervals but not across age intervals, as is done by the hybrid methods, can yield reasonably accurate estimates of standard errors, especially for subgroups of interest with more homogeneous characteristics among their members. Published in 2011 by John Wiley & Sons, Ltd. |
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